Sen. Barbara Boxer (D-Calif.) introduced legislation in March aimed at addressing the potential crisis in providing care for elderly Americans. The bill offers a combination of educational-loan forgiveness and career-advancement opportunities for health care professionals choosing practice in nursing homes.
The Caring for an Aging America Act, S. 2708, would have the federal government provide $130 million over 5 years to benefit physicians, physician assistants, advance practice nurses, psychologists, and social workers choosing geriatrics and gerontology. Aid would come primarily through educational loan repayments for these professionals in. The bill already has been endorsed by the American Geriatrics Society, the National Council on Aging, the National Association of Geriatric Education, the Alzheimer's Association, and the National Association of Social Workers.
The American Medical Directors Association (AMDA), which represents nursing facility practitioners, has approved the bill's concepts in principle. “I'm very positive on the bill,” said Dr. Paul Katz, AMDA vice president and chief of geriatrics at the University of Rochester (N.Y.). “I think overall, this really is a big step forward.”
To benefit from the loan repayment provisions, health care professionals would not only need to complete specialty training in geriatrics or gerontology but also agree to provide full-time clinical practice and service to older adults for a minimum of 2 years. In addition, the bill would expand eligibility for the Nursing Education Loan Repayment Program to include registered nurses who complete specialty training and provide nursing services to older adults in long-term care settings. The proposed law also would expand midcareer specialty training in long-term care services through an existing training-grant program.
Sen. Boxer also proposes creation of a Health and Long-Term Care Workforce Advisory Panel for an Aging America, which would advise federal policy makers on workforce issues related to long-term care for the country's aging population.
“The medical and health community is already struggling to meet the demand for geriatric health care and support services, and the need for trained professionals is only growing,” Sen. Boxer said in a statement. “This legislation will provide incentives to help encourage qualified practitioners to join the geriatrics and gerontology fields.”
Kathleen M. Wilson, AMDA's director of government affairs, said that the association supports the concepts included in the legislation, based on a draft that Sen. Boxer's staff provided last year. At press time, AMDA's public policy committee was reviewing the actual legislation, which Wilson said is made up of initiatives closely similar to the concepts endorsed last year.
The loan guarantees in the legislation could be worth up to $150,000 for a professional who provides full-time health care to older adults for 4 years. “That's fairly substantial, and it has to be substantial to get peoples' attention,” said Dr. Katz. “That's something I've been preaching for awhile.”
However, Dr. Katz also warned that the bill needs to better define “geriatric providers” for the purposes of the legislation's financial aid, especially nonphysician providers.
“Right now, for physicians there's a formal process of being trained in geriatrics, so it's not an issue. But for social workers and therapists, there aren't always specialty courses.” And, he added, the bill needs to specify what kinds of courses would qualify.
Dr. Katz also noted that the bill isn't specific to long-term care. “It's focusing on geriatricians,” he said. “What about people who want to practice in long-term care?”
Overall, though, Dr. Katz said he supports S. 2708.