Annals of Long Term Care

One of the highlights of the American Geriatrics Society’s recent 2008 Annual Scientific Meeting in Washington, DC, was its highly successful Congressional Visits Program. The program is just one element, but an important one, of the AGS’s public policy advocacy efforts.

Because the vast majority of older Americans have healthcare coverage through Medicare, public policy has an immense impact on the quality of the care they receive. That’s why advocating for policy aimed at ensuring older Americans’ access to quality care—policy supporting needed training and research and adequate compensation for those who care for older persons—is such an important part of the Society’s mission.

I’m pleased to report that more than 150 AGS members, representing 42 states, joined AGS’s Congressional Visits Program this past May, to participate in a particularly effective form of advocacy: the face-to-face kind. Before they hit the Hill to meet with their congressmen and urge support for healthcare-friendly policy for older persons, members got a crash course in content and logistics. Under the tutelage of AGS policy leaders Drs. Charles Cefalu, Marie Bernard, and David Reuben, and Chris Cushing of WolfBlock, the Society’s public policy consulting firm, they learned the ins and outs of key legislation that is now before Congress, and how to conduct an effective meeting with congressmen.

All told, these 150-plus members met with 76 legislators. They urged support for quality healthcare in general, and several priority initiatives in particular. These included the Geriatric Assessment and Chronic Care Coordination Act (GACCCA), legislation that would fill a significant gap in traditional Medicare by covering care coordination services for beneficiaries with multiple chronic conditions, and two bills that would create loan forgiveness programs aimed at recruiting and retaining health professionals in careers caring for older adults.

The first of these, the Caring for an Aging America Act, would create a loan forgiveness program for physicians, physician assistants, advanced practice nurses, psychologists, and social workers who complete specialty training in geriatrics or gerontology, and who agree to work with older patients for a minimum of two years. The bill would also expand the Nursing Education Loan Repayment Program to include registered nurses who complete specialty training in geriatrics or gerontology, and who commit to providing care to older adults in home and community-based or facility-based long-term care settings. The second, the Geriatricians Loan Forgiveness Act of 2008, would extend the National Health Service Corps Loan Repayment Program to include geriatric training, forgiving $35,000 of educational debt incurred by medical students for each year of advanced training in geriatric medicine or geriatric psychiatry.

Hill Visits Program participants also advocated for funding for Title VII Health Professions Programs—critically important geriatrics healthcare training programs—and for adequate funds for the National Institute on Aging and the VA in the federal fiscal year 2009 budget. Finally, they alerted their representatives and congressional staff to the findings and recommendations in the Institute of Medicine’s April report “Retooling for an Aging America: Building the Health Care Workforce.” (See June “AGS Viewpoint” for more.) The report, a clarion call for healthcare reform in this country, warns that our healthcare workforce is too small and ill prepared to care for the dramatically growing number of older Americans. Now, about 12% of the population, Americans 65 and older will make up roughly 20% of the population in 2030, Retooling for an Aging America notes. It calls for a three-pronged approach to averting the looming healthcare crisis, an approach that would:

1. Increase recruitment into geriatrics (something loan forgiveness legislation can help accomplish)
2.