PRESIDENT'S LETTER 2008

The publication of the Institute of Medicine's Retooling for an Aging America: Building the Health Care Workforce in mid April was among the highpoints of 2008 for the American Geriatrics Society (AGS).

The report - which concludes that the nation's healthcare workforce is too small and ill prepared to care for the nation's aging population, and calls for sweeping changes - echoes the Society's rallying cry for a concerted effort to ensure the growing number of older Americans access to quality healthcare.

The AGS, with the John A. Hartford Foundation and the Atlantic Philanthropies, played an important role in establishing the need for the IOM study. AGS has long worked to raise awareness that shortages of geriatricians and other eldercare professionals are approaching crisis proportions as the nation's 77 million baby boomers near retirement age. IOM studies such as Crossing the Quality Chasm have focused nationwide attention on critical shortcomings in the US healthcare system. The IOM's Retooling has likewise helped raise awareness of the need for changes that address shortcomings in eldercare.

Written by a 15-member committee that included five AGS members, the report recommends a range of policy and other changes. It advises, among other things, that:

• Medicare and other insurers address financial barriers to recruitment and retention in geriatrics (one of the lowest-paying fields in medicine) by more adequately compensating healthcare providers who care for older adults
  
  
• State and federal governments offer loan forgiveness, scholarships and other financing incentives to professionals who pursue training in geriatrics
  
  
• Federal and state governments increase minimum training standards and improve pay and benefits for direct care workers to improve recruitment and retention in that field
  
  
• Congress and foundations "significantly increase" support for research and demonstration programs that lead to development of new models of care in such areas of eldercare as prevention, long-term, and palliative care, as well as new models of care that promote the effective use of the workforce
  
  
• New models of care address the healthcare needs of older adults comprehensively and in a coordinated manner, provide services efficiently, and encourage older people to be active partners in their own care.
  
  

AGS has been advocating for such changes - changes central to realizing our vision of quality healthcare for all older adults - for many years. Because a significant number of these changes require shifts in public policy, the Society began stepping up its advocacy efforts on behalf of policy supporting quality eldercare in 2007 and continued to do so throughout 2008. With notable successes.

The Society also successfully advocated for federal funding of Title VII Geriatrics Health Professions Programs and Title VII Nursing Workforce Development Programs. These key training programs better prepare healthcare providers to meet older adults' unique healthcare needs. Congress had zeroed out Title VII geriatrics funding in 2007, restoring it in the wake of concerted AGS advocacy campaigns.

In 2008 AGS also assisted members of the House and Senate and their staff with legislation aimed at building the nation's eldercare workforce. The Society worked with Sen. Barbara Boxer's (D-CA) staff on language for The Caring for An Aging America Act. This legislation, subsequently reintroduced in 2009, would establish loan forgiveness and related programs for healthcare providers pursuing training and careers in geriatrics. The AGS assisted Rep. Rosa DeLauro's (D-CT) staff with The Geriatrics Loan Forgiveness Act as well. Also reintroduced in 2009, the bill would expand extend loan forgiveness to a wide range of geriatrics healthcare providers.

The Society launched advocacy campaigns on behalf of the Geriatric Assessment and Chronic Care Coordination Act in 2008. Reintroduced as the RE-Aligning Care Act in 2009 by Sen. Blanche Lincoln (D-AR), Sen. Susan Collins (R-ME) and Rep. Gene Green (D-TX), this legislation would fill a gap in traditional Medicare by covering geriatric assessment and care coordination for beneficiaries with multiple chronic conditions. Research suggests that such comprehensive assessments and coordinated care may both improve outcomes for these seniors and save money.

AGS also reviewed and endorsed The Retooling the Healthcare Workforce for an Aging American Act in 2008. This important legislation, proposed by Senate Aging Committee Chair Herb Kohl (D-WI) and Rep. Jan Schakowsky (D-IL), would implement key recommendations in Retooling for An Aging America.

Toward the end of 2008, the Society launched its Geriatrics Workforce Policy Studies Center, which generates information that supports policy and advocacy efforts aimed at expanding the geriatrics workforce and improving the quality of eldercare. And Nancy Lundebjerg, AGS Deputy EVP, was elected to co-convene the Eldercare Workforce Alliance (EWA) with Steven Dawson, President of PHI, a national organization representing direct-care workers. EWA, which is funded by the John A. Hartford Foundation and Atlantic Philanthropies, was established to implement recommendations in the IOM report and includes organizations representing healthcare professionals, direct-care workers, consumers and family caregivers.

Following the election of Barack Obama, who vowed on the campaign trail to make health reform a priority in his administration, AGS began working with the Obama transition team, advocating for reforms that ensure all Americans, regardless of age, access to quality healthcare.

Policy advocacy is an important route, but not the Society's only route, to realizing our vision of quality healthcare for older adults. Throughout 2008, we also continued to promote access to quality geriatrics care by expanding the geriatrics knowledge base through basic, clinical and translational elder health research. At our 2008 Annual Scientific Meeting, for example, more than 600 geriatrics experts presented studies and led sessions and workshops focusing on geriatrics research, clinical care and education. Through AGS' Geriatrics-for-Specialists Initiative the Society continued to help surgeons and related medical specialists improve care for older adults undergoing surgery.

In 2008, AGS also continued its efforts to increase the number of healthcare professionals employing the principles of geriatrics when caring for older adults. With the number of adults 65 and older expected to nearly double, to 70 million, in the next two decades, the vast majority of healthcare providers in the US will be caring for significant numbers of older patients. AGS' Geriatrics at Your Fingertips, 10th Edition was just one of the AGS publications released in 2008 designed to help healthcare professionals provide older adults with appropriate care.

Through various initiatives and local and national mentoring programs, AGS also continued to recruit physicians and other healthcare professionals into careers in geriatrics. Through the 2008 Annual Meeting's Residents' Mentoring Program, for example, leaders in elder healthcare mentored nearly 60 residents and junior faculty. To introduce other candidates to the field, the AGS Foundation for Health in Aging [FHA] raised funds through its "Evening With Friends" benefit to defray travel costs for 126 promising students who were invited to attend and present their research at the Annual Meeting.

The AGS and the FHA also continued to raise public awareness of older adults' healthcare needs by producing and disseminating authoritative, easy-to-understand elder health and caregiving information, and by reaching out to the media. In 2008 alone, AGS and its Foundation were mentioned nearly 1,000 times in media coverage of aging and health.

The Society will continue to work toward its goal of quality healthcare for all older adults in 2009, building on its successes in 2008.