HOW “TITLE VII” CUTS HURT OLDER ADULTS, AND WHAT YOU CAN DO ABOUT IT

Back in 1998, Congress recognized the importance of addressing the manpower shortage in geriatrics by passing the Health Professions Education Partnership Act of 1998, which was ultimately incorporated into the Title VII section of the Public Health Service Act.

The legislation, which most of us know as “Title VII,” authorizes federal funding of initiatives designed to ease shortages in geriatrics and a variety of other “underserved” disciplines. In geriatrics, Title VII funds—until very recently—supported programs through which academic geriatricians both trained future geriatricians and taught the basics of geriatric care to primary care physicians, nurses, pharmacists, nursing home staffers, and other health care professionals.

Among other things, Title VII funding supported the nation’s 50 Geriatric Education Centers (GECs), which offer a variety of such programs. In 2005 alone, GECs trained more than 50,000 health care professionals from 35 health-related disciplines on how to better care for older adults. These professionals have collectively reported over 8.6 million patient encounters and enhanced quality of care for the older adults they serve.

Yet, despite these accomplishments, Congress zeroed out funding for Title VII geriatrics programs this past December—just weeks before the eldest of the nation’s 77 million Baby Boomers turned 60. The following month, President Bush proposed a 2007 budget that included absolutely no funding for Title VII geriatrics initiatives.

To say that eliminating funding for Title VII geriatrics programs is shortsighted is an understatement. We’re already experiencing major losses as a result of the December cuts. In addition to the GECs and geriatric faculty fellowships, Title VII funding financed Geriatric Academic Career Awards (GACAs). These crucial awards also supported academic geriatricians who both trained geriatricians and instructed other health care professionals in the basics of quality elder care.

Consider the difference the GACAs made at Washington University (WU) School of Medicine, in St Louis. The school, just one of the institutions that benefited from the awards, had two GACA awardees on staff. These geriatricians helped train up-and-coming geriatricians and instructed a wide range of graduate and undergraduate students at the university’s nursing, pharmacy, and allied health schools in geriatrics essentials. In addition, they saw patients in WU’s clinic for older adults, and helped care for residents at a university-affiliated nursing home. The GACA awards helped pay the geriatricians’ salaries, but the money will run out this summer. Because WU is unable to make up the difference, both geriatricians are now looking for other jobs. The most likely outcome is that they’ll end up in clinical positions that don’t allow much, if any, time for training and teaching. That would be a scenario in which nearly everyone loses: the older patients these geriatricians cared for, the health care professionals they taught, and the next generation of older adults, who won’t benefit from a geriatrics work force that’s as well trained as it should be.

Now consider that similar scenarios are playing out nationwide, and you realize that we’ve got to do our utmost to get Title VII geriatrics funding restored as soon as possible. 

Right now, Congress is deciding which initiatives to fund in their 2007 budget proposals, and we need to let our lawmakers know that it’s absolutely imperative to reinstate funding for Title VII. If you haven’t already, please call or write your Senators and Representatives to let them know how desperately we need to restore funds for Title VII geriatrics programs. The American Geriatrics Society has created a new online Advocacy Center (https://www.americangeriatrics.org) to make getting involved in grassroots advocacy efforts like this as close to effortless as possible. Please take a look and take some time to ensure that older adults get the care they need—now and in the future.

If they do, we’ll all be winners. Study after study has found that providing appropriate geriatric care can lower hospitalization rates among older adults and keep them out of nursing homes and in the community. Not only does that ensure better quality of life for older people, it adds up to big savings for all of us.