pushed toward other areas since Medicare requires a 50 percent copayment for outpatient mental health services, compared to 20 percent for most other medical services (ADGAP, 2007a). Furthermore, Medicare does not cover any routine oral-health services.

Financial burdens affect the recruitment and retention of clinical and academic geriatric experts. A 2004 survey of second-year MSW students found that over 60 percent expressed interest in an aging-related internship—if a stipend were available for this activity (Cummings et al., 2005). Junior faculty in geriatrics have lower compensation than those in family or internal medicine (ADGAP, 2004). At higher faculty positions the median dollars paid to those in geriatrics become similar to those paid for other specialties, but the pay of geriatrics specialists still lags behind that of the higher-paid procedural specialties. Between 2002 and 2003 salaries for geriatric physician faculty decreased by 3 percent; during this time period, family medicine salaries increased by 1.5 percent, and general internal medicine salaries remained the same.

GACAs have been instrumental in the development of academic geriatricians. These awards are especially appealing since the grants directly support teaching services during the life of the award.

Recommendation 4-3b: Congress should authorize and fund an enhancement of the Geriatric Academic Career Award (GACA) program to support junior geriatrics faculty in other health professions in addition to allopathic and osteopathic medicine.

The committee supports the extension of GACAs to all doctorate-level health care professionals. As has been discussed, many of the geriatric specialties are limited by the availability of faculty and mentors. The creation of GACAs for other doctoral-level health care professions would help to promote not only the geriatric professions, but would enable educational programs to better educate all professionals in the care of older adults. Recognizing the lag time between the initial training of professionals until the time they are available to become faculty, these training opportunities should begin now.

In June 2007, Senator Bingaman introduced a bill14 that would provide GACAs to doctorate level nurses certified in geriatrics or geropsychiatry. This bill proposed a funding level of $1.875 million per fiscal year (plus administrative costs) to allow for a total of 125 5-year awards for $75,000 in total between 2008 and 2015. A loftier goal could be to have one GACA at every institution that prepares advanced practice professionals. For ex-

14

Nurse faculty and physical therapist education act of 2007. S 1628. 110th Congress, 1st session. June 14, 2007.



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