Recommendation 6-2: Public, private, and community organizations should provide funding and ensure that adequate training opportunities are available in the community for informal caregivers.

Increasing Recruitment and Retention

Recommendation 4-3: Public and private payers should provide financial incentives to increase the number of geriatric specialists in all health professions.

Recommendation 4-3a: All payers should include a specific enhancement of reimbursement for clinical services delivered to older adults by practitioners with a certification of special expertise in geriatrics.

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.

Recommendation 4-3c: States and the federal government should institute programs for loan forgiveness, scholarships, and direct financial incentives for professionals who become geriatric specialists. One such mechanism should include the development of a National Geriatric Service Corps, modeled after the National Health Service Corps.

Recommendation 5-2: State Medicaid programs should increase pay and fringe benefits for direct-care workers through such measures as wage pass-throughs, setting wage floors, establishing minimum percentages of service rates directed to direct-care labor costs, and other means.

Redesigning Models of Care

Recommendation 3-1: Payers should promote and reward the dissemination of those models of care for older adults that have been shown to be effective and efficient.

Recommendation 3-2: Congress and foundations should significantly increase support for research and demonstration programs that

•   promote the development of new models of care for older adults in areas where few models are currently being tested, such as prevention, long-term care, and palliative care; and

•   promote the effective use of the workforce to care for older adults.

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