This Geriatrics Training Program Escaped the Ax. For Now.

In St. Louis, a dedicated team of students travels in a well-equipped van to various locations, including senior centers, nursing homes, and churches, where they conduct comprehensive, hour-long geriatric assessments. This initiative not only provides valuable experience for the students but also serves the community by identifying common issues such as frailty, muscle weakness, and cognitive decline among older adults.

The team, comprising future doctors, social workers, psychologists, and therapists, evaluates patients free of charge and offers printed care plans to guide their ongoing health management.

Meanwhile, across Oregon, community health workers are participating in an eight-hour online training program. This program covers essential topics such as Medicare and Medicaid, hospice and palliative care, and effective communication with patients and their families. “We need these front-line public health workers to know how to provide age-friendly care,” emphasizes Laura Byerly, a geriatrician at Oregon Health & Science University, who leads these efforts.

In Louisville, a similar federally funded initiative is providing geriatrics training throughout Kentucky. Sometimes, the approach is less formal. Sam Cotton, the social worker directing the dementia program, recently received a request from a local Methodist church. Parishioners caring for relatives with dementia sought guidance, and Cotton readily agreed to speak to the congregation about the challenges they face.

These programs, along with 39 others across the country, aim to tackle a pressing issue: the shortage of geriatricians and healthcare providers knowledgeable about aging. Since 2015, Congress has authorized funding for the Geriatrics Workforce Enhancement Program (GWEP), which trains approximately 70,000 individuals annually.

However, recent developments have put these grants at risk. In July, without prior notice, the annual funding disbursements to recipients were significantly reduced. Instead of the anticipated $41.8 million, grantees collectively received only $27.5 million, marking a 34% shortfall, as reported by the Eldercare Workforce Alliance. Further cuts were anticipated.

The Trump administration’s proposed budget for fiscal 2026 eliminated GWEP, along with several other programs funded through the Health Resources and Services Administration (HRSA). Despite bipartisan support and repeated authorizations over five years, the president’s budget aimed to streamline bureaucracy and save taxpayer funds.

As weeks passed without clarity regarding the missing funds, program directors reached out to their congressional representatives, facing the prospect of layoffs and an uncertain future. “This money was appropriated, signed, and sealed, so where is it?” Cotton questioned, highlighting the urgency of the situation.

Questions directed to HRSA yielded few answers. However, on September 10, the programs learned that the previously withheld funds had suddenly been released. GWEP has also been restored to both the House and Senate bills funding the federal health department, although the bills remain subject to change.

This turnaround may be attributed, in part, to the advocacy of Republican Senator Susan Collins of Maine, who is up for reelection next year. In a Senate floor speech, Collins described the program as a “modest investment” essential for ensuring older Americans receive expert care and support.

Despite the relief, the situation has been tumultuous. Marla Berg-Weger, co-director of GWEP at Saint Louis University, noted, “It has been a roller coaster, to say the least.” The withheld payments equated to the funds earmarked for Alzheimer’s and dementia training, leading to significant disruptions in programs across the country.

HRSA stated that all grant programs underwent thorough reviews to align with administration priorities, causing delays in payments. Carole Johnson, the agency’s administrator, expressed surprise at any skepticism regarding the value of a knowledgeable workforce for older adult care, emphasizing the program’s potential for growth.

Despite the challenges, GWEPs continue to extend knowledge about elder care to a wide range of providers, particularly in rural and underserved areas. For instance, the Saint Louis University program recently launched an apprenticeship for certified nursing aides (CNAs) at a suburban nursing home. This initiative aims to address the high turnover rates among nursing home employees by providing comprehensive training tailored to the needs of older patients.

With six women enrolled in the first apprenticeship class, the program offers 144 hours of education on critical topics such as medications, fall prevention, and dementia. Graduates will become certified geriatrics specialists, receiving a stipend and a raise from their employers, with plans to expand the program to other facilities.

As GWEPs navigate these uncertainties, their commitment to enhancing care for older adults remains steadfast.

The New Old Age is produced through a partnership with The New York Times.

In St. Louis, a dedicated team of students travels in a well-equipped van to various locations, including senior centers, nursing homes, and churches, where they conduct comprehensive, hour-long geriatric assessments. This initiative not only provides valuable experience for the students but also serves the community by identifying common issues such as frailty, muscle weakness, and cognitive decline among older adults.

The team, comprising future doctors, social workers, psychologists, and therapists, evaluates patients free of charge and offers printed care plans to guide their ongoing health management.

Meanwhile, across Oregon, community health workers are participating in an eight-hour online training program. This program covers essential topics such as Medicare and Medicaid, hospice and palliative care, and effective communication with patients and their families. “We need these front-line public health workers to know how to provide age-friendly care,” emphasizes Laura Byerly, a geriatrician at Oregon Health & Science University, who leads these efforts.

In Louisville, a similar federally funded initiative is providing geriatrics training throughout Kentucky. Sometimes, the approach is less formal. Sam Cotton, the social worker directing the dementia program, recently received a request from a local Methodist church. Parishioners caring for relatives with dementia sought guidance, and Cotton readily agreed to speak to the congregation about the challenges they face.

These programs, along with 39 others across the country, aim to tackle a pressing issue: the shortage of geriatricians and healthcare providers knowledgeable about aging. Since 2015, Congress has authorized funding for the Geriatrics Workforce Enhancement Program (GWEP), which trains approximately 70,000 individuals annually.

However, recent developments have put these grants at risk. In July, without prior notice, the annual funding disbursements to recipients were significantly reduced. Instead of the anticipated $41.8 million, grantees collectively received only $27.5 million, marking a 34% shortfall, as reported by the Eldercare Workforce Alliance. Further cuts were anticipated.

The Trump administration’s proposed budget for fiscal 2026 eliminated GWEP, along with several other programs funded through the Health Resources and Services Administration (HRSA). Despite bipartisan support and repeated authorizations over five years, the president’s budget aimed to streamline bureaucracy and save taxpayer funds.

As weeks passed without clarity regarding the missing funds, program directors reached out to their congressional representatives, facing the prospect of layoffs and an uncertain future. “This money was appropriated, signed, and sealed, so where is it?” Cotton questioned, highlighting the urgency of the situation.

Questions directed to HRSA yielded few answers. However, on September 10, the programs learned that the previously withheld funds had suddenly been released. GWEP has also been restored to both the House and Senate bills funding the federal health department, although the bills remain subject to change.

This turnaround may be attributed, in part, to the advocacy of Republican Senator Susan Collins of Maine, who is up for reelection next year. In a Senate floor speech, Collins described the program as a “modest investment” essential for ensuring older Americans receive expert care and support.

Despite the relief, the situation has been tumultuous. Marla Berg-Weger, co-director of GWEP at Saint Louis University, noted, “It has been a roller coaster, to say the least.” The withheld payments equated to the funds earmarked for Alzheimer’s and dementia training, leading to significant disruptions in programs across the country.

HRSA stated that all grant programs underwent thorough reviews to align with administration priorities, causing delays in payments. Carole Johnson, the agency’s administrator, expressed surprise at any skepticism regarding the value of a knowledgeable workforce for older adult care, emphasizing the program’s potential for growth.

Despite the challenges, GWEPs continue to extend knowledge about elder care to a wide range of providers, particularly in rural and underserved areas. For instance, the Saint Louis University program recently launched an apprenticeship for certified nursing aides (CNAs) at a suburban nursing home. This initiative aims to address the high turnover rates among nursing home employees by providing comprehensive training tailored to the needs of older patients.

With six women enrolled in the first apprenticeship class, the program offers 144 hours of education on critical topics such as medications, fall prevention, and dementia. Graduates will become certified geriatrics specialists, receiving a stipend and a raise from their employers, with plans to expand the program to other facilities.

As GWEPs navigate these uncertainties, their commitment to enhancing care for older adults remains steadfast.

The New Old Age is produced through a partnership with The New York Times.