1. Aging and Health Program Strategic Plan Update September 2010

2. Goals for Today Quick review of grantmaking approach Review program strategies, grants, and spending Update on progress on target indicators A modest proposal and future directions Aging and Health Program: Strategic Plan Update // 2

3. Grantmaking Approach Only national funder focused on aging and health mission Highly strategy driven Expert staff, engaged in the field Creating change, not grants alone Aging and Health Program: Strategic Plan Update // 3

4. Aging and Health Program: Overview Aging and Health Program: Strategic Plan Update // 4 Better Health of Older Adults

5. Aging and Health Program: Strategic Plan Update // 5 Health Care Delivery Redesigned for Older Adults Health Care Delivery Redesigned for Older Adults Model Development and Testing AARP –Caregiver Support Guided Care Sigma Theta Tau – Leadership Academy Practice Change Fellows Dissemination of Proven Ideas Agents of Change OHSU – Care Management + Partners in Care – Medication Mgmt. U. of Washington – IMPACT VNSNY – CHAMP U. Colorado – Care Transitions Mount Sinai – Palliative Care SHM – BOOST Care Transitions PHI – Coaching Supervision Integrating & Improving Services: Portfolio

6. Aging and Health Program: Strategic Plan Update // 6 Integrating & Improving Services: Outstanding Commitments

7. Aging and Health Program: Strategic Plan Update // 7 Integrating & Improving Services: Grant Outputs Models Adopted in 50 States 3,764 Clinical Sites 5,372 Providers Trained

8. Aging and Health Program: Strategic Plan Update // 8 Goal: Two new models of care demonstrate clinical benefit and feasibility. In Progress Guided Care AARP Caregiver Support PHI Coaching Supervision Integrating & Improving Services: Indicators of Impact Goal: Four models in dissemination become self sustaining in their spread. In Progress Care Management + Care Transitions VNSNY-CHAMP Meds Management Palliative Care IMPACT SHM BOOST

9. Aging and Health Program: Strategic Plan Update // 9 Social Work: Portfolio Social Workers Competent to Care for Older Adults Social Workers Competent to Care for Older Adults Faculty Development GSA – Doctoral Fellows Leadership Academy Curricular Change Curricular Change Pre-Dissertation Awards NYAM – HPPAE CSWE – Gero-Ed Center GSA – Faculty Scholars

10. Aging and Health Program: Strategic Plan Update // 10 Social Work: Outstanding Commitments

11. Aging and Health Program: Strategic Plan Update // 11 Social Work: Indicators of Impact MSW Programs Having >2 Faculty Specializing in Geriatrics MSW Programs with* Coursework in Aging MSW Programs Adopting Hartford Practicum Model for Training *Represents % programs with coursework available, not requiring coursework, which remains our goal.

12. Aging and Health Program: Strategic Plan Update // 12 Nursing: Portfolio All Nurses Competent to Care for Older Adults All Nurses Competent to Care for Older Adults Faculty Development BAGNC Scholarship & Fellowships CGNES Gero Psych Collaborative Curricular Change Curricular Change Gero Nurse Ed. Consortium Associate Degree Programs Adult Advanced Practice Nursing

13. Aging and Health Program: Strategic Plan Update // 13 Nursing: Outstanding Commitments

14. Aging and Health Program: Strategic Plan Update // 14 Nursing: Indicators of Impact Bachelors Nursing Schools Adopting AACN Geriatric Competencies Masters Programs Adopting AACN Geriatric Competencies Bachelors Programs with >1 Geriatrics Faculty Member(s)

15. Aging and Health Program: Strategic Plan Update // 15 Medicine: Portfolio All Physicians Competent to Care for Older Adults All Physicians Competent to Care for Older Adults Faculty Development Centers of Excellence ADGAP – Leadership Surgeons Initiative Reynolds Foundation Programs Curricular Change Curricular Change MSTAR Beeson Williams Jahnigen Scholars Programs Internal Medicine Specialist Initiative ADGAP – Chief Residents

16. Aging and Health Program: Strategic Plan Update // 16 Medicine: Outstanding Commitments Faculty Development

17. Aging and Health Program: Strategic Plan Update // 17 Medicine: Indicators of Impact* % Aca. Medical Centers with Divisions of Geriatrics Average MD faculty = 16 % Medical Schools with geriatric requirements % IM Residencies with some geriatrics requirements *Original Indicators of Impact: Faculty in Divisions of Geriatric Medicine Grow by 20% Medical Schools Adopting AAMC Geriatric Competencies Residencies, Specialties, & Subspecialties Adopting Geriatric Training Standards

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19. Aging and Health Program: Strategic Plan Update // 19 Aging and Health Program: Allocation of Funds Commitments AreaPlanActualProposed Medicine40%41%36%* Nursing24%25%24% Social Work16%20%20%* Services20%10%20%

20. Future Directions 2010 – CGNE & PHI renewals 2011 – Strategic planning – Rebalance faculty development vs. curriculum – Continuing education 2012 – Finish making deferred payments – Make new grants to spend ~$7M unallocated in 2013 Aging and Health Program: Strategic Plan Update // 20

21. Aging and Health Program: Strategic Plan Update Questions & Discussion

22. Aging and Health Program: Strategic Plan Update // 21 Aging and Health Commitments: 2003 - 2010 (in thousands) Outcomes (in dollars) 2003200420052006200720082009**2010 Grand Totals ('03 - '09) Medicine7,22112,9861,51819,78717,9723,40014,8151,81277,699 Nursing3,0504,26718,5875918,1738,1811,3311,78044,180 Social Work3,4499,1855,3839,19514,42504,607046,244 IIS3286,6062,3764,8006,8245,2151,19940027,348 Aging & Health Other01352,3401,264742,40340006,616 Totals By Year (in current $s):14,04833,17930,20435,63747,46819,19922,3523,992202,087 Cumulative Total (Current $s):14,04847,22777,431113,068160,536179,735202,087206,079 Totals By Year (in constant $s):*14,04832,31828,45632,52642,12416,40819,1703,376185,051 Cumulative Total (Constant $s):14,04846,36674,823107,349149,473165,880185,051188,426 Outcomes (percentages) 20032004200520062007200820092010 Grand Totals ('03 - '09) Medicine51.4%39.1%5.0%55.5%37.9%17.7%66.3%45.4%38.4% Nursing21.7%12.9%61.5%1.7%17.2%42.6%6.0%44.6%21.9% Social Work24.6%27.7%17.8%25.8%30.4%0.0%20.6%0.0%22.9% IIS2.3%19.9%7.9%13.5%14.4%27.2%5.4%10.0%13.5% Aging & Health Other0.0%0.4%7.7%3.5%0.2%12.5%1.8%0.0%3.3% Totals:100.0% Includes Projected Commitments through December 2010 *2003 Consumer Price Index Base ** Includes AFAR CoE National Program Office Grant ($8.4 million)

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25. Aging and Health Program: Strategic Plan Update // 24 Aging and Health Grant Payouts: 2003 - 2010 (in thousands) Outcomes (in dollars) 20032004200520062007200820092010 Grand Totals ('03 - '09) Medicine8,1189,4929,6306,0299,1657,5648,4806,23158,478 Nursing7,0446,4246,5675,5506,4074,9526,4413,80243,385 Social Work2,6553,9065,2653,6506,8306,1424,4583,40632,906 IIS4,1322,5773,1911,7775,0424,1955,0773,08825,991 Aging & Health Other4514298131,0701,1428326666205,403 Totals By Year (in current $s):22,40022,82825,46618,07628,58623,68525,12217,147166,163 Cumulative Total (Current $s):22,40045,22870,69488,770117,356141,041166,163183,310 Totals By Year (in constant $s):*22,40022,23623,99316,49825,36820,24121,5462,361152,282 Cumulative Total (Constant $s):22,40044,63668,62885,126110,494130,736152,282154,643 Outcomes (percentages) 20032004200520062007200820092010 Grand Totals ('03 - '09) Medicine 36.2%41.6%37.8%33.4%32.1%31.9%33.8%36.3%35.2% Nursing 31.4%28.1%25.8%30.7%22.4%20.9%25.6%22.2%26.1% Social Work 11.9%17.1%20.7%20.2%23.9%25.9%17.7%19.9%19.8% IIS 18.4%11.3%12.5%9.8%17.6%17.7%20.2%18.0%15.6% Aging & Health Other 2.0%1.9%3.2%5.9%4.0%3.5%2.7%3.6%3.3% Totals:100.0% Payments Made Through August 31, 2010 *2003 Consumer Price Index Base

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28. Aging and Health Program: Strategic Plan Update // 27 AACN – American Association of Colleges of Nursing AAMC – Association of American Medical Colleges ADGAP – Association of Directors of Geriatric Academic Programs BAGNC – Building Academic Geriatric Nursing Capacity BOOST – Better Outcomes for Older adults through Safe Transitions CGNEs – Centers of Geriatric Nursing Excellence GSA – Gerontological Society of America HPPAE – Hartford Partnership Program in Aging Education IM – Internal Medicine MSTAR – Medical Student Training in Aging Research MSW – Masters in Social Work NYAM – New York Academy of Medicine OHSU – Oregon Health & Science University PHI – Paraprofessional Healthcare Institute SHM – Society of Hospital Medicine VNSNY – Visiting Nurse Service of New York Acronyms