Geriatrics Provider Collaboration

Infusing Geriatrics Best Practices in the Dual Demonstration Projects

Hartford bandwidthonline.org © Annie Levy, 2008Over half of the dually eligible population are older adults, many of whom are frail or have multiple chronic conditions. Building evidence-based delivery systems that can best serve this population requires a new level of collaboration between consumer advocates and geriatrics practitioners. The Center for Consumer Engagement in Health Innovation is drawing on the expertise of leaders in the geriatrics community, including front-line physicians, gerontologists, nurses, social workers and other providers and researchers. This partnership seeks to incorporate best practices in geriatrics care, which have been shown to improve efficiency, quality and outcomes in the dual eligible demonstration projects.

Building on the support of the Center from The Atlantic Philanthropies, The John A. Hartford Foundation has provided additional funding to support this innovative collaboration between geriatrics and gerontology experts and health care advocates. Since its inception, powerful bridges have been built, increasing the effectiveness of state advocacy efforts around the demonstrations. This partnership enabled Community Catalyst to produce a series of webinars on geriatrics-competent care in collaboration with the Centers for Medicare and Medicaid Services, The American Geriatrics Society and The Lewin Group. We have also produced a video to illustrate what excellent integrated care to older adults looks like.

In each of the five Geriatrics Provider Collaboration grantee states, Hartford funding has enabled us to engage two geriatrics or gerontology experts to work in partnership with state advocates, as well as a Senior Advisor to this effort, Dr. Gregg Warshaw. The 2015 Geriatrics Provider Advocates are listed below, by state.

Senior Advisor

Gregg WarshawGregg Warshaw, MD, an academic family physician/geriatrician, is a clinical professor in the Departments of Family Medicine and Internal Medicine, Geriatrics Division, School of Medicine, at the University of North Carolina-Chapel Hill. Dr. Warshaw was previously the director of the Geriatric Medicine Program at the University of Cincinnati (UC) College of Medicine from 1987 - 2015. He joined the UC faculty after four years as assistant professor and director of the Geriatric Medicine Program in the Department of Community and Family Medicine at Duke University.

Dr. Warshaw received his medical training at the University of Michigan, and further residency and fellowship training at Duke University, The University of North Carolina, and at Edinburgh University in Scotland. Dr. Warshaw served as the medical director of Maple Knoll Village, a continuing care retirement community in Springdale, Ohio from 1985 – 2014.  He is a past president of the American Geriatrics Society and the Association of Directors of Geriatric Academic Programs. Dr. Warshaw was a 2013-2014 Atlantic Philanthropies Health and Aging Policy Fellow/American Political Science Association Congressional Fellow. He is currently a senior advisor for Community Catalyst’s Geriatrics Provider Collaboration.

Michigan

Gwendolyn Graddy-Dansby, MD, FACP, has been the Medical Director for PACE Southeast Michigan (PACE SEMI), since 2001. PACE SEMI (formerly known as Center for Senior Independence) was the first Program of All Inclusive Care of the Elderly site in the state. Dr. Graddy, in collaboration with the Interdisciplinary Team (IDT) at PACE SEMI developed its Comfort Care program, focused on identifying appropriate patients early and enrolling them into Comfort Care. The goal is to improve and maintain not just quality of life, but quality of death and dying.

Dr. Graddy completed her undergraduate education at the University of Michigan, Ann Arbor in 1980. She graduated from Wayne State University School of Medicine in 1984. She joined the Henry Ford Health System (HFHS) in 1987 and is Board Certified in both Internal Medicine and Geriatrics and is a Fellow in the American College of Physicians. Dr. Graddy is a member of Straight Gate International Church in Detroit and the Department Head for Gate Care Health Ministry. She speaks extensively on healthy aging, caregiving and Alzheimer’s Disease. She has also begun to study the role that PACE has on controlling hospital utilization through its effective care coordination practices. 


New York

Dr. Audrey Chun completed her residency in Internal Medicine at Baylor College of Medicine in Houston, Texas. She then finished her fellowship in geriatrics at the Mount Sinai School of Medicine where she also served as Chief Fellow. As a recipient of a Health Professions Health Resources and Services Administration (HRSA) funded Geriatric Academic Career Award (GACA), she was able to pursue her clinical interests that include geriatric assessment, medical education, and delivery of care in the outpatient setting. She has been featured in the Frontline documentary “Living Old” and has participated in numerous panel discussions on aging in America and its implications. Currently, Dr. Chun is Vice Chair for Clinical Services in the Brookdale Department of Geriatrics and Palliative Medicine, and Director of Coffey Geriatrics at the Martha Stewart Center for Living at the Mount Sinai Medical Center.

Tara A. CortesTara A. Cortes, PhD, RN, FAAN is the Executive Director of the Hartford Institute for Geriatric Nursing and a professor in Geriatric Nursing at the New York University Rory Meyers College of Nursing. Dr. Cortes has developed collaborative models with advanced practice nurses and physicians in traditional as well as nontraditional settings to enhance the care of the American elderly population. The consistent theme across her work is the essential role of advanced practice nurses improving the quality of life in specific patient populations and the interdisciplinary nature of health care. Dr. Cortes is a Fellow of the American Academy of Nursing, a Fellow of the New York Academy of Medicine, a Past Fellow of the Robert Wood Johnson Executive Nurse Fellows Program and a 2013-2014 Health and Aging Policy Fellow. She received the Distinguished Alumni Award from New York University, where she completed her PhD and Masters degrees.

Rhode Island

Richard Besdine MDRichard W. Besdine, MD, has devoted his career to geriatrics through university-based and public health care policy work for more than 35 years. He has trained more than 125 physicians in geriatrics. Dr. Besdine is Professor of Medicine and Public Health, Director of the Center for Gerontology and Healthcare Research, Director of the Division of Geriatrics in the Department of Medicine, and first Greer Professor of Geriatric Medicine, at Alpert Medical School and the School of Public Health of Brown University. He is Chief of Geriatrics for Lifespan, and the other Brown-affiliated hospitals. He is also Chief Medical Officer for Healthcentric Advisors (formerly Quality Partners) of RI, the Quality Improvement Organization for the State of RI. Dr. Besdine also served as Interim Dean of Alpert Brown Medical School (2002-2005). He is past President of the American Geriatrics Society, and was first CMO for HCFA (now CMS) and Director of its Quality Bureau.

Martha Rounds-Watson, MS, APRN, GCNS-BC has been passionate about geriatric healthcare for over 25 years and currently serves as a Clinical Innovation Specialist/Magnet Coordinator at Newport Hospital in Newport, Rhode Island. In her career, she has been responsible for a broad range of geriatric initiatives for frail elders at acute care hospitals, in adult day care and  at assisted living organizations. She has been involved in initiatives to manage common hospital acquired conditions such as falls, pressure ulcers, CAUTI, restraints and delirium. She also has been involved in education of staff in efforts to improve overall geriatric knowledge, especially in delirium management, pain management and palliative care initiatives. Martha holds an MS degree from the University of Rhode Island as an APN Geriatric Clinical Nurse Specialist. She also holds a certification from ANCC in Pain Management.

PAST GPA PARTICPANTS

Michigan

Maureen MickusMaureen Mickus, Ph.D., MSG, is a gerontologist and Associate Professor in the Department of Occupational Therapy at Western Michigan University.  She holds a Ph.D. from Northwestern University and subsequently completed a post-doctoral fellowship at Michigan State University’s College of Human Medicine. Dr. Mickus served on the medical school faculty at Michigan State University for ten years, teaching and conducting aging related research. She joined the faculty at Western Michigan University in 2006 and received the University’s Distinguished Teaching Award in 2011. Dr. Mickus’ work has centered on aging policy and strategies for maintaining older adults in the community. She has published on a variety of mental health and aging topics, including dementia and depression. She serves on multiple boards, including the Michigan Society of Gerontology, Alzheimers Association Great Lakes Chapter and Centracare-Program of All Inclusive Care for the Elderly.

Ohio

Orson Austin MDDr. Orson Austin is a Family Medicine residency graduate of the University of Cincinnati and currently serves as an Associate Professor of Family Medicine and Geriatrics at that same institution. He is an active clinician educator, working extensively with medical students, resident physicians and geriatric medicine fellows. He has lectured extensively on topics of import to both primary care medicine and geriatrics. In addition, he is actively involved in numerous community service activities and is a member of the Alzheimer’s Association of Greater Cincinnati Professional Advisory Council.

 Donald Mack, MD, FAAFP, CMDD was in rural family medicine for 23 years until 2010, when he joined the Ohio State University Wexner Medical Center, Family Medicine Department, with a specific vocational and educational mission in geriatrics, hospice and palliative medicine, and long term care. He is board certified in Family Medicine and has a Certificate of Added Qualifications in Geriatrics, Hospice and Palliative Medicine, and is a Certified Medical Director of the American Medical Director Association.

Washington

Dr. Christine (Himes) Fordyce has been a primary care physician and geriatrician at Group Health in Seattle since 1988. She has served in numerous leadership roles focused on the care of older adults at Group Health including Director of Geriatrics and Long-Term Care, Medicare Medical Director, and Healthy Aging Medical Director, leading the work of integrating care systems for older adults. Most recently this work has focused on the Primary Care Medical Home (PCMH) model for both the Group Health Physicians group practice and the network ACO’s. 

A passionate national, community, and medical education speaker and writer on all aspects of healthy aging, Dr. Fordyce enjoys mentoring the next generation of leaders across the multidisciplinary team including outpatient primary and specialty, hospital, long-term, and community based health care providers. She serves nationally as a senior mentor for the Hartford Foundation and Atlantic Philanthropies supported Practice Change Leaders initiative, is a member of the PCMH Network. 

Carol Toms, MSW, LICSW – It was while she was doing her Social Work practicum in the Geriatric Clinic and Senior Living Center at the Seattle Veterans Administration Hospital that she recognized her passion for working with older adults.  She went on to be the Lead Social Worker for the in-patient Geriatric Team at Harborview Medical Center in Seattle Washington for eight years, working with marginalized seniors facing many social challenges.  She was also a member the Harborview Palliative Care and Hospice Care Team assisting patients and their families with end-of-life issues. She has been working with patients in the dialysis unit at the Seattle Veterans Hospital; many of these Veterans are older adults who are looking to maximize  their quality of life while dealing with a chronic illness.