NJ GWEP

The NJISA at Rowan-Virtua School of Osteopathic Medicine is proud to be a recipient of a five-year Geriatric Workforce Enhancement Program (GWEP) grant, funded for a second cycle by the U.S. Department of Health and Human Services, Health Resources and Services Administration (DHHS-HRSA), effective 7/1/2019. The NJ GWEP improves health outcomes for older adults by developing a healthcare workforce that integrates geriatrics into primary care and maximizes patient/family engagement. The grant also focuses on building Age-Friendly Health Systems and communities through the 4Ms framework (What Matters, Mentation, Medication, Mobility), a national initiative of the John A. Hartford Foundation and the Institute for Healthcare Improvement (IHI).

4Ms Framework for Age-Friendly Health Systems

4Ms Framework for Age-Friendly Health Systems: An Initiative of The John A. Hartford Foundation and Institute for Healthcare Improvement (IHI) in partnership with the American Hospital Association (AHA) and the Catholic Health Association of the United States (CHA).

What Matters
Know and align care with each older adult's specific health outcome goals and care preferences including, but not limited to, end-of-life care, and across settings of care.

Medication
If medication is necessary, use Age-Friendly medication that does not interfere with What Matters to the older adult, Mobility, or Mentation across settings of care.

Mentation
Prevent, identify, treat, and manage dementia, depression, and delirium across settings of care.

Mobility
Ensure that older adults move safely every day in order to maintain function and do What Matters.

NJ GWEP Initiatives

The NJISA, in its leadership role in the NJ GWEP, will undertake practice transformation in its own primary care practices and the practice patterns of its partners. All of the NJ GWEP initiatives include a commitment to interprofessional education and the creation of age-friendly and dementia-friendly health systems and communities within the 4Ms framework. We have engaged with a variety of institutions and community-based partners to advance our goal of improving care for older individuals, their families and caregivers within the 4Ms framework. Our GWEP project initiatives are to:

• Transform primary health care practices and community-based programs to be more age-friendly.
• Integrate the 4Ms (What Matters, Mentation, Medication, Mobility) into daily practice.
• Promote and deliver Alzheimer’s disease education for the healthcare workforce.
• Provide dementia education for patients and family caregivers.
• Increase knowledge about substance/opioid use, high-risk medications, and available interventions and resources.
• Promote Advance Care Planning.
• Identify individuals at risk for falls.
• Review high-risk medications prescribed to older individuals in primary care and community-based settings.
• Promote the use of evidence-based assessment tools and evidence-based resources to improve care of older individuals.

Partners

The NJ GWEP is working with its partners to promote age-friendly health systems and communities. Our partners are committed to providing evidence-based care for older individuals and supporting their families and caregivers.

Wilmington Veteran’s Administration - Community-Based Outpatient Clinic (VA-CBOC)

The Wilmington VA-Cumberland CBOC is located in Vineland and provides high quality, coordinated care for Veterans in lower Delaware and southern NJ. The NJ GWEP works with the VA outpatient clinic to establish a weekly Cognitive Clinic for Veterans with memory problems or related issues.

Clinical faculty from NJISA at RowanSOM work in collaboration with VA primary care providers and other members of the VA interprofessional team to offer services that include: comprehensive assessment, recommendations for ongoing care, and education to patients, families and caregivers about cognitive changes (such as memory-related issues) that impact daily function and safety.   

Fair Share Housing/Northgate II

Northgate II is part of Fair Share Housing, LLC, a non-profit organization founded in 1975, to provide the underserved, particularly in inner cities, with a living environment that offers safe, decent, sanitary housing that is near employment and educational opportunities. This high-rise building contains 298 apartments and houses 340 residents in Camden city. Many of the residents are Spanish-speaking and are minorities aged 55+. Many of the building staff provide case management and support services to the building residents.

Northgate II is a site for interprofessional team training, which provides clinical rotation sites for nursing, social work, and medical students who work with staff to conduct Resident Health Risk Assessments focused on the 4Ms framework. Our goal is to develop person-centered plans of care that supports residents who desire to age in place.     

New Jersey Housing Mortgage and Finance Agency (HMFA)

Since 1983, the NJ Housing and Mortgage Finance Agency has financed over 80,000 affordable multi-family rental units; 2,460 supportive housing units; and is responsible for the oversight of over 92,000 units in its property management and contract administration portfolios. HMFA also oversees the Services for Independent Living (SIL) program, available in 98 HMFA senior citizen buildings and serves approximately 10,500 residents each year.

HMFA identified three affordable housing sites in which to implement the 4Ms framework and the Resident Health Risk Assessment, replicating the work being done at Northgate II.

• Trent Center West, Trenton (246 units)
• Benedict’s Place, Cherry Hill (74 units)
• Rittenberg Manor, Egg Harbor City (99 residents)

At each of the 3 sites, trainings for building staff, residents, family caregivers, and health professions students focus on:

• age-friendly communities (4Ms – What Matters, Mentation, Mobility, Medications)
• dementia
• delirium
• depression
• polypharmacy
• falls

Staff will conduct Resident Health Risk Assessments for building residents, develop person-centered interventions/plans of care based on the 4Ms framework, and work with academic partners to provide interprofessional training experiences for health professions students of multiple disciplines.

NJ Division of Aging Services (DoAS)

Based in the NJ Department of Human Services, the Division of Aging Services offers a single point of access for seniors, people with disabilities and their caregivers through its 21 Area Agencies on Aging and Aging and Disability Resource Connections (AAA/ADRC). It is the state’s resource center for older individuals, family caregivers and the community, and it provides community-based health promotion programs.

DoAS facilitates the NJ GWEP’s access to state-funded, long-term services and supports (JACC, PACE, Alzheimer’s Adult Day Programs) and provides leadership to embed the 4Ms, dementia education and advanced care planning in state-wide initiatives.

Rutgers School of Nursing-Camden (RSoN)

As a state university, Rutgers SoN-Camden offers undergraduate, graduate and professional academic programs that combine on-campus and online programs, hands-on clinical experiences, research opportunities, and local and global service learning. As an inner-city school, RSoN focuses on social justice. They are committed to civic engagement that connects campus resources with the needs of the community and prepares nursing students to become advocates for vulnerable populations.  

Rutgers SoN was a partner on the first GWEP grant, and continues to build on the work they have done in collaboration with NJISA faculty, the GWEP project team, and NGII staff to implement an innovative community-based interprofessional experiential learning opportunity that addresses social determinants of health for nursing and other health professions students.  They will support aging in place consistent with the Age-Friendly Communities 4Ms framework and assist with completion of the Resident Health Risk Assessment in affordable housing settings.   

Stockton University (SU)

A new partner in the NJ GWEP, Stockton is a public university located in southern New Jersey. It has four satellite campuses serving 9,231 undergraduate and graduate students, and is home to the Stockton Center on Successful Aging. Stockton offers graduate programs in nursing, social work, occupational and physical therapy, a minor in gerontology, and is implementing a new program in behavioral health counseling.

As part of the plan for integration of interprofessional education into new field experiences and alignment of the curriculum across disciplines, Stockton will provide interprofessional experiences at affordable housing sites as part of the NJ GWEP and will participate in the implementation of the 4Ms framework. 

Camden Coalition of Health Providers (CCHP)

Camden Coalition is a non-profit corporation that has influenced health system reform by implementing programs that have increased the quality, capacity and accessibility of health care services in underserved areas, like Camden city. Its focus has been to track “superutilizers” of emergency room and hospital services and promote practice transformation to improve access and reduce costs.

CCHP will work with the NJ GWEP and its affordable housing partners to computerize the Resident Health Risk Assessment tool. This will support data collection using the 4Ms framework and help promote implementation of person-centered plans of care.