Geriatric Education Centers inIndian Country:

Resources for Improving theQuality of Care of American Indian and

Alaska Native Elders

Bruce Finke, M.D.

American Indian and Alaska Native (AI/AN) elders are arapidly growing subset of the AI/AN population. Thereare approximately 300,000 elders identified in the

2000 Census, an increase of 26 percent over the decade.We expect the oldest old (85 plus) to increase at the samehigh rate. This blessing brings challenges. The Indian healthsystem, comprised of the Indian Health Service, tribal andurban health programs, is now called upon to care for moreelders with more complicated health status than ever before.

N I C O A ’ S

Monograph SeriesVolume 3 - Number 1

National Indian Council on Aging

Indian Elders

American Indian and Alaska Native (AI/AN) eldersare a distinct population with unique health care

needs. AI/AN elders are found in the 550American Indian tribes and Alaska villages

recognized by Congress and theadditional 114 tribes and villages

recognized by states alone.Just under half live on 310

mostly rural reservations.They speak one or more of200 languages and dialects.

Map 1: American Indian and Alaska NativeElders (55 years plus) from the 1990 Census by County.One dot = 1 AI/AN ElderMap by: Kurt Menke, GIS Specialist, UNM-EDAC using the NICOA - ATLAS project data

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Graph : American Indian and Alaska Native Populations Across Censuses

Map 2: American Indian and Alaska Native Reservations and Trust Lands.Map by: Kurt Menke, GIS Specialist, UNM-EDAC using the NICOA - ATLAS project data

AI/AN elders, similar to elders elsewhere, utilizehealth services more than any other age group.AI/AN elders over 64 years of age comprise 5.7percent of the Indian Health Service (IHS) userpopulation but are responsible for 22 percent ofinpatient day, 11 percent of ambulatory medicaland clinical activities, and 15 percent ofinpatient discharges.1

1: Indian Health Service “Indian Health Focus: Elders”(1997), U.S. Department of Health and Human Ser-vices, Indian Health Service, Office of Public Health,Division of Community and Environmental Health,Program Statistics Team.

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Geriatric Education Centers (GECs) are fundedby the Health Resources and Services Adminis-tration (HRSA) in order to improve access tohealth care for America’s elderly by providingquality education and training in geriatrics forhealth professionals from a variety of disci-plines. The GECs are the only national networkfocusing on geriatric education as a means ofpreparing all health care providers to serve theneeds of a diverse elderly population.

Nationally there are 45 GECs. HRSA fundsapproximately 80 percent of the GECs.

Geriatric Education Centers

Geriatric Education Center objectives:

Improve the training of health professionals ingeriatrics, including geriatric residencies,traineeships and fellowships.

Develop and disseminate curricula on the treat-ment of health problems in elderly individuals.

Train and re-train faculty to provide instruction ingeriatrics.

Support continuing education for health profes-sionals who provide geriatric care.

Provide clinical geriatrics training in nursinghomes, chronic and acute care hospitals, ambula-tory care centers and senior centers.

Map 3: Location of Geriatric Education CentersNone in Alaska

Map by: Kurt Menke, GIS Specialist, UNM-EDAC using the NICOA - ATLAS project data

Map 4: Location of Indian Health Service, Tribal and Urban health facilities and Geriatric Education CentersMap by: Kurt Menke, GIS Specialist, UNM-EDAC using the NICOA - ATLAS project data

LegendIHS, Tribal or Urban health facilityGeriatric Education Center

How can GECs help improve the care of American Indian and Alaska Native elders?

A number of GECs are working with tribal and IHS health carefacilities, senior centers, and tribal programs to provide trainingand education on geriatric topics. These GECs often serve as keyresources in rural areas with otherwise limited availability ofgeriatrics expertise. Map 4 shows the GECs in relationship toIHS, Tribal, or Urban health facilities.

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LegendTitle VI nutrition siteGeriatric Education Centers

Map 5 shows the GECs in relationship to Title VI -funded Tribal nutrition sites (usually located in seniorcenters).

The GECs can also play a valuable role as ageriatric education resources for health careprofessionals training at the many tribal colleges.Map 6 shows the GECs in relationship to tribalcolleges providing education to health careprofessionals.

Map 5: Administration on Aging Title VI Nutrition Programs.Map by: Kurt Menke, GIS Specialist, UNM-EDAC using the NICOA - ATLAS project data

Map 6: Tribal Colleges and Geriatric Education Centers.None in Alaska

Map by: Kurt Menke, GIS Specialist, UNM-EDAC using the NICOA - ATLAS project data.

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Bay Mills Community College12214 West Lake Shore DriveBrimley, Michigan 49715906-248-3354 Voice906-248-3351 FaxDr. Martha McLeod, President

Blackfeet Community CollegeP.O. Box 819Browning, Montana 59417406-338-7755 Voice406-338-3272 FaxMs. Carol Murray, President

Cankdeska Cikana Community CollegeP.O. Box 269Fort Totten, North Dakota 58335701-766-4415 Voice701-766-4077 FaxMr. John Lohnes, President

College of Menominee NationP.O. Box 1179Keshena, Wisconsin 54135715-799-4921 Voice715-799-1308 FaxDr. Verna Fowler, President

Crownpoint Institute of TechnologyP.O. Box 849Crownpoint, New Mexico 87313505-786-4100 Voice505-786-5644 FaxMr. James Tutt, President

D-Q UniversityP.O. Box 409Davis, California 95617530-758-0470 Voice530-758-4891 FaxDr. Morgan Otis, President

Diné CollegeP.O. Box 126Tsaile, Arizona 86556520-724-6669 Voice520-724-3327 FaxMs. C Manuelito-Kerkvliet, President

Dull Knife Memorial CollegeP.O. Box 98Lame Deer, Montana 59043406-477-6215 Voice406-477-6219 FaxDr. Richard Littlebear, President

Fond du Lac Tribal & Community College2101 - 14th StreetCloquet, Minnesota 55720-2964218-879-0800 Voice218-879-0814 FaxMr. Lester Jack Briggs, President

Fort Belknap CollegeP.O. Box 159Harlem, Montana 59526406-353-2607 Voice406-353-2898 FaxMs. Carole Falcon-Chandler, President

Fort Berthold Community CollegeP.O. Box 490New Town, North Dakota 58763701-627-4738 Voice701-627-3609 FaxMs. Elizabeth Yellowbird Demaray,President

Fort Peck Community CollegeP.O. Box 398Poplar, Montana 59255406-768-5551 Voice406-768-5552 FaxDr. James Shanley, President

Haskell Indian Nations University155 Indian Avenue, Box 5030Lawrence, Kansas 66046-4800785-749-8497 Voice785-749-8411 FaxDr. Karen Swisher, President

Institute of American Indian Arts83 Avan Nu Po RoadSanta Fe, New Mexico 87505505-424-2300 Voice505-424-0050 FaxMs. Della Warrior, President

Keweenaw Bay Ojibwa Community College107 Bear Town RoadBaraga, MI 49908906-353-8161 Voice906-353-8107 FaxMs. Debra J. Parrish, President

Lac Courte Oreilles Ojibwa CommunityCollegeRR 2, Box 2357Hayward, Wisconsin 54843715-634-4790 Voice715-634-5049 FaxMr. Schuyler Houser, President

Leech Lake Tribal CollegeRoute 3, Box 100Cass Lake, Minnesota 56633218-335-2828 Voice218-335-7845 FaxMr. Jamie Robertson, Acting President

Little Big Horn CollegeP.O. Box 370Crow Agency, Montana 59022406-638-3100 Voice406-638-2229 FaxMr. Henry Real Bird, Acting President

Little Priest Tribal CollegeP.O. Box 270Winnebago, Nebraska 68071402-878-2380 Voice402-878-2355 FaxMs. Ann Downes, President

Nebraska Indian Community CollegeP.O. Box 164Niobrara, Nebraska 68760402-857-2434 Voice402-857-2543 FaxDr. Ross D. Primm, President

Northwest Indian College2522 Kwina RoadBellingham, Washington 98226360-676-2772 Voice360-738-0136 FaxDr. Tommy Lewis, President

Oglala Lakota CollegeP.O. Box 490Kyle, South Dakota 57752605-455-2321 Voice605-455-2787 FaxMr. Thomas Shortbull, President

Red Crow Community CollegeP.O. Box 1258Cardston, AlbertaCanada T0K 0K0403-737-2400 Fax 403-737-2101Ms. Marie Smallface Marule, President

Salish Kootenai CollegeP.O. Box 117Pablo, Montana 59855406-675-4800 Voice406-675-4801 FaxDr. Joe McDonald, President

Sinte Gleska UniversityP.O. Box 490Rosebud, South Dakota 57570605-747-2263 Voice605-747-2098 FaxDr. Lionel Bordeaux, President

Sisseton Wahpeton Community CollegeOld Agency Box 689Sisseton, South Dakota 57262605-698-3966 Voice605-698-3132 FaxDr. Elden Lawrence, President

Si Tanka CollegeP.O. Box 220Eagle Butte, South Dakota 57625605-964-6044 Voice605-964-1144 FaxDr. T.L. Traversie, President

Sitting Bull College1341 - 92nd StreetFort Yates, North Dakota 58538701-854-3861 Voice701-854-3403 FaxMr. Ron McNeil, President

Southwestern Indian Polytechnic InstituteP.O. Box 10146Albuquerque, New Mexico 87184505-346-2347 Voice505-346-2343 FaxDr. Carolyn Elgin, President

Stone Child CollegeRocky Boy Route, Box 1082Box Elder, Montana 59521406-395-4313 Voice406-395-4836 FaxMr. Steve Galbavy, President

Turtle Mountain Community CollegeP.O. Box 340Belcourt, North Dakota 58316701-477-7862 Voice701-477-7807 FaxDr. Carty Monette, President

United Tribes Technical College3315 University DriveBismarck, North Dakota 58504701-255-3285 Voice701-530-0605 FaxDr. David Gipp, President

White Earth Tribal and CommunityCollege210 Main Street SouthP.O. Box 478Mahnomen, MN 56557218-935-0417 Voice218-953-0423 FaxDr. Helen Klassen, President

LegendTribal CollegesGeriatric Education Centers

Tribal Colleges

Conclusion

The Geriatric Education Centers have an important role to play inthe education and training of health professionals in geriatrics tofoster quality health care for the rapidly increasing population ofAmerican Indian and Alaska Native elders. Increased collabora-tion between the Geriatric Education Centers, tribal colleges, andAmerican Indian/ Alaska Native health facilities is a first steptoward achieving this goal.

“Our elders deserve not only our respect and recognition forall that they have accomplished, but they also merit our best

efforts in ensuring their health and well-being.”

Michael Trujillo, MD, MPHAssistant Surgeon General

Director, Indian Health Service

Page Seven

Alabama1. University of Alabamaat Birmingham GECCH-19, Suite 201 933 19th StreetSouth Birmingham, AL 35294-2041(205) 934-4399

Arkansas2. Arkansas GECUniversity of Arkansas forMedical Sciences4301 West MarkhamLittle Rock, AR 72205-7199(501) 257-5537

California3. California GECDepartment of MedicineUniversity of California Los Angeles32-144 CHS 10833Le Conte AvenueLos Angeles, CA 90095-1687(310) 312-0531

4. Pacific GECUniversity of Southern CaliforniaResource Center3715 McClintockLos Angeles, CA 90089-0191(213) 740-8711

5. San Diego GECUniversity of California,San Diego School of MedicineDepartment Of Medicine200 West ArborSan Diego, CA 92103-8415(619) 543-6275

6. Stanford GECStanford University703 Welch Road Suite H-lStanford, CA 94305-0151(415) 723-7063

Colorado7. Colorado GECUniversity of ColoradoHealth Sciences CenterBox A094, 4200 E. 9th AvenueDenver, CO 80262(303) 270-8974

District of Columbia8. Washington D.C. Area GECGeorge Washington University2150 Pennsylvania Avenue,NW Room 2B-425Washington, DC 20037(202) 994-6055

Florida9. Miami Area GECUniversity of Miami1400 N.W. 10th Avenue (M-865)Dominion Tower, Suite 614Miami, FL 33136(305) 243-6270

10. University of Florida GECP.O. Box 100277, JHMHCGainesville, FL 32610-0277(904) 395-0274

11. University of South Florida GECSuncoast Gerontology CenterUniversity of South Florida12901 Bruce B. Downs Blvd.,MDC50Tampa, FL 33612(813) 974-4355

Hawaii12. Pacific Islands GECUniversity of Hawaii347 N. Kuakini Street, HPM-9Honolulu, HI 96817(808) 523-8461

Illinois13. Illinois GEC NetworkUniversity of Illinois at ChicagoCollege of Associated HealthProfessions438 IIDD-MC 6261640 West Roosevelt Rd.Chicago, IL 60608-6904(312) 413-1520

14.Midwestern GECMidwestern University555 31st StreetDowners Grove, Illinois 60515(630) 515-6034

Iowa15. Iowa GECUniversity of Iowa2153 WestlawnIowa City, IA 52242(319) 353-5736

Kansas16. Kansas GECUniversity of Kansas MedicalCenter3901 Rainbow Blvd.Kansas City, KS 66160(913) 588-1636

Kentucky17. Ohio Valley AppalachiaRegional GECUniversity of KentuckyLigon House658 South Limestone StreetLexington, KY 40506-0442(606) 257-8314

Louisiana18. Louisiana GECLouisiana State UniversitySchool of Medicine1542 Tulane AV, Rm A-317New Orleans, LA 70112(504) 568-5842

Massachusetts19. Harvard UpperNew England GECDivision on AgingHarvard Medical School643 Huntington AvenueBoston, MA 02115(617) 432-2620

Michigan20. GEC of MichiganMichigan State UniversityB215 West Fee Hall EastLansing, Ml 48824-1316(517) 353-7828

Minnesota21. Minnesota Area GECUniversity of MinnesotaBox 197 Mayo420 Delaware Street, S.E.Minneapolis, MN 55455(612) 626-3886

Missouri22. Missouri Gateway GECSt. Louis University School ofMedicine1402 S. Grand BoulevardRoom M238St. Louis, MO 63104(314) 577-8462

Nevada23. Nevada GEC2040 W. Charleston, Blvd.Suite 503Las Vegas, NV 89102(702) 671-2381; Fax, 671-6425

New Jersey24. New Jersey GECUniversity of Medicine &Dentistry of New JerseySchool of Osteopathic Medicine42 East Laurel Rd., Suite 3200Stratford, NJ 08084-1504(609) 566-7141

New Mexico25. New Mexico GECUniversity of New MexicoCenter for Aging ResearchEducation and Service1836 Lomas Blvd., NEAlbuquerque, NM 87131-6086(505) 277-0911

New York26. Consortium of New York GECsNYU Division of Nursing246 Greene St., 5th FloorNew York, NY 10003-6677(212) 998-9016

27. Finger Lakes GECUniversity of RochesterMonroe Community Hospital535 E. Hennetta RDRochester, NY 14620(716) 760-6350

28. Long Island GECUniversity at Stony BrookHealth Sciences Center - MedicineLevel 16, Room 080Stony Brook, New York 11794-8 1 6 3(631) 444-7840

Geriatric Education Centers29. Western New York GECDivision of Geriatrics/GerontologyVeterans Administration MedicalCenter3495 Bailey AV, RM 602CBuffalo, NY 14215(716) 829-3097

North Carolina30. Appalachian GECBowman Gray School of MedicineMedical Center BoulevardWinston-Salem, NC 27157-1051(910) 713-8558

31. Duke GECCenter for the Study of AgingBox 3003Duke University Medical CenterDurham, NC 27710(919) 660-7500

32. North Carolina GECProgram on Aging, GETAUniversity of North Carolina atChapel Hill, CB #7550Chapel Hill, NC 27599-4100(919) 966-6974

Ohio33. Western Reserve GECCase Western Reserve University12200 Fairhill RoadCleveland, Ohio 44120(216) 368-5433

Oklahoma34. Oklahoma GECUniversity of Oklahoma HealthSciences CenterP.O. Box 26901, CNB407Oklahoma City, OK 73190(405) 271-8558

Oregon35. Oregon GECOregon Health Sciences UniversityPortland VAMC Mail Code (14G)P.O. Box 1034Portland, OR 97207-1034(503) 721-7821ennsylvannia36. Delaware Valley GECUniversity of PennsylvaniaInstitute on Aging3615 Chestnut StreetPhiladelphia, PA 191044006(215) 898-1579Contacts:

IHS Elder Care InitiativeBruce Finke, M.D.DirectorPO Box 467Zuni, NM 87327(505) 782-7357/ FAX 782-7405e-mail: bfinke@abq.ihs.govwww.ihs.gov/medicalprograms/eldercare

Tribal CollegesAmerican Indian Higher EducationConsortium121 Oronoco StreetAlexandria, VA 22314(703) 838-0400 / FAX 838-0388e-mail: aihec@aihec.orghttp://www.aihec.org

Health Resources and Services AdministrationBureau of Health ProfessionsJoan Weiss, Ph.D.Chief, Allied Geriatrics and Rural Health BranchParklawn Building Room 9-1055600 Fishers Lane,Rockville, Maryland 20857(301) 443-0430/ FAX 443 0162e-mail: jweiss@hrsa.govhttp://www.hrsa.gov

The National Association of GeriatricEducation Centers (NAGEC)Andrea Sherman, Ph.D.Project Director,The Consortium of New York GeriatricsEducation Centers246 Greene Street, 5th FloorNew York, New York 10003-6677(212) 998-9016/ FAX 995-4561e-mail: andrea.sherman@nyu.eduhttp://www.hcoa.org/nagec/

Sponsors:Analysis for this monograph is drawn from “An Interactive Atlas of American Indian Elders Health”, a projectmade possible by funding from the Indian Health Service, U.S. Department of Health and Human Services,Rockville MD 20857. Reference ISH002063-01 ISH73, Elder Health Care Initiative. This monograph wassupported by funding from the Department of Health and Human Services, Health Resources and ServicesAdministration, Bureau of Health Professions, Division of State, Community, and Public Health.

National Indian Council on Aging10501 Montgomery Blvd. NESuite 210Albuquerque, NM 87111(505) 292-2001/Fax 292 1922www.nicoa.org

National Indian Councilon Aging, Inc.10501 Montgomery Blvd., NESuite 210Albuquerque, NM 87111

NON-PROFITORGANIZATION

U S PostagePAID

Albuquerque, NMPERMIT No.901

Earth Data Analysis CenterUniversity of New MexicoBandalier WestAlbuquerque, NM 87131(505) 277-3622/Fax 277-3614www.edac/unm.edu

Data Analysis Service1009 Bradbury Dr. SESuite 33Albuquerque, NM 87106(505) 272-7597/Fax 842-8018www.populationfacts.com

CAPE Associates6405 Cranbrook NEAlbuquerque, NM 87111(505) 821-8476/Fax 797-7172E-mail lesen@unm.edu

Principal InvestigatorDave BaldridgeExecutive DirectorNational Indian Council on Aging

37. GEC of PennsylvaniaUniversity of Pittsburgh121 University Place, 6th FLPittsburgh, PA 15260(412) 624-9190

Puerto Rico38. University of Puerto RicoGECSchool of MedicineMedical Sciences CampusG.P.O. Box 365067San Juan, PR 00936-5067(809) 751-2478

Rhode Island39. Rhode Island GECUniversity of Rhode IslandProgram in GerontologyWhite Hall 2 Heathman RDKingston, RI 02881-0808(401) 874-5311

South Carolina40. South Carolina GECThe Medical University ofSouth CarolinaHarborview Offcie Tower Suite4 0 819 Hagood AvenueCharleston, South Carolina2 9 4 2 5(843) 792 5487

Tennessee41. Meharry Consortium GECMeharry Medical College1005 D.B. Todd BoulevardCampus Box 69ANashville, TN 37208(615) 327-6947

Texas42. Texas Consortium GECsHuffington Center on AgingBaylor College of MedicineOne Baylor Plaza, Room M320Houston, TX 77030-3498(713) 798-4611

Project Team:

43. South, West, and PanhandleConsortium of Texas GECUniversity of Texas Health ScienceCenter at San AntonioDepartment of Dental DiagnosticScience7703 Floyd Curl DriveSan Antonio, TX 78284-7921(210) 567-3370

Utah44. Intermountain West GECCollege of NursingUniversity of Utah25 South Medical DriveSalt Lake City, UT 84112(801) 582-1565 ext. 2459

Virginia45. Virginia GECVirginia Commonwealth UniversityMCV Campus, Box 980228Richmond, VA 23298-0228(804) 828-9060

Washington46. Northwest GECUniversity of WashingtonBox 358123Seattle, WA 98195-8123(206) 685-7478

West Virginia47. Mountain State GECWest Virginia UniversityCenter on Aging - Eduction UnitP. O. Box 9127Morganton, WV 26505(304) 293-2081

Wisconsin48. Wisconsin GECMarquette UniversityP.O. Box 1881Milwaukee, Wl 53201-1881(414) 288-3712