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Medi-cal changes for California seniors

Medi-Cal Changes for California Seniors

New and expanded Medi-Cal eligiblity criteria in 2022 will allow more people to access Medi-Cal coverage. Medi-Cal changes for California seniors offer many a new chance to qualify for Medi-Cal. Read on to learn more about these changes, which for some seniors could include becoming eligible for WelbeHealth or other PACE programs in your area.

For more detailed information, see the resources listed at the bottom of the article.

  • Expanded Coverage for Undocumented Seniors
    Beginning in May 2022, Medi-Cal benefits will be provided to all individuals over the age of 50 who meet financial eligibility requirements, regardless of immigration status. This includes primary, specialty, behavioral health, long-term care, and much more. Those not currently enrolled in restricted scope Medi-Cal will need to apply to find out if they meet eligibility requirements.
  • Increased Asset Limits
    In July of 2022, the asset limit will increase for many Medi-Cal programs from $2,000 to $130,000 for individuals (plus $65,000 for each additional family member). Once this change is in effect, DHCS will send letters to those who were denied Medi-Cal or terminated coverage for being over the asset limit during the 90 days before the effective date of the change.

How this may affect you: If you were previously denied Medi-Cal enrollment due to immigration status or assets, you may want to consider re-applying.

 

Changes to Medi-Cal Managed Care in 2022 and 2023

The California Advancing and Innovating Medi-Cal (CalAIM) initiative standardizes managed care enrollment and benefits, addresses social determinants of health, and reduces inequities. As part of the CalAIM initiative, some health coverage changes will impact Medi-Cal enrollees across all of California. Other changes only impact certain populations or enrollees in certain counties.

How this may affect you: The way you receive Medi-Cal benefits through your managed care plan may be changing, including the health plan you are enrolled in or the services available through your current Medi-Cal managed care plan.

  • Changes for Dual-eligible, Medi-Cal and Medicare Individuals
    Starting January 2023, dual-eligible individuals will be required to enroll in a Medi-Cal managed care plan. If you are eligible for both Medicare and Medi-Cal, you will receive enrollment forms to choose the plan you want to enroll in. PACE programs such as WelbeHealth will be listed as an option on these enrollment forms. This is a great time to consider participating in WelbeHealth’s PACE services if you are eligible and live in one of our service areas.
  • Changes for those with a Medi-Cal share of cost
    As part of CalAIM, some Medi-Cal beneficiaries* with a share of cost are moving out of managed care, into fee-for-service Medi-Cal. If you have been on a Medi-Cal plan that has a share of cost, you will automatically be enrolled in fee-for-service Medi-Cal unless you live in a long-term care facility. This change affects those enrolled in both Medi-Cal and Medicare and those enrolled in Medi-Cal only.If you were previously enrolled in a Cal MediConnect plan, you will be disenrolled from Cal MediConnect. You will need to select a new Part D prescription plan to cover prescription drugs.Note that under fee-for-service Medi-Cal, there may be some changes to how transportation is made available to you. DHCS’s Transportation Services web page provides instructions on how you can get transportation under fee-for-service.
  • Managed Care Enrollment for Certain Populations
    Certain population groups who are required to enroll in a Medi-Cal managed care plan are expanding statewide. If you are part of one of these special groups, you would have received two notices in the Fall of 2021. You can make a managed care selection or be added to a state-selected managed care plan.
  • End of MediConnect Plans in December
    As of December 31, 2022, if you are enrolled in a Cal MediConnect plan, you will automatically move to a dual special needs plans operated by the parent organization of your Cal MediConnect plan. If you have questions or would like to select a different health plan (including PACE), contact the Health Consumer Alliance (HCA) at 1-888-804-3536. The HCA can assist Californians who are trying to get or keep their health coverage.

 

Could you now be eligible for PACE?

WelbeHealth’s PACE provides all-inclusive coordinated care. Visit welbehealth.com for information about our services.

You may have questions about these Medi-Cal changes for California seniors. At WelbeHealth we have experts available to assist you in evaluating whether you qualify for Medi-Cal. Call us at (888) 530-4415, TTY (800) 735-2922 to learn more.

 

References and Resources:

*Some changes only affect individuals residing in a CCI county (Los Angeles, San Bernadino, Riverside, Orange County, San Diego, Santa Clara, and San Mateo) or a COHS county (Del Norte, Humboldt, Lake, Lassen, Marin, Mendocino, Merced, Modoc, Monterey, Napa, Orange, San Luis Obispo, San Mateo, Santa Barbara, Santa Cruz, Shasta, Siskiyou, Solano, Sonoma, Trinity, Ventura, and Yolo).

Nurse coordinator

Care Coordination for Seniors

Seniors with complex medical conditions often need help managing their care. They see multiple doctors and specialists. They’re taking multiple medications, have several medical appointments a month, and may need assistance in their home. Professional care coordination for seniors can help manage a senior’s health care.

Research shows that 35 percent of those over age 65 have no one assisting them with coordinating their care. Thirty-four percent say a family member coordinates their care.

Care coordination can be beneficial for seniors and caregivers, especially for the 85 percent of older adults who live with one or more complex medical conditions.

What is care coordination?

Seniors, or their spouse or adult child, often do the work of coordinating their care. They make appointments, provide transportation, communicate with physicians, and assist in the home.

Professional care coordination for seniors is more in-depth and comprehensive. It involves multiple medical experts who specialize in the health of the elderly. The team helps the senior meet their medical needs, provides the needed resources, and updates the care team. Care coordination is personalized and uses the input of the patient and caregiver.

The benefits of care coordination for seniors and their families

  • Doctors stay informed. Living with a complex medical condition often means having more than one doctor who provides your care. One goal of care coordination is to keep all healthcare providers informed. This saves the patient from redundant testing, screening, and treatment. Changes in medication, new or worsening symptoms, and changes in medical history are all topics to be shared among your team of physicians.
  • Better healthcare outcomes. Studies have shown that professional care coordination results in better health outcomes. Patients are often more satisfied with the quality of care because it is personalized and streamlined.
  • Social and emotional needs met. Care coordination focuses on the patient’s physical, social and emotional health. Healthcare professionals connect the patient to resources such as counseling and support groups and promote wellness of the mind.
  • Relief for caregivers. Family members often take on coordinating care for their aging loved one. As their loved one’s condition grows more complex, it can be a lot to manage. Professional care coordination for seniors relieves caregivers of doing this, while keeping them informed. Therefore, they have more time to work, rest, or tend to their own health needs.

WelbeHealth provides care coordination for seniors with complex medical conditions.

WelbeHealth’s program of all-inclusive care for the elderly (PACE)  provides professional coordinated care to seniors.

Interdisciplinary Team

At the heart of WelbeHealth’s PACE is the interdisciplinary team. This team stays current on each senior in their care, and adjusts care as needed. Each team member specializes in caring for seniors with complex medical conditions. The team includes specialists such as:

  • Primary care physician
  • Nurse
  • Physical therapist
  • Occupational therapist
  • Recreation therapist
  • Dietician
  • Social worker
  • Home care coordinator
  • Transportation professional

Day Center

WelbeHealth’s day centers make providing coordinated care seamless. In the day center, seniors can get many physical needs met and socialize with other participants. Under one roof, participants can receive:

  • Primary care
  • Dental, vision, and hearing care
  • Physical and occupational therapy
  • Recreational therapy
  • Nutritious meals and socializing with other seniors and staff
  • Exercise
  • Personal care (bathing, grooming, etc.)

Telehealth and Home Care

Professional care coordination for seniors often involves home care. Seniors sometimes need help with housekeeping and personal care. WelbeHealth coordinates that care when it is medically necessary.

Telehealth can help keep seniors connected with healthcare professionals 24/7. This accessibility can help give peace of mind to seniors and their caregivers.

Coordinated Care is Impactful for Seniors.

Coordinated care is impactful for seniors with complex medical conditions. WelbeHealth provides personalized, coordinated care, keeping seniors living well, at home.

Caregiving for elders

Costs of Caring for an Aging Loved One

Many adult children care for a parent in their golden years. Some are surprised by the costs of caring for an aging loved one. Family caregivers spend an annual average of $7,400 of their own money on caregiving expenses. In combination with a possible loss of income due to time away from work, it can sometimes be a financial strain for families.

Here are three steps you can take to reduce out-of-pocket caregiving expenses and recover some financial costs.

1.  Create a budget and track expenses.

Caring for an elderly loved one includes many expenses that you may not think of. Keep track of these expenses. After a few months, you can better predict what your caregiving expenses will be and adjust your budget accordingly. If you have siblings or other loved ones who may share the caregiving costs with you, it is a useful tool to split costs evenly. If you haven’t already, consider asking your loved ones for help with these caregiving expenses.

Possible Recurring Caregiving Expenses Possible One-time Caregiving Expenses
·         Groceries

·         Medical co-payments

·         Travel to and from doctor’s appointments

·         Incontinence supplies

·         Clothing

·         In-home professional care

·         Housekeeping

·         Mortgage

·         Home modification (railings, shower seat, etc.)

·         Medical alert system

·         Vehicle modifications

2.  Research tax implications of caregiving.

Understanding IRS guidelines for caregiver and senior filing can save you money and help you recoup some of your caregiving costs. If you meet these seven requirements outlined by the IRS, you may be able to claim an elderly parent as a dependent on your tax return. You may also be able to deduct medical expenses and home modification costs up to a certain amount. If you’re not sure about IRS rules and guidelines, talk to a tax professional to make sure you qualify for these benefits.

3.  Consider professional support.

For caregivers who want to keep their loved one at home, participating in a local Program of All-Inclusive Care for the Elderly (PACE) can provide professional medical care and significantly reduce the costs of caring for an aging loved one.

PACE provides eligible seniors the following services, typically at no added cost:

  • Preventive care and routine screenings
  • Dental and vision care
  • Transportation to medical appointments
  • Medical supplies, home safety modifications, and much more

PACE participants have a team of health care professionals that work to develop a customized care plan for each individual.

To learn more about WelbeHealth’s PACE services, visit welbehealth.com.

WelbeHealth Celebrates National PACE Month

September is National PACE Month, celebrating the Program of All-Inclusive Care for the Elderly (PACE). WelbeHealth’s innovative PACE model helps California’s frailest seniors live in their homes as long as possible. More than 95 percent of participants enrolled in the PACE program live outside of a nursing home.

“This year, we celebrate National PACE Month as we work to recover from the historic COVID-19 pandemic, which provides us a unique perspective to celebrate the original development of the PACE model of care and envision a future where every American will have access to PACE,” says Shawn Bloom, president and CEO of the National PACE Association (NPA).

Did you know? The incidence of PACE participants contracting or dying from COVID-19 was one-third the rate of nursing home residents.

PACE: A History of Innovative Senior Care in California

There are currently 140 PACE organizations in 30 states. The organizations serve more than 55,000 seniors. Before PACE grew to what it is today, it started in California. The program began in San Francisco in 1971 as a unique way to care for elderly with chronic conditions and to help them maintain independence, dignity, and quality of life in their communities.

PACE has a proven history of providing excellent senior care, while allowing individuals to live safely in the homes and communities they know and love. On average, PACE participants are 76 years old and live with multiple medical conditions. Around 46 percent have some form of dementia.

Fun Fact: In California, 65 PACE centers and alternative care settings care for over 13,000 seniors in 22 counties.

Tapping PACE’s Potential

California’s senior population is growing faster than any other age group. By 2030, 25 percent of Californians will be 60 or older. Senior care must evolve to meet the challenges of caring for the older population. PACE is a critical part of the solution.

“Now the time is right to demand more from our long-term care delivery system. PACE is ready to help every community meet that challenge,” says Bloom.

PACE provides home care, prescription drugs, transportation, meals, therapies, and any other services seniors need to remain safely in their homes. This comprehensive care is preventive in nature and results in better health outcomes for participants.

The PACE model is a critical part of keeping seniors independent and out of the hospital. About 92 percent of seniors enrolled in the program are very satisfied with the care provided by PACE. Additionally, 97 percent of caregivers would recommend PACE.

More Accessible Senior Care

Nearly 90 percent of Californians want access to services that help them live at home in their communities as they age. But, non-white and lower-income Americans report less access to local services that would help them do so. PACE can meet the needs of a diverse aging population, including lower-income seniors and individuals of color. In California, 80 percent of PACE program participants are from communities of color.

Medi-cal changes for California seniors

What is PACE? How can it help me stay independent?

What is PACE, and how can it help me stay well and independent?

Too often, elders and their caregivers struggle to get the help they need in their homes. Maybe you’re experiencing this challenge yourself. If so, you may not realize that WelbeHealth provides an affordable alternative to nursing home care, called PACE. PACE is a program that keeps seniors with complex health conditions living safely in their homes and gives families the support they need. But, what exactly is PACE? What are the benefits of the program? Below, we’ll explain.

What is PACE?

PACE (Program of All-Inclusive Care for the Elderly) is a healthcare option for seniors whose health issues may affect their independence. This program is a great alternative to nursing home care and gives seniors the support they need to continue living safely in their homes.

WelbeHealth provides PACE in a way that participants and their families often say seems almost “too good to be true.” We are committed to unlocking the full potential of seniors through our courage to love, pioneering spirit and shared intent. The program is funded by the federal government, and WelbeHealth is a licensed PACE provider in the state of California. When you enroll in PACE with WelbeHealth, we provide your care, and are also financially responsible for your care. Essentially, the program is your health care provider and health insurance combined.

Fun Fact: As of June 2021, 139 PACE programs were operating in 30 states, serving nearly 56,000 older Americans.

What does the PACE program do?

Once enrolled in the program, participants get access to preventive, coordinated care. A personalized care plan is tailored to each participant’s unique physical and emotional needs. Most coordinated care is administered at the day center. Here are some of the healthcare services provided by the program:

Transportation

For seniors who no longer drive, transportation can be a hassle and a burden for families. PACE provides transportation from your home to the day center and to medical appointments. Rides are wheelchair accessible and comfortable. In addition to taking you from place to place, the highly trained drivers deliver medication and medical supplies to your home when needed.

Dental, Vision and Hearing

Hearing aids, eyeglasses, and dentures are not always covered by Medicare. Participants of PACE receive these medically necessary items at no cost. As a program participant, you’ll have access to a dentist, mental health specialist, ophthalmologist, and more.

If the PACE care team determines that you need to see a specialist to treat a complex medical condition, they will coordinate the visit. Treatment for COPD, dementia, kidney disease, diabetes, and heart disease are all accessible through the program’s network of specialty physicians. And all the transportation is coordinated for you!

FYI: The average PACE participant has 6 chronic conditions. The PACE team is experienced in caring for seniors who have multiple diagnoses.

Social Engagement

Science has proven that social interaction does wonders for our mental and physical health. That’s why PACE has a team of activity specialists who coordinates social activities. Whether it’s board games at the day center, themed meals, or group exercises, there is always plenty going on at the PACE center.

In-Home Assistance

Upon enrollment, we will do a safety assessment in your home. We’ll look for trip hazards, like cluttered walkways and loose rugs. Next, we will make improvements to your home to make it safer, such as installing wheelchair ramps and grab bars if needed. Educating seniors and their caregivers is an important step in preventing falls.

If your PACE care team determines that it is medically necessary, you may also receive medical care in your home from registered nurses and certified nursing assistants. This may include incontinence care, injections and blood draws, as well as wound care.

Telemedicine

PACE participants gain access to telehealth services. You’ll be given a tablet that allows you to access your care team on-demand. Many participants enjoy the comfort of knowing someone is always available if an emergency should occur. Via telehealth, participants can check in with nurses, track their vitals and medications, and participate in virtual activities.

Medication Management

Over 20 percent of older adults report not taking medication as prescribed due to the high cost of their medication. Did you know cutting pills and skipping doses can actually worsen health conditions? When enrolled, your team of healthcare professionals will make sure you take the right medication at the right time each day, which keeps you healthy and living independently.

Additionally, PACE offers Medicare Part D prescription drug coverage. Once you become a program participant, you’ll get your Part D-covered drugs and all other necessary medication from PACE.

Will I have to change my doctor?

Upon enrolling in the program, you’ll begin seeing a doctor at the PACE center. All your healthcare services will be provided by PACE. The doctors and medical staff are highly experienced in caring for seniors with complex medical conditions, so you can trust you’re in good hands.

What are the benefits of PACE?

Interdisciplinary Team

Many parts work together to keep a car running well. Likewise, you need many healthcare providers working together to keep you living well. The PACE interdisciplinary team (IDT) is made up of senior healthcare experts whose top priority is providing you with personalized, coordinated care. They work together, meeting regularly to make sure your needs are met.

The PACE care team consists of:

  • Primary care physician
  • Nurses
  • Physical and occupational therapists
  • Dietitian
  • Social worker
  • Recreational therapist
  • Home care coordinator
  • Transportation professional

Caregiver Support

Because the interdisciplinary team handles all the complicated details of your care, family members and caregivers are relieved from many stressors. Transportation, refilling medications, and coordinating appointments are all done by PACE, significantly reducing caregiver burden. Caregiver training, support groups, and respite care also keep family members supported and educated.

Fast Fact: 97.5 percent of family caregivers would recommend PACE to someone in a similar situation.

What are the PACE eligibility requirements?

Prospective participants must meet the following criteria to be eligible for the PACE program:

  • 55+ years of age
  • Live in the designated service area
  • You are certified by the state as meeting the need for nursing home level of care
  • You can safely live in the community when you join

How much does PACE cost?

What you pay depends on your financial situation.

If you are: Cost (out-of-pocket):
Eligible for Medicaid No cost
Eligible for Medicare and Medicaid No cost
Eligible for Medicare only Pay Medicaid portion, plus monthly premium for Medicare Part D
Not eligible for Medicaid or Medicare Self-pay rate
  • 90 percent are dually eligible for Medicaid and Medicare
  • 9 percent are eligible for Medicaid only
  • 1 percent pay a premium

PACE focuses on you and your care.

The goal of PACE is to provide vulnerable seniors in our communities with the care, medical treatment, and support they need to safely live in their homes for as long as possible. Seniors benefit from personalized, coordinated care, as do their caregivers. With many healthcare services and benefits to the program, it’s a good alternative for many seniors who want to safely age in their homes and community. To learn more, contact us today.

 

Why We Support California Assembly Bill (AB) 523: Because Lifting Regulatory Bottlenecks Saved Lives During Covid-19 Crisis

WelbeHealth Administers First Shipment of COVID-19 Vaccines

LONG BEACH Dec. 31, 2020 – WelbeHealth is administering its first COVID-19 vaccines to its elderly participants this week, beginning at the organization’s center in Long Beach, California. The first seniors received their vaccinations on Wednesday, and additional vaccines will be administered next week.

WelbeHealth, a healthcare provider delivering integrated home-based care for frail seniors across California, received its first shipment of the vaccine earlier this week and rapidly deployed its plan to administer the injections to its highest-risk participants.

“This is a momentous occasion for our programs and our society. It’s essential that we all get vaccinated, not only for ourselves but for the safety and wellbeing of everyone in our communities,” said WelbeHealth President Matt Patterson, MD. “With each vaccine, we are literally saving the lives of our elders who have given so much to enrich our world.”

WelbeHealth provides care as part of PACE (Program of All-Inclusive Care for the Elderly), a longstanding Medicare and Medicaid program that enables older adults to live in the community instead of a nursing home.

At the onset of the coronavirus pandemic, WelbeHealth shifted to a remote home-based care model, providing each participant with an internet-connected WelbeLink computer tablet and delivering care in the home whenever possible. The program has a long track record of positive outcomes, including longer life expectancy and dramatically improved mental health and quality of life. The PACE model has proven dramatically safer for seniors during the pandemic, with 85-95 percent lower infection and mortality rates than nursing homes.

 

 

Vision Exam Month

August is National Vision Exam Month.  Healthy vision is important for people of all ages and is key for seniors to be able to live more independent lives in their homes and communities.  Here are some tips from the CDC on how to keep your eyes healthy.

Try 6 Tips for Healthy Eyes—and a Healthy You

  1. Add more movement to your day. Physical activity can lower your risk for health conditions that can affect your vision, like type 2 diabetes and high blood pressure. As a bonus, it can help you feel your best. Pick activities you enjoy and remember, anything that gets your heart beating faster counts!
  2. Get your family talking… about eye health history. Some eye diseases—like glaucoma and age-related macular degeneration—can run in families. Although it may not be the most exciting topic of conversation, talking about your family health history can help everyone stay healthy. Ask your relatives if they know about any eye problems in your family. Be sure to share what you learn with your eye doctor to see if you need to take steps to lower your risk.
  3. Step up your healthy eating game. Eating healthy foods helps prevent health conditions—like type 2 diabetes or high blood pressure—that can put you at risk for eye problems. Eat dark, leafy greens like spinach, kale, and collard greens that are high in antioxidants called lutein and zeaxanthin, which help prevent macular degeneration and cataracts. Also pick up some fish high in omega-3 fatty acids like halibut, salmon, and tuna.
  4. Stay on top of long-term health conditions—like diabetes and high blood pressure. Diabetes and high blood pressure can increase your risk for some eye diseases, like glaucoma. If you have diabetes or high blood pressure, ask your doctor about steps you can take to manage your condition and lower your risk of vision loss.
  5. If you smoke, make a quit plan. Quitting smoking is good for almost every part of your body, including your eyes! That’s right—kicking the habit will help lower your risk for eye diseases like macular degeneration and cataracts. Quitting smoking is hard, but it’s possible—and a quit plan can help. Call 1-800-QUIT-NOW (1-800-784-8669) for free support.
  6. Give your eyes a rest. Looking at a computer for a long time can tire out your eyes. Follow the 20-20-20 rule—rest your eyes by taking a break every 20 minutes to look at something about 20 feet away for 20 seconds.

Regular vision exams are part of the comprehensive services provided by PACE.  For more about PACE services, click here.

Free photo 5904867 © Nedim Jukić – Dreamstime.com

Offering support to elderly.

Coronavirus has ravaged nursing homes. For many seniors, there’s a safer option.

PACE keeps frail seniors healthy, socially engaged, and thriving, even in these unprecedented times.

By Si France, MD, Founder + CEO, WelbeHealth

(This article was published on Medium.com)

May 4, 2020 – As the Covid-19 pandemic continues to wreak havoc and claim lives across the country, many seniors and their families have grown nervous about the potential for outbreaks in nursing homes. Housing about 1.4 million Americans, nursing facilities are a major component of our country’s senior care infrastructure and are facing increasing scrutiny as hotbeds for the spread of the virus. In late April, California reported that nearly 40 percent of the state’s coronavirus-related deaths had occurred in the facilities, with a Los Angeles Times analysis finding that the actual figure could be even higher.

Older adults and people with underlying medical conditions are already at high risk, with reports of over 20 percent morbidity for patients ages 80 and older. With the added risk of congregate living in close quarters, nursing homes have become some of the earliest sites of coronavirus outbreaks.

That’s not to say that nursing home operators are to blame for this situation. Even the most comprehensive infection control policies and procedures may not be able to fully contain the virus when the nature of the facilities’ design is so high-risk. In one of his recent daily briefings, New York Governor Andrew Cuomo described housing “vulnerable people in one place” as a “feeding frenzy” for coronavirus. Acknowledging the high risk, at least six states have now gone so far as to grant nursing facilities explicit immunity from coronavirus lawsuits.

Unfortunately, these challenges aren’t likely to go away any time soon. Though some states have already begun to relax social distancing requirements and stay-at-home orders, frail seniors will remain at extremely high risk. Research published in the Journal of the American Medical Association found that when distancing measures were loosened after the first wave of the 1918 Spanish Flu pandemic, many cities saw long second waves of deaths in the months that followed. Our most hopeful projections show that the development, testing, and mass distribution of a coronavirus vaccine could take 12–18 months, though even that would be an extraordinarily short timeframe. Some scientists are now suggesting that Covid-19 will never be eradicated, returning in regular waves like the flu. Recent developments in antivirals and neutralizing antibodies provide some cause for optimism and could give us superior treatment options to reduce mortality rates.

Regardless of what the future holds, the devastation of this virus should force us to reevaluate the safest and most effective ways to provide high levels of care for the seniors in our community.

Considering the risk of outbreaks in nursing facilities, what are families to do for their loved ones who need high levels of care? While some may be able to care for elders in their homes, the vast majority cannot. Nursing home-eligible seniors typically need assistance with one or more activities of daily living, such as eating and preparing meals, bathing and grooming, or managing medications — a burden too great for many families to manage without additional support.

Rethinking senior care in the age of Covid-19

Suppose you could design a way to care for frail seniors in the time of coronavirus. What would the ideal model look like? For one, it would need to provide a high level of comprehensive care. Not just medicine, but support for seniors’ daily living activities, physical and occupational therapy, medication management, and more. It would also need to be covered by Medicare and Medicaid insurance, as nearly two-thirds of nursing home residents are supported primarily by Medicaid. Most importantly in our current environment, it would need to help seniors remain in their homes, avoiding the congregate living arrangements conducive to the rapid spread of viral outbreaks.

This model already exists, and thousands of nursing home-eligible seniors around the country are thriving in it.

It’s called the Program of All-Inclusive Care for the Elderly (PACE), and I believe it will revolutionize the way we care for the most vulnerable members of our communities.

PACE was pioneered in the 1970s by On Lok, a community health organization in San Francisco’s Chinatown neighborhood, to provide support services to enable seniors to continue living in their homes rather than in an institutional care setting. Over time, it’s evolved into a comprehensive, fully integrated medical and social care model, funded by Medicare and Medicaid in 31 states around the country. The fundamental philosophy of PACE is that it is better for seniors and their families to be served in the community whenever possible. Though all PACE participants are eligible for nursing homes, 95 percent live at home.

The programs are both health plan and care provider, enabling a comprehensive approach to managing seniors’ care. An interdisciplinary team of physicians, nurses, and other medical professionals actively monitor care plans and respond to changes in participants’ health. And PACE provides far more than just medical care, supporting seniors and their families with meals, transportation to appointments, social activities, and personal care services.

The evidence for PACE is overwhelming. The program has a long track record of positive outcomes, including longer life expectancy, improved quality of life, reduced rates of depression and dementia, and enhanced personal empowerment for seniors. According to a survey by the National PACE Association, 97.5 percent of family caregivers would recommend the program to someone in a similar situation. PACE even saves taxpayers money, reducing government healthcare spending by $10,000 per participant.

Research shows that PACE lengthens life and improves quality of life for nursing home-eligible seniors

PACE is also extremely well-positioned to address the growing crisis of social isolation in our senior communities. As the New York Times recently reported, social isolation and loneliness are major risk factors not only to seniors’ emotional health but their physical health as well. Isolation is associated with higher rates of heart disease and stroke and a 50 percent increased risk of dementia, with isolated seniors suffering “a mortality rate comparable to that linked to smoking, obesity, excessive alcohol consumption, and physical inactivity.”

The pandemic has made it even more difficult for seniors to meet their social needs, with senior centers, day programs, and other public spaces closed. Many nursing homes have even barred all family members from visiting their loved ones. PACE can be the answer to this crisis, enabling seniors to remain home while still receiving exceptional medical care and socialization and activities.

In the time of Covid-19, it’s clear to me that PACE delivered safely in the home with social engagement is the single best option for seniors to stay healthy, active, and engaged while also more protected from the virus.

Like just about everyone these days, our programs have had to adapt during the pandemic. Historically, the PACE model has been centered around a day center, where participants receive medical treatments and physical therapy, socialize with friends and caregivers, and enjoy meals and activities. We’ve transitioned rapidly to deliver care and services remotely, to participants in their own homes.

We’ve rapidly adjusted the way we deliver care, closing our day centers until it’s safe to reopen and launching a remote care model to serve participants in their homes

At WelbeHealth, our PACE programs around California have shifted to a new model of care we’re calling HomePACE, delivering the same suite of services without the physical day center. We started by deploying 4G LTE “WelbeLink” tablets to participants’ homes. Our care teams use the devices to maintain regular video communications with seniors, making hundreds of calls per day to manage medical needs and complete social and behavioral health check-ins.

To contain the spread of the virus, we’ve moved our entire clinical and administrative team to a work-from-home model, never having two team members in the same room unless absolutely necessary for patient care. When in-person medical care is required, it’s done by a single caregiver in the home whenever possible, minimizing potential exposures to Covid-19. Our teams are also completing regular deliveries of medical supplies and meals to participants who need them, and we’re even resuming many of our usual games and social activities remotely via video.

Other PACE programs around the country are also innovating to continue serving seniors during this time. PACE Southeast Michigan partnered with a local grocer to deliver essential care packages of fresh food to participants each morning. LIFE Senior Services in Oklahoma hosted a drive-thru breakfast for its members. Care Resources PACE in Michigan secured a grant to launch telehealth services for its participants. CHA PACE in Massachusetts partnered with a local paramedic firm to provide 24/7 in-home care for Covid-positive patients. PACE programs in North Carolina helped seniors access live streams of religious services. From the beginning, PACE has been built around nimble and creative solutions to meet seniors’ needs, so it’s no surprise that so many programs across the country have been able to adapt to care for their participants.

Despite its long track record of success, PACE still has a massive opportunity for growth. Even in the healthcare community, many physicians and medical professionals are just learning about the program for the first time. PACE serves just over 50,000 seniors today, but the estimated eligible population is much larger: 2 million or more. Recent regulatory changes have begun to enable programs to grow more quickly and efficiently, and demand is growing as more seniors and families learn about the program.

For those of us who know PACE already, the case is clear. It’s the model of care I’d want for myself as a physician and for my senior family members.

Years from now, when we reflect on Covid-19, we’ll remember all the challenges we faced and the tragic loss of so many lives. I hope, though, that we’ll also be able to appreciate one bright spot: a turning point in the way we think about caring for the most vulnerable people in our communities. In the face of this pandemic, it’s more apparent to me than ever before that PACE has the potential to become the “gold standard” of care for frail seniors across our country.

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For more on WelbeHealth services that safely provide comprehensive care for seniors so that they can live more independently, click here.

Dog Rescue Highlights PACE’s unique Model

One of our Stockton PACE participants was hospitalized for a period of time, leaving her dog along at home.  A member of our care staff came to the rescue, ultimately saving the dog and returning her to her owner.  This video shows one example of our PACE (Program of All-inclusive Care for the Elderly) is different from other senior care models, including nursing homes.  One of core values is our “Courage to Love” and we clearly demonstrated how our love for our participants motivates us to go above and beyond.

Rescuing Daisy Video

To learn more about PACE services, click here.

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