Tag Archive for: program of all-inclusive care for the elderly

WelbeHealth center in Modesto

WelbeHealth Modesto Center Opens to Serve Medically Frail Seniors

Physician-led healthcare organization WelbeHealth and Northern California-based healthcare network Sutter Health have opened a new center in Modesto that serves medically frail seniors.

Located at 1224 Scenic Drive, the center is designated a Program of All-Inclusive Care for the Elderly (PACE) alternative care setting. Integrated with WelbeHealth and Sutter’s PACE center in Stockton, the new Modesto location provides day services to PACE-eligible medically frail seniors age 55 and over. The center, which will employ more than 100 full- and part-time employees when at capacity, features:

  • Physical and occupational therapy
  • Personal care and supportive services
  • Meals and nutritional counseling
  • Recreational therapy
  • Access to in-home care and mobile clinic

The new Modesto center addresses a community need, since only a fraction of the over 3,000 PACE-eligible seniors in Stanislaus county are receiving PACE services, according to a WelbeHealth analysis of U.S. Census data and the Medi-Cal Managed Care Enrollment Report.

“WelbeHealth was built on the mission of serving our most vulnerable seniors with greater quality and compassion in underserved communities,” said WelbeHealth CEO Si France, M.D. “As the first provider of PACE services in Modesto since 2019, we are proud to complement our care with a beautiful facility.”

PACE is a national Medicare and Medicaid program that helps keep seniors living in their own homes instead of nursing homes. PACE programs are proven to reduce depression, lower hospitalizations, decrease rehospitalizations, reduce nursing home admissions and improve preventive care, according to recent data from the National PACE Association.

“We are proud to partner with WelbeHealth to enrich the lives of seniors, their caregivers and the broader community,” said Christopher Stanley, M.D., Sutter Health’s chief population health officer. “WelbeHealth shares our commitment to high-quality, community-based healthcare services that help frail older adults anticipate problems and prevent hospitalization or early entry into a nursing home.”

Todd Smith, M.D., foundation area CEO for Sutter Health in the South Valley, said that the importance of good health for aging seniors can’t be underestimated.

“Creating greater access to comprehensive home and community-based healthcare services helps seniors achieve their best health and maintain their independence,” Dr. Smith said.

In addition to the new Modesto center, WelbeHealth has locations in Stockton, Pasadena, Long Beach and Fresno. More than 1,500 seniors were served in 2021. Sutter Health is a not-for-profit integrated health network that serves more than 3 million people in 22 California counties.

Contacts

Jennifer Wezensky
269-274-4071
jennifer@jwprmarketing.com

General Counsel

Blaire Bernard Joins WelbeHealth as General Counsel 

MENLO PARK, CALIF.—Physician-led healthcare organization WelbeHealth today announced that veteran healthcare law attorney Blaire Bernard has joined its leadership team as general counsel. 

Bernard has focused her 20-year legal career on supporting providers whose mission is to expand access to value-based care. Most recently she was general counsel at Iora Health and after Iora Health was acquired by One Medical, she served as senior counsel and compliance officer. She earned a bachelor’s degree from Dartmouth College and a law degree from Boston University. 

“We’re thrilled to have Blaire join our executive team,” said WelbeHealth CEO Si France, M.D. “She is a seasoned value-based care executive and a collaborative mission-driven team player. This is even more important as we continue our focus on clinical and care excellence as a public benefit company.” 

Bernard will lead WelbeHealth’s legal and compliance functions, partnering with executive and operational leaders to execute the company’s mission of bringing PACE to communities in need.  

WelbeHealth recently became the first Program of All-Inclusive Care for the Elderly (PACE) provider to convert to a public benefit company, meaning it is obligated to take into consideration the concerns of all stakeholders while prioritizing corporate responsibility and sustainability. An alternative to nursing homes, PACE is a Medicare and Medicaid program that helps keep people in their communities. 

Founded in 2015, WelbeHealth provides comprehensive home-based medical and social services to vulnerable seniors across California, including the cities of Stockton, Modesto, Pasadena, Burbank, Long Beach and Fresno. For more information, please visit welbehealth.com.   

Doctors and nurses coordinate hands

WelbeHealth Becomes First Program of All-Inclusive Care for the Elderly (PACE) Provider to Convert to Public Benefit Company Status 

FOR RELEASE: IMMEDIATE

DATE: 6/29/2022

WelbeHealth Becomes First Program of All-Inclusive Care for the Elderly (PACE) Provider to Convert to Public Benefit Company Status  

MENLO PARK, CALIF.— Physician-led healthcare organization WelbeHealth recently became the first Program of All-Inclusive Care for the Elderly (PACE) provider to convert to a public benefit company (PBC).

Founded in 2015, WelbeHealth is a leading California PACE provider. An alternative to nursing homes, PACE is a Medicare and Medicaid program that helps keep people in their communities. WelbeHealth provides comprehensive home-based medical and social services to vulnerable seniors across California, including the cities of Stockton, Modesto, Pasadena, Burbank, Long Beach and Fresno.

In joining other companies that have become public benefit companies, including Patagonia, Seventh Generation and Vital Farms, WelbeHealth is exemplifying its commitment to helping seniors thrive and live longer, said WelbeHealth co-founder and CEO Si France, M.D. 

“The seniors we serve are the elders of their communities and families,” Dr. France said. “By helping them thrive, they can live longer lives with greater connection, vitality and meaning. We’re converting to a public benefit company to ensure that our mission and purpose are protected for generations to come.” 

Public benefit companies are obligated to take into consideration the concerns of all stakeholders, not just shareholders, prioritizing corporate responsibility and sustainability. For WelbeHealth, this means participants, their families and caregivers, employees, and the broader community.  

“Both our independent board and management team wanted to formalize WelbeHealth’s commitment to its mission, clinical quality and positive community impact,” said WelbeHealth Board of Directors member Robert Margolis, M.D., founder of the Duke-Margolis Center for Health Policy. “By converting to a public benefit company, WelbeHealth is demonstrating its commitment to operating responsibly, sustainably and in the interest of all stakeholders, both now and in the future.”

This commitment to the greater good is not new. In fact, WelbeHealth was lauded for its elder care during the pandemic. A case study conducted by UC Berkeley found that WelbeHealth had a death rate more than 1.5 times lower than other PACE organizations and almost five times lower than nursing homes while, despite serving patients in some of California’s most impacted counties.  

“As the pandemic came in waves, WelbeHealth mobilized not only to vaccinate its own participants but to also vaccinate thousands in the greater community, which had an exponential impact on saving lives,” Dr. France said. “We want to take full responsibility for our part in making the world a more compassionate, loving place.” 

About WelbeHealth 

Founded in 2015, WelbeHealth is a physician-led organization that coordinates senior care, including all medical and dental care, physical and occupational therapy, transportation to medical appointments, meals and personal care services. WelbeHealth teams close the loop on comprehensive care to keep the most vulnerable seniors living safely in their own homes. WelbeHealth delivers these services through the Program of All-Inclusive Care for the Elderly (PACE), a Medicare and Medicaid program. WelbeHealth operates four programs in California:  Stockton/Modesto, Pasadena/Burbank, Long Beach and Fresno. For more information, please visit welbehealth.com

Together in a time of need

Coming Together in a Time of Need

When Libby Renshaw, Home Health Registered Nurse at WelbeHealth, visited Jim at his West Hollywood apartment, she became very worried, very fast. It was his first day home after multiple seizures had led to a 17-day hospital stay, followed by a month in a skilled nursing facility. She knew coming together in his time of need was critical.

“As I sat with him, I saw that he had severe tremors in his arms and hands,” says Libby. “His muscles were weak from being bedridden, and I also noticed significant memory impairment.”  

All of this was making even simple activities extremely difficult. The hand tremors were especially concerning because they made it hard for him to eat, and he couldn’t administer the insulin he needed to treat his diabetes.  

Jim had a caregiver on site that day, thanks to the quick work of WelbeHealth’s Home Care Coordinator, Michael. In addition, Jim’s good friend Amir was there and said he could assist. But these were only temporary solutions.  

“Living alone at home seemed unrealistic,” Libby says. She gently told Jim that he might need to go back to the skilled nursing facility, and she could tell that he was devastated.  

“He desperately wanted to be at home,” she recalls. “After I left his apartment, I got on a conference call with the care team. We all agreed that we would do everything possible to keep him living at home.” 

After the call, each WelbeHealth team member got to work on their part of the plan. When Libby returned to the apartment the next day, she was amazed by what she saw.  

Physical Changes All-Around 

WelbeHealth team including a physical therapist, occupational therapist, and a dietitian. They came together during Jim's time of need.
Care Team Members

WelbeHealth Occupational Therapist, Christine Gaw, had set up many solutions to make daily tasks easier for Jim.  

That day, he received a new bed rail to get out of bed more easily, and a bedside commode to avoid walking to the bathroom at night. Christine also installed a toilet riser and a shower bench to make the bathroom safer and more usable.  

She brought in a chair cushion, both for comfort and to prevent pressure ulcers, and she arranged for a recliner chair to help Jim transition from sitting to standing.  

Christine had also hunted down adaptive shoelaces—a big deal because Jim kept mentioning that he could no longer tie his shoes. 

Fitness and Food  

The apartment was humming with other team members, as well. Pam, Jim’s assigned Physical Therapist, was teaching Jim and his friend Amir a home exercise and walking program.  

Claire, Jim’s Dietitian, talked to Amir about good food for Jim. She provided ideas and recipes that tracked Jim’s preferences and would also help him manage his chronic conditions.  

Claire and Amir also talked about monitoring blood glucose levels and keeping a log to share with the dietary and medical teams. Claire noted that, in addition to using insulin, Jim could help keep his diabetes in check through his diet. 

Managing Medication  

On the medical side, Jim’s Primary Care Provider Lauren, with help from Registered Nurse Case Manager Jennifer, simplified Jim’s diabetes medications. He went from five insulin injections per day to one.   

Lauren also started Jim on medication to help reduce the tremors. She also educated both Jim and Amir on the side effects of Jim’s new seizure medication and answered all their questions.  

One Request Makes a Big Change 

Even with all these improvements, Jim and the WelbeHealth team were still concerned about whether he could safely navigate through his home, prepare his meals, and remember to take his medication. He clearly needed regular and consistent home care.  

WelbeHealth could arrange for this, but then Amir offered an even better solution; he could move in and care for Jim. Everyone agreed this was a great idea, but there was one problem. Because Jim was in Section 8 housing, strict rules applied. He could have no extra occupants and was concerned about losing his apartment since he didn’t want to violate the rules. 

WelbeHealth Social Worker, Twyla, delivered a solution by requesting a ‘reasonable accommodation’ through Section 8. With this change, a caregiver would be allowed to live in the apartment with Jim. 

Ongoing Support  

Today, WelbeHealth’s Physical Therapist continues to visit and work on conditioning and balance. And the Home Care Coordinator arranges caregiving support to support Amir and Jim. Other team members are available to help whenever needed and answer questions. 

Libby saw Jim recently and was heartened to see he was doing well. “He looked so good, and he was practically walking independently,” she says.  

Ultimately, Libby says, the experience showed her that the people at WelbeHealth don’t hesitate to go above and beyond for their participants.  

“This really is the embodiment of our values,” she says. “It is Courage to Love, Pioneering Spirit, and Shared Intention—all coming together. We provided what this vulnerable senior needed to ‘unlock his full potential’ and live independently in his community. It is a beautiful sight to see.” 

Activities for seniors

Engaging Activities for Seniors of All Ability Levels

For many older adults, staying active is a priority. Keeping up with friends, exercising, and giving back to the community brings fulfillment and joy. WelbeHealth helps facilitate meaningful physical and mental activities for seniors of all abilities.

“At WelbeHealth, activities for are adaptable to any level of ability. We find ways for every participant to engage,” says Esther De Santiago, Engagement Supervisor, Adult Engagement and Activities in Stockton. “These activities are done in a group setting. It is wonderful how the other participants cheer each other on.”

Festive Activities for Seniors

Many of our participants’ favorite activities for seniors are related to holidays and other special occasions. Our centers celebrate birthdays monthly, and national holidays are also celebrated, such as Veteran’s Day. This year, one center honored participant Veterans by giving them a certificate and a special pin to wear.

The Day of the Dead (Dia De Los Muertos) is a two-day Mexican holiday that reunites the living and the dead. Families create offerings to honor their loved ones who have passed on. Participants and staff at one WelbeHealth center worked together to create an altar to honor their friends and family members who have died. They read poetry to express their emotions and remember their loved ones.

Each Halloween, WelbeHealth staff and participants like to dress up in costumes. You’ll find all kinds of spooky characters at our centers––and Halloween candy, of course!

Thanksgiving is always a special time at WelbeHealth. Our centers serve a special candle-lit meal, display fall decor, and share what they are thankful for. After Thanksgiving, there is always lots of holiday cheer! Festive activities, meals, and decor make our centers cheery and bright all the way through New Year’s Day!

Sprint craft activity
Seniors at WelbeHealth do a craft activity.

Educational Activities

Malcomb Forbes, an American entrepreneur, said “It’s never too late to learn.” At WelbeHealth, we agree! Our activity directors bring in guest speakers to present on interesting topics such as poetry, history, and music. We’ve even had Hawaiian dancers come to share and give a hula performance.

We’ve also found that our very own staff and participants are extremely talented. We sometimes give a participant a little tap on the shoulder and ask if they’d like to present their expertise to the center. One of our participants gave a virtual presentation on her writing and art to her peers. She hopes to present in person eventually. We also had an amazing performance by a participant who is an expert in African dance and belly dancing.

One WelbeHealth staff member is a fire-breather. His performance really “lit up” the expressions of the center staff and participants!

Creative Activities

Many of our participants love to get their creativity flowing. Creative activities for seniors like embroidery, origami, knitting, and crocheting are done at the centers.

“Creative projects are something that people of all ages can engage in,” says De Santiago. “When you finish a project and realize that you created something, it can be very satisfying. Plus, we all have fun sharing ideas and creating together.”

Some participants have given back to the community through creative arts. At one WelbeHealth center, a group of participants crochet and knit clothing items to donate to a local NICU. The babies in the NICU get an article of clothing made with love by WelbeHealth participants, and participants get the fulfillment of serving these precious babies and their families.

Entertaining Activities for Seniors

We have a lot of fun at our day centers. If you ask us, fun includes dancing and singing! Participants of all abilities can engage in singing and some form of dancing. Activity directors always adjust so no one is left out of the merriment!

Thriller by Michael Jackson is a classic spooky tune played around Halloween. The famous “thriller dance” accompanies the 1982 song. At one center, participants and staff learned the Thriller dance,  standing or while seated in a chair. Laughter and cheers were shared by all!

Karaoke is a favorite activity for seniors at WelbeHealth. Many of our participants are vocally gifted and love to belt out a song for their peers. Whether you can carry or tune or not, staff and participants always cheer each other on. Whoever has the microphone is guaranteed to feel supported and celebrated!

Exercise Activities

We know that exercise is good for our bodies. It can be great for our minds too! That’s why WelbeHealth incorporates exercise into the daily list of activity options. For those who want to participate in the exercise activities, there are always modifications that can be made. Participants of all ability levels can take part and benefit from the movement.

Exercise activities done in the WelbeHealth centers include:

  • Chair Zumba: An exciting dance workout usually done alongside Latin-inspired music.
  • Tai Chi: A gentle exercise that promotes balance and stretching.
  • Therabands: Band exercise that provides light resistance to strengthen muscles.
  • Group Dance: Led by rehabilitation therapists, this is a fun, light aerobic exercise.

Supportive Activities for Seniors

WelbeHealth participants make it a point to support one another in times of loss and grief. Our participants are never alone in their pain. Each of our centers has support groups to connect participants and allow them to share their story and encourage one another.

As an example, the Forever Friends support group consists of participants and one WelbeHealth staff facilitator. The purpose of the group is for participants to support their peers as through life transitions.

In addition to support groups, WelbeHealth offers mental health services. Combined, support groups and counseling can provide the mental and emotional support seniors need to navigate loss and grief.

Join in the Fun at WelbeHealth

As you can see, there are a lot of activities for seniors at the WelbeHealth centers. An activities calendar is available to participants and their families, so they can see all that is offered. Our activities directors are open to suggestions too!

Learn more about becoming a WelbeHealth participant.

Trevor Moawad, Getting to Neutral

WelbeHealth’s Approach to Navigating the Pandemic Saves Lives

COVID-19 Hits the U.S.: Re-Prioritize and Plan

As the reality of the COVID-19 pandemic began to unfold in March of 2020, WelbeHealth’s CEO, Dr. Si France, and the company’s President, Dr. Matt Patterson, grew increasingly concerned. Information about the virus was still incomplete, but it was clear that WelbeHealth’s population of vulnerable seniors was at high risk from COVID-19. The two leaders spent the weekend of March 14 and 15 creating a plan to help ensure that patients (known as “participants”) and employees would survive the next few months. “We knew that we had to act immediately to save lives, and the best way to do that was to downshift to neutral,” says France.

Over the course of the next few days, the company leaders reevaluated their priorities and replaced them with an intentional focus on a neutral mindset and commitment to the things they could control.

A Neutral Mindset Becomes an Important Tool

WelbeHealth’s successful approach to protecting its employees and participants during the pandemic is featured in the recently released book by Trevor Moawad, “Getting to Neutral.” According to Moawad, many people are alive today, because WelbeHealth’s “dedicated staff took the right next step.”

WelbeHealth’s next steps prioritized the safety of their employees, families, and the seniors in WelbeHealth’s Program of All-Inclusive Care for the Elderly (PACE). The organization used the framework of a neutral mindset to navigate the difficult decisions throughout the pandemic: neither being overly optimistic nor falling prey to the trappings of negativity.

Because of WelbeHealth’s neutral approach, leaders were able to respond to the pandemic in a unique way. When pandemic news became overwhelming, the leadership team encouraged team members to manage their intake, and brought just the facts of the pandemic to the staff on a regular basis. This way, the organization could evaluate the changing situation without judgement, and move forward with plans to minimize the impact of the virus on their frail senior population.

France and Patterson led weekly meetings to inform, update, and encourage all employees to adopt a neutral mindset. Staying neutral allowed WelbeHealth employees to focus on what they could control and their 3-part daily checklist:

1. Read the plan of the day.

2. Execute your assignment.

3. Take care of yourself and your family.

Flexibility in Business Model

Because WelbeHealth is led by mission-driven doctors who oversee operations, clinical departments, growth efforts, and more, the team understood what was at stake, and was quick to act when the pandemic arrived. Before the end of March 2020, WelbeHealth became the first PACE organization to launch an emergency response, and shifted to delivering medical care using a home-based model instead of through the facilities. As part of this model, WelbeHealth became the first company of its kind to provide every participant with a mobile tablet device so they could interact with their medical providers, care team, and other program participants.

As soon as vaccines were available, the company became the first, non-hospital-operated PACE to vaccinate its participants as well as team members. The team also partnered with Central Valley and LA counties and volunteered on weekends to organize vaccination clinics and vaccinate 1,900 seniors and frontline workers in WelbeHealth communities.

Knowing that people were one hundred times more likely to die of COVID-19 if they are not vaccinated, the WelbeHealth team went to work educating its participants on the importance of vaccinations. The company mobilized to provide COVID-19 vaccinations to its seniors, reaching a rate of vaccination significantly higher than the population at-large, with over 90% vaccination rate.

Results of Operating from a Neutral Mindset

WelbeHealth’s neutral mindset, flexibility, and focus on vaccinations statistically saved the lives of many of their participants compared to what would normally be seen in this frail population of seniors. With a much lower rate of COVID-19 death rate than skilled nursing facilities, it’s estimated that over 100 seniors are alive today because they enrolled in WelbeHealth’s program.  As the pandemic continues, the number of lives saved by the company’s safety measures continues to grow.

France says, “Each Welbe team member plays a part in making the world a more compassionate, loving place. The legacy of WelbeHealth’s work will reverberate for generations. By helping our participants thrive and live longer, they are able to extend their profound influence to their families and communities.”

Happy senior

Medi-Cal Changes for Seniors: Free, On-Demand Webinar

WelbeHealth has a new, on-demand webinar for seniors, caregivers, and others to learn about the expanded Medi-Cal eligibility criteria in 2022. These changes will allow more people to access Medi-Cal coverage, and some seniors could become newly eligible for WelbeHealth or other PACE programs.

To watch our webinar, click on the graphic below, or visit welbehealth.com/medi-cal for English, or welbehealth.com/seminarioweb for Spanish.

Could you now be eligible for PACE?

WelbeHealth’s PACE provides all-inclusive coordinated care. For some California seniors, the Medi-Cal changes may mean you become newly eligible for PACE programs such as WelbeHealth.

You may have questions about the expanded Medi-Cal services and health coverage. WelbeHealth has experts to help you learn if you may qualify for Medi-Cal and WelbeHealth’s PACE services. Call us at (888) 530-4415, TTY (800) 735-2922 to learn more.

Elder Fraud: How to Protect Yourself

The FBI estimates that American seniors lose $3 billion a year to elder fraud. Unfortunately, scammers often target seniors because they can be trusting and may have built up a healthy savings account over their lifetime.

Being aware of scams targeting seniors can help you protect yourself. It’s important to recognize the common tactics used in elder fraud so you know if it is happening to you or a loved one before it is too late.

What is Elder Fraud?

Elder fraud is any fraud that targets older adults. Scammers may target seniors by phone call, text message, email, or mail.

For victims, the financial impact of elder fraud can be devastating. The average victim of elder fraud loses around $34,000. Not only does it take a toll financially, but being a victim of fraud can hurt your mental and emotional health too.

Common Scams that Target Seniors

During the pandemic, there has been an increase in scams targeting seniors. As older adults spent more time online to connect with friends and family, fraudsters targeted seniors through emails and other online avenues.

Here are some of the top scams targeting seniors.

  • Romance Fraud
    The criminal targets widows and single elders, earning their trust. Eventually, the scammer asks for small sums of money and then larger.
  • Fake Grandchild
    Scammers will call a senior and say something like, “Hi Grandma, it’s your favorite grandchild.” Then they ask for money for rent, a car repair, or similar.
  • Charity Scams
    Using a fake charity name, criminals ask seniors to donate to a charity that supports a good cause. Online fund-raising pages can also be fraudulent.
  • Government Impersonation
    Criminals claim they work for the government and tell elders they’ll be prosecuted or fined if they do not comply with their request.
  • Tech Support Schemes
    A pop-up appears on the computer screen and says to call a number to resolve a computer issue. When the senior calls, the scammer poses as a tech support representative. They pretend to “fix” the computer remotely while gaining access to sensitive information and asking for payment in return.
  • Sweepstakes and Lottery Scams
    Criminals call or email claiming that the designated senior has won a prize. They say that an initial payment needs to be made by the individual to gain access to the prize.
  • Phishing Emails
    Phishing emails may look like they’re from a company you know or trust. Scammers disguise themselves to gain access to your passwords, bank account numbers, and other sensitive information.
  • Widow Schemes
    Scammers will call a surviving spouse after losing a husband or wife. They claim to work for a financial institution associated with the deceased spouse and claim they need money to pay for fees, overdue bills, etc.

How to Avoid Being a Victim of Elder Fraud

Scammers are always creating new tactics and avenues to target seniors. Here are steps you can take to stay on guard and protect yourself.

Hang Up and Call Back

Scammers often disguise themselves as a business or organization you’re familiar with. They may even disguise their number, so it looks like you’re receiving a call from a local area code. If you receive a call from a person claiming to be from your bank, the Social Security Office, or a particular charity, and they ask for personal information, hang up.

Then, find your most recent bank statement or the official phone number online and call back. This ensures that you speak with the legitimate organization or business.

Be Careful of Links and Attachments

Even if you know and trust the individual who sends you a link via email, social media, or text message, be cautious before clicking on it. You may want to call your friend or family member to verify that they sent you the link. Clicking on suspicious links can lead to viruses or spyware being downloaded to your device–something you want to avoid.

Be Aware of Acquaintances

Sadly, scammers aren’t always strangers. Be cautious when lending money to friends or family members with addiction issues, financial difficulties, or a history of criminal activity.

Reporting Elder Fraud and Scams

If you think you may be a victim of elder fraud, reach out to someone you trust. Don’t feel embarrassed. It’s important to address the issue before it becomes worse.

You can also report the scam to the local police, file an internet crime complaint, or call your local FBI office. Reporting the crime is the first step in getting the scam shut down so other seniors won’t be defrauded.

Lisa Gildea, dental hygienist, and Florentino

Dental Care Helps Seniors and Their Family Caregivers

At WelbeHealth, health care and dental care are integrated and coordinated. Once a medical provider does an initial assessment of a senior entering our program, the senior sees our dental team for preventive dental care and any necessary dental treatments.

Lisa Gildea, an RDHAP (Registered Dental Hygienist in Alternative Practice) at WelbeHealth, has made a difference in the lives of many seniors including Florentino, age 92, and his adult daughter and caregiver, Patricia.

A Caregiver’s Experience

Patricia has been delighted with the services WelbeHealth provides for her father, Florentino, especially the dental services and the in-home support they receive from Home Instead Agency—all provided through the WelbeHealth program. Patricia says, “The regular assistance with quality care from WelbeHealth and the Home Instead Caregivers allows me to continue working my full-time career, while still taking care of my father and my home. I cannot emphasize enough how much peace of mind this generates. If I can pull it off, anyone can. Just don’t give up.”

Patricia says, “Lisa Gildea has been extraordinary with my father. I have never experienced dental customer service like Lisa provides through the PACE program. Lisa spends significant time with me on the phone both before and after each of my father’s dental appointments. She assesses his situation, provides me with the supplies we need for his dental care, and answers all my questions.”

For Patricia, whose father still has a beautiful full set of teeth, it is important to help maintain his teeth now that he can’t do it for himself. Patricia says, “My father spent a lifetime taking care of his teeth, and now it is my turn to help keep them in good condition. As a caregiver, it is important to stay optimistic and tenacious. We have to persevere in finding ways to advocate and take care of ourselves and the elderly in our family and community.”

Patricia continues, “WelbeHealth sets up all his appointments, provides Lisa for his dental care, and picks him up for his appointments. They don’t give up on their geriatric patients. My father really responds to Lisa. She is creative with how she cleans his teeth, is kind, nurturing, and he picks up on that.”

Lisa Gildea and Florentino in a WelbeHealth center

Lisa Gildea and Florentino in a WelbeHeath center

Medical and Dental, all Under One Roof

Lisa Gildea talks about WelbeHealth’s integrated medical and dental services to seniors at community presentations in the Stockton and Modesto areas of California.

The presentations cover the services that WelbeHealth provides to qualifying seniors, with a special focus on its dental services. In each presentation, Gildea provides supplies for tooth brushing and flossing, and dental education such as diet, how to brush teeth and how to floss.

Table with supplies and educational materials at outreach event

Supplies and education for seniors at an outreach event

Gildea explains to senior groups that a WelbeHealth dentist typically handles the first dental visit. The dentist takes a set of x-rays, does an exam, and then explains the cleaning needs and treatment plan to the dental hygienist.

Gildea says, “I do an assessment, a cleaning, fluoride treatment, and put each senior on a routine maintenance and preventative care plan.” She adds, “At WelbeHealth, our goal is to keep seniors as healthy as possible while living in their own homes and communities.”

Gildea says there are advantages to having medical and dental all under one roof. “I can quickly talk to other providers if the senior needs a prescription, for example. Everybody understands what the senior needs—that’s part of the all-inclusive nature of the service.”

WelbeHealth transportation brings seniors to the day center for their appointments. Gildea says, “Many seniors don’t have their own transportation, so it is all pre-arranged according to their needs. If a senior comes in for a cleaning, they can also go to other appointments at the center that day, such as a routine medical check-up, lab work, or physical therapy. This minimizes the number of trips and separate appointments needed.”

Lisa Gildea at community outreach event

Lisa Gildea educates seniors at community outreach events.

The Importance of a Healthy Smile

A healthy smile can boost seniors’ confidence, keep them eating nutritious foods, and promote good health. Gildea says, “Many seniors have worked an entire lifetime and haven’t had access to dental care. I love providing seniors access to dental care to bridge that gap. At WelbeHealth, I have the flexibility to do what is best for the individual.”

Gildea continues, “Helping a senior go from poor oral health to good oral health is very rewarding. And it makes my job feel so much bigger than just doing dental cleanings. I teach seniors about the importance of good daily dental habits and routine dental care. The results are incredible and valuable because our general health is connected to our oral health.”

Gildea says she also enjoys helping seniors go from feeling nervous or fearful about their dental hygiene visit to being comfortable and excited about their visits.

COVID-19 Considerations

With COVID-19 still active in our communities, seniors are often concerned about safety. Gildea says, “WelbeHealth is very cautious about COVID-19, and has good safety measures in place. The pandemic also highlights a growing need to see seniors at home. When needed, I can visit seniors safely where they live.” Gildea takes a portable dental unit to home appointments with all the comforts of the dental office, and she has mobile X-ray equipment.

Gildea says, “Some seniors are in memory care and cannot get to the dental suite, so going to them can be the best option for their dental care.”

Comprehensive Care

WelbeHealth is unique, as it serves as both the payor and the provider. There are no outside restrictions on services such as dentures, extractions, crowns, or fillings. The dental hygienist can do deep cleanings and create maintenance schedules that fit the individual’s needs.  The dentist and dental hygienist collaborate and share information to create a treatment plan that best accommodates the patient.

Seniors enjoy the benefits of personalized and coordinated medical and dental care and have access to activities and socialization along with meals at the center. Depending on the need, Gildea will see between four and six seniors in a typical day. Gildea says, “WelbeHealth allows me to take my time with each senior, and to see them as often as I feel is necessary. This setting gives me the freedom to make decisions based on what is best for the individual.”

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).