A bill that began winding its way through California’s Legislature last week could become a model for how states expand Programs of All-Inclusive Care for the Elderly. If passed, it would require California to provide dual eligible Medicare and Medicaid beneficiaries with literature about PACE the same way it now does for other managed care plans.
“There just isn’t enough widespread awareness around PACE and this model of care,” PACE operator Maria Zamora, CEO of the Center for Elder Independence, told McKnight’s Home Care Daily. “We aren’t asking for preferential treatment, but we are asking to be put on equal footing with other plans, particularly for this subset of the population that we serve so well.”
PACE provides comprehensive medical and social programs for certain frail seniors and disabled adults who qualify for skilled nursing, but can remain in their homes. Those services, along with meals and activities, are provided at PACE centers. During the pandemic, most of those services were provided in participants’ homes.
The relatively little-known program has been around for more than three decades and is offered in 31 states through Medicaid, but there are only about 55,000 seniors and disabled adults currently enrolled in PACE nationwide. With 13,000 PACE clients, California has the largest number of PACE participants in the nation in large part because it doesn’t cap the number of enrollees. Still, California PACE Association President Peter Hensel said the program isn’t attracting the number of clients it should.
“The National PACE Association estimates that enrollment could be 10 times higher, so we are currently meeting only about 10% to 15% of the need,” Hensel told McKnight’s Home Care Daily. “So there are many more eligible people who could benefit from it.”
PACE’s stature has been elevated in recent months as the Biden administration pushes to expand home-and community-based services through its $3.5 trillion budget. In April, Sen. Bob Casey (D-PA) also introduced the PACE Plus Act to strengthen the program by expanding access to it.
Hensel said the California bill has garnered bipartisan support in both the state assembly and senate, as well as support from advocacy groups for the elderly. He is confident it will be passed during this legislative session — and could eventually be copied elsewhere.
“Much of what we do is emulated in other states, so I wouldn’t be surprised if these concepts get picked up by others,” Hensel said.