In summary

The pandemic proved the value of programs that help seniors stay in their homes and out of long-term care facilities. The Legislature should expand them.

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By Cheryl Wilson, Special to CalMatters

Cheryl Wilson, president and CEO of St. Paul’s Senior Services of San Diego, serves as vice chair of the board of directors at CalPACE, California’s association of PACE providers,

Eight in ten deaths from COVID-19 nationwide have been among adults aged 65 years and older. Concentrated among long-term care facility residents, these losses are prompting our nation to rethink how we care for seniors with chronic care needs. 

Seniors want care choices and services keeping them in their homes and policymakers are waking up to that fact. The Program for All-Inclusive Care — a California creation — accomplishes this by combining medical and home care, transportation, and other services. 

The state Assembly is set to vote on legislation dictating whether more seniors can access PACE. We must seize the moment to ensure more seniors receive the care they need to age with dignity and independence in their communities.

PACE cares for adults aged 55 and older living with chronic illnesses and disabilities with a high risk of being placed in nursing homes. On average, PACE participants are 76 years old and live with 20 medical conditions. A third have Alzheimer’s Disease. They are among millions of low-income Californians eligible to receive health care through Medi-Cal and, given their age and disabilities, 75 percent are also covered by Medicare.

The American Rescue Plan includes more than $11 billion to enhance and expand home and community-based services such as PACE. If passed, President Biden’s American Jobs Plan would include a $400 billion expansion of community-based care. State leaders must help drive this urgently needed change.

The pandemic revealed participating in PACE is safer for seniors than nursing homes. The virus is lethal to older adults with underlying health conditions. Yet, nearly 16 percent of Californians enrolled in PACE tested positive for COVID-19 — 80 percent less than those in nursing homes. 

PACE’s low COVID-19 infection rates are the result of care innovations. California gave PACE temporary flexibility during the pandemic, simplifying enrollment and authorizing telehealth technology to ease communication between seniors and doctors. Additionally, staff were retrained and redeployed from PACE centers into the homes of seniors for care, helping them overcome isolation while social distancing. These changes made care more accessible for seniors who cannot easily travel to PACE centers for routine services.

 For example, St. Paul’s PACE in San Diego created roving clinics so nurses and general practitioners could visit seniors in their homes providing treatments, medication management and the COVID-19 vaccination. They also provided meals, home care and medication delivery. 

By passing last week Assembly Bill 523, authored by Assemblymember Adrin Nazarian, a Democrat from D-North Hollywood, lawmakers helped ensure these care innovations endure.

PACE is an underutilized resource that could save the state billions in care costs if we unleash its potential. In California, PACE is 40 percent less expensive than nursing home care, saving taxpayers $131 million this year. Unfortunately, most people who could benefit from PACE don’t know it exists. 

Now lawmakers must pass Assembly Bill 540, carried by Assemblywoman Cottie Petrie-Norris, a Democrat from Laguna Beach. This bill would require the state to include information about PACE in Medi-Cal enrollment forms and outreach programs to people who may be eligible.

By passing AB 523 and AB 540, lawmakers will help the state provide the kind of care Californians want. Nearly 90% want services needed to live at home in their communities as they age, according to a new SCAN Foundation poll. California can meet these expectations while improving equity in aging by expanding access to PACE since all seniors cared for by PACE are low-income and more than 80 percent are from communities of color.

California’s senior population is growing and diversifying faster than any other age group. By 2030, 1 in 4 Californians will be 60 or older. Actions now will ensure California meets the care challenges that come with this demographic change. Expanding access to PACE is part of the solution.

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