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PACE Program of All-Inclusive Care for the Elderly Sandra J. Yoro, APD PACE Policy Analyst May 2015

PACE - dhs.state.or.us · The PACE Model PACE is a Medicare and Medicaid national program that offers an array of health and wellness services in a consolidated all-inclusive service

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Page 1: PACE - dhs.state.or.us · The PACE Model PACE is a Medicare and Medicaid national program that offers an array of health and wellness services in a consolidated all-inclusive service

PACE

Program of All-Inclusive Care for the Elderly

Sandra J. Yoro, APD PACE Policy Analyst

May 2015

Page 2: PACE - dhs.state.or.us · The PACE Model PACE is a Medicare and Medicaid national program that offers an array of health and wellness services in a consolidated all-inclusive service

The PACE Model

PACE is a Medicare and Medicaid national program that offers an array of health and wellness services in a consolidated all-inclusive service model.

Medicare and Medicaid funds cover all medically necessary services.

There are no co-pays or deductibles.

Medicare recipients pay a monthly premium for the long-term care and drug benefits.

Recipients can also pay privately for the PACE program if

they do not qualify for Medicare or Medicaid.

Services are coordinated with the service recipient and their team of healthcare professionals referred to as an Interdisciplinary Team.

Page 3: PACE - dhs.state.or.us · The PACE Model PACE is a Medicare and Medicaid national program that offers an array of health and wellness services in a consolidated all-inclusive service

The PACE Model

PACE services include but are not limited to:

Long-term Care Primary Care Laboratory Tests & Procedures Emergency Medical Services Hospital Care Nursing Home Care Hospice/Palliative Care

Specialty Medical Care: Audiology/Optical/Podiatry Therapeutic Services: Physical/Occupational/Speech/Recreational Dental Services Mental Health Services Social Services Medication: Prescription & Over the Counter Medical Supplies Medical Equipment Adult Day Services Transportation

Page 4: PACE - dhs.state.or.us · The PACE Model PACE is a Medicare and Medicaid national program that offers an array of health and wellness services in a consolidated all-inclusive service

The PACE Recipient & Care Team

The PACE Service Recipient is: 55 years old or older

Living in a PACE service area

Able to reside safely in the community

At Nursing Home Level of Care (SPL 1-13)

The PACE Interdisciplinary Team may include: Medical Doctors

Registered Nurses

Licensed Therapists

Licensed Social Workers

Therapeutic Aides

Dieticians

Other Relevant Healthcare Professionals

Page 5: PACE - dhs.state.or.us · The PACE Model PACE is a Medicare and Medicaid national program that offers an array of health and wellness services in a consolidated all-inclusive service

The PACE Recipient & Care Team

Together the Service Recipient & Interdisciplinary Team:

Develop a plan of care that is comprehensive and responsive to the individual’s healthcare and social service needs.

The PACE provider is responsible for meeting all of the healthcare and social service needs identified in the plan of care.

Page 6: PACE - dhs.state.or.us · The PACE Model PACE is a Medicare and Medicaid national program that offers an array of health and wellness services in a consolidated all-inclusive service

PACE Across the Nation

PACE is a national program currently available in 31 states.

Approximately 23,000 people nationwide participate in a PACE program.

Oregon’s PACE program is one of the first and largest in the country.

Currently Oregon PACE service areas include Multnomah and Clatsop counties and parts of Washington and Tillamook counties with expansion

efforts currently underway in Clackamas county.

Approximately 1,100 Oregonians participate in the PACE program.

"PACE did the impossible for my mother. I never thought she would be able to live with us again."

Page 7: PACE - dhs.state.or.us · The PACE Model PACE is a Medicare and Medicaid national program that offers an array of health and wellness services in a consolidated all-inclusive service

PACE In Oregon

The State of Oregon supports the expansion of the PACE program and PACE providers statewide.

The Department of Human Services-Office of Aging and People with Disabilities currently contracts with Providence Health & Services to provide PACE program

services in the current PACE service areas in Oregon.

Providence identifies/brands the PACE program as Providence ElderPlace.

Services are delivered by Providence ElderPlace staff and/or contractors that make up a network of hundreds of healthcare providers.

About Providence Health & Services Providence Health & Services in Oregon is a not-for-profit Catholic

network of hospitals, care centers, health plans, physicians, clinics, home health care and affiliated services guided by a Mission of caring that the

Sisters of Providence began in the West nearly 160 years ago.

Page 8: PACE - dhs.state.or.us · The PACE Model PACE is a Medicare and Medicaid national program that offers an array of health and wellness services in a consolidated all-inclusive service

PACE In Oregon

Providence ElderPlace Service Areas

ALL OF MULTNOMAH COUNTY

CLATSOP COUNTY Arch Cape, Astoria, Cannon Beach, Hammond, Seaside, Tolovana Park

TILLAMOOOK COUNTY

Manzanita, Nehalem, Wheeler

WASHINGTON COUNTY Beaverton, Tualatin, Cornelius, Forest Grove, Hillsboro, Sherwood, Portland

CLACKAMAS COUNTY (2016)

Portland, Happy Valley, Clackamas, Lake Oswego, Marylhurst, Gladstone, West Linn, Tualatin, Oregon City

Page 9: PACE - dhs.state.or.us · The PACE Model PACE is a Medicare and Medicaid national program that offers an array of health and wellness services in a consolidated all-inclusive service

ElderPlace Health & Social Centers

ElderPlace Health and Social Centers offer service recipients comprehensive integrated care from an ElderPlace team of healthcare and social service

professionals.

If service recipients are unable to attend a Health and Social Center, their team will visit them at home. In addition to receiving healthcare services at the Center,

recipients have the opportunity to participate in social and recreational activities to include a nutritious lunch.

Transportation is provided to and from ElderPlace Health and Social Centers and may be available for medical appointments outside of the Center.

Page 10: PACE - dhs.state.or.us · The PACE Model PACE is a Medicare and Medicaid national program that offers an array of health and wellness services in a consolidated all-inclusive service

ElderPlace Service Sites

.

Cully Residential Care Facility & Health and Social Center 5119 NE 57th Avenue Portland, OR 97218 Ph.: 503-215-8050

Glendoveer Residential Care Facility & Health and Social Center 13007 NE Glisan Avenue Portland, OR 97230 Ph.: 503-215-7850

Irvington Village Assisted Living Facility & Health and Social Center 420 NE Mason Street Portland, OR 97211 Ph.: 503-546-9292

Page 11: PACE - dhs.state.or.us · The PACE Model PACE is a Medicare and Medicaid national program that offers an array of health and wellness services in a consolidated all-inclusive service

ElderPlace Service Sites

Health & Social Centers Only Beaverton

14255 Brigaddon Court Beaverton, OR 97005 Ph.: 971-246-5240

Gresham 17727 E. Burnside Avenue Portland, OR 97233 Ph.: 503-215-9800

Lambert House 2600 SE 170th Avenue Portland, OR 97236 Ph.: 503-760-2075

Page 12: PACE - dhs.state.or.us · The PACE Model PACE is a Medicare and Medicaid national program that offers an array of health and wellness services in a consolidated all-inclusive service

ElderPlace Service Sites

Health & Social Centers Only Laurelhurst

4540 NE Glisan Street Portland, OR 97213 Ph.: 503-215-3738

Marie Smith Health & Social Center 4616 N. Albina Avenue Portland, OR 97217 Ph.: 503-335-9980

North Coast 1150 N. Roosevelt Drive Suite 104 Seaside, OR 97138 Ph.: 503-215-6556

Page 13: PACE - dhs.state.or.us · The PACE Model PACE is a Medicare and Medicaid national program that offers an array of health and wellness services in a consolidated all-inclusive service

PACE Resources

Sandee Yoro, PACE Policy Analyst Direct Line: 503-947-1136 Email: [email protected] PACE Oregon Toll-free: 1-844-224-7223

Providence ElderPlace Administration: 503-215-6556 http://oregon.providence.org/our-services/p/providence-elderplace/

Medicare.gov PACE Overview http://www.medicare.gov/your-medicare-costs/help-paying-costs/pace/pace.html

Centers for Medicare & Medicaid PACE Fact Sheet http://www.cms.gov/Medicare/Health-Plans/pace/downloads/PACEFactSheet.pdf

National Pace Association www.npaonline.org

Page 14: PACE - dhs.state.or.us · The PACE Model PACE is a Medicare and Medicaid national program that offers an array of health and wellness services in a consolidated all-inclusive service

Honoring PACE

This video was produced in 2014 by the National PACE Association.

The Centers for Medicare & Medicaid Services incorporated the video in a PACE training program.

PACE

https://www.youtube.com/watch?v=ZxLzb6tRVRM&feature=youtu.be

On August 19, 1988, President Ronald Reagan issued Proclamation 5847 designating August 21st as National Senior Citizens Day.