PACE Program Allows Elderly To Receive Care At Home
Time catches up with all of us. You have gotten older and your health has begun to fail. But as an important and active part of your community, you would not choose to live in a nursing home or convalescence facility.
When your health requires specialized care, but you want to remain in your home and community, you can enroll in the PACE Program.
What Is PACE?
PACE stands for the Program of All Inclusive Care for the Elderly. It was introduced California in 1990 as five different healthcare programs. By 1998, the State of California has the authorization of creating 10 programs, although currently it has only five in operation: AltaMed Senior BuenaCare, On Lok Lifeways, Community ElderCare of San Diego dba Saint Paul's PACE, Center of Elders' Independence, and Sutter SeniorCare.
The PACE programs' plans are available depending on where you live in California and what your zip code area is. PACE currently covers residents living in the Los Angeles, Alameda, San Francisco, Santa Clara, Sacramento, Contra Costa, and San Diego counties.
PACE offers eligible Californians health care services that are similar to the services they would receive if staying in a nursing home. Yet PACE allows you to receive these services at home and will provide transportation to see doctors and specialists depending on your particular needs. This program saves on nursing home health care costs that can be placed in other health care services.
The PACE program strives to provide the elderly with home-based care, community-based care, managed care, and long-term care in one benefit package. Whether you suffer from a chronic illness or acute medical condition, PACE allows you to receive the services you need by teaming you with health professionals dedicated to providing expert care for your conditions.
Who Is Eligible For PACE?
Anyone at least 55 years of age may be enrolled in PACE if they require nursing home care -- a requirement determined through an assessment by the PACE interdisciplinary care group. Once the assessment is made, it will become certified by the California Department of Health Care Services.
In addition to age and health care requirements, you must show that you can live at home and in your community without putting your health at risk. You must also live in the county and zip code area that has a PACE program.
PACE Program Benefits
Participants who enroll into one of the PACE programs can receive the full inclusive range of acute care as well as long-care benefits. Your prescription and non-prescription medications are covered by the PACE program once approved by the interdisciplinary care team. You will also receive hospital care, nursing care, primary medical care, meals, home care, day care, and transportation services.
PACE has many health care professionals on staff -- physicians, speech therapists, physical therapists, home health care aides, occupational and recreational therapists, clinical nurses, healthcare workers, and social workers -- whom you may see during your enrollment in the program.
With PACE, you have a health program available without having to go to a nursing home to receive the medical care that you require. This allows you the freedom to stay active in your community while given the medical attention to stay healthy.
PACE Program Restrictions
When you are a participant in the PACE program, you will not be able to keep your own doctor. You also cannot enroll in PACE if you are covered by another Medicare HMO. You are only allowed to enroll in one Medicare program at a time. So take this into consideration if you are currently enrolled in a Medicare/HMO, because you will be removed from the program once you enroll in PACE.
When enrolled in PACE, you cannot pick and choose which services you will receive, such as only needing the transportation and home care. The specialists will evaluate your individual medical needs and create a care plan that utilizes all the benefits that are available so that you will get the full treatment for your ailments.
Also be advised that if you do not qualify for Medicaid, you will have to pay outright for a portion of the program's premium. If you qualify for Medicaid, that program will pay this PACE premium for you.
What Happens If You Want To Leave The PACE Program?
You are not under any obligation to continue in PACE if you are unsatisfied with the services. You can leave the program and seek health care from another provider or from traditional Medicare/Medicaid benefit programs.
What Happens If Your Medical Needs Change?
A chronic medical condition may worsen to the point where you are no longer able to function or live in your home without putting yourself in danger. When this happens, the best decision concerning your health may involve going to a nursing home.
If you are enrolled in the PACE program and your medical needs change to the point that you need nursing home care, PACE will pay for the health care that you require. You will also still be seen by the interdisciplinary care team to ensure you get the full health benefits that are available when/if the time comes that you are able to leave the nursing home and return to your personal home.
What Is CalPACE?
CalPace is the association chapter located in California that spreads advocacy and knowledge concerning the PACE program. CalPACE hopes to ensure the health care benefits of the PACE program are available to all eligible Californians who have chronic or acute conditions so that they may receive the care they need without leaving their homes. CalPACE ensures that PACE participants receive the highest-quality care from the most qualified health professionals and specialists.