Early in the COVID-19 pandemic, the high number of deaths among long-term care facility residents rightfully prompted our country to rethink how we care for older adults with chronic illnesses and disabilities.
Now, 90 percent of seniors and their families want care options that allow them to safely age in place in their own homes. However, family caregivers—many of whom are “sandwiched” Gen-Xers caring for both aging parents and young children while working—cannot and should not shoulder this burden alone.
Currently, a bill that would ease this burden for caregivers sits on Gov. Gavin Newsom’s desk, awaiting action. Now that he has survived a recall attempt, Newsom must turn his attention to this important piece of legislation, which would bring a flexible, life changing caregiving option to more families: PACE, or program of all-inclusive care for the elderly services.
PACE is a flexible, comprehensive system of health care and social support for adults aged 55 and older, regardless of income, that allows them to stay in their own homes instead of going into a nursing facility. Older adults enrolled in PACE, one third of whom have Alzheimer’s and all of whom qualify as low-income, have fewer emergency room visits, unnecessary hospital admissions and long-term nursing home placements.
The PACE model began with one community group in San Francisco 50 years ago. Now there are 140 organizations in 30 states serving more than 55,000 enrollees. PACE is a permanent part of Medicare programs and an option for state programs like Medi-Cal, and seniors enrolled in PACE receive individualized care while living at home, able to access all the medical and social services they need in one place.
Last year, PACE was allowed to expand home-based care and telehealth services for medically frail seniors. This flexibility allowed for even more personalized care for PACE participants, who were able to stay at home and see their family and caregivers as needed—and kept their COVID-19 cases about 80% lower than the case rate among nursing home residents.
Demand for PACE services markedly increased during the pandemic, including at the Gary & Mary West PACE in San Marcos, which currently serves several hundred participants in North San Diego County.
Unfortunately, PACE remains an incredibly underutilized resource, and most of the seniors and families who could benefit from the program don’t know it exists.
The American Rescue Plan and President Biden’s American Jobs Plan include billions of dollars in funding to enhance and expand home and community-based services for seniors, but our governor needs to make this change a reality for families in California by signing Assembly Bill 523 into law. AB 523, introduced by Assemblymember Adrin Nazarian, a Democrat from North Hollywood, will allow more seniors statewide to access expanded PACE services that were put in place during the pandemic.
By 2030, 1 in 4 Californians will be 60 or older. Some 80% of PACE participants are from communities of color. A state population as diverse as ours needs a flexible, inclusive, efficient care system that will help seniors age successfully in place, keeping them in their homes and communities. Expanding PACE now will enable our state to meet the care challenges that come with this demographic change, because PACE centers are uniquely prepared to serve all of California’s seniors, regardless of income or care complexity.
September is National PACE Month, when we celebrate PACE’s positive impact, and raise awareness of this innovative care mode. The pandemic has made it vital to put every effort into helping it grow to reach more families and seniors who need it.
As they continue to deal with the uncertainty around the Delta variant, and even as we enter a post-pandemic world, family caregivers deserve more than pats on the back from our leaders for being “unsung heroes.” Now more than ever, they need a flexible caregiving option that supports them and helps keep their elderly loved ones safe, healthy, engaged with their communities and in their homes.
Gov. Newsom, the time for PACE is now.
Rena Smith is the executive director of Gary and Mary West PACE of North County San Diego in San Marcos. Established with a grant from the San-Diego-based Gary and Mary West Foundation, West PACE offers high-quality, comprehensive and coordinated healthcare, social services and support for seniors who want to successfully age in place rather than in a nursing home.