The U.S. House of Representatives passed the PACE Innovation Act on Oct. 21. The legislation encourages the Centers for Medicare & Medicaid Services (CMS) to allow providers to develop pilot programs using the PACE Model of Care to also serve individuals under 55 and those at risk of needing a nursing home.
The U.S. Senate passed companion legislation (S. 1362) in August with bipartisan support.
The legislation is expected to be signed into law shortly by President Obama.
“This legislation is another milestone for the PACE Model of Care,” said Shawn Bloom, president and CEO of NPA. “PACE providers have had many ideas about how to innovate the PACE model to serve younger people with disabilities and seniors so that they can enjoy a high quality of life in the community. We are excited to see what is possible given the opportunities this legislation will create to build on the PACE experience.”
Currently, to enroll in a Program of All-Inclusive Care for the Elderly (PACE®), a person must be certified to meet a nursing home level of care, be age 55 or over, live in a PACE service area, and be able to live in the community with the support of PACE services at the time of enrollment. At this time, there are 116 PACE programs serving 35,000 enrollees in 32 states.
At a recent House Energy and Commerce Health Subcommittee hearing, Tim Clontz, senior vice president for Health Services at Cone Health and chair of the NPA Public Policy Committee, observed “The PACE model can be adapted to serve people under the age of 55 and people at risk of needing a nursing home level of care. People with early-onset Alzheimer’s, a younger person with physical disabilities, or a person with an intellectual or developmental disability deserve the same options as the elderly.”
NPA has been working with Congress for several years to find ways to use the success of the PACE model to address the challenges faced by others with on-going, complex care needs.
“Existing care models are often expensive and still leave gaps in care that can be hard to successfully navigate,” Bloom said. “PACE organizations are eager to demonstrate how its interdisciplinary, all-inclusive approach can improve health outcomes and quality of life for younger individuals who qualify to enroll.”
NPA recognized the leadership of Reps. Chris Smith (R-NJ-4) and Earl Blumenauer (D-OR-3) and Sens. Tom Carper (D-DE) and Pat Toomey (R-PA) on the important legislation.
“One of my guiding principles is to find what works and do more of it,” Sen. Carper said. “This PACE legislation will give CMS the flexibility it needs to do just that by allowing this physician-led, coordinated health care program to expand as efficiently as possible in Delaware and throughout the country. We’ve begun to address the problem of rising health care costs, and broadening the reach of programs like PACE will help us continue to provide seniors with excellent health care while reducing costs. Providing PACE programs with the room they need to grow and innovate will give more seniors the chance to remain in their homes, while receiving excellent health care and social services.”
“In Pennsylvania, PACE — or LIFE (Living Independently for Elders) — programs have been extremely successful in helping seniors to remain in their own homes rather than having to go into a costly nursing home or institutional setting,” said Sen. Toomey. “The PACE Innovation Act builds on this successful approach. I urge the president to sign this bipartisan legislation into law so an even greater number of vulnerable and disabled individuals who wish to stay in their communities can access quality health care and social services.”
“The PACE Innovation Act will provide the federally supported PACE organizations with much needed flexibility to bring the benefits of coordinated medical and long-term services to more seniors who seek to live independently in the setting of their choosing,” said Rep. Smith. “PACE has a proven track record of success in New Jersey and around the country and our legislation will enable more seniors to receive the all-inclusive care they need.”
“PACE is centered on the belief that it is better for individuals and their families to receive both medical care and long-term social services and supports in the home and community whenever possible,” said Rep. Blumenauer. “Providing both existing and new programs with the flexibility to expand will allow more people to maintain their dignity and autonomy and support families during challenging times.”