Riverside Health System opened its first PACE program in Hampton just four years ago. This week, Riverside held a symbolic ribbon-cutting for its fifth facility, the first in Newport News, and it has a target opening date of Oct. 1.
The Program of All-Inclusive Care for the Elderly offers coordinated, integrated care in the community for those over 55 who qualify for nursing home care. Funded by a partnership between Medicaid and Medicare, its comprehensive care includes medical services — dental, vision and hearing included — meals and social activities in a day program. Those who are Medicare-eligible only can pay a fixed monthly premium to participate.
"Riverside is the largest PACE provider in the state. It's the fastest growing part of the health system. One-third of the Riverside system is dedicated to older individuals," said Gordon L. Gentry Jr., board chairman of the health system's Lifelong Health Division.
PACE is based on a model started in San Francisco, Calif., more than 30 years ago. That, in turn, was taken from a "day hospital" concept used in England. The program, which involves both federal and state support, now has 80 providers in 28 states. Former nurse's aide Jennie Chin Hansen, CEO of the American Geriatric Society, led the pioneering San Francisco program, On Lok, for more than 11 years. "This model helps people stay in the community. It's based on well-being and family support," she said, noting that it received bipartisan Congressional support for its cost-effectiveness in providing care to the most vulnerable. "It's not for 'other people.' It's for all of us," Hansen emphasized, adding that her own parents had utilized the California program.
The fastest growing demographic in the U.S. is those over 85, and the average age of PACE participants is 80, she said.
"They're people with multiple clinical problems, problems with activities of daily living, with memory or cognitive loss. It's a program for people who need their care managed or coordinated, not for the 80-year-old who is playing tennis or looking after grandkids."
The appeal of PACE for Hansen is its team-based approach rather than the usual hierarchical medical approach. She cites the inclusion of everyone who comes in contact with participants for responsibility in providing care, from the drivers to the physicians.
"The best person to counsel may not be the social worker, but a direct worker who is closer to that participant," she said. "There's more fluidity."
"It's a team sport to make life the best it can be. That's the heart of it," echoed Paul Evans, medical director of Riverside's PACE programs. One of his patients, Carolyn Hume, 85, has participated in the Hampton PACE since 2008. "It's an extension of the family at home," said her daughter, Brenda Moyer. She credits it with restoring her health as the caregiver, as well as giving her mother a greatly improved quality of life.
The program's flexibility means that nontraditional health-enhancing activities can be incorporated, from doing laundry for those who don't have facilities at home to going on fishing expeditions and attending ball games. PACE also does home assessments to improve safety and access by building ramps, adding bathroom grab bars, and the like. "It's so much better than taking another pill," said Hansen.
The flexibility allowed by the inclusive model also allows for common-sense measures, such as prescribing a brand-name pill that can be taken once a day for a forgetful patient, instead of a generic that might require four a day that they don't remember to take. "It's care based on people-centered awareness. It helps to avoid expensive hospital stays," she said.
The Newport News site, a revamped department store in the Denbigh section, will host a primary care physician, a registered nurse, a dietitian, occupational and physical therapists, a pharmacist, aides and drivers, and can accommodate 175 participants. Of those, about 20 percent will use the specialized services for those with dementia, estimates Craig Connors, Riverside vice president of managed care.
The fifth PACE project of the Richmond architecture firm, Walter Parks, the design has been refined using lessons learned from the other sites. Connors points out the multiple skylights that provide plenty of natural light, the improved spacing and size of bathrooms and shower facilities, and the overall flow. "We've learned that integrating the staff and the participants works best," he said, indicating shared quarters throughout.
Want to enroll?
What: The PACE program is open to those age 55 and older, who qualify for nursing home care. The center has a target opening date of Oct. 1; it will be open from 7 a.m. to 6 p.m. Monday through Friday.
Where: Riverside PACE Newport News, 439 Oriana Road, Newport News.
Information: Call Emily, 757-234-8106 or email firstname.lastname@example.org.Copyright © 2015, Los Angeles Times