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HAMILTON – Health and Senior Services Commissioner Heather Howard today marked the opening of the state’s first Program of All-inclusive Care for the Elderly (PACE).
Operated by St. Francis Medical Center as LIFE (Living Independently For Elders) St. Francis, the program began admitting participants in April, and held a dedication ceremony this morning. St. Francis is part of the Catholic Health East (CHE) System.
PACE is an innovative Medicare program that provides frail individuals age 55 and older comprehensive medical and social services coordinated and provided by an interdisciplinary team of professionals in a community-based center and in their homes, helping program participants delay or avoid long-term nursing home care.
LIFE St. Francis is located at 1435 Liberty Street in Hamilton Township and has been approved by the U.S. Centers for Medicare and Medicaid Services (CMS) to serve individuals who reside in Mercer County or in Bordentown, Florence, or Roebling in Burlington County.
“PACE recognizes and supports the independence and dignity of older adults in need of daily help,” said Governor Corzine. “PACE brings New Jersey one giant step closer to achieving its goal of ensuring all older adults have access to high quality long-term health and supportive services in the least restrictive environment possible.”
“Older adults want services in their homes and communities,” said Health and Senior Services Commissioner Heather Howard. “Under the leadership of St. Francis Medical Center, this program provides comprehensive health care and social services where people live. It offers an alternative to nursing home care.”
Each PACE participant receives customized care that is planned and delivered by a coordinated, interdisciplinary team of professionals working at the center. The team meets regularly with each participant and his or her representative in order to assess the participant’s needs. Care plans usually integrate some home care services from the team with several visits each week to the PACE center, which serves as the hub for medical care, rehabilitation, social activities and dining.
To participate in PACE, an individual must be 55 years of age or older, require nursing home level of care but be able to live safely in the community at time of enrollment with the services of PACE, and reside in the service area of a PACE organization. PACE participants may disenroll from the program and return to their former Medicare and Medicaid coverage plans at anytime and for any reason.
PACE provides its participants with all services covered by Medicare and Medicaid, without the limitations normally imposed by these programs. It also provides any other services deemed necessary by the interdisciplinary team that would allow program participants to remain in the community.
Services provided by PACE include, but are not limited to, primary care (including doctor, dental and nursing services), prescription drugs, adult day health care, home and personal care services, and hospital and nursing home care if and when needed. Transportation to and from the center and all off-site medical appointments are also provided.
“Under the PACE model, the community center serves as the core location for service delivery,” said Commissioner Howard. “They are like doctor’s offices, adult day health care centers, congregate meal sites and senior centers rolled into one. They truly provide one-stop shopping for older adults in need of home and community-based care.”
PACE agencies receive a set amount of Medicare and Medicaid funds each month to ensure participant care, whether services are provided in the home, community or in a nursing home setting. This capitated funding arrangement rewards providers who are flexible and creative in providing high quality care and gives them the ability to coordinate care across settings and medical disciplines. The program also accepts participants who pay privately.
PACE currently operates in 65 markets nationally and has been in development in New Jersey since 2004, when DHSS received a grant from CMS and technical assistance from the National PACE Association to study bringing the program to the state. Besides funding feasibility studies to determine the best locations for PACE, the National PACE Association award provided education for state staff, and outreach to communities and potential providers.
LIFE St. Francis was developed, in part, with a grant from the NJ Health Initiatives Program of the Robert Wood Johnson Foundation. Our Lady of Lourdes Medical Center, also a member of CHE, operates a second PACE in Pennsauken. It began enrolling participants in May. DHSS staff members continue working with non-profit and public healthcare administrators to establish additional PACE markets throughout the state.
The PACE model was developed in San Francisco in the 1970s as ON LOK, the Chinese-American community’s alternative to nursing home placement. It was formally established by CMS as a permanent Medicare Advantage option in 1997.
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Department of Health
P. O. Box 360, Trenton, NJ 08625-0360