PACE

The way some older Arkansans receive long-term care is going to change.

In nine short years the first baby boomers turn 65. Today most elderly live independently, in their own homes. The same will be true when the baby boomers hit age 65. In fact, the percent living independently will likely rise as disability rates continue to fall. However, because the baby boomers will swell the number of 65+ over the next several decades, the actual number who need long-term care services will increase dramatically.

Historically, long-term care meant nursing homes. Today that is no longer true. During the last three decades new forms of long-term care have emerged. Home health, personal care, day care, home delivered meals, respite care, assisted living and other home and community-based options give many people a choice in how and where they receive care.

A new choice is coming. It is called PACE, which stands for Program for All-inclusive Care for the Elderly. PACE programs serve individuals certified by their state to need nursing home care.

Why PACE? The National PACE Association (NPA) points out the advantages: PACE Programs take many familiar elements of our traditional health care system and reorganize them in a way that makes sense to families, health care providers and the government programs and others that pay for care.

As Arkansas seeks to develop a comprehensive long-term care system, consumers have repeatedly said, “Let the money follow the client.” In other words, don't force individuals into an institution or program that they don't need or want — create programs built around the needs of individual consumers.

That is what PACE is all about. It combines Medicare and Medicaid into one funding stream and allows the PACE provider to shape services that meet individual needs.

The program is able to provide the entire continuum of care and services to seniors with chronic care needs while maintaining their independence in their homes for as long as possible. Care and services include:

While the advantages are many, PACE projects are not simple to structure or implement. Combining Medicare and Medicaid is complex, both for the provider and the State and Federal governments. A PACE provider assumes financial risk through a capitated system. That means PACE providers get a fixed payment each month. This gives them the flexibility to provide preventative care, prescription drugs and other services for which Medicare would not normally pay. On the other hand, if it costs more money to provide that care, it comes out of the provider's bank account.

In 1997 Congress authorized the number of PACE sites to increase from 15 to 40, with an annual increase of 20 sites thereafter. Currently, authorization exists for 100 PACE sites. However, the number of PACE sites stands today at 25, with 17 in the process of coming online.

To address the challenges of accelerating PACE implementation, the John A. Hartford through the National Pace Association, have awarded funding to a small number of states including Arkansas.

If you would like to placed on an "Interested Parties" list and learn more about PACE, send you name, address, phone number and e-mail address to: