Promotion of innovations in elderly care

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In summary

AB 523 helps make community-based care options more effective in helping seniors where they need care.

By Eileen Kunz, Special on CalMatters

Eileen Kunz is Head of Government Affairs and Compliance for On locomotive, in the San Francisco, Santa Clara, and Alameda counties, and Chairman of the Board of Directors for CalPACE, the California Association of Programs of All-Inclusive Care for the Elderly.

A revolution began in a one-room office in San Francisco 50 years ago. Dr. William L. Gee and social worker Marie-Louise Ansak attempted to keep seniors with chronic illnesses and disabilities out of nursing homes by caring for them in their homes and communities.

They founded On Lok and their vision led to the all-inclusive care program for the elderly known as PACE – a pioneering model of care that combines community-based health care with social services and has been adopted by 140 organizations in 30 states.

In California, seniors enrolled in PACE have an average of 76 years old and live with 20 conditions. A third suffer from Alzheimer’s. This combination makes them particularly susceptible to COVID-19, but they have been diagnosed with COVID-19 at a quarter the rate of nursing home residents.

This is no small victory. California’s nursing homes accounted for 4% of the state’s COVID-19 cases but 20% of deaths – underscoring the need to provide more community-based care options like PACE that are also over 40% cheaper.

PACE’s low infection rates are the result of nursing innovations developed through operational flexibilities that the state temporarily allowed during COVID-19. Enrollment has been simplified to help seniors avoid months of care delays. Telemedicine was approved to make it easier for seniors to communicate with doctors. Qualified nurses have been retrained and sent to senior homes by the PACE centers to provide care.

Assembly Bill 523 awaits action from Governor Gavin Newsom, and it turns those practices into permanent care options. The bill, tabled by MP Adrin Nazarian, a Democrat from Van Nuys, also allows PACE organizations to continue innovating their operations to more effectively and safely serve seniors where and how they need care.

By signing AB 523, Newsom can ensure that the dedicated PACE organizations in California continue to provide safer, more coordinated, and more affordable care.

Seniors enrolled at PACE receive individual care from a team of doctors, nurses, therapists and helpers – familiar faces that they, their family and their home know. That personal touch is why 92% of seniors enrolled in PACE recommend it.

PACE-cared seniors are predominantly low-income and more than 80% come from colored communities. They often have no home or family support, making PACE their only way to avoid being uprooted and placed in a nursing home.

For example, after Newsom’s shelter-in-place order last year, one of the participants could no longer receive physiotherapy or take part in social activities at On Lok. His dementia caused increased hallucinations and he felt isolated and depressed. His care team – consisting of a doctor, consultant and nursing staff – began with routine home care. He also overcame his loneliness by praying with On Lok’s chaplain and began by learning how to use Zoom, playing games, joining a support group, and singing with friends. He even received the COVID-19 vaccine at home from the nurse on the care team when it was available.

Almost 90% of Californians want such services so that they can live at home with dignity and independence even in old age. The state can meet these expectations and improve age equity by expanding PACE.

California’s elderly population is growing and changing faster than any other age group. The population of our country is also getting older. President Joe Biden has proposed addressing this challenge through a $ 400 billion plan to invest in home and community-based services.

By signing AB 523, Newsom can help unleash the potential of PACE to protect the health and wellbeing of the frail seniors in California by maintaining the best care options available. It can also ensure the nation continues to seek inspiration in California to build tomorrow’s aging infrastructure.

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