H5405_9_04/10/06
Introductions Do you know someone in a Nursing Home? 2
PACE Mission To provide high quality, affordable, integrated health care services to the elderly that promote autonomy, quality of life and individuals’ ability to live in their communities. We keep people out of nursing homes! 3
PACE Overview • For more than 40 years, PACE has made a difference in the lives of Bay area seniors and their families. • We provide a full range of medical and social services through the PACE model ( P rogram of A ll- inclusive C are for the E lderly.) • PACE Nationally: 87 programs in 29 states. • We are a choice in the CCI initiative • TWO PACE programs in Alameda County 4
CEI Service Area • CEI operates three PACE centers in Oakland and one in Berkeley • We serve residents in all the communities from El Sobrante and Richmond to South Hayward. 5
On Lok Service Area • On Lok Lifeways operates two centers in Fremont • In Alameda County, we serve residents in Fremont, Union City, and Newark. • On Lok Lifeways also serves San Francisco and most of Santa Clara County 6
PACE Offers a Full Range of Services • Primary/Nursing Care • Transportation • Hospital Acute Care • Medical Specialists • Emergency Services • Rehabilitation Therapies • Mental Health • Podiatry • Nutrition and Hot Meals • Dental • Social Services • Optometry • Home Health Care • X-ray, Lab work • Medications • Ambulance • Recreational/Social Activities at the PACE Day Center 7
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Support for Seniors and Families • PACE partners with families by providing: Coordination of all medical appointments Day care at the PACE center Transportation Home care Much more • Care coordinators provide a single point of contact for family members. 9
Interdisciplinary Care Team • We use an interdisciplinary team approach to develop customized, individual care plans for each participant. 10
Homecare Nurse Primary Driver Care Doctor Case Manager/ Mental Health Social Worker Participant and Family Nurse Practitioners Specialist and Clinic Staff Day Center Worker and Dietitian Activity Rehabilitation Therapist Therapist 11
How is PACE Funded? • PACE is funded by Medicare and Medi-Cal. • Some participants have a share of cost for Medi-Cal that they have to continue to pay to PACE. • Participants can also pay an out-of- pocket “private pay” fee if they don’t have both Medicare and Medi-Cal. (Some Long-term Care policies) • We also do non-profit fundraising. 12
Who is Eligible for PACE? • 55 years of age or older. • A resident of PACE’s service area. • Assessed by the PACE interdisciplinary team to require nursing home level of care (and certified by the CA Department of Health Services as such). • Able and willing to live in the community without jeopardizing their health or safety. 13
Who is a good candidate for PACE? • Frequent emergency room visits • Four or more chronic conditions • Need skilled nursing care • Need consistent monitoring of a health condition. (like medication management or wound care) • High ADLs or IADLs • Would be safe living in their environment with the help of PACE 14
Unique Features and Enrollment Process with Coordinated Care Initiative & PACE • PACE is one of the three options, but a senior cannot default into PACE • In PACE, Medicare and Medi-Cal are bundled, so seniors use a PACE physician with their coordinated services. 15
Unique Features and Enrollment Process with CCI and PACE • PACE enrollees must be assessed by the PACE plan and certified as nursing level of care by DHCS. (Takes longer to enroll – 30ish days.) • Seniors interested in PACE will have 60 days to go through the enrollment process. They still need to indicate a second choice CCI Medi-Cal plan in case they end up not enrolling in PACE. 16
CEI PACE Center Locations Berkeley PACE Center 1497 Alcatraz Ave Berkeley Co-located with Mabel Howard senior housing (RCD) 17
CEI PACE Center Locations Downtown Oakland PACE Center 1955 San Pablo Ave Oakland Co-located with San Pablo Hotel senior housing (EBALDC) 18
CEI PACE Center Locations Eastmont Center (upper level) Josie Barrow Center (lower level) 7200 Bancroft Ave Oakland Co-located with Miley Gardens senior housing 19
On Lok Lifeways PACE Center Locations in Alameda County Fremont Center 159 Washington Ave., Fremont Peralta Center 3683 Peralta Blvd., Fremont 20
Enrollment Process • In-home appointment • Tour of PACE center • Health Assessment • Approval by the State DHCS • Family Enrollment Conference • After enrolling, seniors must receive all of their care from PACE providers. If they use out of network providers, they are personally responsible for the cost of those services. 21
How to make a referral to CEI Please call: CEI Member Services (510) 433 -1150 (510) (433-1165) TDD 8 AM to 5 PM, Mon – Fri www.cei.elders.org 22
How to make a referral to On Lok Lifeways Please call: Bevi Kothare at (510) 648-5415 or Johara Arduz at (510) 828-2529 TTY (415) 292-8898 8 AM to 5 PM, Mon – Fri Visit our website: www.onlok.org 23
Questions? ? 24
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