The scene is set for a possible expansion to Programs of All-Inclusive Care for the Elderly (PACE) in the U.S.
Sen. Bob Casey, a Democrat from Pennsylvania and chairman of the Senate Special Committee on Aging, on Thursday introduced the “PACE Plus Act,” a bill that aims to expand access to PACE across the country.
The legislative effort comes roughly two weeks after aging services advocacy group LeadingAge identified PACE as a core part of its plan for strengthening senior care.
PACE is a Medicare and Medicaid program that helps keep people in their communities instead of nursing homes. Oftentimes, programs are run out of community-based centers with the support of in-home care providers and their staff.
In total, there are at least 138 PACE organizations operating 272 PACE centers in 30 states, serving roughly 55,000 participants combined, according to the National PACE Association.
If passed, the PACE Plus Act would make room for the creation of new PACE programs and the expansion of current ones through federal grants. The legislation also encourages non-PACE states to take up the model by providing incentives.
“It would provide grants to organizations for PACE startups to help cover some of the up-front costs to develop PACE that organizations incur before the first person is enrolled,” Robert Greenwood, senior vice president of public affairs at the National PACE Association, told Home Health Care News in an email. “Several sections of the bill, one calling for PACE pilots and one that allows states flexibility in changing eligibility requirements for PACE enrollment, also allow PACE to further innovate to meet the needs of the communities they serve.”
Based in Alexandria, Virginia, the National PACE Association is an industry advocacy group that focuses on federal and state policies to support the financial viability of the PACE model.
In theory, the legislation would increase the number of seniors and people with disabilities eligible for PACE services at a time when the nation is trying to shift care away from traditional long-term care facilities.
Additionally, the legislation aims to cut through red tape by lowering the bureaucratic burden that growing PACE programs face while also providing technical assistance resources.
So far, the PACE Plus Act has drawn support from the National PACE Association and a handful of individual operators, including InnovAge (Nasdaq: INNV), the largest PACE system in the country and the only publicly traded organization.
Denver-based InnovAge serves 6,600 seniors in Colorado, New Mexico, California, Pennsylvania and Virginia. The company’s president and CEO, Maureen Hewitt, said she was encouraged by the introduction of PACE-specific legislation.
“The need for comprehensive, at-home caregiver and health services for older Americans continues to grow, and since the onset of the COVID pandemic, we believe it has become even clearer that PACE is one of the most effective models of care for frail seniors,” Hewitt told HHCN in an email.
Jade Gong, founder and principal of consulting firm Jade Gong & Associates, also has a favorable view of the legislation.
While Gong believes that the bill is comprehensive, she still said the Federal Coordinated Care Office should be included in a review of federal policies.
“The only thing I would add is to have the Federal Coordinated Care Office — which would be a needed central point of coordination and support for PACE — be asked to undertake a comprehensive review of federal policies that could be modified to support and facilitate PACE expansion,” Gong said in an email. “For example, PACE programs cannot have more than one service area expansion or center under review at the same time, a policy which obviously is a severe limitation on the ability of PACE to scale.”
In general, the PACE Plus Act is in line with the Biden administration’s greater push to increase home- and community-based services.
Last month, the Biden administration unveiled the American Jobs Plan, a $2 trillion infrastructure proposal. This plan earmarked $400 billion to go toward home-based care.
The American Jobs Plan also pushes for the expansion of the Money Follows the Person (MFP) program, which allows certain Medicaid users to more seamlessly move from a nursing home back into the home.
In all likelihood, the COVID-19 emergency’s impact on nursing homes and other long-term care facilities, as well as the nation’s past underinvestment in home-based care, were top of mind when rolling out this plan.