program of all -inclusive care for the elderly · pace success stories oren’s story prior to...
TRANSCRIPT
PACE Program of All-Inclusive Care
for the Elderly
The New Era of Healthcare for North Carolina Seniors
Presented by: Renee Rizzuti, FABC, MHA, LNHA
CEO/Executive Director, PACE of the Southern Piedmont
Overview of Challenges We Face
Rapidly Increasing Numbers of Elders
Overview of Challenges We Face
Rapidly Increasing Numbers of Elders
1%
PACE Population and Resource Risk
Strategies for Service Utilization
1. Preventing Deterioration Post Episode of Care 2. Improve Self-Management of Chronic Condition & Wellness 3. Aligned Network for Optimal Patient Outcomes
Mecklenburg Aging Profile
32% with 1 or more disabilities
Mecklenburg Aging by Groups
PACE is the Solution
What Is PACE?
PACE coordinates and provides comprehensive preventive, primary, chronic, palliative and end of life care and services so that older individuals can continue living in the community. PACE is a full-risk capitated health plan for any medical
care provided in any location.
Alternative to institutional care for the frail elderly
Originated by family members in
1983 in San Francisco, CA
Permanent Medicare program (1997)
Medicaid program since 2008 in NC Capitated, comprehensive,
coordinated, managed care
History of PACE
31 States Have PACE
45,000+ Served
35 North Carolina Counties Have PACE
Growing PACE is a Legilslative priority as study completed viewed as the innovative community medicine model of our future.
Federally regulated by Medicare – CMS
State regulated by Division of Medical Assistance – NC
Department of Health and Human Services
Adult Day Center Certification
State and Federal Regulations
A Not For Profit owned by four (4) other not for profit organizations; health system, home health, continuing care retirement community, and hospice. Opened July 1, 2013 We have served over 350
Participants and their families over five (5) years. Growth plans for 2019 include
alternative care sites for easier access to our services
Our Story
Service Area
Essential Elements
High Functioning Interdisciplinary Team Effective, Ongoing Care Coordination Clinical Utilization Management Presence in the Home Efficient Transportation System Socialization Systems
NC PACE Video
NC PACE Association Video
Who Is Eligible?
Lives in a PACE service area
55 years of age or older
Meets Medicaid criteria for
nursing home level of care
Able to live in a community
setting, when enrolled, without
jeopardizing health or safety
Voluntary enrollment and disenrollment
Who Is Served?
AGE
The Heart of PACE
• Care Management
• Authorization of Care and Services
• Comprehensive Assessment and Care Planning
PACE
Medication Supplies
Specialty Care
DME
Meals Personal Care
Subacute Care
Hospital Care
PACE Network
Medical Clinic Team
Medical Director Rafael Miranda, MD
Board Eligible Internal Medicine
Dawn Owens, DO Board Certified
Family Medicine
Tarra Boyd, DNP-FNP-BC, MSN/MBA-HC
Nurse Practitioner
Pacharo Ndupu, MSN, ARNP, FNP-C
Nurse Practitioner
PACE Day Center Proven quality outcomes
Medical Clinic Therapy Nutrition Recreation Therapy Socialization
PACE is a capitated managed care program with
full-risk for ALL necessary care
NC elected Department of Social Services to
financially qualify PACE participants
Medicare Advantage Plan & Medicaid Benefit Plan
Comprehensive Health Plan Benefits • Primary medical care • Therapy (Physical,
Occupational, Speech, Recreational)
• Specialists (Dentistry, Optometry, Audiology, etc)
• Social Work Support
• Caregiver Respite • Acute hospital care • Emergency care • Long Term Care • Prescription drugs • Medical Equipment &
Supplies
• Transportation • Homecare Services • Dietitian/Nutrition • Behavioral Health
All authorized needs are covered 100%, No Co-Pay.
PACE Success Stories Arden’s Story
Prior to PACE, hospitalized and
frequent falls, told will never walk Enrolled to PACE: Several months of Therapy,
walks today Able to move into apartment and
live independently again with a few hours of in home care provided by PACE
Her daughter is thankful for the support and oversight
“I feel safe with my Primary Care Physician and
spending time with friends at PACE.”
PACE Success Stories Oren’s Story
Prior to PACE, worked for City of Charlotte and
Johnston YMCA. In nursing home as health declined, referred to
Charlotte Housing and Money Follows the Person supported home transition.
Enrolled to PACE: Able to move into independently with Attends Men’s Club and therapy He is thankful to live at home again.
“I’m thankful for the care and support of all these amazing
programs and services.”
PACE Success Stories Gwen’s Story
Prior to PACE, in nursing home as health declined Enrolled to PACE: Able to move into home with friend with special
bed provided by PACE Attends Tai Chi and Chair aerobics Her caregivers are thankful for the transportation
and medical care “”I am functioning at
a higher level than ever before. PACE
has brought me back to life.”
Without PACE, Participants and Their Families are Struggling
Frail Elders • Isolated • Bored • Dependent • Difficulty Accessing
Care • Uncoordinated Care • Fear of Nursing Home
Placement
Family Caregivers • Worried • Tired • Running Around to
seek care • Hard to Maintain
Work Schedule
“I Love Everything about PACE!”
We Are Here To Help
PACE of the Southern Piedmont Referrals (704) 887-3853
PACE Medical Clinic and Day Center Location 6133 The Plaza
Charlotte, NC 28215
Open Monday – Friday 8:00am – 5:00pm