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Walkers in a nursing home
Walkers in a nursing home. Photo via Pixabay

No matter how complex their health or mobility issues are, every older person deserves to be treated as a vibrant person and their wishes respected. Per almost 90% of people aged 55 and overit means maintaining their independence and staying in their own homes.

However, many factors, such as a fall or lack of a support network, can unfortunately force an older person to move into a shared space, such as a nursing home. As we have seen during the COVID-19 pandemic, they are often not the ideal place to care for the frail elderly. In fact, the inhabitants of these objects were dying at a rate three times higher than their counterparts who stayed in their homes thanks to a better, different in-place aging option: Comprehensive Elderly Care Program.

Right now, too many older people cannot access innovative and cost-effective care through PACE because income thresholds keep them from qualifying Medi-Cal. But new rules will go into effect in July to allow more people to take advantage of this innovative care model.

Expanded access to PACE saves lives

For seniors who qualify, PACE programs such as Gary and Mary West Pace in San Marcos provide coordinated comprehensive health care, social services, transportation and other support. PACE participants they are 24% less likely to end up in the emergency room and have far fewer hospital admissions. And, as an added bonus, PACE care is less expensive for taxpayers than similar programs for seniors with similar medical needs, saving the state millions of dollars.

people like J.L., a West PACE participant in San Marcos, will readily attest to the positive impact PACE has had on their lives. West PACE provides JL with affordable transportation for doctor visits and non-emergency medical visits, as well as skilled home care through partnership with DocGo. Enrolling in PACE has allowed him to leave the facility and return to his own home, where his family can visit him more regularly, and has significantly reduced the number of hospitalizations.

Unfortunately, more and more older people are in the so-called “forgotten middle”, unable to afford quality health care, but also unable to qualify for Medi-Cal and participate in programs such as PACE.

So it was with Josephine at Oceanside. After a fall forced her to move to a skilled care facility for a month, her daughter worked with West PACE and Elderly Care Foundation to get Medi-Cal coverage to help her enroll in PACE and stay in her own home. It was found that Josephine was ineligible for Medi-Cal because her assets were in excess of allowable limits, even as she struggled to cover her rental housing and home care needs from her limited Social Security income. She was ordered to “squander” her remaining assets in order to obtain insurance coverage.

The cost of treatment without Medi-Cal was prohibitive and her family was unable to afford it. A month later, Josephine died from complications resulting from a fall. While PACE may not have cured her illness, we are confident that she would have improved Josefina’s quality of life and supported her family members during the time she left.

spread the word

While it may be too late for Josephine, the good news is that effective July 1, 2022, the asset limit for many Medi-Cal programs will increase from $2,000 for individuals and $3,000 for couples to $130,000 for individuals. individuals plus $65,000 for each additional family. member. Starting May of this year, people over the age of 50 who meet financial requirements can receive Medi-Cal benefits regardless of immigration status.

If you’ve previously been denied Medi-Cal, consider reapplying this summer. Tell your family, friends and other loved ones who would benefit from taking a look at their situation and see if they can eligibility for Medi-Cal and afford to enter PACE.

And if you’re looking for other ways to get involved, ask your members of Congress to support Extended PACE Law 2022which will further lower barriers to PACE enrollment by ensuring that more seniors and their caregivers have access to this innovative health plan.

Rena Smith – Managing Director Gary and Mary West Pace in San Marcos. She is an Oceanside resident.

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