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The National PACE Association Applauds Legislation to Assist Rural Health Care Providers to Develop PACE


ALEXANDRIA, Va., June 2 -- Legislation to offer assistance to health care providers working to develop Programs of All-inclusive Care for the Elderly (PACE) serving rural areas has been introduced in the Senate.

“PACE providers have a long history of working to expand access to the PACE model of care to greater numbers of individuals who could benefit from the coordination of high quality care the PACE model provides,” Shawn Bloom, president and CEO of the National PACE Association, said. “This legislation represents an opportunity to serve seniors in rural areas, which is where most seniors live.”

PACE programs serve people over age 55 who meet their state’s criteria for needing nursing home care and who are able to live safely in the community.

“The need for coordinated, comprehensive, community-based care is just as great in rural America as in urban America,” said Alan Morgan, Interim Executive Director of the National Rural Health Association. “PACE can succeed in small towns and in the country just as it has in big cities.”

The PACE model enables health professionals from many different disciplines to work together to plan and provide the full range of primary, acute and long term care and supportive services an eligible person needs to remain as independent as possible.

S. 1067, the Community Options for Rural Elders (CORE) Act, was introduced with bipartisan support from Senators Sam Brownback (R-KS), Blanche Lincoln (D-AR), Byron Dorgan (D-ND) and James Jeffords (I-VT).

“Because resources are already stretched so thin, it is often difficult to get started in rural areas innovative programs that have been successful in urban areas,” Dave Horazdovsky, president of the Evangelical Lutheran Good Samaritan Society, the nation’s largest non-for-profit long term care organization.

The CORE Act would provide start-up funds of up to $750,000 per program with total start-up funding limited to $7.5 million across all programs.

The CORE Act recognizes the need for some flexibility in PACE program operations vis-a-vis current PACE regulatory requirements. For example, the bill would allow CMS to waive requirements related to the provision of services in the PACE center -- a location that works well for service delivery in urban areas but may be less appropriate in rural areas where travel distances between PACE center and enrollee’ homes may make the large, centralized location less desirable.

Another important feature of the legislation would be to create financial protection in the event of extraordinary medical expenses so that rural providers with smaller enrollment pools can better anticipate their exposure to risk. For an enrollee whose medical expenses were more than $50,000 a year, the provider would be reimbursed for 80 percent of those expenses up to $100,000 per person, per year.

The National Rural Health Association (NRHA) and the National PACE Association (NPA) have been working together with rural providers to develop innovative PACE service delivery models that would allow a PACE program to operate in a rural community. Eleven rural providers that have been working to develop PACE models to serve their communities recently attended an NPA Rural PACE Workshop preceding the NRHA annual meeting in New Orleans.

Organizations attending the Rural PACE Workshop on May 18, 2005:

Cape End Manor (Provincetown, MA); Wellfleet Council on Aging (Wellfleet, MA); Orleans Council on Aging (Orleans, MA); Northland Healthcare Alliance(Bismarck, ND); Providence Benedictine Nursing Center (Mount Angel, OR); Home Care and Hospice (Olean, NY); Saint Anne of Winona (Winona, NY); Charleston Area Medical Center Institute (Charleston, WV); Lopez Health Systems, Inc. (Crystal City, TX); Good Samaritan Center (Sioux Falls, SD); Hospice of Siouxland (Sioux City, IA)


The National PACE Association works to advance the efforts of Programs of All-inclusive Care for the Elderly (PACE) to support, maintain, safeguard and promote the provision of quality, comprehensive and cost-effective health care services for frail older adults.


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