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[Extensions of Remarks]
[Page E62]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
INTRODUCTION OF THE COMPREHENSIVE CARE FOR SENIORS ACT OF 2019
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HON. EARL BLUMENAUER
of oregon
in the house of representatives
Thursday, January 17, 2019
Mr. BLUMENAUER. Madam Speaker, today I am pleased to introduce the
Comprehensive Care for Seniors Act of 2019. This legislation would
direct CMS to promulgate the long overdue Programs of All-Inclusive
Care for the Elderly (PACE) final rule by April 1, 2019.
PACE is a proven care model delivering high-quality, comprehensive,
integrated and coordinated community-based care to both Medicare and
Medicaid beneficiaries 55 years of age or older, who meet the criteria
for a nursing home level of care, but wish to live at home. Multiple
studies show that people receiving care from PACE organizations live
longer, experience better health, have fewer hospitalizations and spend
more time living at home than those receiving care through other
programs.
PACE is a comprehensive, capitated, fully integrated, provider-based
health plan. At present, there are 124 PACE organizations operating in
31 states, serving over 45,000 elders and those living with
disabilities every day. PACE operates based on the fundamental
principle that it is preferable in terms of quality of life, quality of
care, and costs to public and private payers for PACE-eligible
individuals to be served in the community whenever possible. Ninety-
five percent live at home in their communities.
The PACE organization assesses each individual upon enrollment and
develops a personalized care plan, implemented primarily by PACE staff
across all settings of care twenty-four hours a day, seven days a week,
365 days a year. Most PACE participants, 90 percent, are dually
eligible for Medicare and Medicaid. The average participant is 76 years
of age, and lives with multiple chronic, complex medical conditions,
which often significantly limit activities of daily living.
Approximately half live with dementia. Thus, PACE organizations enroll
an exclusively high-risk, high-cost population, with 85 percent being
at least 65 years of age, and 15 percent between the ages of 55 and 64.
When individuals with chronic and medically complex conditions do not
have access to care, their quality of life is diminished, which over
time leads to increased expenditures. PACE deliberately was constructed
to address the chronic care needs of individuals by providing timely
and clinically appropriate treatments and social supports.
Currently, PACE programs operate under outdated regulations from
2006. It is critically important that CMS issue the PACE final rule,
which will bring much needed regulatory flexibility, allowing PACE
organizations to innovate and grow to best serve their participants,
their families, and their communities. I urge all of my colleagues to
join me to pass the Comprehensive Care for Seniors Act of 2019.
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