Why PACE: program of all inclusive care for the elderly
Programs of All-inclusive Care for the Elderly (PACE) serve seniors with chronic care needs by providing access to the full continuum of preventive, primary, acute, and long term care services. PACE Programs California take many familiar elements of our traditional health care system and reorganize them in a way that makes sense to families, health care providers and the government programs and others that pay for care.
For consumers, PACE provides:
Caregivers who listen to and can respond to their individualized care needs
The option to continue living in the community as long as possible
One-stop shopping for all health care services
For health care providers, PACE provides:
Capitated funding arrangement rewards providers that are flexible and creative in providing the best care possible
Ability to coordinate care for the individuals across settings and medical disciplines
Meets increasing consumer demands for individualized care and supportive services arrangements
For those who pay for care, PACE provides:
Cost savings and predictable expenditures
Comprehensive service package emphasizing preventive care that is usually less expensive and more effective than acute care
A model of choice for older individuals focused on keeping them at home and out of institutional settings
What is PACE and how is PACE Paid for?
What is PACE? PACE is a fully capitated program in which the Centers for Medicare PACE Program and Medicaid Services (CMS) pays the Medicare capitation, and each State establishes and pays the Medicaid capitation. These capitated payments are combined at the provider level, creating a flexible funding pool for all primary, acute and long term care services.
The goal of rate setting for PACE is to establish capitation rates that are acceptable to both providers and payers. In general, the Medicare capitation payment is about one-third of the payment PACE providers receive for each enrollee.
Why Consider PACE for the Future
PACE provides a full range of preventive, primary, acute and long term care services that enable frail older individuals to live in the community as independently as possible
PACE provides care and services consistent with emerging consumer demands for individual choices in health care and services
PACE combines adult day settings, home care, interdisciplinary teams, transportation systems and capitated payment systems so that providers can respond to the unique needs of each frail elderly individual served
Twenty-six providers have successfully replicated the PACE model, demonstrating the value of high quality, individualized care PACE provides for its participants. Eleven other providers are operational and on their way to developing PACE programs
America has been going through a difficult financial time in the recent years. We have heard of innumerable people losing their jobs, and becoming penniless because of the recession. In this context, CNA jobs have taken a huge market. Due to the short period of studies, and the ease of the preparations in becoming a CNA, this field is being eyed by many today. Compared to other fields, nursing has been projected to be the occupation with the highest increment of job opportunities with about an expected increase of at least 21%.
What is a CNA?
CNA are assistants to other medical professionals in a hospital like LPN, RN and doctors.
They are also said to be the ‘eyes and ears’ of nurses. They perform all the basic duties of the patients, like dressing them, feeding them, cleaning them, giving injections and noting any physical development in patients. They are the ones who interact personally with the patients, and help in their recovery. A CNA can work in any kind of medical environment: hospitals, nursing homes, personal homes, senior day care or other institutions.
CNA scope in California
The California government claims that the state was deficit of almost 47,000 nurses in 2010. These figures are expected to triple only in about ten years. California is also said to be the state with the most advertised nursing and CNA posts. Additionally, the CNA training is comparatively cheaper in California than other states. Hence, if you are a CNA in California, you are very likely to get a job as soon as you complete your course. The jobs are, however, concentrated in cities like Los Angles, San Diego and San Francisco.
Becoming a CNA
The California state government requires a CNA to be at least 16 years of age. First of all, one will have to enroll in a state approved CNA course. The duration requirement for CNA classes in California is 150 hours; for the federal government it is 75 hours. This course comprises of 50 hours of theoretical classes and 100 hours of practical classes. In addition, the courses are usually free if you agree to work for them after your course is complete. After completing the CNA course, one will need to pass the certification exam that is conducted by Public Health Aide and Technician Certification Section of California. Then, the applicant will have to go through physical tests to prove that she doesn’t have any health issues that could hinder her practice. After all these procedures a nursing assistant will finally be called a certified nursing assistant’ and gets ready for a job.
Difficulties faced during jobs
CNA jobs are not as easy as they seem. In spite of the easy path to becoming a CNA, the duties and responsibilities are way too hectic. One will have to go through a lot of mental as well as physical pressures. One may have to do night duties, and may have to go through disastrous cases. One will need to keep oneself strong at heart so as to tackle frightening situations. The keeping up of the hygiene of patients may be uneasy. CNAs are responsible for reporting the slightest changes and developments in the patients, so they have to be active every second during their shift. The worst part is that, despite doing so much for patients, they are hardly accredited for their contribution in their health.
However, no job can be impeccable. It has its own pros and cons. With all the difficulties at one side, it also has positive aspects to it. Becoming a CNA has no pre-requisites, and thus can be taken up by anybody. They earn quite well, somewhere between $ 9.5 and $ 14 an hour. With experience, their salary will increase more and more. The salary also depends on the kind of place one works. Most of all, CNA is a great job if one likes helping others. It is very rewarding and one receives so many blessings from patients. This blissful feeling cannot be compared to any other materialistic factors; this feeling is what makes a CNA overcome all the difficulties and hardships.
Anyone who begins looking into long-term care options will quickly run into the terms Medicare, Medicaid and Medi-Cal. Many people are confused but these are three different programs. In today’s post, Let’s do our best to give you a basic overview of the three different programs.
Let’s talk about the three M’s. The Medicare, Medicaid and Medi-Cal.
So these terms are used a lot for seniors because they are the medical services that you receive once you reach age 65. But there is a ton of confusion around them. And unfortunately the names are so close to each other, that people often interchange them and use them alternately when their very different programs.
Let’s start with a few definitions to kind of clarify things for folks.
The first is, what is Medicare?
(Medicare) is probably the most common government benefit that seniors are able to take advantage of next to Social Security. What it is, is it’s the medical coverage for seniors over the age of 65. So, it covers doctor visits. It covers prescriptions. It covers hospital stays and to a certain extent it will cover some long term care or some skilled nursing stay if you’re rehabilitating from a surgery. But it is the most common and you often get it when you’re 65. That means you stop having to pay private health coverage premiums. And it’s the most common program out there. It is very different from Medicaid.
Medicaid is a federal and state medical program for seniors that allows for payment if that person is age and disabled and they qualify, asset wise or financially, for this service. It’s a form of welfare. You apply for Medicaid at the wealth your local county welfare office. And it will provide for the majority of the costs of a stay in a skilled nursing facility. It also provides for in-home care for elderly if you qualify. For in-home caregivers to come in if you have a long term illness. And in some states it will cover assisted living – not in California.
The final M, Medi-Cal.
And that is California’s version of Medicaid. So again, it’s administered through the welfare department in your county. So that’s where you would apply. That’s you know, you would get assigned a social worker. And those are where the services would derive from. It is a different program in California as it’s different in every other state. In California the qualification requirements are different than any other state good example of that is PACE.
If You’re Googling Medicaid and Medi-Cal, you’re going to get some mixed information. So, the recommendation is if any of you need Medicaid or Medi-Cal, you should contact an experienced attorney who works in this area. Because, the rules and regulations are very complicated and it is risky to go it alone.
That is the difference between Medicare, Medicaid, Medi-Cal. This might have confused you even more, don’t know. But always, when push comes to shove and you need to get information.
We don’t like to think about this level of retirement housing but it is always waiting in the wings. It may just mean that you need therapy and physical assistance after recovering from surgery or other medical problems before returning to your own home. It doesn’t have to be a negative experience, but it is important to make your wishes known to your family before the unexpected occurs.
A skilled nursing facility, or nursing home, provides care to those who need nursing care but do not need to be hospitalized. This kind of care may be needed after a major surgery, an accident or for step down care after leaving a hospital if you are too frail to go home.
Essential Element For Nursing Facilities
An essential element to grasp regarding skilled nursing facilities is that levels of care can vary, even within the same facility, ranging from intensive round the clock nursing, to personal care with minimal assistance and without any active nursing care.
Hospital facilities, called extended care facilities, are located within the hospital itself and provide the next highest level of nursing care after being hospitalized for an acute episode of some kind. These facilities are expensive and are not meant for long term residence so the average stay is only one or two weeks.
For example st paul medical clinic, a non-hospital based medical clinic will also provide comprehensive nursing care and includes a multitude of other services. A Skilled Nursing facility can be for either short-term, post-hospitalization recovery, or long-term for a permanent impairment.
A Skilled Nursing facility is often a comprehensive health care center, which means as you get better you can move down to the next level (an intermediate care system).
Intermediate Care Facilities
Assisted Living Care Facilities are good for those who are unable to live independently, but do not require intensive nursing care. These places provide medical attention and assistance with eating, dressing and bathing. There is always a licensed nurse on duty for emergencies.
Medicare and private insurances will pay only up to their coverage limits. Care has to be prescribed specifically by a physician and the patient has to have been recently discharged from an acute care hospital.
The only way to determine if a nursing home is a good one is to visit it yourself. Speak with staff members and with the residents and keep your eyes open. Your first impression may be your most important screening tool, but visit at different times of the day and ask questions about everything. Ask for and read state inspection reports. If you are looking at long term care and perhaps Medicaid coverage you will want to make sure the facility meets the requirements. Multiple moves are very confusing to people who already have a lot of negative things going on in their lives. Just because you are old does not mean that you don’t have the right to be happy. Finding a nice place is important but don’t forget that it is equally important to select a facility that is close to where the rest of family resides. Nursing home staff members are warm and caring individuals but it is up to the family to provide true social interaction.
How to Choose a Certified Aging in Place Specialist
Let’s talk about how to choose a Certified Aging in Place Specialist. Also, let’s talk about some financing options for aging in place modifications. In general, there are two types of funding to pay for modeling of your parents’ home, private and public. The most likely source of private funds are their own. Perhaps they have enough savings to cover the renovations or a home equity loan might be a good source of funds, especially if they have sufficient income to cover monthly payments verses just taking out all of the cash from their savings.
Another option is a reverse mortgage which could also free up funds to pay for other services such as in home senior care. It’s best to check with your parents’ Financial Advisor before making a determination on which of these options might be best for them. Sometimes home modifications can be prescribed by your parents’ doctor. If that’s the case, get the prescription in writing and your parents may be able to claim a medical deduction on their federal Income Tax return.
On the same note, check with your parents’ private health insurance company to see if they will pay for the modification. Show them the prescription from the Doctor or Physical Therapist. If the insurance company says no, getting a written letter of denial is suggested. Other private funding options include contributions, donations and in-kind work from family members, community service groups, churches or other non-profit organizations. Be sure to check with your parents’ local Senior Center or Council on Aging for possible referrals.
The other funding option is public sources which are normally income and needs based. Funds may be available for home modification under the Medicaid Home and Community Based Services Waiver. Another option is to call your local Social Security office to see if any of the equipment your parents need might be covered under Medicare PACE Program, or if either of your parents is a veteran, contact the local VA to see if funding is available through that agency.
Many states and communities also offer home modification programs to help some homeowners pay for necessary changes. Local community development or social services agencies usually administer these programs, so contact your parents’ town or city hall for information. Some of these community programs have carpenters, plumbers, electricians and painters on staff to do the work.
Other programs furnish free labor and the homeowner purchases the necessary material. Low interest or no interest loans, usually not repayable until the homeowner sells or leaves the home are offered by other programs. Some programs simply provide a list of reliable contractors and assist in the process of receiving bids, selecting the contractor, developing a contract and ensuring that the work is performed in accordance with the contract.
As you can see there are certainly a lot of options out there, it’s wise to help your parents do their homework before committing to any aging in pace or other home improvement project. Doing so could save your parents’ valuable dollars all while making their house a place where they’ll be able to call home for a lifetime.