Google Street View | PACE vans help seniors make it to their medical appointments.

Access to senior care in the most rural areas of the Central Valley has long been a challenge. Transportation, managing doctor and specialist visits or struggling to find in-home care options, many seniors in the Valley are left with a “what about me?” feeling.

For Tulare and Kings counties, help is on the way at the new PACE Center. Opened this past summer, the center fills a much-needed role for senior care in an underserved region.

But how did senior health care get so difficult to access in the Valley, and what does PACE (Program of All-Inclusive Care for the Elderly) hope to bring to the community?

 

Historically unhealthy

It’s well known that the region has trouble recruiting health care professionals. That’s exacerbated by the sheer demand as the population ages. Rural areas have it the worst.

Anshuman Srivastava, a Visalia physician, said that nationwide, 57 million Americans reside in rural areas. The Central Valley has historically fallen behind urban regions in senior care access.

“Because of this the health disparity has gotten worse compared to the urban areas,” Srivastava said. “If you compare the data…we have around a 21,000-health-professional shortage in rural areas compared to only a 900-shortage in urban areas.”

Srivastava said the issue often stems from prioritization of other essential needs over health — not due to lack of concern, but lack of awareness.

“I’m not going to blame any people, patients or populations about it,” Srivastava said. “It’s more because health was never a priority for them.”

 

Pick up the PACE

Grady Dodson, the Visalia PACE Program Director at Family Healthcare Network, agreed that a lack of health care professional incentives also have caused the Valley to fall behind.

The opening of a new PACE Center, providing senior care to residents in Tulare and Kings counties, hopes to change the narrative for senior care.

PACE stands for Programs of All-inclusive Care for the Elderly and aims to provide just that — a continuum of well-rounded, holistic care for seniors, comprising many of the various specialties the community requires under one roof.

 

Founded by Dr. William Gee and social worker Marie-Louise Ansak in San Francisco in 1971, the program keeps senior citizens out of hospitals and nursing homes, focusing on improving the quality of life for communities’ most health-vulnerable populations.

“We want to see seniors age in place, remain in their communities,” Dodson said. “We know the quality of life for them is much higher there than it is, per say, going into a skilled nursing home.”

 

Medicare partner, provider

The PACE Center in Visalia is funded by Medicare and functions as its members’ primary care provider, along with offering specialist services and partnering with local specialists to fill the gaps not directly provided by PACE itself.

The 25,000 square-foot center, located at 500 E. School Ave. in Visalia, also boasts its own facilities including a day center for recreational therapy activities. Programming is meant to combat depression and loneliness — something that is elevated in the senior community.

 

 

 

At the PACE center, members receive a hot lunch, engage in games and activities and also have access to a quiet room, as well as bathroom facilities with showers for members in need of hygiene assistance.

“It’s really a holistic approach to their care,” he said. “The PACE Program also helps with taking care of their medications.”

 

Personalized care

PACE’s system has patients working closely with an interdisciplinary team (IDT) to determine their individual needs.

“Each member of the IDT, they all do their assessments — they spend a great amount of time with the participant,” Dodson said, evaluating their diets, social needs and other health concerns. “Each new participant gets that thoroughness to individualize their care plan.”

Dodson added that each patient also has their own voice, granted the ability to advocate for themselves. Families also have the ability to voice their concerns.

“It really becomes personal because there’s not a ‘cookie cutter,’ unlike other health care models that are out there,” he said. “PACE is guided by that principle.”

Dodson said that through PACE’s work, MediCal has saved $131 million in health care costs through finding correct services for patients, preventing overlap of services and improving general day-to-day life through continuous care.

 

Angels on wheels

In addition to the personalized services offered at PACE, the center also offers transportation — a key need for many senior residents in more rural communities.

“Many of our seniors suffer from health issues simply because of a lack of transportation,” Dodson said. “If you have parents and loved ones, aunts and uncles, grandparents — some of them are not getting there because you’re busy at work and they can’t get to their next appointment.”

An employee in the health care field for 17 years, Dodson, a Valley native, said that he has seen many different medical models, but said that PACE’s holistic approach and access to care is second-to-none in the health care industry. The center’s treatment of its members differs from the standard health care industry’s technique of “for service” visits.

 

“Similar to Costco, they’re a member,” Dodson said. “You don’t treat members the same way you treat a customer; a customer’s going to be a one-time shopper…that’s the current model we have in health care now.”

 

Another on the way

WelbeHealth company recently announced plans to build a second Visalia PACE center — 17,000 square feet at 1150 S. Ben Maddox Way in a complex that already includes a Kaweah Health clinic and DaVita Dialysis, reported the Sun-Gazette newspaper.

WelbeHealth is a physician-led public benefit company founded in 2015 that provides comprehensive health care services for seniors.

There are 99 PACE Centers and Alternative Care Sites in 27 counties serving 22,000 participants annually throughout California.

Tulare and Kings county residents interested in PACE must be 55 years or older, live in the region served by a local PACE Center, be certified in the State of California as requiring nursing home-level care and be able to live safely in the community with PACE assistance.

The Tulare/Kings County PACE Center can be reached at (877) 326-PACE (7223) or by email at pace@fhcn.org. Visitors are also welcome to stop by for more information at the PACE Center in Visalia, located at 500 E. School Ave.