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  • Daniel Duncan

A Better Model for Senior Care

I recently received an email from a voter in District 14 asking if I would support expanding a particular program in Laurens County. I'd only ever heard of a PACE program that helped teachers get certified, and I was already for that. But this voter, let's call him John, stated that his situation was pretty rough and he would likely need more care than his family could provide in the near future. He had heard of a program administered by Prisma Health in Columbia and Greenville that helped seniors and disabled people stay in their homes instead of being placed in a nursing home.

This definitely grabbed my attention, because my mom and my sister both worked in nursing homes for decades. Those are a nightmare on many levels, particularly in staffing and resources, but the care model itself is not great. With the limited, low paid staff that are at many for-profit facilities, they are forced to keep patients in their rooms most of the time. They're more like a hospital than a home, so it's no wonder most patients last only 6 months once they're admitted. It's not the kind of environment where one can thrive.

After reading some of the research that John provided me (see footnote), I started reaching out to Prisma to learn more. It took a few calls, because right now I'm just a rando off the street, but finally I had a conversation with almost the right person. They told me the basics of the program, who to talk to for better information, and eventually I got to talk to the administrator of the program. I could tell that they were passionate about this care model, and would love to make it available beyond Greenville and Columbia. They used to administer the now defunct long term care facility on the third floor of Laurens County Hospital, so they already had a connection to District 14.

So what is PACE? It's similar to Adult/Elder Day Care, in that patients are brought to a facility to spend the day, and return to their homes at night. This allows patients to age in their homes and not be admitted into a care facility full time. With aging and infirm parents and in-laws, I can see right away the benefit of such a program, but there's more. Requirements of the PACE program mean that the facility has to have an on-site doctor's office to meet the urgent and primary care needs of the patients. So there's no need to run back and forth to various facilities, it's a one-stop shop for daily care. It's also focused on making sure patients interact with each other, rather than stay in bed all day. There are quiet areas if a nap is needed, and a nutritional meal is served each day, but the focus seems to be helping patients stay active in whatever capacity they can.

Now, it is not free. Medicare, and Medicare + Medicaid both cover 100% of the costs. Medicaid patients currently pay about $3800 a month, which is less than an inpatient care home, but they also have to pay their home expenses. I also don't know how much the state would need to put in to develop a facility in District 14, but I'm passionate to see this happen. I am betting there's some building in the Cross Hill or Waterloo area that could be converted and also serve Greenwood county. I'll be working on helping make this a reality, whether or not I win this election, but my being able to request an earmark would definitely help.

Footnotes: https://www.npaonline.org/policy-advocacy/state-policy/research

https://www.medicare.gov/your-medicare-costs/get-help-paying-costs/pace

https://vimeo.com/502750464/3c707f0c70

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