[Congressional Record Volume 161, Number 154 (Wednesday, October 21, 2015)]
[House]
[Pages H7079-H7080]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




              AMENDING TITLE XI OF THE SOCIAL SECURITY ACT

  Mr. BRADY of Texas. Mr. Speaker, I move to suspend the rules and pass 
the bill (S. 1362) to amend title XI of the Social Security Act to 
clarify waiver authority regarding programs of all-inclusive care for 
the elderly (PACE programs).
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                                S. 1362

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. CLARIFICATION OF WAIVER AUTHORITY REGARDING PACE 
                   PROGRAMS.

       Subsection (d)(1) of section 1115A of the Social Security 
     Act (42 U.S.C. 1315a) is amended by striking ``and 
     1903(m)(2)(A)(iii)'' and inserting ``1903(m)(2)(A)(iii), and 
     1934 (other than subsections (b)(1)(A) and (c)(5) of such 
     section)''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Texas (Mr. Brady) and the gentleman from Oregon (Mr. Blumenauer) each 
will control 20 minutes.
  The Chair recognizes the gentleman from Texas.


                             General Leave

  Mr. BRADY of Texas. Mr. Speaker, I ask unanimous consent that all 
Members may have 5 legislative days within which to revise and extend 
their remarks and include extraneous material on S. 1362 currently 
under consideration.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Texas?
  There was no objection.
  Mr. BRADY of Texas. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I rise in strong support for S. 1362, the PACE 
Innovation Act of 2015.
  The companion bill in the House, H.R. 3243, was introduced by my 
longtime colleague and a real champion for the elderly and the frail, 
Chris Smith of New Jersey.
  This legislation is a commonsense, bipartisan approach to increasing 
flexibility in our healthcare system.
  PACE, or the Program of All-Inclusive Care for the Elderly, is an 
integrated care program that provides hands-on, long-term care and 
support to beneficiaries who need an institutional level of care but 
continue to live at home. Many of these beneficiaries are dual 
eligible, or eligible for both Medicare and Medicaid.
  Hardworking Americans who care for these beneficiaries and want to 
keep their loved ones at home have relied on this program for well over 
a decade, as the program has now expanded to 32 States.
  There are two programs currently operating back in Texas, and I am 
looking forward to monitoring the program's continued success back 
home.
  However, currently, the PACE model is limited to seniors who meet a 
specific list of criteria, Federal and State, for needing a nursing 
home level of care. The PACE Innovation Act would allow Medicare to 
test the PACE benefit on other vulnerable populations.
  With the popularity and success of the PACE program, it is clear 
that, to live up to its full potential nationally, other populations 
should be targeted to benefit from comprehensive PACE models.
  These beneficiaries are some of our Nation's most vulnerable, who, 
along with their families, have chosen not to enter into full-time 
nursing home care at a facility.
  Studies have shown that people receiving care from PACE organizations 
have better outcomes and less hospitalizations and, more importantly, 
have more time to spend with their families in their own homes--and 
that is key.
  The PACE Innovation Act is revenue-neutral and widely supported.
  I would like to thank fellow Ways and Means Committee members Charles 
Boustany, Mike Kelly, Lynn Jenkins, Earl Blumenauer, Bill Pascrell, 
Bill McDermott, and Richard Neal for their strong support of this 
effort and encourage that the whole House vote to pass S. 1362 under 
suspension of the rules and send it to the President's desk.
  Mr. Speaker, I reserve the balance of my time.

                              {time}  1815

  Mr. BLUMENAUER. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I appreciate the comments from my friend from Texas. Mr. 
Speaker, there is occasionally a little bit of controversy around the 
House, a modest amount of disagreement, and, of course, that is just in 
the Republican conference. There are lots of things that get the 
spotlight.
  But I appreciate the leadership of my friend with our Health 
Subcommittee on Ways and Means for there are things below the radar 
screen where we have been working in a thoughtful and bipartisan way to 
try and see if we can thread the needle on a number of these things 
that don't have to cost a lot of money, and they enable us to be able 
to refine healthcare opportunities.
  One of the biggest accomplishments of the session was getting the SGR 
monkey off our back to deal with the sustainable growth rate in a 
bipartisan fashion, and there have been, I want to say, about 12 bills 
that have moved out of our Health Subcommittee that deal with 
initiatives going forward.
  What my friend from Texas said about the PACE Act is absolutely true. 
This is an opportunity for us to take a proven set of techniques to 
help seniors who want to stay at home, who do not want to be in nursing 
facilities, being able to give them the flexible needs in terms of 
services, and it works.
  I represent a program in Portland, Oregon, Providence ElderPlace. It 
serves over 1,000 Oregonians. It has got a solid track record. It has 
costs that are lower than average if they were Medicaid beneficiaries. 
In some States, these savings can be nearly 30 percent.

[[Page H7080]]

  There are opportunities here to be able to give better ongoing 
service. The hospital readmission rate, for example, the program I 
mentioned in Oregon, is far under the national average of 15.2 percent. 
It is about half that rate.
  This simply extends this opportunity to a broader range of 
beneficiaries, people who have complex health conditions, but who are 
younger, for instance. They are no less deserving of this opportunity. 
I am absolutely convinced that the results will be every bit as strong.
  Mr. Speaker, I appreciate having this bill move forward, and I 
appreciate the advocacy of my friend, Mr. Smith from New Jersey. We 
seem to find a variety of things to work on together in this Congress, 
and there is nothing that I think is more important and is going to 
have more long-term impact for people who are quite vulnerable. It is 
going to save the Federal Government money while it provides better 
outcomes for patients and for their families.
  With that, Mr. Speaker, I reserve the balance of my time urging 
strong support from my colleagues.
  Mr. BRADY of Texas. Mr. Speaker, I am really proud to yield 4 minutes 
to the gentleman from New Jersey (Mr. Smith), a real champion for the 
elderly and the fragile who has really been a leader for so many years 
on this key issue.
  Mr. SMITH of New Jersey. Mr. Speaker, first of all, let me thank 
Kevin Brady, the chairman, for his extraordinary leadership on this and 
so many other issues, and Mr. Blumenauer, with whom we have worked 
together to build a strong bipartisan push for this piece of 
legislation.
  I do rise in strong support for passage of S. 1362, the PACE 
Innovation Act. Identical to the companion bill that I introduced along 
with Mr. Blumenauer, this bill will provide PACE programs with 
flexibility to bring a proven model of care to new populations. The 
program for all-inclusive care for the elderly, or PACE, is a widely 
popular program serving over 30,000 seniors around the country.
  For those unfamiliar with PACE, the program delivers the entire range 
of medical and long-term services, including medical care and 
prescription drug services, physical or occupational therapy, day or 
respite care, and medical specialties such as dentistry, optometry, and 
podiatry.
  Currently, eligibility for PACE is limited to those aged 55 and over 
who meet State-specified criteria for needing nursing home-level care. 
This program will provide wellness and keeps people in their homes. It 
is already doing it. Now more people will benefit from it. It improves 
outcomes. And this is all for people who otherwise would be paying 
catastrophic costs for nursing home care.
  Mr. Speaker, PACE has seen a significant growth in recent years, 
including a 30 percent increase in the number of people receiving 
services over the last 3 years alone.
  PACE has a proven track record in my own State of New Jersey where 
programs currently serve roughly 900 seniors throughout the State.
  Just last week, Mr. Speaker, I had the opportunity to attend the 
grand opening and ribbon cutting of a new PACE program in Monmouth 
County, and it is New Jersey's fifth program.
  When I first heard about PACE, I worked hard to bring this valuable 
program to my State back in 2009. Even though it was around before 
that, it was one of the best kept secrets around.
  They then formed the first PACE program called LIFE, Living 
Independently for Elderly, at St. Francis Medical Center in the Trenton 
and Hamilton area. I have visited St. Francis LIFE often since and on 
its fifth anniversary was overwhelmed by the appreciation of seniors 
and their families for the program's ability to raise or maintain their 
quality of life.
  The limits, however, and operational restrictions placed on PACE do 
not allow these programs to serve many others in need. Chronological 
age should not be the determinant.
  If somebody is disabled and could use and should use a nursing home 
and is eligible, this gives another option to the family to keep them 
at home. The legislation will allow CMS to establish pilot programs and 
waive restrictions and test how to best deliver results for new 
populations.
  As Tim Clontz, the chairman of the National PACE Association's Public 
Policy Committee, testified before the Health Subcommittee on the 
Energy and Commerce Committee, he told stories about a man named Jim 
G., a 54-year-old man with early-onset Alzheimer's disease.
  He was hospitalized for a lung infection and, as a result, stayed 
home alone during the day, where he was isolated and struggled with 
activities of daily living, such as personal grooming, household 
chores, and child care.
  His wife quit her job to care for him full time, but his needs were 
more than she could handle. He was permanently placed in a memory care 
unit, and since PACE was not an option for Jim--remember, he is 54 
years old--his wife is crowd-sourcing to try to pay his medical care. 
This heartbreaking story could have been eliminated.
  I also chair the Alzheimer's Caucus, Mr. Speaker, here in the House, 
and I can tell you there are many patients with early onset who could 
benefit and benefit in a very, very significant way with this change in 
law.
  I look forward to the President's signature. Again, I want to thank 
you, Kevin, for your leadership and your very distinguished staff.
  Mr. BLUMENAUER. Mr. Speaker, I yield myself such time as I may 
consume to close just by saying, again, I express my appreciation to 
the chairman and to Mr. Smith for moving this forward.
  We find that the evaluations of the PACE program have proven that 
participants experience better health outcomes, fewer unmet needs, less 
pain, less likelihood of depression, and fewer hospitalizations and 
nursing home admissions.
  There are people out there now, if we make this change, that are 
ready to extend this higher quality of care for very deserving, needy, 
and vulnerable people who are younger than the threshold 55 years of 
age.
  Mr. Speaker, I urge we vote tonight, enact it into law, and let these 
people get to work serving these people in a new and profoundly 
improved way.
  Mr. Speaker, I yield back the balance of my time.
  Mr. BRADY of Texas. Mr. Speaker, I yield myself such time as I may 
consume to close.
  Mr. Speaker, I want to thank again these champions, Mr. Smith and Mr. 
Blumenauer, for coming together on a very important program that makes 
so much sense.
  This is our mom or our dad, our loved one who wants to get care, but 
doesn't want to be in that nursing home. It is good for them, it is 
great for the family, and it is good for the taxpayers.
  It just makes common sense. Having this strong, bipartisan support 
for this bill I think is every reason for it to pass through this 
House, to be signed by the President, and be expanded all across 
America.
  So, Mr. Speaker, I stand in strong support for the PACE Innovation 
Act and urge its passage. With that, I yield back the balance of my 
time.
  The SPEAKER pro tempore (Mr. Costello). The question is on the motion 
offered by the gentleman from Texas (Mr. Brady) that the House suspend 
the rules and pass the bill, S. 1362.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill was passed.
  A motion to reconsider was laid on the table.

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