[Congressional Record Volume 165, Number 10 (Thursday, January 17, 2019)]
[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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