The California PACE Association (CalPACE) is a 501(c)(6) association dedicated to the expansion of comprehensive health care services to the frail elderly through the Program of All-inclusive Care for Elderly (PACE).
Although the CalPACE programs have worked as an informal collaborative in the past, they have identified the need and the benefits both collectively and individually, by formalizing the relationship. To this end, CalPACE was developed to support, safeguard, and expand PACE programs and initiatives in California through education and advocacy to enhance the lives of PACE participants and their caregivers.
CalPACE was formed in 2007 as the nation’s first state PACE trade association to solve problems facing PACE providers and the seniors they serve. California’s four PACE organizations of that time – AltaMed, The Center for Elders’ Independence, On Lok, and Sutter Senior Care with St. Paul’s Senior Services, an organization applying to be a PACE provider – founded CalPACE.
At that time, new PACE provider applicants and existing PACE programs faced costly and extreme delays in the state’s processing of applications. Enrolling seniors in all the California’s PACE programs took months due to delays in completing nursing home level of care determinations.
From the beginning, CalPACE has built camaraderie while bringing PACE voices together to change the policy environment for PACE providers in California. Now, it takes approximately 18-months to site a new PACE facility, PACE enrollment takes five business days, and there are no caps on PACE growth. Our key milestones as an association are summarized below.
2007 CalPACE incorporated as a 501(c)(6) in August. On Lok hosted CalPACE in its San Francisco offices and served as staff, with its CEO Bob Edmondson named the association’s first Executive Director and Board of Directors’ Chair.
2008 St. Paul’s PACE Reasner Center opened, meeting California’s cap under AB 1601, of 1991, authorizing DHS to contract with up to 5 PACE organizations.
2011 Peter Hansel named CEO of CalPACE, which establishes a new headquarters, in Sacramento.
AB 574 signed into law, increasing the number of authorized PACE contracts from 10 to 15.
2012 SB 1008 signed into law, establishing PACE as an enrollment option in the Coordinated Care Initiative, including Cal MediConnect, the state’s dual demonstration project providing integrated care options for beneficiaries eligible for both Medicare and Medicaid.
The Department of Health Care Services (DHCS) streamlines the PACE level of care review process, reducing enrollment in PACE to 5 business days.
2013 Caps on PACE enrollment removed through a California State Plan Amendment with the Centers for Medicare and Medicaid Services.
2014 SB 870 signed into law, increasing PACE Medi-Cal reimbursement rates to a level no less than 95 percent of fee-for-service equivalent costs for a comparable population.
2015 California PACE provider organizations grow to 10. Enrollment surpasses 5,000.
2016 SB 833 – the PACE Modernization Act – signed into law, changed the rate-setting methodology for PACE organizations, eliminated the cap on the number of PACE programs in law, allowed for profit PACE organizations, and directed DHCS to work with feds to create regulatory flexibilities.
2017 30 PACE centers and alternative care sites serve California.
2019 40 PACE centers and alternative care sites serve California.
AB 1128 signed into law, transferring oversight and regulation of primary care clinics, adult day health centers, and home health agencies serving PACE from the Department of Public Health to the Department of Health Care Services.
2020 California PACE provider organizations grow to 15. Enrollment surpasses 10,000. 50 PACE centers and alternative care sites serve California.
California PACE providers are among the first to vaccinate seniors for COVID-19. Vaccination rates for many providers exceeded 85%, a level unmatched in the Medi-Cal program.
DHCS grants PACE providers operational flexibility during the COVID-19 public health emergency. Enrollment was simplified and telehealth authorized to ease routine communication between seniors and doctors. Additionally, staff were retrained and redeployed from PACE centers into the homes of seniors for care, helping them overcome isolation while social distancing. These flexibilities fueled care innovations enabling PACE organizations to keep COVID-19 infection rates low. Compared to nursing home residents, seniors enrolled in PACE were over 73% less likely to contract COVID-19.
2021 California PACE provider organizations grow to 20. 60 PACE centers and alternative care sites serve California.
California releases The Master Plan for Aging, following CalPACE’s participation as a member of the Stakeholder Advisory Committee.
AB 133 signed into law, increasing PACE awareness and access by requiring PACE, as part of the implementation of the state’s CalAIM initiative, to be presented to Medi-Cal beneficiaries as a Medi-Cal managed care enrollment option and included in all enrollment materials and outreach and enrollment assistance programs.
DHCS’ Home and Community-Based Services Spending Plan of federal American Rescue Plan Act funding makes PACE eligible for training and stipend funds and one-time incentive payments for direct care workers and clinical workforce training grants.
2022 70 PACE centers and alternative care sites serve California. Enrollment surpasses 17,000.
DHCS’ plan to unwind key regulatory flexibilities in place during COVID-19, preserves the ability of PACE providers to use telehealth as an alternative to face-to-face interactions, place participants in facilities outside of approved service areas, when necessary, use brokers for marketing, and receive direct referrals from hospital and facility discharge planners.
SB 184 signed into law, allowing PACE organizations to use video telehealth to conduct assessments for eligibility for enrollment in PACE.
Peter Hansel, the first CEO of CalPACE, announces his retirement. The CalPACE Board of Directors selects Val Sheehan as the next CalPACE CEO.
2023 Implementation begins of CalAIM provisions requiring PACE to be presented as a managed care enrollment option to beneficiaries who must enroll in managed care.
4 new PACE organizations are expected to begin operations in California.