Tahlequah Daily Press

August 1, 2008

Seniors staying on PACE


Area residents driving west on Fourth Street may notice Cherokee Nation Elder Care and immediately dismiss it as a nursing home for Cherokee citizens.

Actually, it’s neither.

CNEC is Oklahoma’s first facility to participate in the federal Programs of All-inclusive Care for the Elderly (PACE), and the first to be sponsored by an Indian tribe. But sponsorship is where the tribal affiliation ends, according to CNEC Program Director Ben Stevens.

“I have a board of directors I report to, and I don’t answer to the chief or the tribal council,” said Stevens. “Cherokee Nation was very generous in providing the funding for the startup so we could qualify for the federal and state grant funding to become a PACE facility.”

PACE is a federal program designed to keep elders living in their homes, connected with their communities and out of nursing home facilities. The PACE center consolidates the services of an adult day health center, primary care office and rehabilitation facility into a single location.

“My catch-phrase to anyone who thinks we’re a nursing home or adult day center is ‘we’re similar, but different,’” said Stevens.

According to Stevens, the application process to become a PACE facility is quite rigorous, and requires that the agency have a facility, staff, supplies and equipment – essentially lacking only participants – before ever making the application.

Service include, but aren’t limited to, primary care, rehabilitation, prescription medication, meals and nutritional counseling, respite services, caregiver training, home health and transportation.

“We provide team-base care management,” said Stevens. “The interdisciplinary team consists of a full-time physician, clinical nurses, physical therapist, occupational therapist, adult day center nurses, activities director, dietitian and transportation director, and they all have equal say in planning for a participant’s care. No decision can be made without the agreement of the team, the participant, the participant’s caregiver and family. We treat participants holistically. All of these people come together, compare notes and customize a plan of care for the participant.”

Any services not provided by CNEC are contracted out, and vendors are paid directly by CNEC – not Medicare, Medicaid or private insurers, said Stevens.

Currently CNEC partners with Tahlequah City Hospital and Northeastern State University’s College of Optometry and its audiology and speech pathology lab.

TCH CEO Brian Woodliff is pleased with the arrangement.

“The citizens of Cherokee County are fortunate to have the Cherokee Nation seeking out and being awarded grants and funding like the PACE program,” said Woodliff. “Tahlequah City Hospital is proud to partner with PACE to provide ancillary services such as laboratory, radiology and hospital services. Providing access to healthcare is one of the barriers to a healthy senior lifestyle, and PACE provides unique programs that include transportation, nutrition and pharmaceuticals for this population.”

Prospective participants must:

• Be 55 years or older.

• Be certified by the state as needing some level of nursing home care.

• Be able to be safely cared for in their home.

• Live in a PACE service area. CNEC’s PACE area is defined by zip code, and serves elders living in the following zip code areas: 74347, 74352, 74364, 74368, 74423, 74464, 74471, 74452, 74427, 74451, 74434 and 74441.

“It’s an interesting coincidence that we only cover one of the Muskogee zip codes, and our coverage area ends on Cherokee Street,” said Stevens. “However, we already have plans to add programs that will cover the Stilwell, Muskogee and Claremore areas.”

CNEC provides transportation to and from the facility, as well as to and from any necessary contract caregivers.

Participants of CNEC PACE must agree to assign the agency as their primary care physician and to no longer receive individual Medicare or Medicaid services.

“The cost to the individual varies,” said Stevens. “Participants with Medicare or Medicaid do not lose their coverage, but Cherokee Elder Care becomes the administrator of these benefits. This means that the participant maintains their Medicare or Medicaid benefits and becomes eligible for additional services offered here.”

PACE accepts Medicare and/or Medicaid and private pay. Some participants may have a minimal monthly obligation. Once someone becomes a participant, he or she is “locked in,” and is liable for the cost of services - except emergency services - obtained without Personal Care Team approval.

All prescription and non-prescription drugs deemed necessary by the PACE team are paid for by the program. On average, PACE participants attend the day center three times a week.

Learn more

To find out more about the PACE program at Cherokee Nation Elder Care, call (918) 453-5554 or visit the Web site http://elder care@cherokee.org.