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Farmville PACE Center Coming Soon

FARMVILLE – Farmville and the surrounding seven-county area are poised to become PACE-setters later this year.

PACE stands for a Program of All-Inclusive Care for the Elderly and Centra PACE's nationally-recognized program targets a November opening in the former Longwood Village Shopping Center's movie theater complex, currently under renovation.

PACE is a comprehensive program for adults 55 years of age and older who meet the criteria for nursing facility placement but prefer to remain living at home and have an assessment indicating that living at home with the support of the PACE program is a safe alternative.

The program provides adult day-care as one part of its comprehensive and individualized participant care.

Farmville will be an expansion site from Centra PACE's Lynchburg facility, its executive director Debra Maddox told Town Council during a briefing for Town officials this month. The program expects to create approximately 40 local jobs to care for 125 PACE participants at the Farmville site.

PACE, whose foundation can be traced to a community-based system of care begun in San Francisco in the 1970s, is funded through Medicare and Medicaid and is a program of the Commonwealth of Virginia, with both state and federal oversight.

There are 82 PACE programs in 29 states. Centra opened its first PACE site in Lynchburg in 2009.

“If you think about a mission, a purpose and a goal, it's a way to keep individuals at home for as long as we can, as long as they're physically able to stay at home,” Ms. Maddox told Town Council.

Centra PACE admits patients into its program on a monthly basis, usually the first of each month, and an assessment is done to make sure they are eligible to be part of the program.

The PACE program, explained Ms. Maddox, also a Nurse Practitioner, “is certified through Medicare and Medicaid and those two entities pay for the services…When you join the program you actually turn your Medicare and Medicaid card in. We let you keep it. We put a sticker on it that says 'Don't use this card, use your PACE card,' and we become that insurance company and we pay for all of your medical needs.”

The program is cost-free, except in rare instances where a nominal fee may be necessary for someone not qualified for Medicaid.

But those who become PACE participants are not locked into the program. They can just as easily opt-out later.

“If you choose to join the program, that's great. If you choose to dis-enroll at any time and go back to your Medicare and Medicaid medicines, that's okay, too,” Ms. Maddox said. “It's just a different option for those individuals who say 'I really want to try to live at home for a little bit longer and I need some assistance.'”

The assistance includes transportation.

PACE has a fleet of buses and provides transportation to the facility each morning, Monday through Friday, and then takes those enrolled in the program back home. Participants receive medical care and enjoy a host of activities. Staff, meanwhile, are on-call 24-hours a day, seven days a week.

“It truly is a 24-hour (program). We have administrative staff on call 24 hours a day, we have a physician, a nurse practitioner on call 24 hours a day, and the same services will be extended in Farmville,” Ms. Maddox assured Town Council.

The services are based upon an individualized blueprint for each participant's care.

An interdisciplinary team develops a program of care specific to each PACE participant, Kim Woodley told Town Council as part of its June monthly meeting.

“We have an interdisciplinary team that is made up of physicians, nurses, dieticians, occupational therapists, physical therapist; if needed, we have a speech therapist that we consult,” said Ms. Woodley, Quality Coordinator for Centra PACE, and who will also serve the Farmville PACE site in that capacity.

“We have transportation, activities, and the whole idea is to develop a plan of care that's individualized for each person. No two people will have the exact same plan of care,” she said.

“We look at the goals the participant and their families want to achieve with that healthcare. Whether they want to achieve a functional status or maybe just a palliative status where they are comfortable. We look at all of those things and then we put together a care plan,” Ms. Woodley detailed.

The PACE program is also involved in the life and care of its participants when they are home each evening and on weekends.

“We have a home care coordinator. We look at what's going on in the homes so that we can assist them in optimizing their homes by safety features. We try to minimize any adverse events that might occur in the home,” Ms. Woodley told them. “We have a social worker who assists in a variety of areas, including resources and making sure participants have what they need.”

The interdisciplinary team gets together every six months to review the care plan for each participant.

“Or sooner if necessary. If a participant has a change in level of care,” Ms. Woodley explained, “they get together sooner, or if the participant or family members want it sooner. But at a minimum every six months they get together, they look at the progress that's been made-did they meet the goals that were set? If so, that's great. Are there new goals we want to set? If they didn't meet the goals, what do we need to do to help them achieve those goals?”

And those goals for each PACE participant, Ms. Woodley stressed, “are outcome based…We have to have evidence that they met them. They're not just all touchy-feely. They're very evidenced-based.”

Ms. Woodley told Town officials that her “role in the program is in the quality area, so we have a lot of checks and balances to evaluate where we are and are we meeting our targets organizationally…”

Covering the financial aspects of the Centra PACE program, George Graham explained that it is “an agreement between the state and federal government…so we receive both funding from Medicare, for their Part A and B, or hospital stays and out-patient stays, as well as their Part D program. So we are a licensed Part D program, provide any and all medications (participants) might require.

“We also receive money from the state, Medicaid. If a person does not quality for Medicare then they're just Medicaid-only; we can still enroll them in the program,” Graham continued. “Or if the person does not qualify for Medicaid they can enroll in the program as a Medicare-only participant and then they would pay a small fee, which is less than what it would normally cost them in a nursing facility.

“The majority of our participants, I want to say currently in Lynchburg, pay zero dollars each month for this program. It's absolutely free,” noted Graham, the program's office manager in Lynchburg and who will also serve the Farmville site. “Probably about 90 percent of them it's absolutely free.”

The PACE program also provides ten days of respite care, allowing family members to go on vacation without having to worry about the well-being of a loved one.

“For example, if your mother or father is living with you and you want to go out of town, but they can't really travel, we provide ten days of respite in a facility,” Graham explained, “so that way you could go out of town for a wedding or go on vacation.”

Ms. Maddox told Town Council that, “when you join the PACE program you need to have assistance at home…You need to have a family member that's going to assist you with the care, and you have to (need) a nursing home level of care. In order to do that you need to have the department of social services do an assessment as well as someone from the health department do an assessment and let us know you meet that nursing home level of care.”

Referring to the adult daycare, Ms. Maddox said, “that's a part of the PACE program.”

But the services go far beyond that.

“When we say all-inclusive care that's just one part of the PACE program. When you come into the center there's a physician's office and a team of clinic staff-that includes nurses, nurse practitioners, medical assistance-that takes care of your needs, just like you were going to go to the doctor's office. And they have a daily clinic schedule available for all the participants that join the program,” explained Ms. Maddox.

Transportation, it was emphasized, will be provided by the PACE program for its participants.

“We have a fleet of six buses in Lynchburg. We'll probably have six or seven buses or more in this area. We go and actually pick the participants up each morning. We bring them into the program,” Ms. Maddox said. “If they need to go out to see a specialty physician-cardiology, neurology-we have a general practitioner who works on the PACE site, but the bus actually takes them to their physician's offices so they don't have to worry about transportation.

“We provide dental services, we provide audiology, we provide dentures, we provide the vision screening; we make sure they get there, make sure they get their prescription. We actually take them to get their glasses. We take them back for their visits,” she said, “so it truly is a comprehensive package of care.”

Physical therapy will also be provided.

“We have a gym, a physical therapy department, an occupational therapy department that's also on the site. And the nice thing about that is if there is any rehabilitation you don't have to jump through a lot of hoops,” she told them. “You get that rehabilitation when you're there…”

And prescriptions.

“We have a full time pharmacist,” Ms. Maddox said.

Following the presentation, Ms. Maddox asked for questions from Town Council.

Town Council member Dr. Edward I. Gordon asked if the Farmville PACE site would employ local people and Ms. Maddox said, “Yes, that's our goal. When we're fully operational-and it takes about two to three years-40 jobs available for Farmville and the surrounding counties.”

Elaborating, Ms. Maddox said that she, Ms. Woodley and Graham would work with both the Lynchburg and Farmville PACE sites, and there will be a center director's position, “but everyone else will be hired locally.”

Council member Sally Thompson then asked if participants would be offered activities during their day at the PACE center and was told by Graham that PACE employs a recreational therapist and recreational therapy aides. “We're licensed by the department of social services as an adult daycare center as well and so activities is a major portion of the day…The majority of participants' time is in the center doing activities, whether it be physical activities, crafts, games, different things for dementia patients, a variety of things we utilize…”

The Farmville PACE site hopes to establish a mutually beneficial relationship with Longwood University faculty and staff.

“That's one of the things we're hoping to work with here, as well, because Longwood has recreational therapy department, and so we're very excited to have that resource. That's something that we don't have in Lynchburg…so we're very excited to work with the university,” Graham said, “to involve those students and involve the professors, as well, to put on a very good activities program.”

Centra's Lynchburg PACE site has gotten off to a flying start, consistently meeting state and national standards, so much so that national conferences have included its staff among its agenda presenters and presentations.

The Lynchburg site, in fact, has had three consecutive federal surveys, or inspections, with zero deficiencies.

“We actually were compared to Johns Hopkins' PACE program as one of only two sites in the first three years of operations to have zero deficiencies for the Region 3 of Medicare,” Graham noted, “so that was a big compliment to us.”

“We presented on the national level and the federal level. Kim actually just presented at a PACE conference in Philadelphia a few months ago…and we're going to in Los Angeles at the national PACE conference this October.”

Centra PACE also presented at the national PACE conference in San Francisco last fall.

The Farmville PACE program will service Prince Edward, Buckingham, Appomattox, Cumberland, Amelia, Nottoway and Charlotte Counties.

The PACE trio who briefed Town Council has been visiting those counties in the service area, establishing contacts. The Farmville Centra PACE center does not need Town Council approval but Ms. Maddox told Town officials they wanted to let Farmville's leaders know what is going on so “you'll know who we are and what we're all about.”

(Disclosure: Ms. Woodley is the wife of Herald editor Ken Woodley, who wrote this story as part of his regular coverage of Town Council)