Committee hears bill to establish PACE program in Nevada to keep seniors at home

Senate Bill 207, presented March 11 to the Nevada State Senate Committee on Health and Human Services, would require the Department of Health and Human Services (or a designated health authority) to establish and administer a Program of All-Inclusive Care for the Elderly (PACE) in Nevada.

Sponsor Senator Angie Taylor (Senate District 15) told the committee the bill mandates the state create a PACE program that can be operated by the department or in partnership with public or private entities, including federally qualified health centers (FQHCs) or private providers. The proposal authorizes the department to apply for federal waivers, accept federal and private grants, and contract with organizations to run PACE sites that provide integrated medical and social services to nursing-home-eligible seniors who wish to remain at home.

Senator Angie Taylor said the programrepresents "a 1-stop shop" for seniors who need medical, rehabilitative and social services but want to stay in their homes and communities. She described an interdisciplinary team model and noted the state can contract with qualified private providers or health centers to operate PACE centers.

Oscar Delgado, chief executive officer of Community Health Alliance, described the PACE center model as combining clinic services and an active living space where participants receive meals, transportation and day programming while also having on-site providers, pharmacy and rehabilitation services. He said PACE keeps participants at home in roughly 95 percent of cases nationally and emphasized caregiver support and socialization benefits.

Josh Kurtzig, chief executive officer of Valor Health (a PACE operator in other states), told the committee PACE uses a capitated payment model and assumes financial risk for participants' full continuum of care. "It's in our financial interest to keep them healthy and out of the hospital," Kurtzig said, and he offered participant satisfaction data from his programs, noting 92 percent of respondents in a recent internal survey said their lives were better after joining PACE.

Former Governor Robert List, who has inspected PACE operations in other states, urged adoption and said preliminary state modeling shows potential savings: he cited an estimate presented during testimony that enrolling 2,000 participants could save the state and federal governments about $14 million, and 5,000 participants could save about $35 million. He and proponents argued PACE can reduce emergency room visits, hospitalizations and nursing-home placements.

Supporters at the hearing included the Nevada Primary Care Association, SCAN Group (which operates My Place Health), Nevada State Medical Association, Catholic Charities of Northern Nevada, and the National PACE Association. These witnesses emphasized PACEoffers integrated care for elders with complex medical and social needs, may produce cost savings relative to institutional care, and can be adapted for rural areas through telehealth and local partnerships.

Committee members asked about prior local attempts at comparable programs, Medicaid reimbursement rates, how the program would reach rural communities, how telehealth would be used where broadband is limited, and whether FQHCs have capacity to participate. Josh Kurtzig and Oscar Delgado said federal PACE rules require a set of core services (including primary care, social work, transportation and home care) and that providers typically contract with local hospitals and clinics to deliver care in geographically dispersed areas; Kurtzig said rural PACE programs exist nationally and can use telehealth and local partnerships to operate.

Kelsey Avery of SCAN Group and Peter Fitzgerald of the National PACE Association noted federal support and grant opportunities for rural PACE development. Senator Taylor said the bill removes a prior requirement that only the Aging and Disability Services Division could establish PACE and instead allows the Department of Health and Human Services or a designated health authority to implement the program.

No formal vote was recorded at the hearing; the sponsor urged support and said the bill positions Nevada to join 33 other states and the District of Columbia that have PACE programs.

Votes at this hearing: none (hearing held; no final action taken).