Novel program to help Fresno County’s chronically ill seniors

At 65, Linda Corbin struggles with so many ailments — diabetes, heart disease, eye and lung problems, the list goes on — she easily could find herself in a nursing home. And getting to her many medical appointments around Fresno isn’t easy since Corbin relies on a wheelchair and buses to get around.

Now Corbin and other medically frail seniors in the area can find the help and resources they need thanks to a novel health care program in Fresno County.

Called PACE — Program for All-Inclusive Care for the Elderly — the program provides a coordinated, one-stop shop for qualified Fresno County residents to get their medical and social needs addressed.

PACE will provide chronically ill seniors with comprehensive, coordinated medical care to help them manage their health needs and keep them in their homes and communities.

“We want to keep these seniors out of nursing homes and in their own communities,” said Abe Marouf, chief financial officer for nonprofit PACE Fresno County. “No one wants to be put into a nursing home.”

Fresno County’s program is one of nine in California, and the only one operating in the San Joaquin Valley. About 3,500 seniors in Fresno County fit the profile of a PACE patient, and the program hopes to serve up to 400 of them. Twenty are now enrolled.

To qualify for PACE, participants must be over 55, currently on Medicare (federal health insurance for the aged and disabled) or Medi-Cal (the state-federal health insurance for the poor) and must be living safely on their own. They also must live within one of the 51 designated zip codes. Most are in Fresno County, with a few spilling into Madera and Tulare counties.

The Fresno County PACE program was spearheaded by the Marouf family, who operate an adult day health-care facility in Orange County. They got some encouragement from Joanie Ballantyne, who owned her own adult day care facility in Fresno until 2009, and is friends with the Maroufs. Ballantyne now sits on PACE’s board.

“The Maroufs reached out to me because I had mentioned we needed a PACE program in the area,” Ballantyne said.

Ballantyne worked as a nurse for 40 years and heard about PACE through that work. She reviewed other PACE programs throughout California as well, researching them online and speaking with representatives on the phone.

“It was after I learned about the program through research that I realized how valuable it would be here in Fresno,” Ballantyne said. “We have so many eligible seniors here.”

Coming to the Valley was not easy. PACE Fresno County took out $3.5 million in loans to cover start-up costs, then sought out sponsors and donors who were interested in the organization.

“Our primary sponsors and donors are individuals. It was a very hard process,” Marouf said.

Many of these sponsors and individuals are from Orange County, home to the Maroufs.

PACE has agreements with Medicare and Medi-Cal in which PACE receives a flat monthly payment from the two entities for each patient who enrolls.

“It’s our job to manage that money for our patients,” Marouf said.

The concept began about 40 years ago in San Francisco as an alternative to building a nursing home in Chinatown. The model has gradually spread to 104 programs in 31 states.

The services and techniques behind PACE are what make it unique, said Peter Hansel, executive director of CalPace, an association that advocates for expansion of these types of programs.

“PACE programs have proven that they can significantly enhance the quality of life of frail elderly,” Hansel said. “No California PACE program has ever failed.”

Recent growth of the PACE programs has to do with the awareness of these programs growing all over the country, he said.

“People recognize these types of programs now, and areas that don’t already have them recognize their community could benefit from one,” Hansel said.

Fresno’s PACE facility, near Kern Street and Van Ness Avenue in downtown, includes both a recreational and daytime center, as well as a fully licensed medical clinic where patients can see doctors and specialists. Each patient meets with the staff and doctors to communicate any changes in their health status.

Seniors who sign on must give up their existing network of doctors. Instead, they use the physicians, hospitals and specialists that PACE contracts with through the clinic. PACE Fresno is currently contracted with roughly 100 medical personnel in the area. A head medical director, home care coordinator, activity director and many others check on patients daily, making sure they are receiving the care they need.

“This method of having lots of different people watching the patients works well because we get to observe them from all angles,” Marouf said.

Dr. Ara Soghomonian, an internal medicine doctor who is on staff at the Fresno PACE clinic, believes this system of health care is beneficial to chronically ill seniors.

“We as a staff can carefully oversee the medical aspect of a patient and there are others observing the social and emotional aspects,” Dr. Soghomonian said. “It keeps everyone on the same page and avoids long-term problems.”

Other benefits include unlimited access to the facilities, free transportation and nurses on-call at all times.

“If the patient is at home and believes they need medical attention, they can call us and we can send a nurse out to see them,” Marouf said. “The point is to keep them out of the ER if they don’t actually need to be there.”

That constant attention is what appealed to Corbin, who lives in downtown Fresno. She said she struggled with coordinating her own medical life before PACE, resulting in more problems than she started with.

“Sometimes, the buses I take to appointments wouldn’t have room for my wheelchair and I would miss my appointment,” Corbin said, who is currently enrolled in PACE.”It was extremely stressful.”

Corbin is excited about the benefits she will receive through PACE.

“They have everything here,” Corbin said. “It’s amazing how much stress is off my shoulders now that I have this program.”

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For more information

For more information about PACE or to schedule a tour of the facility, call (855) 630-7223.

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