TRAVERSE CITY — Grand Traverse County officials received a primer on how PACE North operates, yet took no action to rescind cancellation of a vendor contract between the Commission on Aging and the elder services nonprofit.
“I want to reiterate that I absolutely support PACE and I believe it’s a very valuable source of services for people in the community,” said Commissioner Addison “Sonny” Wheelock, Jr.
“But we have hundreds of people in this community the Commission on Aging is servicing,” he added. “The fact that of those hundreds of people, somewhere between two and four are utilizing the program, doesn’t make sense to me.”
Wheelock said commissioners should spend their time seeking solutions to the COA services waiting list, the length of which interim director Meredith Goodrick described as “horrendous.”
Additional burdens of the vendor contract are the extensive staff training and paperwork required, Goodrick said, which take time away from serving seniors who may have no other access to services.
“We cannot at this point be compliant and we’re putting (PACE North) at risk if they have a survey,” Goodrick said. “We don’t have the ability to be compliant at this point.”
A “survey” is another term for a state or federal inspection.
County Administrator Nate Alger confirmed there are approximately 500 people who are waiting for one or more services the COA provides, such as home health care, housecleaning, help managing their medications or outdoor services like lawn mowing or window cleaning.
PACE North, one of 22 centers or satellite centers of the Program of All-Inclusive Care for the Elderly in Michigan, is designed to provide a variety of healthcare and socialization services to adults 55 and older, who qualify for nursing home care but prefer to stay in their own homes.
PACE North employs its own healthcare workers, yet also utilizes vendors such as the Commission on Aging, to provide services to enrollees.
Theoretically there could be some overlap between clients served by the COA and those enrolled in PACE North, though eligibility requirements are not the same.
To qualify for the county’s COA services, a person must be 60 or older and life in Grand Traverse County. Fees for the services vary and are based on a client’s income.
To qualify for PACE North services, a person must be 55 or older, have a medical assessment that qualifies them for nursing home level of care, be able to live independently with the benefit of PACE services and live in one of the 43 zip codes PACE North is approved to serve.
Enrollees are insured by PACE, which receives a per person per month payment from Medicaid — what PACE Executive Director Sherrie Moseler called a “capitation” — as well as additional revenue from enrollees who are private pay.
Michele Reardon, PACE outreach director, previously estimated the private pay monthly cost to enroll was about $5,000.
Services not provided at the PACE center, or not provided by PACE employees, are provided by outside vendors, who are part of the PACE Network, Moseler said.
“The PACE Network is so important,” Moseler told commissioners. “This is where I hated to lose the vendor contract with the COA. Because it takes a village. We can’t do this all on our own.”
Moseler previously confirmed that at one time as many as 5 PACE North enrollees were being served by COA staff in their vendor capacity, though the current number is 2.
PACE North has paid COA about $4,900 over the life of the contract, which will expire at the end of the year and not be renewed.
The terms of the contract state the county must give PACE North a 90-day notice, which commissioners agreed to do last month.
“It is very clear that the COA is unable to provide the commitment to the PACE program that was initially agreed upon,” Moseler said. “The training and the requirements for PACE are very clear. And so I accept the 90-day notice.”
Commissioner Gordie La Pointe, who has toured the PACE North’s Garfield Road center and met with Moseler and Reardon, asked about vendor contracts with Commission on Aging of other nearby counties.
Moseler said PACE North has vendor contracts with COAs in Benzie and Antrim counties, though PACE North enrollees are not currently receiving services from staff at either one.
Most of PACE North enrollees — 65 percent — are from Grand Traverse County and the next highest percentage come from Wexford County, she said.
Staffing issues are responsible for the long waitlist at Grand Traverse County’s COA, Alger and Goodrick said. Grand Traverse County has posted four openings at the COA: a home chore worker, a homemaker aide and two universal aides