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SAN MARCOS, California >> Two mornings a week, a van arrives at Mario Perez’s Escondido home and takes him to a new senior center in this city in northern San Diego County, where he eats a hot lunch, plays cards, and physically becomes therapy to restore the balance that he lost after breaking both legs in a fall.

If he wants, he can shower, cut his hair or have his teeth cleaned. Those visits twice a week are the highlights of the week for Perez, a 65-year-old retired mechanic who has diabetes and is legally blind.

“The people here are very human, very kind,” he said. “I’m going to ask three days a week.”


The non-profit Gary and Mary West PACE center, which opened in September, is California’s newest addition to a care system for vulnerable and weak seniors, known as the comprehensive elder care program.

The services of PACE, a national program primarily funded by Medicaid and Medicare, are intended to keep people aged 55 years and over who require care levels in a nursing home at home and out of the hospital for as long as possible.

The program is more important than ever as baby boomers grow older, the proponents say.

“The rapidly growing senior citizen population in California and across the country will put enormous pressure on our current fragmented and often inefficient health care system,” said Tim Lash, president of Gary and Mary West PACE. California officials view PACE as an integral part of the state’s strategy to improve care for the elderly.

The National PACE Association said the data it collected prior to 2019 showed that seniors enrolled in PACE cost statements cost on average 13% less than the cost of caring for them through other Medicaid-funded services, including nursing homes.

Perez, like 90% of PACE enrolled nationwide, is a recipient of both Medicaid and Medicare. He is part of a population with a low income and multiple chronic conditions.

PACE participants who do not receive medical benefits from the government can pay from their own pocket. For Gary and Mary West, the tab varies from $ 7,000 to $ 10,000 per month, depending on the level of care.

Nationally, 50,000 registered participants participate in PACE programs in more than 260 centers in 31 states. In California, PACE serves nearly 9,000 vulnerable seniors at 47 locations.

PACE programs offer all services that fall under Medicare and Medicaid nationwide, and employees include nurses, primary care physicians, social workers, dieticians, drivers and personal caregivers, as well as physical therapists, occupational therapists and recreational therapists. PACE subscribers often have conditions such as vascular disease, diabetes, congestive heart failure, depression and bipolar disorder.

Approximately two thirds of the PACE participants have some degree of cognitive impairment. The center of Gary and Mary West is no exception, therefore it has an alarm on all doors. If the participants become agitated, they are led to the ‘rest room’, a softly lit room with a soundtrack in the ocean and a sun lounger.

On weekdays, participants can arrive at the center at 8 a.m. and stay until 4:30 p.m. A PACE driver takes care of transportation to and from the center and appointments with external specialists.

The center was opened with money donated by San Diego billionaires Gary and Mary West, telemarketing and telecommunications entrepreneurs. They have donated around $ 11 million to set up PACE centers across the country.

The center in San Marcos is spacious and cheerful, with sofas and chairs scattered throughout and lots of natural light. It is meant to feel “like a friendly, inviting living room,” Dr. said. Ross Colt, a retired army colonel who came to work with Gary and Mary West PACE a year ago as the front-line physician.

Participants at the center can receive physical and occupational therapy in a rehabilitation gym and the facility has a spa where they can shower or have their hair done.

The executive director, Renata Smith, remembered a woman whose husband had washed her with a garden hose before she came to PACE. “We are talking about basic human dignity here,” said Smith. “The spa gives participants a good feeling about themselves.”

PACE programs also send personal care workers to the participants’ homes.