LIFE (Living Independently for Elders) Offers a New Community Based Care Option

Written By: Perry Landon, Executive Director of Albright LIFE LIFE (Living Independently for Elders) is Pennsylvania ’s version of the program known nationally as PACE (Program of All-Inclusive Care for the Elderly). This model of care is centered around the belief that it is better for the well-being of seniors with chronic care needs, and their families, to be served in the community whenever possible. A full range of preventive, primary, acute and long term care services are provided by LIFE programs, so that participants can live in the community as independently as possible. This model of care began in the early 1970’s in the China-Town Beach area of San Francisco , where a non-profit corporation was formed to create a new community based system of care. Over the next 30 years, this model of care developed, with the first programs receiving Medicare and Medicaid “waivers” to operate in 1990. The Balanced Budget Act of 1997 established the PACE model as a permanently recognized provider type under both the Medicare and Medicaid programs. Until recently, PACE (LIFE) programs were established in urban neighborhoods, with designated service areas defined by zip codes covering a few city blocks. More recently, states, including Pennsylvania , have begun to expand the services into rural settings, with designated service areas defined by county boundaries. Like the aging waiver program, LIFE serves individuals who are 60 years of age or older, who would otherwise qualify clinically to be in a nursing facility, but who choose instead to remain in their homes with the support of LIFE program services. The National PACE Association describes the typical participant as very similar to the average nursing home resident: 80 years of age; 7.9 medical conditions and limited in approximately three activities of daily living. Forty nine percent of PACE participants have been diagnosed with dementia. Despite the high level of care needs, 90% of PACE participants are able to continue to live in the community. PACE/ LIFE services are comprehensive in nature. Services can include: 1) Adult day health center, that provides nursing; physical, occupational and recreational therapies; meals; nutritional counseling; social work; and, personal care; 2) Medical care provided by the Albright LIFE primary care physician; 3) Home health care and personal care; 4) All necessary prescription drugs; 5) Social services; 6) Medical specialists such as audiology, dentistry, optometry, podiatry, and speech therapy; 7) Respite care; and, 8) Hospital and nursing home care when necessary. Because the LIFE interdisciplinary health care team authorizes and coordinates their care, Participants and their families see the program as a one-stop shopping alternative that simplifies their access to health care. Clinical eligibility for participation in LIFE programs is determined through an assessment done by the Area Agency on Aging, in cooperation with the individual’s personal physician. The level of care is called “nursing facility clinically eligible.” Payment for Albright LIFE services may come from Medicaid and Medicare or from private funds. Long term care insurance may also be a source of payment for LIFE services. To qualify for Medicaid to pay for LIFE services, the individual’s available income and available resources must be at or below certain ceilings. The available income ceiling is 300% of the federal benefit rate, which is currently $1,911 a month. The available resource ceiling is $8,000. The Medicaid program does allow individuals with income in excess of the ceiling to qualify for Medicaid benefits by paying a monthly share of the cost of LIFE services, with Medicaid paying the monthly remainder. If an individual wishes to pay privately for participation in the LIFE program, his/her monthly premium is equal to that amount that would otherwise be paid by Medicaid. Currently that monthly private pay premium amount is $4,178. You can learn more about PACE by logging on to the National Pace Association website at www.npaonline.org or log onto the PA Office of Long Term Living web site at www.dpw.pa.us and select Information for Families and Individuals, and scroll down to LIFE. Perry Landon is the Executive Director of Albright LIFE in Lycoming and Clinton Counties. He can be contacted at 322-5433 or at perry.landon@albrightcare.org. Marshall, Parker & Associates has a complete listing of current LIFE Programs in Pennsylvania (as of September 2008) below. Pennsylvania LIFE Programs Albright LIFE 901 Memorial Avenue Williamsport PA , 17701 Ph: 570-322-5433 E-mail: lycoming-clinton-life@albrightcare.org WEBSITE: http://www.albrightlife.org Counties Served: Lycoming and Clinton LIFE Geisinger 2300 Adams Avenue Scranton PA , 18509 Ph: (800) 395-8759 Fax: (570) 558-6161 WEBSITE: http://www.lifegeisinger.org Counties Served: Lackawanna , Luzerne , Wyoming LIFE Geisinger 1100 Spruce Street Kulpmont , PA 17834 Ph: (866) 230-6465 Fax: (570) 373-2101 WEBSITE: http://www.lifegeisinger.org Counties Served: Columbia , Montour, Northumberland, Schuylkill , Snyder, Union SeniorLIFE Johnstown 401 Broad Street Johnstown PA , 15906 Ph: (814) 535-6000 E-mail: info@seniorLIFEjohnstown.com WEBSITE: http://www.seniorLIFEjohnstown.com Counties Served: Blair, Cambria , Dauphin, Somerset , Westmoreland, York Life at Home 701 Chester Pike Sharon Hill PA, 19079 Ph: (888) 843-0443 E-mail: jill.idan@genesishcc.com Counties Served: Chester , Delaware LIFE – Pittsburgh One - Parkway Center - 875 Greentree Road Suite 200 Pittsburgh PA , 15220 - Ph: (412) 388-8042 WEBSITE: http://www.lifepittsburgh.org County Served: Allegheny Community LIFE 2400 Ardmore Boulevard Suite 700 Pittsburgh PA, 15221- Ph: (412) 436-1320 WEBSITE: http://www.commlife.org Counties Served: Allegheny, Westmoreland St. Agnes/Mercy LIFE 1900 South Broad Street Philadelphia PA , 19145 Ph: (215) 339-4563 WEBSITE: http://www.stagnesmedicalcenter-pa.org County Served: Philadelphia LIFE – University of Pennsylvania School of Nursing 4101 Woodland Avenue Philadelphia PA, 19104- Ph: (215) 573-7200 WEBSITE: http://www.lifeupenn.org County Served: Philadelphia LIFE-NWPA 149 West 22nd St. Erie PA , 16502 WEBSITE: http://www.lifenwpa.org Counties Served: Clarion, Crawford, Erie , Forest , McKean, Mercer, Venango, Warren   Return to Marshall, Parker & Associates' Home Page