The implementation of the PACE program under HF4839 is substantial as it aligns Minnesota's long-term care services with updated federal regulations while promoting a model that integrates both health and social services. By mandating that the Department of Human Services develops a PACE state plan amendment by October 2024, the bill outlines a clear timeline for operationalizing this program. The requirements indicate that the program seeks to mitigate hospital and nursing home admissions by providing optimal outpatient care, thus potentially transforming how elderly care is financed and delivered in the state.
Summary
House File 4839 (HF4839) introduces the Program of All-Inclusive Care for the Elderly (PACE) in Minnesota, which aims to provide comprehensive, community-based long-term care services to eligible individuals aged 55 and older. The PACE program is designed to deliver services in a more coordinated manner, allowing seniors to receive medical and non-medical services primarily in outpatient environments or at home, thereby addressing their healthcare needs effectively while aiming to keep them out of institutions. This bill will establish a framework requiring eligible individuals to elect participation in PACE, representing a shift from traditional Medicare and Medicaid programs.
Contention
While the PACE model is designed to enhance care for the elderly, it may raise concerns regarding the financial risks imposed on PACE organizations, which must assume responsibility for all costs generated by participants. Critics might argue that this could lead to operational challenges for these organizations, particularly in cost management and service delivery. The potential for varying interpretations of eligibility criteria and access to care may also create contention among stakeholders, including healthcare providers and policymakers, particularly as community-based healthcare continues to evolve within a shifting regulatory landscape.
Rates and rate floors modified for services involving disability and elderly waivers, customized living, nursing and intermediate care facilities, personal care assistance, home care, nonemergency medical transportation, and community first services and supports; provisions modified; residential settings closure prevention grant program established; and money appropriated.
MinnesotaCare and medical assistance enrollee cost-sharing elimination; individual, small group and State Employee Group Insurance Program cost-sharing prohibition
Human services; provisions modified relating to disability services, aging services, and substance use disorder services; Deaf and Hard-of-Hearing Services Act modified; subminimum wages phased out; blood-borne pathogen provisions expanded to all state-operated treatment programs; and expired reports removed.