Health & Medicine

Sutter medical team expands to ensure frailest Sacramento seniors can age at home

The Sutter health care team that serves the Sacramento region’s frailest senior citizens on Tuesday opened a $11.6 million center that will allow staff to care for roughly three times the patients now seen in two smaller facilities.

“We expect to serve about 1,000 with the new facility,” said Phil Chuang, vice president of strategy for Sutter. “About half of those seniors are in the center on any particular day, but many of them are receiving care every day in their home. An aide may be going into their home and helping them get ready every day, or they may be helping them to cook a meal at home.”

The new Sutter facility, at 444 N. Third St. in Sacramento’s River District, is part of a federal health initiative known as PACE, Program of All-Inclusive Care for the Elderly, that treats the whole person rather than their set of medical conditions. The 45,000-square-foot center replaces two centers that Sutter had on Franklin Boulevard and U Street in Sacramento.

During tours of the facility on Tuesday, about 150 people including U.S. Rep. Doris Matsui, D-Sacramento; state Sen. Richard Pan, D-Sacramento, a practicing pediatrician; and City Councilmember Jeff Harris marveled at the integration of natural light, interior gardens and artwork created by the seniors themselves.

“They didn’t just think about the physical concerns alone,” Matsui said. “They have a library in there, books in there. They’re teaching you all sorts of things about how to walk again or how to climb stairs. The artwork in there is lovely because it’s not institutional artwork.”

Matsui said she loved that seniors chose a spirited painting from Roseville artist Margarita Chaplinska of a cellist who seems to be floating amid the colorful notes of his music. The center not only includes a large day room where seniors can eat and socialize but also a medical clinic, a salon, a laundry room, a practice kitchen and bathroom where seniors can re-learn daily life skills, a gym for physical therapy and interior garden areas where they can relax

“We have had fantastic engagement from our seniors and from our staff in designing the building,” Chuang said. “We wanted it to reflect our seniors’ desire for a place that they will spend a lot of time in. We really wanted the building to enable our staff to do their best work.”

Nationally, PACE serves about 38,000 participants at 122 centers in 32 states, said Erin Shvetzoff Hennessey, chief executive of Minneapolis’ Health Dimensions Group, a consulting company that helps health providers assess the need for new PACE centers. The number of PACE programs is rising, Hennessey said, because Medicare and Medicaid are expanding the use of a payment model that pays based on patient health outcomes.

“We’re seeing more and more interest in PACE programs as Medicare moves toward value-based payments,” she said. “PACE is proven to be a program that is able to take care of seniors and manage their chronic illnesses more effectively than traditional health care.”

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Sutter PACE seniors, many of whom qualify for both Medicare and Medi-Cal, will be able to see primary care physicians at the new center, eat a hot meal, take advantage of opportunities for recreation or get ancillary treatments from physical therapists or other medical personnel.

The staff at Sutter SeniorCare coordinates and provides any acute, preventive, primary or long-term care services that their senior patients need to continue living independently in their community. Sutter employs drivers and maintains a fleet of vehicles that transport the seniors to and from the center, medical appointments and field trips.

“Sutter SeniorCare PACE is one of the oldest programs in the country,” Chuang said. “It’s been around for over 25 years. PACE was actually created in San Francisco in the ’70s by an organization called On Lok, and it really was designed to support seniors living independently in the community and trying to keep them out of ... being committed long-term to a nursing home.”

More than 30 years ago, the Centers for Medicare & Medicaid Services decided that the health outcomes for seniors in the On Lok program were so promising that the organization wanted to test it out nationally. Sutter signed on as a pilot test site, Chuang said. Over the years, study after study has shown PACE enrollees have remarkably good health outcomes and governments realize big cost savings.

In a Texas study, for instance, PACE participants had fewer hospital admissions and shorter hospital stays than comparable populations of frail elderly patients. In Wisconsin, PACE enrollees had fewer hospital admissions, hospital days, emergency room visits and preventable emergency room visits than comparable groups. A South Carolina-specific study showed that, despite being older and more impaired, PACE beneficiaries survived longer than participants in another government-funded program.

PACE has been around for decades now, but it remains something of a secret, said Dr. Susan Hardy, who runs a PACE program in suburban Boston. Many PACE programs provide care such as intravenous hydration and antibiotics in the patients’ home, preventing trips to the hospital, Hardy said.

Chuang said that every member of the health care team in PACE – drivers, dietitians, home health aides, social workers, therapists and more - watch for changes in seniors’ cognition or mobility or demeanor and report changes to doctors or nurses. Members of the team will serve the same patients and their families for years, Chuang said, and they strive to keep their seniors from winding up in emergency rooms.

Carmichael resident Clint Allison said that his 69-year-old father Bob Allison had suffered a stroke and had to use a wheelchair when he initially started coming to Sutter’s SeniorCare Center in 2010. Allison and his wife Shavon said he and wife decided to take his father into their home, but the stress of caring for him and their young children led them to wonder how much longer they would be able to keep him out of a nursing home.

“After the stroke, my father stopped having contact with his friends,” Allison said. “He was extremely isolated. He was home with us, but there wasn’t much drive. He really didn’t have much of the motivation to do anything. When PACE started, it was almost an immediate improvement.”

Bob Allison had to use a wheelchair to get around after the stroke, his son said, but after starting PACE, he was able to lose 100 pounds and regain his ability to walk.

“They would come pick him up and he would go there throughout the week,” Allison said. “It was really the interaction with people. It was getting him active, doing things he just would not have done otherwise.”

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