The PACE Program: A Compassionate Solution for Aging with Dignity That California Must Embrace

The Promise of Comprehensive Elder Care

In a state grappling with an aging population and strained healthcare resources, the Program of All-Inclusive Care for the Elderly (PACE) stands as a beacon of hope and practical solutions. This community-based program represents one of the most effective yet tragically underutilized resources in California’s long-term care landscape. PACE provides wraparound medical and social services designed specifically to help seniors age with dignity and independence while remaining in their communities. The program’s comprehensive approach encompasses everything from primary care and physical therapy to dental services, transportation, meals, home care, and day center activities – creating a holistic support system that addresses both medical and social needs.

How PACE Works and Who Benefits

The beauty of PACE lies not only in its comprehensive nature but also in its accessibility. Funded through Medicare and Medi-Cal, PACE is available to Californians 55 or older who live within a program’s service area and require nursing-home-level care. This funding structure makes it a feasible option for a wide range of individuals, breaking down economic barriers that often prevent seniors from accessing quality care. The program’s community-based model ensures that services are delivered in settings familiar to participants, reducing the trauma and disorientation that often accompanies institutional care.

Proven Effectiveness and Cost Efficiency

The empirical evidence supporting PACE’s effectiveness is nothing short of remarkable. A 2021 study by CalPACE, the state’s PACE advocacy association, revealed stunning outcomes: PACE participants experienced 44% fewer hospitalizations and 26% less emergency room usage compared to similar non-PACE individuals. Even more compelling, 98% of PACE participants continued to live in their communities despite requiring nursing-home-level care. The program also demonstrated superior results in mental health outcomes, with participants showing lower rates of depression, better medication adherence, and significantly higher satisfaction with their care.

The financial benefits are equally impressive. In 2024 alone, PACE enrollment saved California taxpayers $369.4 million – a staggering figure that demonstrates how compassionate care can also be fiscally responsible. With Medi-Cal costs rising and nursing home capacity strained, PACE represents precisely the kind of smart public policy that addresses multiple challenges simultaneously.

The Tragic Underutilization Crisis

Despite these extraordinary results, only about 10% of eligible older adults are enrolled in PACE programs across California. This underutilization represents a catastrophic failure to deliver proven, compassionate care to our most vulnerable citizens. The limitations are primarily geographic, infrastructural, and awareness-based: PACE currently serves less than half of California’s counties, leaving vast regions without access to this vital service. The significant upfront investment required to establish new programs, combined with complex state and federal licensing processes, creates formidable barriers to expansion.

Even in areas where PACE programs exist, countless eligible seniors, caregivers, and healthcare providers remain unaware of their availability. This knowledge gap means that thousands of Californians who could benefit from comprehensive, dignified care continue to struggle without it.

A Moral Imperative for Expansion

The underutilization of PACE represents more than just a policy failure – it constitutes a moral crisis. As a nation founded on principles of human dignity, liberty, and compassion, we have an obligation to ensure our elders can age with the grace and respect they deserve. The fact that a program demonstrating such remarkable success in both human and financial terms remains inaccessible to 90% of those who qualify is nothing short of scandalous.

From a constitutional perspective, the right to life and liberty must include the right to age with dignity in one’s community. PACE embodies these fundamental American values by empowering seniors to maintain their independence while receiving the support they need. The program’s community-based approach respects the autonomy of individuals while providing the collective support that defines a compassionate society.

With nearly one in four Californians projected to be over age 60 by 2030, the urgency of expanding PACE cannot be overstated. The coming demographic shift will strain our healthcare system, social services, and state budget in unprecedented ways. PACE offers a proven solution that addresses these challenges while upholding our values as a society that honors its elders.

The economic argument for PACE expansion is overwhelming. The program’s demonstrated cost savings – $369.4 million in a single year – represent taxpayer money that could be reinvested in other vital services or returned to citizens. In an era of constrained public resources, investing in programs that deliver both superior outcomes and significant savings is not just good policy – it’s essential stewardship of public funds.

Practical Solutions for Expansion

To address the geographic limitations of PACE, California must prioritize state-level funding to help new programs launch, particularly in underserved areas. The complex licensing processes that currently hinder expansion should be streamlined through bipartisan cooperation between state and federal authorities. This regulatory reform must maintain quality standards while eliminating unnecessary bureaucratic barriers.

Simultaneously, we must launch comprehensive outreach campaigns targeting families, caregivers, and healthcare professionals. Many who would benefit from PACE simply don’t know it exists – a failure of communication that can and must be addressed through coordinated public education efforts.

The Human Cost of Inaction

Behind the statistics and budget figures lie real human stories – seniors struggling to maintain their independence, families stretched thin providing care, and individuals facing the heartbreaking choice between inadequate home care and institutionalization. Every day that passes without expanding PACE means more seniors denied the dignity and support they deserve. It means more families facing financial ruin from care costs. It means more emergency room visits and hospitalizations that could have been prevented.

The emotional toll of this neglect is immeasurable. Seniors who built our communities, raised families, and contributed to our society deserve better than to spend their final years struggling alone when proven solutions exist.

A Call to Action

Expanding PACE is not merely a policy recommendation – it is a moral imperative that reflects our fundamental values as a society. We must demand that our elected officials prioritize this expansion, recognizing that how we care for our most vulnerable citizens defines our character as a state and as a nation.

The solutions are attainable: targeted funding for new programs in underserved areas, streamlined licensing processes, and comprehensive awareness campaigns. What has been lacking is the political will to make senior care a priority. As citizens committed to democracy, freedom, and human dignity, we must create that political will through advocacy, education, and holding our representatives accountable.

PACE represents the best of American values: innovation, compassion, community, and practical problem-solving. It demonstrates that we can create systems that are both fiscally responsible and deeply humane. The program offers hope for a future where every older adult can age with the support, grace and respect they deserve – but only if we have the courage and conviction to make that future a reality.

Our seniors deserve nothing less than our full commitment to expanding this vital program. Their dignity, our values, and our shared humanity demand nothing less.