Public Statements

Letter to Ways & Means Committee hearing, “Caring for Aging Americans”

4 min
November 25, 2019

The Honorable Richard Neal
House Committee on Ways & Means
1102 Longworth House Office Building
Washington, DC 20515

The Honorable Kevin Brady
Ranking Member
House Committee on Ways & Means
1139E Longworth House Office Building
Washington, DC 20515


RE: Submission for the record, Ways & Means Committee hearing, “Caring for Aging Americans” (Nov. 14, 2019)

Dear Chairman Neal:

On behalf of West Health, I am pleased to submit written comments for the Ways & Means Committee hearing held on November 14, 2019, entitled “Caring for Aging Americans.”

Solely funded by philanthropists Gary and Mary West, West Health is a family of nonprofit and nonpartisan organizations including the Gary and Mary West Foundation and Gary and Mary West Health Institute in San Diego, and the Gary and Mary West Health Policy Center in Washington, D.C. West Health is dedicated to lowering healthcare costs to enable seniors to successfully age in place with access to high-quality, affordable health and support services that preserve and protect their dignity, quality of life and independence.

With the population of seniors in the U.S. projected to reach 56 million in 2020, and more than 73 million by 2030, the need for senior-appropriate care across the nation has never been greater. West Health has a long history of working to create and foster new integrated care models that improve health outcomes and better address both the medical and non-medical needs of seniors and their families. Marking a key milestone in these efforts, earlier this year we celebrated the grand opening of the Gary and Mary West Senior Emergency Care Unit at UC San Diego Health in La Jolla—a collaboration to improve the hospital experience for older adults by focusing on the “front porch” of the healthcare system, the emergency room, where almost half of seniors are typically admitted to the hospital. We would be pleased to discuss any of these initiatives further, should they be of interest to the Committee. However, we write specifically to highlight our efforts regarding the Program of All-Inclusive Care for the Elderly, or PACE, which was discussed at the hearing.

On October 10, West Health marked the opening of the Gary and Mary West PACE in north San Diego County. Established with a grant from the Gary and Mary West Foundation, the nearly 20,000-square-foot center and its team—including physicians, social workers, nurses, nutritionists, and physical and occupational therapists—offers high-quality, comprehensive and coordinated healthcare, social services and support for vulnerable seniors with chronic care needs who want to successfully age in place rather than in a nursing home.

PACE is a model of person-centered care that has been shown to reduce rates of emergency room visits, unnecessary hospital admissions, long-term nursing home placements and the cost of care, as well as the strain on family caregivers. Over 90 percent of PACE participants successfully remain in their homes and communities, and many live longer, are more socially engaged and have a better quality of life than people living in nursing homes or other institutional settings.

Gary and Mary West have contributed nearly $11 million in funding from different West Health nonprofits to ensure more seniors across the country are able to receive their healthcare from PACE centers and continue living in their communities. The Gary and Mary West PACE center is the flagship of these efforts. It provides a wide range of services, including adult day programs, medical care, social services, dentistry and home care, in addition to physical, occupational and speech therapy. It also provides transportation to and from the center and outside medical appointments, as well as to social activities, meals, pharmacy, long-term services and supports, caregiver training and support groups. All services are managed by an interdisciplinary care team to ensure care coordination and clear communication to participants and their families.

Gary and Mary West PACE is among the first programs in the nation to have a co-located state-of-the-art dental facility serving PACE participants as well as area seniors. The Gary and Mary West Senior Dental Center is our second dental center in the San Diego area and offers comprehensive oral healthcare services from specialists trained in geriatric dentistry, including oral exams, cleanings, fillings, treatment for gum disease, extractions and dentures.

As the Committee tackles issues around how to help people age successfully in our country, we urge you to look to PACE as a model to be replicated further, with support from Congress in the form of additional funding. As of July 2019, there are 263 PACE centers around the country. As many as 95 percent of the seniors served remain living in their communities, at an average age of 76, even though 35 percent of them require assistance with 5 to 6 activities of daily living. This is a remarkable success and a “win-win” in that it allows seniors to age with dignity in the homes they love and saves Medicare and Medicaid resources by reducing institutional spending. This is a path forward for many aging Americans.

Unfortunately, we know that only an estimated 2 percent of eligible seniors are currently enrolled in PACE. This is a shockingly low proportion of those who can be helped, and West Health believes expanding the reach of this program can do so much to help many more older adults have better health and a better quality of life.

Given these incredible statistics, we are partnering with the National PACE Association (NPA) and The John A. Hartford Foundation on the PACE 2.0 project. Through PACE 2.0, NPA is working with so-called “PACE Setters,” which are PACE organizations that are achieving broader reach in their communities with new standards for enrollment, growth rates and market penetration. Through these collaborations, NPA has been able to develop tools to support PACE programs across the country as they expand their enrollment and services. Given the positive impact on seniors, we are eager to help catalyze the growth of these programs with the goal of bringing the benefits of PACE to more seniors.

We must improve how our healthcare system cares for our aging Americans, who will be our grandparents, parents and ourselves—either now, or in the near future. PACE is one way to ensure seniors can remain in their home, if that is what they choose, with dignity and autonomy, ensuring that they can continue living in and contributing to the communities they love.

We hope our input is helpful to the Committee and urge you to consider the expansion of PACE as a strategy to ensure success in aging. Please do not hesitate to contact me with any questions or to arrange a visit to the Gary and Mary West PACE. We would be honored to host you and any member of the Committee.

Shelley Lyford