COLCHESTER, Vt. -
Louise Frances Diamond is a cowgirl.
"You know it!" she said.
She's an independent woman who'd rather be riding a horse, but instead she's battling a serious health issue.
"My spine is collapsing. I've gone from 5-foot-3 to 4-foot-11," she said.
But Louise doesn't want to go into a nursing home. That's why she's a participant in PACE-- a program that helps seniors in Rutland and Colchester maintain their independence. PACE provides everything from housekeeping and personal care to medical services at people's homes or in its day facilities.
"It's a capitated program, so we're paid by Medicaid and Medicare and it's a per member, per month payment," said Jeanne Hutchins, a PACE board member.
PACE has 88 successful programs in 29 states, but no longer in Vermont. On March 31 it will close both its Rutland and Colchester facilities. That means 140 participants will need to find other care and 80 employees will be laid off.
"I just feel like I'm sad. I'm very sad," Louise said.
"Is PACE needed in Vermont? Yes. Is the model financially viable? It seems not so," Hutchins said.
PACE says it has been struggling financially for years. That's because it says Vermont's Medicaid reimbursement rate is lower than other states. And the majority of participants signing on to the program lately are sicker and need more costly services.
"When people choose to go to PACE, they were choosing to go when they were very sick and we used a lot of resources. We didn't have that spread that you need to keep a capitated program running," Hutchins said.
"I was shocked," Susan Bresee said.
Bresee's 82-year-old dad, Ralph, was one of PACE's first participants after he suffered a stroke and needed a variety of services. He was able to live more independently with the support PACE provided.
"They've kept him healthy. He's never been back to the hospital or emergency room, never went to a nursing home," Bresee said.
But now Ralph is in a nursing home due to PACE's impending closure. Cowgirl Louise hopes to find a program similar to PACE, so she can keep her independence and remain at home.
"If I can, I want to maintain as much independence as possible. I think everybody wants that," she said.
PACE says it's working to link its participants up with other services and suspects many people will partner with the VNA.
