A shortage of workers, especially home-based caregivers, is threatening expansion of All-Inclusive Care for the Elderly (PACE) programs, according to a new survey.
A poll last summer of 92 PACE directors by nonprofit Altarum found nearly all were experiencing a workforce shortage and more than half reported higher-than-usual staff turnover. The positions most likely to be open were home-based personal care staff, nurses, drivers, and center-based personal care staff.
The report noted that PACE faces some significant challenges when it comes to recruiting staff. Competition for nurses is especially intense as many providers are offering signing bonuses, flexible scheduling and other perks. Altarum researchers also stated the program faces tough competition for low-wage staff, such as personal care workers and drivers, from sectors, such as retail and hospitality.
Still, the survey also noted that PACE does have advantages over competitors. Field research found that personal care staff in PACE programs have higher job satisfaction, with a greater sense of teamwork. They also tend to feel more valued for their opinions than direct care workers in other settings.
PACE, a program funded by Medicare and Medicaid, helps frail adults age in their homes and communities, rather than nursing homes. Participants receive medical care, meals and social programs in PACE centers, in addition to services in their homes.
Although the program has been hailed by senior service advocates, it has been slow to take off as a model. There are currently 144 PACE programs operating in more than 30 states, serving roughly 60,000 people.
In 2021, Sen. Bob Casey (D-PA) introduced the PACE Plus Act to expand the program to more states. The legislation would increase the number of seniors eligible for the program, reduce bureaucratic red tape to start PACE programs and expand grants to help states start new programs or expand existing ones.
