Providing services to allow fragile senior citizens to remain independent in their homes longer is the purpose of the newly established PACE programs in Bismarck and Dickinson.

Rodger Wetzel, whose 40 years of involvement in senior citizens' issues includes serving with nearly every group in the state that deals with senior issues, was named executive director of the new Northland PACE - Programs of All-inclusive Care for the Elderly - an effort that aims to offer comprehensive care to keep nursing home-eligible people in their own homes.

Participants in PACE can be referred from helping agencies or be self-referred; to be eligible, they must be 55 or older and meet the criteria for needing nursing home care.

Eventually, the Bismarck program will serve about 175 people; the Dickinson PACE can serve about 20 to 30, said Tim Cox, president of Northland Health Care Alliance, which was awarded a $532,000 grant to develop the PACE programs in rural North Dakota. Northland Healthcare Alliance includes 25 entities, hospitals and long-term-care facilities throughout the state.

PACE will offer a continuum of care for fragile seniors, stepping into gaps to coordinate components of care such as transportation, physical and occupational therapies, meals and medications, physician, nursing and social worker care, personal care issues and paperwork, said Cox and Wetzel.

Funding for the program comes from Medicare and Medicaid; establishing this program has been a six-year process, Cox said.

The PACE model can be traced back to San Francisco in the early 1970s, Cox said. This is the first PACE program in North Dakota, Wetzel said, and among the first PACE sites to adapt the largely urban model to a rural program. North Dakota is one of 14 sites awarded special grants by Centers for Medicare and Medicaid Services as a rural model for PACE, he said.

Networking as collaboratively as possible with allies from social services to health care providers to transportation groups makes it possible for PACEto coordinate the many layers of paperwork, funding questions and other obstacles that often seem overwhelming to people, Wetzel said.

Those challenges make it easy for homebound people to become depressed, to stop taking their medications or neglect meals or personal care, making them more susceptible to infections, often requiring expensive trips to emergency rooms, he said.

In addition to providing coordinated care, PACE aims to be a fun and enjoyable place to come to, he said, where birthdays are celebrated, blanket-warmers are on hand, and where people will be really listened to, "an upbeat experience." Participants have a care team, which helps adult children preserve their role as family members.

"We want (them) to be happy and healthy and well; it should be fun," Wetzel said.

Wetzel invited the community to come down and visit the PACE site at 201 N. 24th St.

Some people have called the program "too good to be true," he said with a laugh. "But that's the way things ought to be. Little things aren't always so little."

(Reach reporter Karen Herzog at 250-8267 or karen.herzog@bismarcktribune.com.)