CalOptima held a ribbon-cutting ceremony Thursday for Orange County’s first center intended to keep older, low-income disabled residents out of nursing homes, with formalities punctuated by politics, rivalries, lobbying and humor.

The official opening of the 23,650-square-foot PACE center in Garden Grove brought back four of the former top CalOptima executives who initiated the development of PACE, which is intended to provide a single location for comprehensive medical treatment of adults older than 55 who have serious disabilities.

PACE stands for Program of All-Inclusive Care for the Elderly. The idea, developed in San Francisco in the early 1970s and now adopted by 29 states, is to provide the range of Medicaid and Medicare treatments in a single location and at the same time allow older adults to continue living at home rather than in nursing homes or receiving expensive home nursing services.

Initially, the center dedicated Thursday will be able to enroll about 250 people with a maximum daily attendance of about 150. The per-patient cost for PACE is estimated at $30,000 a year compared to the estimated $100,000 annually for disabled, elderly, low-income adults who require nursing home or continual in-home nursing care.

The local program was initiated at least five years ago by executives who no longer work for CalOptima, the county’s $1.5-billion health plan for more than 450,000 residents, mostly children along with disabled and low-income elderly residents.

Roughly two dozen top and key CalOptima executives left in the past two years after Supervisor Janet Nguyen leveled a series of nonspecific allegations of mismanagement, took control of the agency and remade its board of directors to give medical providers a stronger voice.

In the past, Nguyen was highly critical of some of the former executives, but Thursday she praised them for developing the PACE program, even though she still disagrees with some areas, like the 20-year building lease.

“I wasn’t supposed to be speaking,” Nguyen told the audience of health providers and nonprofit organizations after being asked by CalOptima CEO Michael Schrader to address the group.

Then she thanked the former CalOptima executives present: state Medi-Cal Division Chief Margaret Tatar, former CalOptima CEO Richard Chambers, former CalOptima Chief Financial Officer and acting CEO Michael Engelhard and former Chief Medical Officer Dr. Gertrude Carter.

“I too believe in it [PACE],” she said, but then added, “The difference is how we get there.”

Even so, she asked the audience to applaud the former executives and they did.

Informal discussions afterwards were a chance for one-on-one lobbying for issues critical to certain groups. For example, Jon Gilwee, UC Irvine’s health issues lobbyist, was able to separately buttonhole Schrader and Nguyen to push UCI’s position on current contract negotiations affecting payments to specialist doctors.

And the ribbon-cutting ceremony officially opening the PACE center for inspection included humor. An oversized pair of ceremonial scissors loaned to CalOptima by the county proved too dull for CalOptima board Chairman Mark Refowitz to cut the ribbon. Nguyen came to his rescue with a backup pair of regular scissors and quickly snipped the ribbon to signal the building’s official opening.

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