Inside BoldAge PACE

Lisa [: 00:00:00

Listeners, welcome to Aging in Full Bloom with Lisa Stockdale. I'm your host, Lisa, and today I have a very special guest in studio with me, Kathleen Sheldon. Hi, Kathleen. Hi, Lisa. I love it when I get to have in studio guests because usually folks are on the phone and it's a little bit different. So this reminds me that there's a reason to get dressed and do your hair and all those crazy things, which I think I did warn you I was going to the spa right after. Huh. But anyway, you look great.

Lisa [: 00:00:30

Aw, thank you. Kathleen is director of outreach and engagement for BoldAge PACE here in Franklin County, which is where we are podcasting from. And she is going to talk to us about this program in the senior service arena. How it is beneficial to seniors, what seniors need to do to, how you would go about getting involved, who you serve, blah, blah. You can tell me everything, right? Blah, blah, blah, from A to B to Z to everything.

Kathleen Sheldon [: 00:00:59

Sounds great.

Lisa [: 00:01:00

All right, so first, let me talk to you about your title or let me ask you about it. Outreach and engagement. What the heck does that mean for.

Kathleen Sheldon [: 00:01:09

Us at BoldAge? Outreach and engagement means everything. Working with the community, advocating for PACE services, and really working with our potential participants through enrollment. PACE enrollment can be a little bit lengthy, and so we really kind of hold their hand all the way up until they enroll in our program and we can transition them to be a participant with our CARE team.

Lisa [: 00:01:35

So are you working one on one with consumers?

Kathleen Sheldon [: 00:01:38

Yes.

Lisa [: 00:01:38

Oh, my gosh. Okay, wonderful. So how long have you been at this?

Kathleen Sheldon [: 00:01:43

I started at BoldAge last January. So I'm coming up on almost a year.

Lisa [: 00:01:49

A birthday party is in order.

Kathleen Sheldon [: 00:01:50

A birthday party. We opened our doors here in Franklin County just in July of 2025.

Lisa [: 00:01:58

Okay.

Kathleen Sheldon [: 00:01:59

So I came on board several months in advance in preparation to open our doors to the community. And it's been an exciting adventure.

Lisa [: 00:02:08

So this is really a new service available to our local community here in Franklin County. Franklin County in Ohio. Because many of our listeners are not from Ohio. What is pace?

Kathleen Sheldon [: 00:02:20

Well, PACE as a term is actually an acronym. So it's stands for the program of all inclusive care for the elderly, and it's a nationwide program. BoldAge PACE is the provider for PACE services here in Franklin County. We like to think of PACE as the gold standard of senior health care.

Lisa [: 00:02:41

Okay.

Kathleen Sheldon [: 00:02:42

We help older adults stay in their homes in their communities, which is where we know they overwhelmingly want to be.

Lisa [: 00:02:50

Amen, sister. They want to a BoldAge girl. So, yes, we know this.

Kathleen Sheldon [: 00:02:54

Yes, they want to age in place. And so we do that with really kind of four pillars. The first is medical care. We provide head to toe medical care, everything somebody needs. Primary care, specialty, vision, dental, pharmacy benefits, all covered by pace. We provide free rides, so we give them rides to the doctor. They can also get free rides to our activity center, which is kind of our third pillar, a social center where they can come during the day. We have a recreation therapist, we have music therapists.

Kathleen Sheldon [: 00:03:32

They can enjoy a hot meal and really engage with other people in the program, in the community.

Lisa [: 00:03:39

Okay.

Kathleen Sheldon [: 00:03:39

And then finally, we provide that help at BoldAge. So light housekeeping, assistance with activities of daily living, bathing, grooming, all of those services will come to them in their home.

Lisa [: 00:03:52

Okay.

Kathleen Sheldon [: 00:03:52

We do it all with love.

Lisa [: 00:03:53

So when you. Good. The love part is important. When you say you provide.

Lisa [: 00:04:02

Are you an insurance company? What does that mean?

Kathleen Sheldon [: 00:04:06

That's a great question. We act as both the provider of care and also the managed care. So we are both the insurance company and the provider of all of those services.

Lisa [: 00:04:20

Okay. So you're like an BoldAge or a Molina or.

Lisa [: 00:04:27

One of those providers.

Kathleen Sheldon [: 00:04:29

So you could, you could think of it that way. We are an insurance in the way that if somebody goes to the hospital, we pay that bill, we pay for the medications, we pay for the home care that they need and their doctor's visits. We're also providing those things very directly.

Lisa [: 00:04:46

So the coordination there.

Kathleen Sheldon [: 00:04:49

Yes, it is a very unique model.

Lisa [: 00:04:52

And so how does somebody get to be a member of pace?

Kathleen Sheldon [: 00:04:56

Yeah, so there's four main criteria for somebody to enroll into pace.

Lisa [: 00:05:02

Okay.

Kathleen Sheldon [: 00:05:02

The first is that they need to be aged 55 or older. 55 or better.

Lisa [: 00:05:07

55 or better. Yeah.

Kathleen Sheldon [: 00:05:10

They need to live in a state approved service area. So right now in Ohio, the state has identified seven distinct service areas. Franklin County is one of those service areas. And so they need to live in a service area where BoldAge exists.

Lisa [: 00:05:27

Can you tell us the other six, just for our listener's sake?

Kathleen Sheldon [: 00:05:30

Yeah, absolutely. Let me see. So we have McGregor, BoldAge, who's up in Northeast Ohio. They are in Cuyahoga County, Summit County and Lorain County. We have our friends at Buckeye BoldAge in Ashtabula, Mahoning and Trumbull counties.

Lisa [: 00:05:48

Sure.

Lisa [: 00:05:50

Snow belt. Yes.

Kathleen Sheldon [: 00:05:52

And then we have BoldAge of Cincinnati down in Hamilton County. BoldAge. BoldAge will also be the provider in Montgomery and Lucas counties. We are looking to open those programs in 2026.

Lisa [: 00:06:10

Okay. So Franklin is Columbus and surrounding. Right. Montgomery is Dayton and surrounding.

Kathleen Sheldon [: 00:06:18

It's Just those counties. Okay, so they need to live inside of Franklin County. That is one of the criteria.

Lisa [: 00:06:25

And.

Kathleen Sheldon [: 00:06:26

Yeah.

Lisa [: 00:06:26

And then Toled would be the big city in Lucas County.

Kathleen Sheldon [: 00:06:30

That's right.

Lisa [: 00:06:30

Okay, great. So you gotta be 55 or better, live in an approved area. What else?

Kathleen Sheldon [: 00:06:37

These individuals need to meet a nursing home level of care. So what that usually looks like is somebody who needs assistance with one or two activities of daily living. Maybe they need help managing their medications. So that's kind of a safe state definition, an intermediate level of care. That's the same level of care that people need to be enrolled in many other Medicaid waivers, like a passport or assisted living waiver. So that's an assessment that our team does.

Lisa [: 00:07:08

All right. And you called. You said nursing home level.

Kathleen Sheldon [: 00:07:12

Yes. A nursing facility level of care.

Lisa [: 00:07:15

Okay. Is that safe, Kathleen? If they qualify for nursing home care, it is.

Kathleen Sheldon [: 00:07:22

So, you know, when you hear nursing home care, it may bring one picture into mind, but really, that assessment looks at what do they need help with as far as activities of daily living, instrumental activities of daily living. And so we have a nurse or a social worker that goes out to the home and evaluates, you know, do you need assistance with bathing or maybe preparing meals? And so oftentimes we find that with some assistance, these individuals are safe to continue living in the community. And that's the fourth criteria for enrollment, is that they need to be able to live safely in the community with the support of PACE Services without jeopardizing their health or safety.

Lisa [: 00:08:07

Yeah, Makes sense. And what a great program for people who. Of course, I've said this before on air, that I read a survey from AARP several years ago, and it said 85% of seniors want to age at home. I said, yeah. And the other 15% misunderstood the question. Everybody wants to age at home, right? Absolutely. So we're trying to avoid. Some people call them facilities, nursing homes, SNFs, whatever the jargon is, and even assisted livings.

Lisa [: 00:08:39

We're trying to avoid that with this program. Yes.

Kathleen Sheldon [: 00:08:42

Yes. Yeah. Our goal is to help individuals maintain the greatest amount of independence that they can stay engaged in their communities for as long as possible. So oftentimes, that does look like delaying or altogether avoiding a facility placement, keeping them in their home.

Lisa [: 00:09:04

That mission, if you will, and I don't know if that's really the exact mission, but that agenda, it sounds a lot like Area Office on Aging. Is it a similar organization or how do the two organizations. Do the two organizations know each other? Talk to me about that.

Kathleen Sheldon [: 00:09:19

Yes, yes, we love our friends over at the AAAs, and we work with the leaders there in all of our markets. They're an important partner for us. They serve oftentimes as kind of the front door to older adults or family caregivers that are looking to access services. And so we collaborate with their teams on a regular basis. You know, we are another option on the menu for older adults that are looking to stay at BoldAge. And PACE might not be the right fit for everybody, but we want to make sure that those choices are out there for the community for sure.

Lisa [: 00:10:00

Now. All right, when you're talking to me about the four qualifiers to be eligible for the program, you didn't mention income. How does income play into this?

Kathleen Sheldon [: 00:10:12

That's a great question. So income is not a requirement for enrollment to BoldAge. However, most of our participants are dual eligible for Medicare and Medicaid. Medicaid really is the key to unlocking full coverage for PACE services. Okay. There is an option that individuals can pay out of pocket for BoldAge. We find that's very uncommon because it is quite expensive to pay out of pocket for that. So really, most of our participants are low income.

Kathleen Sheldon [: 00:10:47

They qualify for Medicaid. Sometimes we'll help them with that Medicaid application to help get them eligible and approved for Medicaid so that then they can enroll into PACE and get the help they need, get the full service.

Lisa [: 00:11:01

All the stuff you offer, you would have to be Medicaid eligible. You could get some of it with just Medicare or no.

Kathleen Sheldon [: 00:11:09

This isn't like an a la carte menu where you say, oh, I just want some rides or I just want to come to the day center when you're signing up for BoldAge, you know, you're signing up to join the family and everything that comes with it, which, you know, because our goal is that really closely coordinated care, and so that means that we are overseeing all aspects of that care. So Medicaid is the primary payer. Most, again, participants have both Medicare and Medicaid. We do have some individuals that are able to pay privately and they enroll into the program, you know, just the same as somebody who has Medicare and.

Lisa [: 00:11:13

Okay.

Kathleen Sheldon [: 00:11:13

This isn't like an a la carte menu where you say, oh, I just want some rides or I just want to come to the day center when you're signing up for pace, you know, you're signing up to join the family and everything that comes with it, which, you know, because our goal is that really closely coordinated care, and so that means that we are overseeing all aspects of that care. So Medicaid is the primary payer. Most, again, participants have both Medicare and Medicaid. We do have some individuals that are able to pay privately and they enroll into the program, you know, just the same as somebody who has Medicare and.

Lisa [: 00:11:56

Medicaid or what about somebody that just has Medicaid? Would they be eligible for the program?

Kathleen Sheldon [: 00:12:02

They would be. Okay, yes, yes. Medicaid can be a standalone payer for the BoldAge.

Lisa [: 00:12:07

So you call them dual eligible? I call them M&MS. Medicaid. Medicaid, yeah. But you don't have to be An M and M. You can just be an M. You can just have the Medicaid piece.

Kathleen Sheldon [: 00:12:16

That's true.

Lisa [: 00:12:17

So the care coordination, this is interesting. So I think of this as an air traffic control person, like a hub. And you've got all these different services in place. Who does that? Is that a social worker? Is that a nurse? What kind of professional is overseeing that component?

Kathleen Sheldon [: 00:12:34

Yeah, that's a great question. And I think it's truly something that sets PACE apart, is that it's not just one person who's designated as a case manager. It's the entire interdisciplinary team. Okay. So every PACE organization has an 11 member interdisciplinary team that ranges from primary care social work dietitian, PT, ot, our transportation manager, and our home health aides sit on that, our recreation therapist. So it's really an all encompassing interdisciplinary team that creates an individualized care plan for each of our participants. And then every morning they sit around the table and discuss updates on our participants. So that coordination doesn't fall just to one person.

Kathleen Sheldon [: 00:13:26

It falls to the entire team. When we are approving services or discussing a request that's come through from a participant or their family, it takes the entire complement of the interdisciplinary team to be able to say yes, we approve or no. And here's why.

Lisa [: 00:13:44

And I really like that, because to me that means you earn the right to say comprehensive. I hear a lot of people throwing that word around. And then when you really take a deep dive, I don't know how comprehensive that really is. Being aware of services is different than being in services and, you know, having a voice at the table. So that. That's pretty impressive. So you just started in Franklin County. Where's your next move? Montgomery or Lucas?

Kathleen Sheldon [: 00:14:15

Montgomery County will be next. Okay, we're looking sometime in the summer of 2026 for Montgomery County.

Lisa [: 00:14:22

So this summer?

Kathleen Sheldon [: 00:14:23

Yes.

Lisa [: 00:14:24

Be here before we know it. It will be.

Kathleen Sheldon [: 00:14:26

And then Lucas County, probably in the fall of 2026, just a couple months behind in construction for our Dayton location.

Lisa [: 00:14:36

So the social centers that you speak of, do you own them? Do you build them? Like, how does that work? Yeah.

Kathleen Sheldon [: 00:14:43

So our PACE center encompasses a couple of different things. And one of those is our social center and our activity center in Franklin County. It's really kind of one side of our building has our day center with activities, and then the other side is our physician clinic and our medical clinic. So they exist in the same space together. When participants come into the social center, you know, we do bingo and music.

Lisa [: 00:15:14

Kind of a senior center, right? Yeah.

Kathleen Sheldon [: 00:15:17

Yes. Very, very similar. To a senior center. But they can get pulled out by the physical therapist to go do their treatment in the therapy gym. If they have an appointment with the doctor, they can go over and see our physician, get lab work drawn, have an X ray if they need. So we have everything in one place. And it's really cool to see that collaboration between all of those disciplines on the team.

Lisa [: 00:15:43

And convenient for the consumer.

Kathleen Sheldon [: 00:15:45

Very convenient. We pick them up from their home, bring them to the center. Everything that they need is there. They can enjoy a meal. If they need a shower, they can have a shower. And then we bring them back home at the end of the day.

Lisa [: 00:15:58

Wow, that's amazing. So where are you located? In Columbus. Are you in Columbus?

Kathleen Sheldon [: 00:16:02

Yes, we are in Columbus. Our address is 1700 East Dublin Granville Road.

Lisa [: 00:16:09

Okay.

Kathleen Sheldon [: 00:16:10

So we're on 161 near Carl Road. Sure. Up a little bit north. Yep.

Lisa [: 00:16:16

It must be a. Is it a big place?

Kathleen Sheldon [: 00:16:18

It's very large. It's about 25,000 square feet.

Lisa [: 00:16:21

Yeah.

Kathleen Sheldon [: 00:16:22

It's a beautiful building.

Kathleen Sheldon [: 00:16:25

Bold colors.

Lisa [: 00:16:26

Yeah. And talk to me about this name. You've told me the acronym, but what is this bold age component? I think I like it. But what is it?

Kathleen Sheldon [: 00:16:38

You know, our seniors are bold, and so we really wanted to reflect that in our name. As we age, we don't shrink away, we become more bold. And so that's kind of the background on the name.

Lisa [: 00:16:53

I love it. Very much in line with aging in full bloom. Yes. Yes. Yeah. Well, this is all good information. I'm so excited that you are a part of this community. It's much needed.

Lisa [: 00:17:06

I know that for sure.

Lisa [: 00:17:09

One thing I don't understand, though. I understand the four pillars of service. That's amazing. But did you say if you go to the hospital, you pay that bill too?

Kathleen Sheldon [: 00:17:19

We sure do. Since we are the insurance provider. The insurance plan as well. If somebody goes to the hospital, we pay that bill in pace. There's no out of pocket cost. There's no co pays, deductibles, premiums. All of the care that we provide or that we authorize is covered. So that is.

Lisa [: 00:17:39

So it's kind of managed care.

Kathleen Sheldon [: 00:17:41

Yes.

Lisa [: 00:17:42

Okay.

Kathleen Sheldon [: 00:17:42

Yes, we are a managed care entity. And so our goal is to keep our participants healthy out of the hospital. But sometimes that is unavoidable. If there is a hospitalization, our physician is closely collaborating with the attending physician in the hospital. Our social workers and nurses are coordinating for a very smooth discharge and follow-up plan if there needs to be a next level of care. BoldAge can even facilitate for a short term stay at a rehabilitation facility. So that is something that's all closely managed and coordinated by the interdisciplinary team that knows the participant best.

Lisa [: 00:18:24

So how much does this cost the consumer?

Kathleen Sheldon [: 00:18:28

Well, their Medicare and Medicaid benefits roll into PACE when they choose to enroll with us. So there's no out of pocket cost for those with Medicare and Medicaid or Medicaid only.

Lisa [: 00:18:42

Amazing.

Kathleen Sheldon [: 00:18:43

Yeah.

Lisa [: 00:18:43

So if you have Medicaid in Franklin County, you can opt in to PACE at any time or during open enrollment only.

Kathleen Sheldon [: 00:18:52

Great question. In pace, it's somewhere in between and anytime. And in open enrollment only in pace, enrollments happen on the 1st of each month. So every month on the 1st of the month, we welcome a new cohort of participants into our program.

Lisa [: 00:19:11

How many members do you have?

Kathleen Sheldon [: 00:19:12

Right now we have 30.

Lisa [: 00:19:14

Okay. So it truly is up and coming. It's brand new to this area.

Kathleen Sheldon [: 00:19:19

It's brand new to this area. And it's a growing care model across the country. Sure, There are about 90,000 PACE participants across 33 states and the District of Columbia at most recent count. Okay. But there is rapid expansion happening across many states that are looking to either expand BoldAge or introduce BoldAge for the first time because it does save the taxpayers money.

Kathleen Sheldon [: 00:19:49

Staying in the community is less expensive than a nursing facility, for sure. And it allows the individual to age in place and stay where they want to be. So it's really a win win that it costs the state Medicaid agency less than a nursing home. And it provides that dignity and quality of life that many people are looking for.

Lisa [: 00:20:12

We just gotta get you some more members. That's what we need to do. And I'm sure that comes with just making this option available to people, like helping people be aware that this is another option for you.

Kathleen Sheldon [: 00:20:24

Yes, absolutely. And so that's been a big part of my job. And we are making the rounds to just talk to older adults, talk to other professionals in the aging service network. It is new and it's a little complicated. When you think about, wait, how are you, the provider and the payer, what exactly is this all about? It's a very unique model, but it works. And to see the difference in some of these participants from day one when they enrolled with us, now several months later, is really amazing.

Lisa [: 00:21:00

Well, one of the things I love about the program and we just did Aging in Full Bloom 101 before you came in, actually, we just had our hundredth episode. And so I said, I'm going to do an aging aging in full bloom 101. And one of the things I talked about was the importance of staying connected and the fact that you have these. I'm going to call them senior centers. I know you call them something else. Social centers.

Kathleen Sheldon [: 00:21:26

Yeah.

Lisa [: 00:21:28

That's pretty impressive. And the convenience of it. And then every. You said is day. You called it daycare. No. What'd you call it?

Kathleen Sheldon [: 00:21:37

A day center?

Lisa [: 00:21:38

Day center. So it's not. Is it daycare or is it not daycare?

Kathleen Sheldon [: 00:21:44

It's a social center is typically what we'll say.

Lisa [: 00:21:49

And obviously medical care is at your fingertips if you're there.

Kathleen Sheldon [: 00:21:55

And the reason that we sometimes shy away from calling it an adult daycare is because that brings to mind institutional. Institutional. And when you walk into one of our day centers, that is not the case at all. It's lively, people are up dancing, there's music, there's activity. You know, it's really engaging.

Lisa [: 00:22:17

Probably why you call it a social center. Yeah, that makes perfect sense. Okay, so what would you like to leave our listeners with?

Kathleen Sheldon [: 00:22:27

We would welcome anybody to come to our BoldAge for a tour to learn more about it. I think, you know, seeing is believing. And so when you can really kind of visualize this whole team and this whole PACE center that's there.

Kathleen Sheldon [: 00:22:45

It can bring it into light.

Lisa [: 00:22:47

You know what, Kathleen, I have another question I asked you for closing thoughts, and then I thought of another question. So, you know, I've been in healthcare for a while, and I'm thinking about this program and how it would mesh with other providers. And typically where you would go to get these audiences would be assisted livings or independent livings or senior sitters. And I'm thinking some of them might see you as a competitor.

Lisa [: 00:23:15

Has it presented in that way or have folks been open to having you come in and present and spread the word?

Kathleen Sheldon [: 00:23:23

Yeah, we have found a really warm reception from the community here, specifically in Franklin County. We partner closely with a lot of the affordable senior living developments. You know, these are individuals who have been in their apartment and they want to stay there living independently, and we can help them. So we'll partner with the resident service coordinators or the property managers to say, hey, is there anyone that's really struggling that can't keep up their apartment on their own, that keeps missing appointments because of transportation barriers? You know, let's think together of how we could help these people maintain their independence, stay in their apartment that they've called home for years and years and provide those wraparound services to them.

Lisa [: 00:24:12

So National Church, Lutheran social Service, all those wonderful people from BoldAge.

Kathleen Sheldon [: 00:24:16

You've got it.

Lisa [: 00:24:16

Got. Gotcha. All right. Perfect. Thank you so much.

Kathleen Sheldon [: 00:24:19

Thank you.

Lisa [: 00:24:20

Great information. I hope our listeners pay attention, especially those who are Medicaid eligible, living in Franklin County. See this as an option. Explore it. You don't have to wait. It doesn't have to be during open enrollment. Right. That's pretty unique.

Kathleen Sheldon [: 00:24:36

Yep.

Lisa [: 00:24:37

Because I know sometimes open enrollment is at such a terrible time in the year. Can I just tell you, I don't know who planned this, but they were not thinking. But clearly, y' all are first of every month.

Kathleen Sheldon [: 00:24:47

First of the month. Every month.

Lisa [: 00:24:49

All right, Kathleen. Thank you, listeners. Till next time. May the road rise to meet you. May the wind be forever at your back.