Approaches to Successfully Implementing or Expanding PACE Programs
May 8-10 | Dallas, TX
Meet the State PACE Forum Speakers
We are excited to announce the speakers for the State PACE Forum. Our presenters include members from state agencies, the Center for Medicare & Medicaid Services, and leadership from several PACE organizations. They bring unique insights into the discussion for all things PACE.
Kentucky – Department for Medicaid Services, Long Term Services and Supports (LTSS)
Division Assistant Director
Learn More About Alisha
Alisha Clark is currently the Assistant Director of Kentucky Medicaid’s Division of Long-Term Services and Supports. A registered nurse since 2002, Ms. Clark spent eight years providing direct patient care before joining Kentucky Medicaid. Her Medicaid experience includes the hospital, renal dialysis, ambulatory surgery programs, and call center management. She has worked for the Division of Long-Term Services and Supports since 2016, first as manager of the intellectual and developmental disabilities branch before moving into her current role. Kentucky Medicaid’s Division of Long-Term Services and Supports handles programs such as HCBS waivers, PACE, nursing facilities, home health, and private duty nursing.
Illinois Department of Healthcare and Family Services, Division of Medical Programs
Public Service Administrator
Learn More About Lisa
Lisa Gregory is the Public Service Administrator with Illinois’s Division of Medical Programs. Ms. Gregory has over twenty-five years of experience across several industries including: higher education; health care; finance; federal, state, and municipal government. Her functional areas of experience include public relations, government affairs, strategic planning, project management; and communications. Lisa’s notable professional achievements include: passage of legislation that created ICash, a program that returns unclaimed assets to the original owner or their heirs; Bright Start, a 529 College Savings Plan; and the Illinois Community Health Center Act. She has secured over $12 million in federal and state funding for federally qualified health centers and over $5 million for higher education. She will be adding the Program of All-Inclusive Care for the Elderly to her list of professional achievements and believes this is the most challenging, yet exciting and rewarding, work she has overseen thus far during her career.
Colorado Department of Health Care Policy and Financing
Supportive Long Term Care Programs Unit Supervisor
Learn More About Bryan
Bryan Fife has been over the PACE Program for the State of Colorado for the past 8 years. In his tenure, he has overseen numerous PACE expansions, conversion of the nation’s largest PACE provider from non-profit to for profit and ushered in key initiatives such as obtaining detailed encounter data. Currently, Bryan Fife is working to expand the State of Colorado PACE compliance program by developing a PACE specific license and a value-based payment program. In his spare time, Bryan loves to run, climb and experience everything the great Colorado outdoors has to offer.
Oklahoma Health Care Authority
Learn More About Nicole
Ms. Collins is the PACE Manager at the Oklahoma Health Care Authority, the state’s Medicaid Agency. She started at the agency ten years ago in Provider Services before moving into the role of overseeing the administration of the PACE program for the state. While working in Provider Services, Ms. Collins was able to travel the state to provide education and assistance to Soonercare (Oklahoma’s Medicaid Program) providers with policy interpretation, claims resolution, and new initiatives for all provider types before having the opportunity to work with PACE. In her tenure with the PACE program, she has implemented many quality oversight activities to include monthly desk reviews, quarterly enrollment audits, monthly safety reporting, disenrollment surveys, and audit protocols.
Centers for Medicare and Medicaid Services
PACE Technical Director, Division of Health Homes, PACE and COB/TPL
Learn More About Cindy
Cindy Proper is currently the PACE Technical Director within the Division of Health Homes, PACE and COB/TPL in the Disabled and Elderly Health Programs Group, Center for Medicaid and CHIP Services. She has been with the Centers for Medicare and Medicaid Services since July 2010. Prior to that she worked for more than 25 years for the Commonwealth of Pennsylvania’s, Department of Human Services, and for fourteen of those years was actively involved in the development, implementation and management of the Programs of All-inclusive Care for the Elderly in Pennsylvania.
Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services
Health Insurance Specialist
Learn More About Angela
Angela began her federal career at CMS in 2001. In her time within the agency, her work has spanned numerous program areas, including 1915(c) home and community-based waivers, pre-admission screening and resident review (PASRR), state plan amendment reviews, integrated care models and primary care case management programs (ICM/PCCM), and programs of all-inclusive care for the elderly (PACE). Within Angela’s current work on PACE, she serves as the subject matter expert for the state attestation pages that are submitted with applications, and also provides expert review of the Medicaid rate methodology section of PACE state plan amendments. Angela received her Bachelor of Science in Psychology from University of Maryland. Prior to her federal service, she worked in special education in Howard County, Maryland.
Jared Duzan, CFE
Myers and Stauffer
Learn More About Jared
Mr. Duzan has an extensive public health care background of nearly thirty years, both serving state Medicaid agencies now as a principal with Myers and Stauffer and formerly with the Indiana Family and Social Services Administration. He has extensive experience in Medicaid reimbursement strategies and systems in numerous disciplines, including PACE, behavioral health, acute care, psychiatric hospitals, physicians, practitioners and dentists, durable medical equipment and medical supplies, pharmacy, and community-based housing. He is an expert in Medicaid financing and compliance issues, including UPL demonstrations, intergovernmental transfers, and certified public expenditures. Mr. Duzan’s experience also includes engaging stakeholders, conducting training sessions, developing cost studies and working with industry partners to identify common ground solutions to health equity, access, non-federal share financing and service delivery models. He researches policy and reimbursement issues, designs survey instruments, and prepares fiscal models. Mr. Duzan is a partner-in-charge in the rate setting and federal compliance practice, which includes PACE, certified community behavioral health clinics (CCBHC), and analysis of substance use disorder (SUD) policy, as well as rate and reimbursement systems, upper payment limits, and federal compliance. His engagements are designed to improve the equity and efficiency in health care delivery, improve outcomes, and reduce the cost of government-sponsored health care programs. Mr. Duzan serves as chair of Myers and Stauffer’s national state PACE workgroup, a collaboration of subject matter experts within the firm to share best practices, emerging trends, and care insights within the world of PACE. Additionally he has spent the last two years as project director on state PACE engagements; working with the team to establish processes and procedures for state agencies to successfully implement PACE programs.
Rose Anne Howland, RN, MS, CFE, CHC, CPHQ, LFACHE
Myers and Stauffer
Learn More About Rose Anne
Ms. Howland, a senior manager with Myers and Stauffer, is an accomplished health care professional with many years of experience in health care. Her background includes responsibilities primarily related to compliance, quality and resource management, health facility licensure, and accreditation. She has held leadership roles including Chief Executive Officer, Chief Nurse Executive, Vice President, Chief Quality Officer, and Compliance Officer positions in an academic medical center, ambulatory health center, and acute care and specialty hospitals. Ms. Howland has published on the topic of healthcare quality in peer reviewed journals and served on the external faculty of a large, well-known healthcare entity accreditation body.
She serves as a leader on the firm’s Managed Care Engagement Team. Ms. Howland has worked with the Centers for Medicare & Medicaid Services (CMS) since 2012 and provides direction, oversight, and support of Medicare Advantage Organizations and Prescription Drug Plans (MAPD) compliance and performance audits. Her responsibilities include project management; conducting field and desk audits; supervising staff; interaction with health plan and CMS personnel; report preparation; and corrective action review. Ms. Howland has participated in approximately 40 Program of All Inclusive Care for the Elderly (PACE) audits, serving as Audit Lead or Element Lead. Over the last three years, she has been instrumental in providing operational, clinical, and quality expertise to the firm’s state agency clients regarding PACE initiatives. In addition to licensure in nursing (RN), she holds a bachelor’s degree in nursing (BSN), a Master’s degree, and is certified in health care compliance (CHC), fraud examination (CFE), medical auditing (CPMA), and healthcare quality (CPHQ). She holds Lifetime Fellow status (LFACHE) with the American College of Healthcare Executives (ACHE).
Renae Blunt, CPA, MSM, CGFM
Myers and Stauffer
Learn More About Renae
Ms. Blunt has health care-related accounting experience, both in industry and public accounting. Her experience also includes serving as an administrator of an Illinois nursing home. Ms. Blunt has been with Myers and Stauffer for over 27 years consulting state Medicaid agencies. She has provided leadership in the firm’s Frankfort, Kentucky, office, since 2000, which includes the firm’s rate setting contract with the Kentucky Department for Medicaid Services (DMS). Ms. Blunt serves on the firm wide leadership team for the Nursing Facilities Engagement Team. This team focuses on national initiatives and impact to state Medicaid agencies, training and development of personnel, and best practices in servicing our state agency clients. She served on an internal task force committee of Myers and Stauffer personnel researching PDPM (Patient Driven Payment Model) and assisting in drafting numerous client briefs and communications. Ms. Blunt also managed the Value-Based Purchasing forum held for state agencies to explore numerous topics related to quality and value-based purchasing reimbursement methodologies. Ms. Blunt has spent the last three years assisting the firm’s state agency clients on PACE initiatives. In this capacity, she has served as the project leader establishing processes and procedures designed to assist state agencies with successfully implementing PACE programs.
Vicki Bartlett, RN, BSHA, CCM, COC
Myers and Stauffer
Learn More About Vicki
Vicki Bartlett is a senior manager for Myers and Stauffer, with 30 years of experience in acute nursing, quality improvement, managed care, case management, nursing leadership, Medicaid program integrity, regulatory compliance, health care litigation, and health care auditing. She has been a member of the Myers and Stauffer team for 10 years, serving in multiple capacities on projects for federal and state agency clients. Federal projects include compliance auditing of Medicare Advantage and Prescription Drug Plan Programs and Programs of All-Inclusive Care for the Elderly (PACE). Her experience with Myers and Stauffer also involves leadership roles over Program Integrity initiatives, including Recovery Audit Contracting, in addition to litigation support services. Ms. Bartlett facilitates the firm-wide clinical committee where she has provided clinical expertise for a variety of initiatives. Currently, Ms. Bartlett offers her clinical guidance on state PACE consulting and compliance initiatives. In this role, she provides consulting expertise in the development, implementation, and quality review of PACE initiatives for states. She has provided program application reviews, federal requirements compliance reviews, stakeholder engagement strategies, State Readiness Reviews, and post implementation quality audit tools.
Seth Adamson, ASA, MAAA
Learn More About Seth
Mr. Adamson has 11 years of experience with Medicaid managed care rate setting and other actuarial analyses pertaining to public health programs. Mr. Adamson’s Medicaid managed care experience includes physical health capitation rates, mental health/substance abuse capitation rates, PACE UPL development, case rate development, and rate development for populations/services with limited Medicaid data. This work includes detailed statistical analysis, such as Monte Carlo simulations and full credibility testing, to understand the variability and volatility of the data being used which can then inform the appropriate actuarial adjustments for accurate rate development.
Myers and Stauffer
Learn More About Catherine
Ms. Snider is a director with Myers and Stauffer and has extensive experience in public policy management assuring Medicaid program integrity and monitoring contract compliance across Medicaid service areas. She has supported the design, implementation, and evaluation of care delivery transformation and payment models to improve population health, integrate physical and behavioral health services, and address social determinants of health. Models have included managed care entities, accountable care organizations, regionally-based multi-sector collaborations, hospital-based systems of care, primary care, and the Program for All-Inclusive Care for the Elderly (PACE). Ms. Snider is experienced in the use of Section 1115(a) waiver authority to advance the use of alternative payment models (APMs), evidenced-based protocols, performance measurement, and decision support solutions. She has led negotiations with CMS to ensure alignment between waiver objectives, activities, documentation, and formative and summative evaluations.
Matt Varvaris, CPA
Myers and Stauffer
Learn More About Matt
Mr. Varvaris, a senior manager with Myers and Stauffer, has more than 10 years of experience working with health care and government-related entities. Specifically, he manages federal government clients, providing oversight of managed care organizations and PACE organizations, including the performance of compliance audits. He has prior experience as a director of accounting and reimbursement for large non-profit multi-hospital healthcare systems. Prior to working in health care, he has significant auditing experience with Big 4, national and regional accounting firms, providing assurance and advisory services to non-profit and financial services clients.
Jennifer Farley, RPh
Myers and Stauffer
Learn More About Jennifer
Ms. Farley, a manager with Myers and Stauffer, has more than 25 years’ experience working with health care and government-related entities. Specifically, for the last 10 years, she has worked with federal and state government clients, providing oversight of managed care organizations and PACE organizations, including the performance of compliance audits in the areas of Medicare Part D Formulary Administration, Medicare Part D Coverage Determinations, Appeals and Grievances as well as managing compliance audits of PACE organizations. For state government clients, she provides annual fiscal analyses of beneficiary lock-in programs. She has over 15 years’ experience as a retail pharmacist in both management and staff positions specializing in immunization administration, medication therapy management (MTM) program participation and billing, and third party Medicaid and Medicare Part D claims processing. She is currently a registered pharmacist in North Carolina, Minnesota, New Mexico, and Virginia, and is certified in MTM and immunization administration.
Day 2: From the Provider’s Perspective (presented virtually)
Heidi Ortolaza-Alvear, AM, MPP
Vice President of Strategy and Business Development
Learn More About Heidi
Heidi Ortolaza-Alvear is Esperanza Health Centers’ Vice President of Strategy and Business Development. Esperanza is a Federally Qualified Health Center (FQHC) serving roughly 50,000 patients through five primary care clinics across Chicago’s southwest side. Esperanza is working to launch their first PACE center by July of 2024. In her role, Heidi leads strategic planning and key growth initiatives and helps build and maintain Esperanza’s community relationships. Before Esperanza, Heidi was Deputy Director of Strategy and Impact at EverThrive Illinois, where she worked to address the root causes of health inequities among women, children, and families in Illinois. Heidi began her career in community health at Erie Family Health Centers, an FQHC on Chicago’s north and west sides. She received her Master of Arts in Social Work, Master of Public Policy, and Certificate in Health Administration and Policy from the University of Chicago and her bachelor’s degree from Carleton College. Heidi is an alumna and board member of High Jump Chicago and is a Leadership Greater Chicago fellow Class of 2022.
Horizon Adult Health Care and American Health
President and CEO
Learn More About Kelly
Mr. Upchurch is the President and CEO of Horizon Adult Health Care and American Health Management. He has served in administration of health care his entire career. He has extensive experience in inpatient, outpatient, home health, rehabilitation services, and adult day health care. Mr. Upchurch served four years as the President of the Kentucky Association of Adult Care Centers and have held the position of Legislative Chair for KAAD the last seven years. Mr. Upchurch received his master’s in clinical psychology from Eastern Kentucky University.
Elizabeth (Liz) Fowler, MPH
Bluegrass Care Navigators
President and CEO
Learn More About Liz
Liz Fowler is the President and CEO of Bluegrass Care Navigators, a Kentucky-based national leader in delivering high quality end-of-life care and a pioneer in developing new programs that are responsive to the evolving needs of seriously ill patients and their families in both rural and urban communities. For more than 30 years Ms. Fowler has brought leadership and a commitment to innovation in health care and nonprofit organizations in Kentucky, Florida and California. Ms. Fowler is a nationally recognized leader in hospice and palliative care and currently is an active member of the National Hospice and Palliative Care Organization’s board of directors, past president of the Kentucky Association of Hospice and Palliative Care, faculty member for the Center to Advance Palliative Care’s
Samantha (Sam) Black, LCSW
PACE Executive Director
Learn More About Sam
Samantha Black, LCSW has 25+ years of direct care and leadership experience in hospice, palliative, and PACE programs. Sam has served as the Executive Director of TRU PACE with TRU Community Care in Lafayette, CO since 2018. Sam brings her extensive social work and leadership experience to bear in the service of low-income frail elderly, with a passion for partnership with local, state and federal entities to drive high-quality care and services, cost-effectiveness and innovation to ensure services in perpetuity for the most vulnerable of our communities.
National PACE Association
Learn More About Shawn
Shawn Bloom is the President and CEO of the National PACE Association (NPA). Shawn has been with NPA since 2000 at which time there were 18 PACE organizations operating in 6 states. Currently, there are 147 PACE organizations in 31 states serving approximately 60,000 individuals. Prior to NPA, Shawn spent 5 years as the Executive Director of the Missouri Association of Homes for the Aging (MoAHA), which represented not-for-profit long-term health care and housing facilities in the state of Missouri. Shawn previously worked in the Policy and Governmental Affairs Division of the American Association of Homes and Services for the Aging (AAHSA) – now called Leading Age – a Washington, D.C. based trade association that represents not-for-profit long-term health and housing services for the aging. Shawn has testified before the U.S. Congress, state legislative committees as well as the National Academy of Sciences on elderly and long-term care policy issues.