{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T21:15:13Z","timestamp":1780089313503,"version":"3.54.0"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T00:00:00Z","timestamp":1737072000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000909","name":"John A. Hartford Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000909","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020097","name":"Foundation for Opioid Response Efforts","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020097","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000905","name":"Commonwealth Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000905","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Program of All\u2010inclusive Care for the Elderly (PACE) is a comprehensive care model that aims to promote aging in the home and community for older adults who are nursing\u2010home eligible needs\u2010wise. Older adults experience age\u2010related barriers to accessing behavioral health (BH) services. PACE programs play an important role in providing all\u2010inclusive health care for individuals over 55 who are dually eligible for Medicaid and Medicare. This article investigates behavioral health integration (BHI) within PACE Organizations (POs), produces a conceptual framework for BHI within PACE, and reports on current BH practices and programmatic needs to support the growing BH needs of participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The team adapted the BH\u2013Serious Illness Care (BH\u2010SIC) Model, to produce a conceptual framework for BHI within PACE (BHI\u2010PACE Model). The model informed a mixed\u2010methods sequential approach to assess BHI at POs that include (i) a survey, (ii) use\u2010case interviews of POs, and (iii) qualitative analyses of interviews.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We present the domains and subdomains for the BHI\u2010PACE Model. With respect to the national BH in PACE assessment, 38 POs representing 119 sites and 25,806 participants participated in the survey and 15 POs representing 58 sites and 10,029 participants participated in interviews. Survey results revealed a high rate of BH comorbidities among PACE participants (60% median rate, IQR: 70\u201344). The most common reasons for referral to BH specialists were depression and mood disorders 92.1%, behavioral and psychological symptoms of dementia (BPSD) 57.9%, and anxiety disorders 55.3%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>POs' current BH practices and challenges can guide other POs to better integrate BH. Integrating BH into the PACE model requires policy\u2010level action, though quality measurement and value\u2010based care efforts can support this endeavor.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.19327","type":"journal-article","created":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T04:20:48Z","timestamp":1737087648000},"page":"1566-1575","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A Framework for Behavioral Health Integration in the Program of All\u2010Inclusive Care for the Elderly (\n                    <scp>PACE<\/scp>\n                    )"],"prefix":"10.1111","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0897-6468","authenticated-orcid":false,"given":"Alexa","family":"Fleet","sequence":"first","affiliation":[{"name":"New York State Psychiatric Institute  New York New York USA"},{"name":"University of Massachusetts Boston Department of Gerontology  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alya","family":"Simoun","sequence":"additional","affiliation":[{"name":"New York State Psychiatric Institute  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Shalev","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine Division of Geriatrics and Palliative Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitta","family":"Spaeth\u2010Rublee","sequence":"additional","affiliation":[{"name":"New York State Psychiatric Institute  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taryn","family":"Patterson","sequence":"additional","affiliation":[{"name":"West Health Institute  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liane","family":"Wardlow","sequence":"additional","affiliation":[{"name":"West Health Institute  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tessa","family":"Roth","sequence":"additional","affiliation":[{"name":"New York State Psychiatric Institute  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harold Alan","family":"Pincus","sequence":"additional","affiliation":[{"name":"New York State Psychiatric Institute  New York New York USA"},{"name":"Columbia University Irving Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,17]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2008.11.004"},{"key":"e_1_2_10_3_1","unstructured":"\u201cProgram of All\u2010Inclusive Care for the Elderly (PACE)|CMS \u201daccessed January 27 2023 https:\/\/www.ms.gov\/Medicare\u2010Medicaid\u2010Coordination\/Medicare\u2010and\u2010Medicaid\u2010Coordination\/Medicare\u2010Medicaid\u2010Coordination\u2010Office\/PACE\/PACE."},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2022.09.004"},{"key":"e_1_2_10_5_1","unstructured":"\u201cPACEFinder: Find a PACE Program in Your Neighborhood|National PACE Association \u201daccessed March 9 2023 https:\/\/www.npaonline.org\/pace\u2010you\/pacefinder\u2010find\u2010pace\u2010program\u2010your\u2010neighborhood."},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2008.12.002"},{"key":"e_1_2_10_7_1","volume-title":"Behavioral Health \u2010 2014 Data","author":"National PACE Association","year":"2014"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2023.10.033"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.202000903"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.18416"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/1525822X05282260"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gerinurse.2018.12.014"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/1744987107081254"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11135\u2010021\u201001182\u2010y"},{"key":"e_1_2_10_15_1","unstructured":"Courageous Conversations \u201cHello we Are Courageous Conversations \u201d2023 https:\/\/courageousconversation.com\/about\/."},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2018.3329"},{"issue":"1","key":"e_1_2_10_17_1","first-page":"2","article-title":"Chronic Disease Management: What Will It Take to Improve Care for Chronic Illness?","volume":"1","author":"Wagner E. 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