Fallon Health Plans to Expand Inclusive Care Program into Southeastern Massachusetts

This article was originally published on South Coast Today.

Fallon Health, a not-for-profit healthcare services organization based in Worcester with more than 45 years of experience providing care, has plans to open a new Summit ElderCare PACE Center in Dartmouth by the end of this year.

PACE, a Program of All-Inclusive Care for the Elderly, provides services to adults 55 and older, including adults with complex medical needs, so they can age with dignity in their home or community. It’s the biggest PACE program in Massachusetts.

Kristine Bostek, senior vice president of PACE Programs, said if the service area that would include Bristol and Plymouth counties and part of Barnstable County receives final approval, there may be as many as 9,000 residents eligible for PACE in the area.

“We’re excited about the opportunity to really continue to help the state meet their goal of being statewide for PACE, and that’s something that we’re really excited to be able to continue to do over the next several years,” she said.

The other Massachusetts Fallon PACE locations are in Webster, Lowell, Leominster and Springfield. Fallon also has a PACE in western New York.

It’s called a PACE desert

Bostek said Fallon Health has worked closely with Massachusetts officials who had an interest in expanding services to the Dartmouth area as part of PACE’s expansion across the state.

She said Mass Health officials focused on Dartmouth because there are many people in the area who are eligible for the program and live within the 35-mile radius of the closest Fallon PACE center in Webster.

All PACE programs across the country are regulated by and work with the Centers for Medicare & Medicaid (CMS). The first PACE program in Massachusetts opened 30 years ago in Worcester, and there are now five PACE programs across 10 counties.

While the project is still in the development and implementation phase, Bostek said they are in the process of constructing a new building at 491 Faunce Corner Road.

The Massachusetts Executive Office of Health and Human Services has granted preliminary approval to file an application with CMS seeking authorization to build the PACE facility in Dartmouth, but it can’t open without final approval.

As care provider and insurer

Bostek said PACE is the care provider through its clinical staff and is also the health insurer for its program participants.

“These individuals that are in our program would otherwise live in a nursing home,” she said. “They are complex older adults who have a lot of medical and likely social needs and therefore it’s a huge responsibility for us to take care of them 24 hours a day every day of the year.”

Bostek said they will be reaching out to educate the public about what PACE does for its referral sources and other providers from the community and the people who will benefit from the program and their caregivers.

Fallon Health has a presence in the area with its other services, she said, and PACE wants to build relationships with the hospital systems and providers as well as senior agencies and grassroots organizations to get to know the area better as part of its commitment.

The capacity of the facility

The Dartmouth facility would be Fallon’s largest PACE site. Bostek said it’s anticipated there will be 300 to 350 people enrolled in the PACE program over the course of several years based on experience with their other locations.

She said it’s a very personalized and involved process because it’s a big step to take to enter the program, and most of the people are on Medicaid and Medicare and must meet eligibility requirements and qualify as eligible for a nursing room level of care.

The case model requires 11 different disciplines to everybody that enrolls in a PACE program with an interdisciplinary team consisting of providers including a medical doctor, a nurse, physical therapist, occupational therapist, speech therapist, a social worker, a dietitian, a health aid and a transportation coordinator.

“These people live independently in the community with the services that we provide so we do a lot of that in their homes whether it’s therapy, nursing or meetings with the social worker, the doctor or the nurse practitioner,” she said.

The building will feature clinical space with exam rooms, day rooms for activities, socializing and meals, a rehabilitation gym, separate space for memory care needs, conference rooms for meetings, outdoor space and office space for staff.

They can also receive medical care, get physical therapy or meet with a dietitian at the center.