To view and download a PDF version of this article, written by Melissa Erickson, click here.
To view and download a PDF version of this article, written by Melissa Erickson, click here.
This was originally posted on WCVB.com. Read the full post and watch the video here.
COVID-19 has dramatically impacted older adults, through illness or the isolation often needed to keep them healthy. In Massachusetts, a free program is supporting those able to stay in their homes by partnering with families as the pandemic continues to take its toll.
Gloria Williams has always been independent. As she got older and her medical needs increased, she was determined to stay at her home in Dorchester.
“Just to leave my home and to a nursing home, I’m not ready for that yet,” Williams said.
So about 10 years ago, she joined MassPACE: Programs of All-inclusive Care for the Elderly. It’s a federally and state-funded program, an alternative to nursing home care that keeps seniors living at home.
“In general, older adults prefer to age in place at home if they can,” said Dr. Adam Burrows, medical director for the Upham’s Corner Health Center PACE program in Dorchester.
He said participants are 55 years and older, with medical and social needs that would qualify them for a nursing home. Instead, they’re trying to live at home and that’s where PACE teams come in.
“Made up of primary care providers, social workers, nurses, occupational and physical therapists, registered nurses, dietitians who together assess our participants, decide on a finely calibrated individualized care plans,” Burrows said.
Pre-COVID, much of this work had been done at the PACE centers — the clinical care as well social events — but the coronavirus changed that.
“So we relied on daily telephonic outreach. We relied on video technology. We relied upon staff going into homes,” Burrows said.
They also relied on family like Williams’ granddaughter, TaMarsha Williams. PACE hired and trained her to be Gloria’s personal care worker.
“It was all new to me, but I know I can give her the best care. When we were younger, she took care of me and my siblings and now it’s reversed. Me taking care of her, just trying to pay her back,” TaMarsha Williams said.
Burrows said that sense of community is exactly what PACE is about.
“When we think of taking care of these very vulnerable older adults, we’re also thinking about how do we create healthier households and healthier communities.”
There are 130 PACE programs across the country, eight of them in Massachusetts. Nationally, they’re seeing an increased interest in the program as families and older adults look for options.
Massachusetts Secretary of Health and Human Services, Marylou Sudders, to join PACE Leaders and Frontline Workers in Speaking at Event
MassPACE, the Massachusetts Association of the Programs of All-inclusive Care for the Elderly (PACE), today announced it will host the second annual MassPACE Conference virtually from October 28-29, 2020. The event will bring together key elder care leaders and state and national partners to collaborate on improving care
for the vulnerable elderly population in the state of Massachusetts.
The 2020 event will feature presentations on how PACE has pivoted to an at-home care model to protect elderly participants during COVID-19; strategies to drive long- lasting change to elder care; and how to partner with health and community organizations to improve the lives of older adults. Attendees will hear from PACE leaders, frontline workers, and state representatives as they discuss the biggest issues facing elder care, such as evaluating nursing home placement, addressing health disparities, and preventing avoidable emergency department visits and hospitalizations for those most at risk.
Marylou Sudders, MSW, ACSW, the Secretary of Health and Human Services for the Commonwealth of Massachusetts, will deliver the welcome and keynote address. Since joining Governor Baker’s cabinet in January 2015, Sudders has led the Executive Office of Health and Human Services, which represents 52% of the state’s
budget, and is comprised of 12 agencies, 2 state-operated Soldiers’ Homes and MassHealth, the state’s office of Medicaid. Sudders has advanced strategic policy priorities, including restructuring MassHealth into a population-based health coverage system, addressing the opioid epidemic, integrating physical and behavioral health care, and strengthening community-based services. Governor Baker appointed Sudders to lead the Massachusetts COVID-19 Command Center, a role she continues to hold, in addition to serving as Health and Human Services Secretary.
Adam Burrows, M.D., Medical Director for Upham’s PACE, the PACE organization of Upham’s Corner Health Center, will speak to the session “Thinking About Nursing Home Placement,” elaborating on critical factors to consider while evaluating nursing home placement versus at-home care and highlighting the use of his organization’s hybrid consumer-directed personal care worker program as a strategy for caring for participants at home. Dr. Burrows has been the Medical Director of Upham’s PACE since its inception in 1996 and has helped guide the program’s expansion to three PACE Centers throughout the city of Boston. He is a member of the Boston University Medical Center’s Geriatric Medicine faculty and just completed a two-year term as Chair of the National PACE Association’s Board of Directors.
Robert Schreiber, M.D., Vice President and Medical Director of Fallon Health’s Summit ElderCare program, will present the session “A Proactive Approach to Early Identification of Risk During the Pandemic and Beyond,” focused on how to leverage data to identify and intervene with at-risk patients to prevent unnecessary hospitalizations. Dr. Schreiber oversees medical care for Fallon’s PACE program, which is the sixth largest in the country and largest in New England. With more than 1,200 participants, Fallon has 5 PACE sites in Massachusetts and one in Western New York. Previously, Schreiber served as Medical Director of Evidence-based Programs at Hebrew SeniorLife and Medical Director of the Healthy Living Center of Excellence.
Wednesday, October 28 – Thursday, October 29, 2020
The event will be held virtually. For more information, visit https://whova.com/portal/massp_202010
To register for the event, visit https://whova.com/portal/registration/massp_202010
If you are a member of the media interested in complimentary access, please contact Kahler Buckley at firstname.lastname@example.org
To learn more about MassPACE please visit masspace.net. Attendees looking to connect ahead of the conference can join the conversation on Twitter by using the hashtag #MassPACEConference2020.
Join with other PACE employees, vendors, elder stakeholders, and aging services providers as we celebrate 30 years of PACE in the Commonwealth of Massachusetts. PACE in MA has grown from one small pilot program in 1990, to eight programs serving almost 5,000 participants and their families and caregivers in 2020. And now more than ever, it is time to take this program statewide. We are positioned for exponential growth as we look to make this program more accessible, sustainable, and desirable for those who need it most – our valued older adults, and individuals with disabilities.
Challenges present opportunities. With the onset of the COVID-19 pandemic in March, 2020, the PACE model as well as related elder healthcare programs, have pivoted to turn Center-based care into home delivered care ranging from doctor house calls to social encounters and activities. For PACE, what changes have been made that could endure long after this pandemic subsides? How can we work together to achieve our vision of making PACE accessible to every eligible consumer in the Commonwealth? How can we better partner with other mission-driven elder health care and community organizations to continue to make the lives of our older adults better? Join us as our leaders, front line workers, and state and national partners present educational and networking sessions on these topics and more!
For registration, a list of this year’s speakers and an event schedule, visit our MassPACE Virtual Conference events page.
Dates: October 28-29, 2020
Register here: https://whova.com/web/massp_202010/
BOSTON – September 9, 2020 – MassPACE, the Massachusetts association of the Programs of All-inclusive Care for the Elderly (PACE), is celebrating National PACE Month in September. The National PACE Association (NPA) has designated September as National PACE Month to raise awareness and celebrate the difference PACE makes in the lives of enrolled seniors, their families and their communities. PACE is a federally and state funded program that offers an alternative to nursing home care by providing eligible individuals with robust healthcare and social services to keep them living safely at home.
All of the PACE providers in Massachusetts are participating in National PACE Month by developing socially distanced programming to support older adults with long-term health needs and keep them engaged in their health. Element Care, a MassPACE program serving communities north of Boston and the Lowell and Lawrence regions, is conducting a Healthy Aging educational campaign to help members maintain their health while living at home. MassPACE is also using National PACE Month to highlight its ability to curb COVID-19 infections and, in many cases, fatalities. While 22 percent of infected nursing home residents in Massachusetts have died due to COVID-19 infection according to Dignity Alliance Massachusetts, less than 2 percent of MassPACE participants residing at home have succumbed to the virus.
“Every September, National PACE Month affords us a wonderful opportunity to highlight the significant impact our program has on elders as well as their families and communities,” said Candace Kuebel, executive director of MassPACE. “Though this year is different because of COVID-19, we are celebrating the resilience of our program and our ability to pivot and continue helping seniors living at home while navigating social distancing protocols. It has been a challenging several months, but we are happy that our unique structure has allowed us to continue upholding our mission of giving our participants freedom to live their lives in the community.”
To adapt to the pandemic, MassPACE member agencies swiftly transformed their care model, previously based in physical PACE centers, to at-home care delivery. The programs deployed tablets and similar technology for audio and video telehealth, social programming, nutritional counseling, and more to prevent gaps in care and sustain member engagement throughout the pandemic. The programs have also provided additional support and training for family caregivers when they are available to care for loved ones. Clinics at MassPACE centers have remained open by appointment, even while many appointments took place in participant homes.
“Caring for older individuals with multiple healthcare needs has been particularly challenging during this pandemic,” said Shawn Bloom, NPA president and CEO. “To keep participants and staff as safe as possible, the PACE model of care has been adapted from bringing individuals into a PACE center several times a week to providing services in the home. The flexibility of the model in the face of this pandemic has been inspiring.”
Massachusetts was one of the first states to pilot PACE. Since the launch of its first program in 1990, the Massachusetts PACE programs have grown to be one of the largest in the nation, serving more than 5,000 elderly individuals through eight regional programs across 28 PACE centers. Nationally, a total of 134 organizations operate 264 PACE centers in 31 states. Currently, more than 51,000 individuals are enrolled in the program. Though all enrollees are eligible for nursing home care, PACE has been successful in keeping more than 95 percent of its enrollees in the community and out of nursing homes.
In order to enroll in PACE, a person must be 55 or over, live in the service area of the PACE organization, meet clinical eligibility requirements for nursing home placement, and be able to live safely in the community with the support of the PACE organization. To learn more about MassPACE and enrollment, please visit masspace.net.
The MassPACE Association’s Mission is, through advocacy, education and policy research, to provide leadership and support for growth, access, quality, and success of PACE in the Commonwealth of Massachusetts. The VISION of MassPACE is that PACE will be accessible to every eligible consumer in the Commonwealth of MA and recognized as an extraordinarily innovative, accessible, valuable and effective model of care for individuals with significant healthcare needs.
The National PACE Association (NPA) works to advance the efforts of PACE programs, which coordinate and provide preventive, primary, acute and long-term care services so older individuals can continue living in the community. The PACE model of care is centered on the belief that it is better for the well-being of seniors with chronic care needs and their families to be served in the community whenever possible. For more information, visit www.NPAonline.org and follow @TweetNPA.
Date and Time: June 30, 2020, 2:00 – 3:30 pm ET (11:00 am – 12:30 pm PT)
The Program of All-Inclusive Care for the Elderly (PACE) is an evidence-based care model for older adults who meet a nursing-home level of care but live in community settings. These organizations blend funding from Medicare and Medicaid to integrate preventive, acute, and long-term care as well as services to address social needs. While many services are provided in PACE day centers, PACE organizations have adapted the delivery of services to meet patient needs during the COVID-19 pandemic.
This webinar, coordinated by the Better Care Playbook and the National PACE Association and made possible through support from the Seven Foundation Collaborative and West Health Policy Center, will highlight innovations adopted by PACE organizations during the pandemic to provide care for older adults with complex needs. Lessons shared will be broadly applicable to organizations serving vulnerable older adults in other settings during the pandemic as well, particularly through integrated health plan approaches. In addition, speakers will review state policy considerations to address the long-term needs of older adults requiring a nursing home level of care in the context of COVID-19.
In a 2018 blog post, the Institute for Healthcare Improvement (IHI) describes PACE as “safe alternative to nursing homes.” While posted in 2018, this post is more relevant than ever in light of the COVID-19 crisis.
More than 1.8 million seniors over the age of 65 in the United States live in supportive care facilities, but many would choose to remain at home if they could. The following excerpt from IHI’s No Place Like Home: Advancing the Safety of Care in the Home report presents a program that provides nursing home-level care to patients in their own homes.
To optimize the care of nursing home-eligible individuals receiving care at home or in a community-based setting, in 1990 the federal government began offering states Medicaid waivers to enable experimentation with value-based service models. The Program of All-Inclusive Care for the Elderly (PACE), an initiative originally developed by San Francisco’s On Lok Senior Health Services, was among the first programs. PACE aims to avoid nursing home placement by providing a broad range of care services to Medicare and Medicaid beneficiaries who clinically require a nursing home level of care. The program provides flexibility for caregivers; offers tailored services that manage the complex medical, functional, and social needs of frail elders; and promotes adherence to home safety standards.
Congress authorized 10 PACE replication sites in 1986 and codified PACE as a permanent Medicare program in the Balanced Budget Act of 1997. To date, 31 states offer PACE options to frail elders; 90 percent of PACE enrollees are eligible for both Medicare and Medicaid.
For individuals who are deemed eligible for a nursing home level of care by their state’s administering agency, PACE offers an alternative option: living in their homes and communities while receiving coordinated, highly tailored health care services spanning the care continuum. Eligible seniors are assigned to a specific PACE organization that includes an interdisciplinary team comprising clinicians and support service providers. The interdisciplinary team is responsible for conducting initial and periodic participant assessments, performing care planning, and coordinating 24-hour care delivery.
The program includes these components:
PACE organizations provide a wide range of services, including adult day programs, primary and preventive care, nutritional support, pharmacy services, social services, transportation, and other support services. Members of the interdisciplinary team coordinate services, based on a comprehensive baseline needs assessment. Within 30 days of enrollment, beneficiaries receive in-person assessments conducted by the interdisciplinary team, including an in-home assessment by a team member. Additional assessments are conducted at least every six months thereafter. Care is provided at PACE centers, at home, or in the community through contracts with other community-based providers. PACE center safety standards, outlined in federal regulations, address wheelchair accessibility, handrails, safe water temperatures, housekeeping chemical storage, cleanliness, and infection control protocols.
PACE Interdisciplinary Team Members of the PACE Interdisciplinary Team
At a minimum, the assessments address the following health and safety concerns:
The program is funded by a combination of sources, including Medicare, Medicaid, and private payers. Reimbursement is a fixed per member per month fee that covers the entire spectrum of participant-tailored services that care for the whole person. Because PACE assumes the full risk of the participant, the organization may find it cost-effective to provide interventions that are not traditionally covered by Medicare or Medicaid. For example, if the interdisciplinary team determines that a participant needs to have an air conditioner installed in his or her apartment perhaps because of a pulmonary condition, the program could cover that expense.
This post was initially published by the IHI Multimedia Team on 10/4/2018. You can read this original post here.
Massachusetts PACE organizations take very seriously their commitment to maintaining the safety and security of all of the older adults, their families, and caregivers, as well as their staff, vendors, partners, and communities. Please follow the tabs below for links to resources with more information about some of the directives and resources PACE organizations are monitoring and following in their response to the COVID-19 crisis.
This was originally posted in CommonWealth Magazine. Read the full post here.
JAMES WOODBERRY, wheelchair bound and severely depressed, struggled to find hope. Overwhelmed by his condition and a complex health system, the 80-year-old Boston resident and his family faced a grim future. It was only after several failed attempts that he came across a program equipped to handle his needs — the Program of All Inclusive Care for the Elderly, or PACE.
PACE’s vision is simple, allowing seniors who qualify for nursing home level of care to age in place, at home. The program started as a federal demonstration project in 10 locations across the US in the late 1980s. By 1990, it became a permanent provider for individuals covered under both Medicare and Medicaid, the so-called “dual eligibles.” Structured as an adult day center, members have access to medications, primary care providers, social services and more, every day of the week.
This year, East Boston Neighborhood Health Center, one of the 10 pilot centers, celebrates 30 years of partnership with PACE. Called “Neighborhood PACE,” the East Boston health center’s program is Massachusetts’ longest running. Noteworthy is the housing component unique to Neighborhood PACE. The health center is a long-time partner of the East Boston Community Development Corporation. Together, they converted a former East Boston school into the first PACE center in Massachusetts to offer housing in 2007.
Despite the program’s long history, PACE operates under the radar. Manny Lopes, president and CEO of the East Boston health center and chairman of the board of Boston’s Public Health Commission, wants this to change.
PACE providers deliver integrated, patient-centered care that values personal choice. Dr. James Pedulla, medical director of East Boston’s PACE since its inception, knows that the care and time he devotes to patients is uncommon in most health care settings today. For him, a rewarding feature of the program is direct access to an interdisciplinary network. At PACE, everyone from drivers to clinical providers are part of the team.
Woodberry, a member of Neighborhood PACE for over 10 years, is one of the program’s biggest champions. For him, the program is a blessing. “I thank God I am in a place that I get the kind of care I get, the kind of caring that I get,” he said.
A former professional football player, Woodberry found his inability to walk a constant source of anguish. With the support of his PACE team, Woodberry regained his ability to walk and met his personal goal to play 18 holes of golf – twice.
A typical day for Woodberry starts with waking up in his own apartment and going down to the PACE center, which operates in the same building, for breakfast and conversation with other PACE enrollees. Woodberry gets his medications dispensed on site by one of the staff members, is able to participate in center activities, and meet with his primary care provider or another member of the clinical team.
For Woodberry, the adult day center model, which is unique to PACE, has been particularly influential. The decline in his physical health led him down a path of deep depression. He started to withdraw from his family and friends, feeling hopeless and defeated. Daily access to a space that facilitates social interaction and relationship building provided the strength and support he needed to recover. When asked what life would be like without PACE, Woodberry said matter-of-factly, “I’d be dead. What you see today is a helluva different person.”
The significant improvement in Woodberry’s mental and physical health is not lost on his family. Before discovering PACE, Woodberry’s daughter was prepared to uproot her life from New York City to Boston. Enrolling her father in PACE afforded her the choice to stay in New York while remaining involved in his care. In fact, once Woodberry attained the independence he was yearning for, it became easier for him to accept his daughter’s help. With direct access to the site nutritionist, Woodberry’s daughter can send him home cooked meals that comply with his recommended diet.
Family members of enrollees are invited to visit the facilities, communicate directly with the clinical care team, and attend regularly scheduled team meetings. Highlighting the impact that PACE has on family members, Lopes says, “We reduce some of their stress… allow them to go back to work or feel like they can go back to work without worrying about leaving mom or dad home alone.”
So why don’t more PACE programs exist? And why aren’t more seniors enrolled in PACE?
Assessing PACE’s success has been challenging due to its nature and population. Susan Ciccariello, director of coordinated care for the state’s Executive Office of Health and Human Services, has spent several years overseeing the PACE program. She acknowledges that the data on its effects are limited. The program’s impact on quality of life, mortality rates, and costs remains unclear. What is unequivocal however, is the growing interest in PACE both by state officials and seniors.
Currently, 129 PACE programs exist across 31 states, 8 in Massachusetts. The state saw a 5 percent increase in PACE enrollees in 2018. Nationwide, enrollment has increased 120 percent since 2011, now covering 45,000 enrollees. More recently, the federal government is allowing, for the first time, for-profit companies to become PACE providers.
Across the state, there has been a general trend towards coordinated health care models with the emergence of Senior Care Organizations, One Care plans (i.e., Medicare-Medicaid plans), and Accountable Care Organizations. These programs vary in eligibility, benefits, and funding source but share a similar goal to PACE — to provide comprehensive, integrated care that improves quality of life years for a growing number of seniors.
Despite existing for much longer, enrollment in PACE has lagged behind its counterparts. According to Ciccariello, a major reason for this large difference is access and awareness. Qualifying seniors are often not aware of the program or do not live in close proximity to a PACE site.
Recognizing these barriers, the Baker administration has established goals for streamlining the program and eliminating “PACE deserts.” The administration’s plans for the 2019-2020 calendar year include a review of costs and programming at each site, standardization of eligibility, enhancing awareness and access for qualifying residents, and establishing a more reliable system to collect data and create transparency among different program sites.
While no one size fits all solutions, stories like Woodberry’s are a good reminder that PACE has the potential to thrive, and scaling up the program is worthwhile. For Manny Lopes, the East Boston health center director, PACE is a symbol of what US health care should look like. He sees the expansion of PACE and models like it as an encouraging sign of a health care system that values the “voice and choice” of the people it serves.
Monica Vohra is a community health physician and advocate in Boston.
Join us for a networking and learning experience as we celebrate the unique aspect of integrated care demonstrated by the Program of All-Inclusive Care for the Elderly (PACE). There are eight PACE plan providers across Massachusetts serving 5,000 consumers in the community. The MassPACE Association was formed in 2017 for the purposes of providing leadership and support for growth, access, quality, and success of PACE in the Commonwealth of Massachusetts. Come hear about innovations, best practices, and caring for yourself and others in this hands-on interactive conference. Registration includes, lunch, raffles, workshops, and the networking wine and cheese reception following the workshops.
The Vision of MassPACE is that PACE is accessible to every eligible consumer in the Commonwealth of Massachusetts and recognized as an extraordinarily innovative, accessible, valuable and effective model of care for individuals with significant healthcare needs.
Registration 11:30 – 12:00
Lunch 12:00 – 1:30
Workshops – 1:30 – 4:30
Networking Wine and Cheese Reception – 4:30 – 6:30