Formative experiences guide participants in self-renewal, spiritual growth and community building

By JULIE MINDA

About a decade ago, Cardinal Timothy Dolan challenged ArchCare — the Archdiocese of New York's health care ministry — to help develop a solution for the growing number of elderly clergy who wished to age in place but whose congregations could not meet their health care needs.

ArchCare came up with an effective answer: It would extend the comprehensive medical and social services ArchCare already provided frail seniors through its PACE centers to the retired clergy in the congregate living centers they called home. Since then, ArchCare has created PACE center satellites for two congregations in New York state and is preparing to do the same for a third.

"Cardinal Dolan wanted retired religious to get services from an organization that understands the importance of them staying in religious community," says ArchCare President and Chief Executive Scott LaRue. "We developed a program to meet those needs and that allows much independence for the religious (men and women). We understand religious communities. This is the perfect fit for a health care ministry of the church."

PACE stands for Program of All-Inclusive Care for the Elderly. The Centers for Medicare & Medicaid Services pay PACE providers to deliver comprehensive medical and social service to keep frail, elderly participants out of nursing homes and living in the community. With few exceptions, participants have low incomes and are covered by both Medicare and Medicaid insurance.

Trinity Health PACE's MERCY Life program has had similar success extending the PACE model of care to men and women religious in congregant living. And both ArchCare and Trinity Health PACE have been taking PACE programs to secular congregate living developments, including low-income apartment complexes for seniors.

Anne Lewis, chief operating officer of Trinity Health PACE, says, "As a Catholic health care ministry, our core values and mission closely align with those of the religious communities we serve. We are grateful to be able to give back to our founding orders by providing supportive services in the place the religious members call home."

She adds, "We are open to all opportunities to expand PACE. PACE expansion is near and dear to our hearts."

Opportunity for creativity
According to the National PACE Association, PACE is for people aged 55 or older and certified by the state to need nursing home care although capable of living safely in the community with the benefit of supportive services.

PACE provides its enrollees with primary medical care; referrals to medical specialties; behavioral health services; physical, occupational and recreational therapy; prescription drug benefits; meals; nutritional counseling; adult day care; home health care; personal care assistance; social services; caregiver respite care; and other services that allow frail clients to age in place in their homes.

Most of these services are provided in PACE centers and at enrollees' homes. PACE coordinates hospital and nursing home care for participants.

Currently there are 149 PACE programs operating 306 PACE centers in 32 states. In 2021, the National PACE Association launched a broad-based effort to help PACE organizations grow more quickly. Its strategies included efforts to broaden the PACE eligibility criteria to open the program to younger people with life-altering disabilities.

Robert Greenwood, National PACE Association senior vice president of communications and member engagement, says even before the 2021 expansion effort began, PACE centers had been extending their reach by offering their services via the satellite model in buildings and neighborhoods with clusters of PACE-eligible people.

These areas of expansion included housing complexes subsidized by the U.S. Department of Housing and Urban Development or Veterans Administration and assisted living complexes.

An equalizer
ArchCare has PACE centers in Manhattan, the Bronx, Staten Island and Westchester. About eight years ago, it signed on to establish PACE services — as an extension of its Bronx PACE center — at Murray-Weigel Hall, a close-by residence owned by the Jesuits that houses retired Jesuits. PACE has 39 Jesuit clients at Murray-Weigel Hall.

Soon after bringing PACE to the Jesuits, ArchCare began offering PACE services from its Harlem PACE center for retired Sisters of Charity at a nearby supportive housing complex called the Kittay Senior Apartments. It currently has about 20 sisters enrolled in PACE at the complex. Later this year, ArchCare will begin providing services out of its Westchester PACE center to sisters at two convents in Rockland County, New York.

Last month, ArchCare launched PACE services through the satellite model for residents of Draper Hall, a government-subsidized 201-apartment building which has been renovated for low-income seniors. If they qualify based on age, income and their disability status, older adults in the numerous housing complexes surrounding Draper Hall in East Harlem also can join that PACE program. ArchCare expects there will be a lot of Hispanic and Chinese clients and it is hiring staff who speak the enrollees' languages.

ArchCare is contracting to provide PACE services to adult home facilities in the Bronx and Staten Island for seniors, many of whom have complex health needs. The facilities are run by the W Group Assisted Living Communities, an operating company that runs 21 senior housing facilities in New York and one in Florida.

At the satellite outposts, ArchCare hires and employs all the PACE staff, and ArchCare maintains the relationship with and receives capitated payments for enrollees' care from the Centers for Medicare & Medicaid Services. LaRue says providing PACE in satellite locations is not a revenue generator but more of a break-even venture for ArchCare.

Elizabeth Rosado, vice president of PACE for ArchCare Senior Life, says there's no "one-size-fits-all" when it comes to how ArchCare provides PACE services. Rosado says of enrollees, "We make sure we're honoring all their wishes, when it comes to how they want to be cared for."

In some cases, the hub center's staff goes to the satellite location to provide services to the seniors there. In other cases, PACE staff members exclusively care for seniors in their residences.

LaRue says seniors who take advantage of PACE offerings suffer less social isolation, and have better quality of life and better health outcomes than peers not enrolled in PACE.

Relationship building
Trinity Health PACE owns or manages 14 PACE programs in nine states, that have a total of 22 PACE centers. Its Mercy LIFE PACE program in Philadelphia uses the satellite model to provide services to retired members of four Pennsylvania religious communities: the Sisters of Mercy at McAuley Convent in Merion Station, the Sisters of Saint Francis at Assisi House in Ashton, the Sisters of the Immaculate Heart of Mary at Camilla Hall in Malvern and the Jesuits' Manresa Hall in Merion Station.

Trinity Health PACE provides services to more than 250 clergy between the four sites. Mercy LIFE staff operate out of PACE centers to deliver their services to the men and women religious in their residence halls. Clergy clients can receive services at the PACE centers as well.

Trinity Health PACE provides PACE services to several secular sites. It opened Mercy LIFE Valley View in 2014 at a residential campus in Elwyn, Pennsylvania, for seniors who are deaf. Currently 23 people there receive PACE services. And in fall 2022, Mercy LIFE launched PACE services at Kinder Park Community in Woodlyn, Pennsylvania. The affordable housing complex for seniors is operated by the Delaware County Housing Authority.

As with ArchCare, Trinity Health PACE maintains the relationship with CMS.

When it comes to the sites serving women and men religious, Mercy LIFE has a staffing agreement with the religious communities, based on the number of congregation members enrolled in the program. Under this arrangement, Mercy LIFE pays for the staff working with congregation members enrolled in PACE.

Lewis says Mercy LIFE staff work to understand the religious communities or the secular partner organizations and the characteristics and needs of the PACE participants living in those communities. "We learn what they want and what they don't want."

It's all about what will work for the partner organizations and their members, she says.

For further reading:

Catholic Health World : "PACE providers help keep fragile seniors safe during pandemic"

Catholic Health World : "Congregations encouraged to act to ensure eldercare ministries endure"