For about a decade, a pressing concern resonated with Cardinal Timothy Dolan: the growing number of elderly clergy desiring to age within their communities, yet facing healthcare needs that their congregations were not equipped to meet. This challenge spurred ArchCare, the health care ministry of the Archdiocese of New York, to innovate and develop a solution. Their answer was the Archcare Program Of All-inclusive Care For The Elderly, or PACE, a pioneering approach to senior care.
ArchCare’s solution was ingenious in its simplicity and effectiveness. They decided to extend the comprehensive medical and social services already available to frail seniors through their existing PACE centers to retired clergy living in congregate settings. These settings were more than just residences; they were homes and communities deeply valued by the clergy. By bringing PACE services directly to these communities, ArchCare ensured that the clergy could age in place with dignity and the necessary support. Since its inception, ArchCare has successfully established PACE center satellites for two religious congregations in New York State and is actively planning a third, demonstrating the scalability and adaptability of their model.
“Cardinal Dolan’s vision was clear: retired religious individuals should receive services from an organization that truly values their desire to remain within their religious community,” explains Scott LaRue, President and Chief Executive of ArchCare. “We crafted a program specifically to address these needs, fostering independence for both men and women in religious life. Our deep understanding of religious communities makes this initiative a perfect embodiment of the Church’s health care ministry.”
The acronym PACE stands for Program of All-Inclusive Care for the Elderly. Funded by the Centers for Medicare & Medicaid Services, PACE programs are designed to provide comprehensive medical and social services. The core objective is to enable frail, elderly individuals to live in their communities, avoiding the need for nursing home placement. Typically, PACE participants are characterized by modest incomes and dual eligibility for both Medicare and Medicaid, ensuring access to care for those who need it most.
ArchCare is not alone in recognizing the value of extending the PACE model to religious communities. Trinity Health PACE, with its MERCY Life program, has also achieved significant success in bringing PACE care to men and women in religious congregate living. Furthermore, both ArchCare and Trinity Health PACE are expanding the reach of PACE programs to secular congregate living developments, including affordable senior apartment complexes, indicating the broad applicability of this care model.
LewisAnne Lewis, chief operating officer of Trinity Health PACE, emphasizes the mission alignment. “As a Catholic health care ministry, our fundamental values and mission are deeply resonant with those of the religious communities we serve. We are privileged to give back to the religious orders that laid our foundation by providing supportive services within the familiar environment they call home.” She further notes the openness to PACE expansion, stating, “We welcome all opportunities to broaden PACE’s reach. PACE expansion is something that is very important to us.”
Unlocking Creative Potential in Senior Care
The National PACE Association highlights that PACE is designed for individuals aged 55 and older who meet their state’s criteria for nursing home level of care. Despite needing this level of care, PACE participants are capable of living safely in their communities with the support of comprehensive services.
PACE programs offer a wide spectrum of services to enrollees. These include primary medical care, specialist referrals, behavioral health services, physical, occupational, and recreational therapies, prescription drug coverage, meals, nutritional counseling, adult day care, home health care, personal care assistance, social services, caregiver respite care, and numerous other supportive services. The overarching goal is to empower frail seniors to age in place comfortably and safely within their own homes and communities.
The majority of these services are delivered at dedicated PACE centers and within the participants’ homes. PACE programs also coordinate hospital and nursing home care when participants require these higher levels of care, ensuring seamless and integrated healthcare.
Currently, the PACE landscape includes 149 programs operating across 306 centers in 32 states. Recognizing the growing need for these services, the National PACE Association launched an initiative in 2021 aimed at accelerating the growth of PACE organizations. Key strategies include advocating for broader PACE eligibility criteria to encompass younger individuals with life-altering disabilities, thereby extending the reach of PACE to a wider population in need.
Robert Greenwood, Senior Vice President of Communications and Member Engagement at the National PACE Association, points out that even prior to the 2021 expansion efforts, PACE centers were proactively extending their services through satellite models. These satellites were strategically located in buildings and neighborhoods with significant clusters of PACE-eligible individuals. This included collaborations with housing complexes supported by the U.S. Department of Housing and Urban Development (HUD) or the Veterans Administration (VA), as well as assisted living facilities, demonstrating a commitment to reaching diverse senior populations.
PACE as a Healthcare Equalizer
ArchCare’s footprint includes PACE centers strategically located in Manhattan, the Bronx, Staten Island, and Westchester. About eight years ago, ArchCare took a significant step by establishing PACE services as a satellite of its Bronx PACE center at Murray-Weigel Hall, a Jesuit residence for retired members. Currently, PACE provides care for 39 Jesuit clients at Murray-Weigel Hall, showcasing the program’s effectiveness within religious communities.
Building on this success, ArchCare extended PACE services from its Harlem PACE center to retired Sisters of Charity living at the Kittay Senior Apartments, a nearby supportive housing complex. Approximately 20 sisters are currently enrolled in PACE at this location. Looking ahead, ArchCare is poised to launch PACE services from its Westchester PACE center to serve sisters residing at two convents in Rockland County, New York, further expanding its reach within the religious community.
Recently, ArchCare introduced PACE services via the satellite model for residents of Draper Hall, a government-subsidized 201-apartment building renovated to provide affordable housing for low-income seniors. Eligibility extends beyond Draper Hall residents; older adults in surrounding housing complexes in East Harlem who meet age, income, and disability criteria can also enroll in this PACE program. Anticipating a diverse clientele, including a significant Hispanic and Chinese population, ArchCare is actively recruiting bilingual staff to ensure culturally competent care.
ArchCare is also forging partnerships to deliver PACE services to adult home facilities in the Bronx and Staten Island. These facilities, operated by the W Group Assisted Living Communities, cater to seniors with complex health needs across 21 locations in New York and one in Florida.
In the satellite model, ArchCare assumes responsibility for hiring and employing all PACE staff and maintains the direct relationship with the Centers for Medicare & Medicaid Services, receiving capitated payments for enrollee care. Scott LaRue clarifies that satellite PACE locations are not primarily revenue-generating ventures but rather represent a commitment to breaking even while expanding access to essential care.
Elizabeth Rosado, Vice President of PACE for ArchCare Senior Life, emphasizes the personalized nature of ArchCare’s PACE approach. “We recognize that there’s no ‘one-size-fits-all’ solution in PACE,” Rosado states. “Our priority is to ensure we are honoring each enrollee’s individual wishes and preferences regarding their care.”
Service delivery models vary. In some instances, staff from the central PACE center travel to satellite locations to provide care. In other cases, dedicated PACE staff are based directly at the satellite location, exclusively serving residents within those communities.
LaRue underscores the profound benefits of PACE participation for seniors. Those enrolled in PACE experience reduced social isolation, improved quality of life, and demonstrably better health outcomes compared to their peers who are not enrolled, highlighting the holistic impact of the ArchCare Program of All-Inclusive Care for the Elderly.
Building Relationships, Fostering Trust
Trinity Health PACE operates or manages 14 PACE programs across nine states, encompassing a total of 22 PACE centers. Their Mercy LIFE PACE program in Philadelphia effectively utilizes the satellite model to deliver services to retired members of four religious communities in Pennsylvania: the Sisters of Mercy at McAuley Convent, the Sisters of Saint Francis at Assisi House, the Sisters of the Immaculate Heart of Mary at Camilla Hall, and the Jesuits at Manresa Hall.
Through these four sites, Mercy LIFE provides PACE services to over 250 clergy members. Mercy LIFE staff are based at PACE centers but deliver services directly within the residence halls of these religious communities. Clergy clients also have the option to receive services at the PACE centers themselves, offering flexibility and choice.
Trinity Health PACE extends its services beyond religious communities to secular settings as well. Mercy LIFE Valley View, opened in 2014 at a residential campus in Elwyn, Pennsylvania, is a pioneering PACE program specifically designed to serve deaf senior adults. Currently, 23 residents receive PACE services at this location. Furthermore, in the fall of 2022, Mercy LIFE launched PACE services at Kinder Park Community in Woodlyn, Pennsylvania, an affordable housing complex for seniors managed by the Delaware County Housing Authority, further demonstrating their commitment to diverse senior populations.
Similar to ArchCare, Trinity Health PACE maintains the direct relationship with CMS for funding and program oversight.
For sites serving religious communities, Mercy LIFE establishes staffing agreements based on the number of congregation members enrolled in PACE. Under these agreements, Mercy LIFE directly funds the staff dedicated to providing care for congregation members participating in the PACE program, ensuring financial sustainability and dedicated resources.
Lewis emphasizes the importance of understanding the unique cultures and needs of both religious communities and secular partner organizations. Mercy LIFE staff prioritize building strong relationships and learning “what they want and what they don’t want” to tailor services effectively.
Ultimately, the success of PACE programs, whether run by ArchCare, Trinity Health PACE, or other organizations, hinges on creating partnerships that truly work for the partner organizations and, most importantly, for the seniors they serve. The ArchCare Program of All-Inclusive Care for the Elderly stands as a powerful example of how compassionate, comprehensive, and community-focused care can transform the aging experience.
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”
