Overview
The PACE model of care can be traced to the early 1970s, when the Chinatown-North Beach community of San Francisco saw the pressing needs of families whose elders had immigrated from Italy, China and the Philippines for long term care services. Dr. William L. Gee, a public health dentist, headed the committee that hired Marie-Louise Ansak in 1971 to investigate solutions. They, along with other community leaders, formed a nonprofit corporation, On Lok Senior Health Services, to create a community based system of care. On Lok is Cantonese for "peaceful, happy abode."
| Events in PACE Organization of Rhode Island's History |
| 1971 |
William Gee, DDS, and two others execute articles of incorporation for the nonprofit Chinatown-North Beach Health Care Planning and Development Corporation (later renamed On Lok Senior Health Services) and retain Marie-Louise Ansak to study the feasibility of building a nursing home in the community. She finds a nursing home would be both infeasible financially and culturally inappropriate. Instead she obtains funding to train health care workers, in cooperation with University of California San Francisco. She also outlines a comprehensive system of care combining housing and all necessary medical and social services, based on the British day hospital model. |
| 1973 |
On Lok opens one of the nation’s first adult day centers in San Francisco. |
| 1974 |
On Lok begins receiving Medicaid reimbursement for adult day health services. |
| 1975 |
On Lok adds a social day care center and includes in-home care, home-delivered meals and housing assistance in its program. |
| 1978 |
On Lok’s model of care expands to include complete medical care and social support of nursing home-eligible older individuals. |
| 1979 |
On Lok receives a four-year Department of Health and Human Services grant to develop a consolidated model of delivering care to persons with long term care needs. |
| 1983 |
On Lok is allowed to test a new financing system that pays the program a fixed amount each month for each person in the program. |
| 1986 |
Federal legislation extends On Lok’s new financing system and allows 10 additional organizations to replicate On Lok’s service delivery and funding model in other parts of the country. |
| 1987 |
The Robert Wood Johnson Foundation, the John A. Hartford Foundation and the Retirement Research Foundation provide funding to On Lok and the first replication sites to support their efforts. |
| 1990 |
The first Programs of All-inclusive Care for the Elderly (PACE) receive Medicare and Medicaid waivers to operate the program. |
| 1994 |
With support of On Lok, the National PACE Association is formed.
11 PACE organizations are operational in 9 states. |
| 1996 |
21 PACE programs are operational in 15 states. |
| 1997 |
The Balanced Budget Act of 1997 establishes the PACE model as a permanently recognized provider type under both the Medicare and Medicaid programs. |
| 1999 |
Interim Regulation published in November.
30 PACE programs are operational in 19 states. |
In 1999, the Board of Directors of CareLink, a non profit network of long term care providers, voted to approve the development of a PACE program in Rhode Island. They came to this decision after careful examination of the future needs of Rhode Island seniors. Seniors prefer to remain in their homes as long as possible. The number of seniors is growing both nationally and in the state. The CareLink network would benefit from the addition of a program that served seniors who want to remain in the community and have considerable health needs that threaten their ability to live independently.
CareLink received grant support from the Rhode Island Foundation to complete the business plan and the market study. The conclusion to both of these activities was clear- bring PACE to Rhode Island. CareLink was selected by a request for proposal process through the state. We began the two year journey of completing the federal application to earn the designation of being a PACE program. At the end of that journey, CareLink received approval by the Centers for Medicare and Medicaid and by The Department of Human Services in Rhode Island to open the first PACE center.
CareLink opened The PACE Organization of Rhode Island in December 2005. It is a stand alone not for profit health program serving frail elders who meet the program qualifications. As the only PACE program in the state, the program has enrolled clients that live in all regions of the state.
In 2007 there were 42 PACE programs operational in 22 states.
In 2008 there were 61 PACE programs operational in 29 states.