Saint Joseph PACE
In 2015, when Stacey Newton accepted a position with Trinity Health as Executive Director for its new, in-development Program of All-Inclusive Care (PACE) in Mishawaka, Indiana, neither she nor her early staff had experience with PACE. Though Newton, a registered nurse, had once worked for the state’s Department of Health, she had never heard of PACE. Indeed, she thought the model looked too good to be true.
The Early Days
Once onboard, Newton set about hiring staff and overseeing the renovation of the building that would become the PACE center. Along the way, she learned valuable lessons. From working with vendors and structural engineers to hiring staff, developing Saint Joseph PACE was a learning process.
A consultant recommended Newton hire Pharmastar to handle the program’s Part D needs. Trinity Health and its PACE programs in other states had previously partnered with Pharmastar, and Newton and her staff quickly felt comfortable with the Pharmastar team. “Pharmastar was extremely helpful and beneficial with the start-up, Part D monitoring, and compliance monitoring,” Newton said.
When it came to staffing the new program, there were a few missteps initially. As a healthcare professional, Newton assumed most people who worked in the field had been exposed to individuals from various socioeconomic backgrounds. However, she soon realized that some team members had never dealt with the types of issues many of the participants faced and lacked the experience to provide assistance.
In addition, there were complications with the state review process. PACE was still new in Indiana, and Saint Joseph PACE was only the second program. At the same time the program was opening, the state changed their level of care determination process and switched to a cloud-based program.
Marketing also presented challenges. “With the new PACE model, it was constant education, constant repeating of the message,” Newton said. “Just being new, and no one having any idea what the PACE model is, was the biggest challenge and still is today.”
Teamwork for Better Outcomes
The Saint Joseph PACE team has overcome these and other challenges since welcoming their first participants in September 2016. As of August 2021, the program boasts a census of 183 participants with more than 60 staff members.
Newton is proud of the program’s growth and its staff. “Our staff is absolutely incredible,” she said. “Every single discipline has so many years of experience. No matter what happens, we’ll support our participants in the best way our team knows how, for the best outcomes. We saw that through the pandemic; we saw teamwork.”
Lessons from COVID
As with PACE nationwide, the COVID-19 pandemic had a major impact on Saint Joseph PACE. The day center and clinic closed, with the latter opening only for extreme emergencies. The entire model of care changed, almost overnight. Before the pandemic, about 85-90 different participants attended the day center daily, so the PACE team knew participants’ needs were met with meals and services including physical therapy (PT), occupational therapy (OT), and recreational therapy. When the model of care flipped, team members who usually worked in the center went out in the community to deliver services in their participants’ homes.
While the shift may not have been seamless, the new model worked. From the Recreational Therapist who put together activity packets, to home care and clinic nurses out in the field, to the leadership team making daily phone calls to participants, participants’ needs were met. As of August, the majority of care was still being provided in-home, with only 12-15 participants in the center each day.
Some of the practices implemented in response to the pandemic will continue, including daily calls to participants. Each day Newton and her leadership team review the charts of their assigned groups of participants to see if any staff members have recently met in-person with the participant. If no one has, the PACE team member will call the participant to check in with them, an important daily touch. Also, with some participants coming into the center only once a week, the activities packets have proven to be popular. Though Newton cannot say if Zoom calls will continue, the PT and OT teams will continue to provide home exercise programs to participants who might not be able to come to the center.
Looking to the Future
Newton’s primary goal for Saint Joseph PACE is growth. “We’re fortunate our census didn’t take a huge hit,” she said. “We’re currently at 180 participants and would like to see steady growth. We’ve learned we can serve these folks at home, too.” While the Saint Joseph PACE team had considered 250 participants a growth goal, the number was based on square footage and onsite staffing. Now that Newton knows participants can be served in their homes, and she has seen firsthand that the PACE model is even better and more flexible than she first realized, that number might be even higher.