Every weekday at 10 a.m., seniors whose lives have been impacted by issues such as Alzheimer’s, dementia, or injuries and frailties that come with aging arrive at Providence ElderPlace in Spokane's Nevada Heights neighborhood for four hours of adult day care.

There, seniors enjoy coffee and tea while socializing with others, followed by a mind-stimulating game, lunch, and a few more activities, such as kickball, coloring, or flower planting in the community garden, before being driven back to their homes.

In June 2020, the 30-year-old center formerly known as Providence Adult Day Health added Providence ElderPlace to its services, offering another layer of support through a medical and social services coordinated care model designed to help older adults remain independent and stay in their homes longer.

Located at 6018 N. Astor, northeast of the Providence Holy Family Hospital campus, Providence ElderPlace is a federally recognized Program of All-Inclusive Care for the Elderly, or PACE, organization that offers a more centralized alternative to the existing fragmented network of providers, insurers, and transportation barriers that often complicate aging in place for older adults. 

The model builds on Providence Health & Services-Washington’s three decades of experience operating the federal program in western Washington with two Providence PACE locations in Seattle and locations in the cities of Renton, Kent, Everett, and Redmond.

Marketing and enrollment specialist for Providence ElderPlace, Lecy Huotari, says the Providence PACE Spokane site was inspired by the program's success on Washington’s West Side coupled with a desire to bring that same model of care to vulnerable adults in Eastern Washington. 

Since opening, the PACE program has recorded less than one emergency visit per member per year, a 24% lower hospitalization rate than dually-eligible beneficiaries who receive Medicaid nursing home services. The program has also supported a decreased rehospitalization rate 16% lower than the national rate, and fewer nursing home admissions, explains Huotari. 

According to the National Institutes of Health, the PACE program is effective in reducing depression among its participants. A study of the program showed 27% of new PACE enrollees scored as depressed on an assessment administered before enrollment. Nine months later, 80% of those individuals no longer scored as depressed.

“A lot of people that I’ve enrolled, they don’t have a lot of family support,” Huotari says. “They’re just doing things on their own and don’t know what to do.”

Providence ElderPlace is open to adults 55 or older who meet the criteria for nursing facility level of care as defined by the Washington State Department of Social and Health Services. Participants also must live in the service area, be Medicaid-eligible, or willing to pay privately. 

Providence ElderPlace's premium is equal to the Medicaid rate, Huotari says. Private-pay premiums are about $10,000 a month.

Once enrolled, Providence ElderPlace functions as both a health insurance and health care provider, with each member assigned a team of medical and social care professionals, called an interdisciplinary team, dedicated to coordinating health and long-term care services.

The interdisciplinary teams consist of primary care providers, registered nurses, social workers, physical and occupational therapists, mental health providers, pharmacists, dietitians, van drivers, a chaplain, in addition to home care coordinators, and personal care aides. Members can find most of these services at the Providence ElderPlace facility which houses a PACE clinic, a therapy and rehabilitation gym, private offices, a commercial kitchen, and a gathering space for those who also enroll in adult day care. For dental care, the facility contracts with outside providers; however, it provides all transportation, Huotari adds. PACE also provides additional medically necessary care and services not covered by Medicare and Medicaid.

“PACE will cover everything that Medicaid and Medicare cover,” she says. “We have a little bit of leeway to where … if it’s really bothering them or causing them pain, then we’re going to cover those services, and they’ll never receive a bill. They don’t ever have a copay, and they don’t ever have a deductible.”

In addition to medical and health services covered under one roof, members are also provided with daily living support. Those services include medication reminders, bathing support, meal prep, home health coordination, incontinence supplies, and medical equipment such as walkers, compression socks, and medical beds.

The program provides members with an intimate level of care, Huotari contends. Members are not just dropped off at the curb for their visits and appointments, but escorted in. Because everything is centralized under one roof, specialists report back into the system, medications are automatically rerouted through the PACE pharmacy, and hospital discharges trigger rapid follow-up visits, “so there is no lapse in care,” she says.

Adding a PACE program at the adult day health center was a natural fit, Huotari says. The day health center was created to support vulnerable adults by providing mobility and social community. Providence ElderPlace provides an added layer of support to help keep as many adults as possible independent and in their homes longer.

Participants in the adult day care program can sign up for Providence ElderPlace or remain on their current medical plans, while members who sign up for Providence ElderPlace have full access to both the day care center in addition to wraparound services.