‘The Program of All-Inclusive Care for the Elderly’ and The Green House model: An Innovative and Cost-Effective Partnership for Comprehensive Care
By Lori Gonzalez / Posted on January 23rd, 2017
Lori Gonzalez is a PhD researcher at the Claude Pepper Center of Florida State University who studies alternatives to traditional nursing care and social inequality.
The first Green House homes included in a Program of All-Inclusive Care for the Elderly (PACE) partnership will open in early February, joining together two of the nation’s most promising long-term care models. The Harry and Jeannette Weinberg Green House homes, located in the Thome Rivertown Neighborhood in Detroit, Michigan will serve approximately 21 lower-income older adults who are otherwise able to live safely in the community, but who are currently residing in skilled nursing facilities. According to Capital Impact Partners, serving these older adults in Green House homes with the support of PACE, compared to providing care in a traditional nursing facility, is expected to save the state’s Medicaid system about $130,000 per year.
PACE began in California in the 1970s as an alternative to institutional long-term care. A group of Chinese, Italian, Filipino, and other immigrants held cultural views about caring for their loved ones that departed from the larger culture of aging in nursing homes. They formed “On Lok” meaning peaceful, happy abode. By 1986, On Lok developed the nation’s first comprehensive model of coordinated care and by 1997, the program became a permanent provider under Medicare and a state option under Medicaid. Today, PACE operates 116 programs in 32 states and serves over 30,000 older adults, most of whom are dually eligible for Medicare and Medicaid. PACE operates with the belief that, “it is better for the well-being of seniors with chronic care needs and their families to be served in the community whenever possible.” With the assistance of the PACE program, 90% of participants who might otherwise enter a nursing home are able to live in the community.
PACE provides comprehensive care to those who are eligible for the program. PACE eligibility includes being 55 or older, certified by the state to need a nursing home level of care, residing near a PACE care center, and having the ability to live safely in the community. When an individual enrolls in PACE, they (and their family) meet with a team of care professionals including social workers, nurses, primary care physicians, and nutritionists to help craft a plan to serve an elder in the community. PACE participants visit a PACE care center routinely where they, depending on their plan of care, might receive a flu shot, dialysis, dental care, respite care, a hot meal, physical therapy, transportation, or participate in social activities. Family members who visit the center receive counseling or advice on how to care for their loved one.
Green House homes also provide quality care and quality of life, but in a residential setting. In Green House homes, “elders and others enjoy excellent quality of life and quality of care; where they, their families and the staff engage in meaningful relationships…” and when licensed as ALFs, they provide a community-residential setting for elders that is expected to exceed the quality provided by other ALF models. Green House homes are not just homelike, they are places where elders call home.
The goals and values supported by PACE and The Green House model are similar and their partnership will honor elders’ preferences to avoid a nursing home and to live in the least restrictive care setting possible. Green House homes provide high quality residential living and PACE provides the physical health, mental health, social health, and family support for both acute care needs and long-term care needs. Furthermore, PACE and Green House value the belief that all elders should have access to quality care and a good quality of life. PACE serves mostly dual eligible, frail elders and Green House homes are meant to be available to all, regardless of income or wealth. The Green Houses at Rivertown Neighborhood, along with PACE will support these values by serving 21 low-income elders.
Aging in place is highly desired by older adults, but sometimes financially out of reach. The Thome Rivertown model demonstrates that creating a Continuing Care Retirement Community for lower income individuals is possible and that when PACE and Green House are integrated into that community, high quality, cost-effective care is achievable.
By Heather Sawitsky / Posted on March 6th, 2015
Heather Sawitsky, of White Oak Cottages, writes a moving piece about the movie, Still Alice. White Oak Cottages are Assisted Living Green House homes where people living with dementia are creative, resourceful and whole. By creating an environment that is small and warm, and where people are deeply known, The Green House model is a best practice.
Still Alice, a movie based on Lisa Genova’s novel about a linguistics professor who develops early onset Alzheimer’s, is now in wide release. For those who love people with the disease, and for those who are hoping to avoid this disease (which by my count includes everyone) the question is, “Why would anyone want to see this movie?”
The answer might be because the film adaptation is a poignant and dignified presentation of a disease that is usually described in ways that exaggerate its symptoms and stigmatize its victims. Or it may be because Still Alice presents the experience of the degenerative disease through the eyes of Alice, reminding us that a person with Alzheimer’s still strives for normalcy, involvement, and emotional connection. Or it may be because the wide-angle view of the film speaks to how all of us will need to learn to master loss: of physical abilities, loved ones, and sometimes, memory.
Julianne Moore, who plays the professor Alice Howland, turns in a masterful performance. Determined not to “make it up”, Ms. Moore spent months researching Alzheimer’s disease, speaking with clinicians, women with early onset Alzheimer’s, and family members. She also underwent the same battery of cognitive tests given to those with suspected Alzheimer’s. Her performance carries the film and has earned her an Oscar® nomination.
There is one other element that sets this film apart. One of its directors, Richard Glatzer, was diagnosed with ALS in 2011. There are many parallels between ALS and Alzheimer’s. Both are neurodegenerative diseases that slowly, incrementally rob a person of their abilities. With ALS, patients lose their ability to use their muscles, thus depriving them of their ability to walk, stand, use their hands, speak, and ultimately, breathe. With Alzheimer’s, people are slowly robbed of their ability to find words, remain oriented, practice their professions, and recognize their loved ones.
Still Alice is a powerful, but restrained look at one woman who is trying to hold onto her identity and her place in the world, knowing that each week she will be able to do something less well, but not knowing what the next loss will be. Richard Glatzer’s keen understanding of this terror and his determination to live a full life notwithstanding, help make this a film that will inform and inspire.
By Mary Hopfner-Thomas / Posted on October 14th, 2014
It’s the kind of issue that all marketing directors are happy to manage—an unexpected “rush” of Elders that want to move in ASAP to your new Green House homes! Well that is precisely what happened at Water’s Edge in Mankato, Minnesota.
Since the first Elders moved in this past August…there has been a whirlwind of activity to welcome Elders into their new homes and to make sure that all hiring and training is accomplished on time. In fact, during the first week of opening their first home, they moved in 9 Elders! “We certainly hadn’t planned it that way,” said Director of Operations, Brooke Olson, “but it’s not a bad problem to have so many Elders want to move in when you first open your doors!”
Water’s Edge is comprised of three assisted living Green House homes, each with 12 private bedrooms. They are operated by Grace Senior Services. The owners, Brad and Heather Bass have long been committed to serving Elders in their community. They opened their first adult day service in their home more than 18 years ago. They currently have several senior housing cooperatives, and adult foster care program, two assisted living communities and now the new Green House homes at Water’s Edge.
The second home is nearly full, so training and hiring will begin for the third home very shortly. The plan for Water’s Edge had always included a position for Marketing and Elder Enrichment, but they were not going to fill it until much later. However, with the pace of occupancy, they decided that the role was going to be needed much sooner. In September, they welcomed Rachel Carpenter to their team.
We congratulate Water’s Edge on their success and wish them only the best moving forward!
By Mary Hopfner-Thomas / Posted on July 8th, 2014
Despite the long winter and flooding in Minnesota this year…the ribbon cutting ceremony at Water’s Edge on June 26th was a real success. The first Green House homes located in Mankato, Minnesota will be welcoming Elders in mid-July. Congratulations to all!
The three story project, with an assisted living Green House home on each floor, was developed and will be operated by Grace Senior Services. Owners, Brad and Heather Bass along with their children and other city officials were all on hand for the grand opening event.
Water’s Edge is located on the Mankato hilltop and will offer wonderful scenic waterfront and woodland views. Of course every Green House home also offers private bedroom and bathrooms for Elders, a central hearth area, full kitchen with home cooked meals, and a dining room area. It can be chilly during those Minnesota winters, so Water’s Edge will also include heated bathroom floors and a “four-season sun porch” for each home.
The Director of Operations for Water’s Edge will be Brooke Olson. The initial team to staff the first home is currently receiving their 128 hours of additional training to their current certification as a nurse, licensed practical nurse or nursing assistant.
The supplemental training is a hallmark of The Green House model of care. The people who live and work in a Green House home collaborate to create a flexible daily routine that meets and Elder’s needs and preferences. If they wish, Elders can help cook, and assist with housekeeping or laundry. There is no predetermined routine, which facilitates independence and an Elder’s ability to pursue individual interests and schedules. Deep relationships between the Elders and staff are one reason that the Green House model creates dramatic improvements in quality of life and care.
Capital Impact Partners was critical in the development and funding of Water’s Edge. They provided $1.5 million in financing for the project: One million from the Robert Wood Johnson Foundation’s program-related investment (PRI) and $500,000 from the AARP Foundation PRI funds. Capital Impact Partners, a congressionally chartered, non-profit community development finance institution provides financial services and technical assistance nationwide to help make high-quality health care, healthy foods, housing and education more accessible and attainable, and eldercare more dignified and respectful. Water’s Edge owner Brad Bass was most pleased to work with Capital Impact Partners, “You have a great program and excellent staff. I could never have done this without all of your extensive resources! Not to mention the funding that was really the igniter to get this development going”.
We wish the team at Water’s Edge only the best as they welcome their Elders into the Green House homes during the upcoming weeks! Again, congratulations to all!
By Mary Hopfner-Thomas / Posted on March 11th, 2014
They are being developed and operated by Grace Senior Services. The owners, Brad and Heather Bass, have been committed to serving Elders for many years. In fact, they started their journey by opening an adult day service in their home 17 years ago. They currently have several senior housing cooperatives, two assisted living communities, and an adult foster care program.
Brad and Heather are most excited about bringing The Green House model to Minnesota. The new Director of Operations for Water’s Edge, Brooke Olson will be welcoming 36 Elders to the homes when they open. Of course, we’re all hopeful that by June the snow will have melted and the flowers will be blooming!
By ghblog / Posted on August 31st, 2012
White Oak Cottages, an assisted living Green House residence in Westwood, MA for elders living with memory loss, has launched its website.Just as the White Oak Cottages’ mission and emphasis is to cater the complex needs of residents with dementia and Alzheimer’s Disease, the new White Oak Cottages website caters to the needs of its viewers. It’s clean, aesthetically pleasing, informative and easy to read.
The website focuses on education for the viewer. Visitors will learn about The Green House Project and its mission and what makes a Green House Residence so different from traditional assisted living residences and nursing homes. The website will feature a calendar of upcoming educational events at White Oak. These onsite programs include a professional speakers series, family support sessions and CEU programs. The website will also feature a blog dedicated to providing useful, relevant and compassionate information to families, professionals and others interested in dementia. Blog content will be updated weekly and will cover a variety of topics including explanations of dementia behaviors, putting mass media news stories about Alzheimer’s and dementia into an informed context, ideas for taking day trips and activities with your memory impaired loved one, and a down and dirty explanation of a clinical trial.
For more information, to sign up for their email newsletter or to plan a visit go to www.whiteoakcottages.com
By Mary Hopfner-Thomas / Posted on July 10th, 2012
The homes will be called Water’s Edge at Willow Brook, and will be developed and operated by Grace Senior Services. Brad and Heather Bass are the owners and have a deep commitment to serving elders. They began their journey by opening an adult day service out of their home in 1997 and now have several senior housing cooperatives, two Assisted Living facilities, an adult foster care program, and a team of dedicated staffers to work with all of the elders.
During the groundbreaking event, Brad expressed his enthusiasm for the project, “We are excited to be part of the national replication project for Green House homes and for the opportunity to bring this special model to Mankato and the state of Minnesota.” The three homes should be open early next year. A warm welcome to our newest members of the Green House family!