September 16, 2022

WASHINGTON, DC – The National PACE Association (NPA) and representatives of several Programs of All-Inclusive Care for the Elderly (PACE) testified before the National Advisory Committee on Rural Health and Human Services, which provides guidance to the secretary of U.S. Department of Health and Human Services (HHS).

The three-day meeting at multiple sites in Kansas focused on overcoming barriers to growth in rural communities for PACE, which the New York Times has called “the underdog of senior care.”

“NPA commends the committee for selecting PACE as one of their two focus areas for the year,” said Shawn Bloom, president and CEO of NPA. “The PACE model of care has been successful in improving the quality of life and health outcomes of older Americans living in rural areas.”

Peter Fitzgerald, executive vice president of Policy and Strategy at NPA, cited the benefits of PACE, which allows seniors to remain cared for while living independently in their own homes. Across the country, 147 PACE programs serve more than 60,000 people in 32 states, he reported, but millions more could be served if barriers to the program were removed.

Fitzgerald highlighted five federal actions that would expand PACE in rural areas:

  • Increase access to and affordability of PACE for Medicare-only beneficiaries living in rural areas. By serving all older adults – not just those who are also eligible for Medicaid – more rural PACE organizations would be able to achieve a sufficient enrollment size to be financially viable and operationally efficient. 
  • Expand Veterans Affairs Medical Center (VAMC) contracts with PACE organizations. Because many veterans in rural areas live far from VAMCs, they have limited access to the primary care and other services they need. 
  • Encourage PACE partnerships with existing rural community-based services and organizations. Rural PACE organizations should be allowed to offer PACE center services in a range of settings and work with a range of partners. Expanded use of alternative care settings to supplement the PACE center will add to the options available for rural older adults to receive care and participate in activities. 
  • Approve PACE organizations as practice sites for Eligible Health Professions and Nursing Workforce Development programs. 
  • Support the expanded use of telehealth and telecare by making permanent the temporary flexibilities granted during the COVID-19 public health emergency.  

“Research indicates that the PACE model is associated with improved health outcomes, including fewer hospitalizations and emergency room visits, fewer unmet needs and better caregiver support,” Fitzgerald testified. “PACE improves the quality of life for its participants and their caregivers.”

He said PACE participants report fewer unmet needs and higher satisfaction with their quality of life. Family caregivers report high levels of support associated with a reduction in the level of burden they experience. This, in turn, increases their ability to care for their own health and that of younger family members. Caregivers of PACE participants often report being able to resume employment because of the care provided by PACE to their loved one.

The representatives of PACE programs who testified before the committee were Melissa Hooven, CEO, and Jennifer Heidmann, MD, medical director, of Humboldt Senior Resource Center, in Eureka, CA; John Galdamez, DO, medical director, and Connie Davis, executive program director, of Cherokee Elder Care, in Tahlequah, OK; Shawn Sullivan, president and CEO of Midland Care, in Topeka KS; Justin Loewen, executive director of Bluestem PACE, in McPherson, KS; and Regina Sayers, executive director of Appalachian Agency for Senior Citizens in Cedar Bluff, VA.

Bloom stated, “We are hopeful the committee will issue recommendations to further empower existing PACE organizations to serve more elders in rural areas, as well as facilitate the establishment of additional rural PACE organizations.”


The National PACE Association (NPA) works to advance the efforts of PACE programs, which coordinate and provide preventive, primary, acute and long-term care services so older individuals can continue living in the community. The PACE model of care is centered on 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. For more information, visit and follow @TweetNPA.

David Harrison

Back to Top