About Us

LIVING AT HOME: Your Goal, Our Priority

PACE is a program that allows older adults who need nursing home care to continue living in their homes as long as possible.

National PACE Association (NPA) provides leadership and support for the growth, innovation, quality and success of the PACE model of care.

Since 1994, NPA has represented the interests of programs of all-inclusive care for the elderly in a rapidly changing health care environment.

In the near future, through our 2022-2025 strategic plan, NPA will encourage and support responsible PACE growth through advocacy, quality and workforce initiatives, with a steadfast commitment to diversity, equity and inclusion in all that we do.

Learn More About our Commitment to DEI

Our Core Activities

Advocacy Educational offerings Information and data Technical assistance Networking

in support of PACE sustainability and growth through appropriate payment, regulation and innovation policies

that support the efficiency, effectiveness and success of PACE programs

that allow PACE programs to understand and respond appropriately to opportunities and challenges

with operational, financial, regulatory, policy, data analysis and quality improvement issues and activities

among PACE professionals on effective and innovative strategies, operations and practice


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 for long-term care services by families whose elders had immigrated from Italy, China and the Philippines. William Gee, DDS, a public health dentist, headed the committee that hired Marie-Louise Ansak in 1971 to investigate solutions. Along with other community leaders, they formed a nonprofit corporation called On Lok Senior Health Services to create a community-based system of care. On Lok is Cantonese for "peaceful, happy abode."

  • 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 financially infeasible and culturally inappropriate. Instead, she obtains funding to train health care workers in cooperation with the 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.

  • 1978

    The On Lok 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 grant from the Department of Health and Human Services to develop a consolidated model of delivering care to persons with long-term care needs.

  • 1986

    Federal legislation extends the new financing system and allows 10 additional organizations to replicate the On Lok 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.

  • 1994

    With the support of On Lok, the National PACE Association (NPA) is formed. 11 PACE organizations are operational in nine 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 is published in November. 30 PACE programs are operational in 19 states.

  • 2000

    The Robert Wood Johnson Foundation and the John A. Hartford Foundation fund the PACE Expansion Initiative to assist NPA in expanding the benefits of the PACE model of care to more families in need.

  • 2001

    Alexian Brothers Community Services in St. Louis becomes the first PACE provider to become a full, permanently recognized part of the Medicare and Medicaid programs.

  • 2006

    Final Regulation is published in November. Congress awards grants of $500,000 to 15 organizations for rural PACE expansion.

  • 2014

    107 PACE programs are operational in 32 states.

  • 2015

    The PACE Innovation Act is passed by Congress and signed into law by President Obama. 116 PACE programs are operational in 32 states.

  • 2018

    123 PACE programs are operational in 31 states serving an estimated 45,534 participants.

  • 2019

    PACE Final Rule is published.

There are 167 PACE organizations operating in 33 states and the District of Columbia. More than 300 PACE centers serve over 76,000 participants across the country.
View the latest PACE in the States report.