No Place Like Home
Photo/Christina H. Davis
Karen Longo, Vice president, executive director, Summit ElderCare
Karen Longo has worked in nearly every role possible at Worcester-based Fallon Community Health Plan since she joined in 1985, from sales to service to product development. Her most recent role has been helping shepherd the organization’s fledging Summit ElderCare program, which is about to open its fourth location on Grafton Street in Worcester. The program provides the elderly and frail with a whole host of medical and social services in one location with the goal being to keep people healthy enough to live at home and avoid expensive full-time nursing home care. Summit ElderCare is part of the federal Program for All-Inclusive Care for the Elderly (PACE). Here, Longo talks about the specifics of the program.
>> Summit ElderCare has locations on East Mountain Street in Worcester, Leominster and Charlton. What about Grafton Street made it a good spot for your fourth location?
Our flagship site at East Mountain Street is always running at capacity. We have limited space for new enrollees, so this [new site] is a way for us to meet the continued demand by expanding the availability of our services. This site being so close to Route 20 and Route 122 was ideal because it really helped us to offer a site that would shorten the travel times for many of the people who are interested in the program.
>> What’s been the biggest challenge you’ve had in getting Summit ElderCare up and running?
The biggest challenge we have is getting the word our to consumers that they have options to keep their loved ones at home. Very often people think that a nursing home is their only option when a person gets very frail. They may not realize that in today’s world there are creative alternatives to give people that chance to keep someone at home with their family.
>> What’s the difference between PACE and adult day care?
A PACE center combines the integrated medical care and rehab services and geriatric case management with the adult-day activities and meals and socialization services. It takes adult daycare and it broadens it to be a much more comprehensive service.
>> How does the funding for Summit ElderCare work?
Basically, we receive a fixed amount of money from several sources for each enrollee for each month of membership. Instead of needing to file a claim every time we provide any type of service, we have a pool of money for all our enrollees’ care. That funding structure allows our team to be creative in providing the services that are necessary.
>> What are those funding sources you mentioned?
For most of our enrollees it’s Medicare, which is the federal medical program, and Medicaid or MassHealth, which is the Massachusetts program for medical care and long-term care supports. Some people chose to private pay because they find they aren’t eligible for Medicare/Medicaid assistance.
>> How consistent has your funding from the federal and state government been?
At a policy level, the federal and state governments have both been very supportive of PACE. We do always revisit our strategic plans because the Medicare/Medicaid funding arena is uncertain at times and we are not guaranteed that our revenue will go up every year. In fact, we’ve had experiences where revenue has gone down, which can be challenging.
>> How do you expect the presidential election to affect funding?
Any time there’s an administration change there’s a re-visitation of policy. But it would be hard to believe that they would not be supportive of PACE because of its proven effectiveness. It’s a proven model of care.
ONLINE EXCLUSIVE: Find out what Karen Longo likes most about her job:
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