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Rural Health Information Hub
Rural Health Information Hub

National PACE Association

  • Project Title: Rural PACE®
  • Program Representative Interviewed: Sam Kunjukunju, Director of Project Management
  • Location: National
  • Program Overview: The Program of All-inclusive Care for the Elderly (PACE) is a national model that focuses on enabling older adults with chronic health conditions and functional limitations to remain in their communities as they age by receiving comprehensive and coordinated care. The model originated in the early 1970s in the Chinatown-North Beach community of San Francisco, CA, to address the long-term care needs of older immigrants from China, Italy, and the Philippines. In 1971, Dr. William L. Gee, a public health dentist, headed a committee that hired Marie-Louise Ansak to investigate solutions to long-term care needs. The committee, along with other community leaders, formed the nonprofit corporation On Lok Senior Health Services to create a community-based system of care as an alternative to institutional-based long-term care. In 1986, federal legislation extended financing to allow 10 additional demonstration organizations to replicate the On Lok services model. By 1990, the model became known as PACE and was permanently established as a recognized provider under the Balanced Budget Act of 1997. Section 5302 of the Deficit Reduction Act of 2005 authorized the rural PACE program, which initially enrolled 15 providers across the country to develop PACE programs to serve rural older adults aging in place. As of March 2025, PACE has been replicated and expanded to over 180 organizations located in 33 states and the District of Columbia, with about 16% of PACE programs being rural.

    PACE programs provide comprehensive preventive, acute, and long-term services and supports to individuals aged 55 or older, certified by their state to need a nursing home level of care, who can live safely in the community at the time of enrollment, and live in a PACE service area. Although all PACE participants must be certified to need a nursing home level of care to enroll in PACE, 95% of PACE participants live in a community setting rather than a nursing home.

    Read more about the PACE program in the Rural Services Integration Toolkit.

Models represented by this program: