A system of services for the elderly

Loretto Brings Community Organizations Together to Provide a Continuum of Care in Central New York

True systems of care for the agingwhich provide a continuum of support services to the elderly and disabled-are as embryonic as integrated healthcare information systems. One exception is Loretto, a private, not-for-profit organization based in Syracuse, NY. For many years Loretto has worked to develop a system of long-term care services throughout central New York State.

Using innovative partnerships, Loretto has built housing and services for the chronically ill, frail elderly in urban, suburban, and rural sites dotted throughout the Syracuse community and in towns as far as 30 miles away. This complex entity serves 5,000 clients annually with a staff of 1,300. Loretto's average client (76 percent are women) is a widow in her eighties with a low income, although Loretto also serves middleincome persons in need. Most clients have multiple health problems and need assistance with several activities of daily living.

COMMUNITY CAMPUS FOR FRAIL ELDERLY

One of Loretto's most ambitious and innovative projects is its North Syracuse community campus for low-income frail elderly. Loretto is developing the campus with the goal of providing safe and secure housing, healthcare, and social supports so that residents can continue to reside in the community rather than moving to a nursing home.

Malta House Apartments, a HUD 202 project, was recently completed, and its 51 units are all occupied. Still under construction is a day health center, the Sally Coyne Center for Independence, which will house Loretto's PACE (Program of All-Inclusive Care for the Elderly) program. PACE enables persons eligible for skilled nursing care to remain in their own homes with intense care management and numerous support services. (See Health Progress, September-October 1998, pp. 4145, for a full description of the PACE program.) Until the center for independence is complete, Loretto's Independent Living Services is managing the PACE program for 40 enrollees out of a temporary site located in Malta House. Loretto has been awarded a second HUD 202 grant to build another 48-unit apartment building, Malta Manor. The campus will also include a library, park, and farmers' market.

To make the project possible, several organizations joined forces with Loretto: St. Joseph's Hospital Health Center, a 431-bed tertiary care institution that cosponsors Loretto's PACE program; Christopher Community, a subsidiary of Catholic Charities with 20 years of experience in developing housing; the Knights and Dames of Malta; and the village of North Syracuse. Members of the Order of Malta have provided volunteer services, an endowment fund for the campus, and homelike furnishings, wallpaper, carpeting, and artwork for the public areas of Malta House. The village is building pavements and roadways and will help develop the library, park, and market.

SOME EXAMPLES OF LORETTO'S SCOPE

Loretto's sites have evolved in response to changing community needs. Many organizations have collaborated in developing programs, so services and settings vary in size and function. Some examples are Loretto at James Geddes, Loretto Community Residences, Mahan Gorham Manor, and Castle Rest Nursing Home.

Loretto at James Geddes, located in the city of Syracuse, is a 48-apartment complex offering assisted and enriched living (which provides a lower level of assistance, day care programs, and meals) for low-income elderly adults. The Syracuse Housing Authority subsidizes rents.

Much smaller is the nearby Loretto at St. James. Loretto purchased the parish's old convent as a group home for eight mentally ill older persons. In rural Elbridge, NY, Loretto leases Mahan Gorham Manor, a Civil War-era mansion, from the parish for $1 a year. Its eight residents, who need some assistance with activities of daily living, receive home healthcare and meals.

The Nottingham Senior Living Facility, a 370unit apartment complex in suburban Syracuse, provides independent and enriched living for older people of all income levels, as well as a 40bed skilled nursing facility.

Castle Rest Nursing Home, a 160-bed skilled nursing facility, is located in a predominantly African-American community in Syracuse. Loretto assumed management of the home when it went into receivership in 1988. Since then Loretto, collaborating with the Syracuse Black Leadership Council, has helped secure funds for a major renovation and has aided in transferring ownership and management to the local community.

COMMUNITY OWNERSHIP

Loretto is owned by the community; 80 percent of community residents are Catholic. The organization consists of seven corporations, but these are all managed by one board of trustees. A seven-member corporation includes the ordinary and auxiliary bishops of the Syracuse diocese and annually elects the board.

Loretto hopes its collaborative model will be replicable in other parts of the country. Kathryn Ruscitto, Loretto's senior vice president, has consulted with organizations in the Diocese of Charlotte, NC, that are interested in developing a community campus similar to the one in the Village of North Syracuse. "Our unique strength," she says, "lies in Catholic healthcare working in collaboration with long-term care, Catholic Charities, and other public/private partnerships. Together we can offer stronger care to our communities."

Copyright Catholic Health Association of the United States Jan/Feb 1999
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