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UNDERSTANDING THE PACE PROGRAM

The Elder & Disability Law Firm, APC April 19, 2022

The Program for All-Inclusive Care for the Elderly—PACE—is designed to provide multiple layers of care outside of a hospital setting for the elderly with multiple chronic conditions. The beauty of PACE is that it allows participants to stay in their homes as much as possible while receiving all the care they need.

If you or a loved one is 55 years of age or older and suffering from chronic health conditions in or around Redlands or neighboring communities in California, contact The Elder & Disability Law Firm, APC, to discuss your options for long-term care, including PACE. The firm is dedicated to helping the elderly protect their assets and plan for their needs going forward.

WHAT IS PACE?

The Program of All-Inclusive Care for the Elderly is a comprehensive plan available in 31 states, including California. PACE is designed to provide customized health care and social engagement opportunities for older adults while they remain in their communities and their own homes.

Most of the health care and social engagement takes place in a PACE adult daycare center. In addition, each participant is assigned an interdisciplinary team of medical specialists to care for their health care needs. Attendance at the daycare center depends on the individual’s needs. Some individuals come three times a week, others only once a month. Transportation is provided for free. 

ELIGIBILITY REQUIREMENTS

To join the PACE program, the senior must be:

  • At least 55 years of age

  • Reside in a community that is designated as a PACE service area

  • Able to live at home without risk of health or safety issues

  • Meet any other requirements set by the California Department of Health Care Services (DHCS)

While all PACE participants must be certified to need nursing home care to enroll in PACE, only about 5 percent of PACE participants nationally reside in a nursing home.

SERVICES PROVIDED

Medicare and Medi-Cal may provide many of the same services that PACE does, but PACE is more of a comprehensive approach. Under Medicare and Medi-Cal, you will be more on your own in choosing your health care and other providers, while PACE will develop a comprehensive plan for your health care and overall well-being. If your assessment reveals that you need care beyond what Medicare and/or Medi-Cal provide, PACE may still cover those needs. PACE provides a full range of services needed for the elderly’s proper treatment and care, which include but are not limited to:

  • Primary care, including doctor and nursing services

  • Dentistry

  • Home Care

  • Hospital Care

  • Laboratory/X-Ray services

  • Meals

  • Adult daycare center for socialization and recreational therapy

  • Prescription drugs

  • Transportation to the PACE center or other medical appointments

A participant does not need to go to a daycare center to receive medical or other services. In-home services are also provided. The goal is to keep frail seniors remain in the communities where they reside. Some 92 percent of PACE participants say they would recommend the program to others.

ENROLLING IN PACE

IF YOU WISH TO ENROLL IN PACE, A CERTIFIED ENROLLMENT SPECIALIST WILL MEET YOU AT YOUR HOME TO ASSESS YOUR ELIGIBILITY AND GIVE YOU AN OVERVIEW OF THE PROGRAM’S OBJECTIVES AND SERVICES. AFTER THAT, YOU WILL BE INVITED TO VISIT THE FAMILY HEALTH CENTER FOR OLDER ADULTS NEAR YOU TO MEET PROVIDERS, NURSES, AND STAFF.

During the visit, you will receive a no-cost interdisciplinary assessment to complete a Level of Care application required by the DHCS. After that, DHCS will decide to enroll you or not.

HOW AN EXPERIENCED ATTORNEY CAN HELP

The Elder & Disability Law Firm, APC has been dealing with elder issues for over three decades, and its attorneys have developed a deep understanding of the ins and outs of the programs available. If you live in Redlands, Rancho Cucamonga, Riverside, Palm Springs, or anywhere else in California, contact an elder law attorney to discuss PACE.