MDHHS contacts CMS Central Office to notify them of the possible addition of PACE sites.Potential organization prepares and submits a PACE application to MDHHS.Potential organization submits a letter of intent and the feasibility study to MDHHS (address listed below).Potential organization completes a feasibility study.Potential organization researches Federal regulations and information available from the National PACE Association to assess the feasibility of becoming a PACE organization.Organizations should understand and complete the following general steps: It may take up to two years to complete the process to become a PACE organization. A contract is also signed between the PACE organization and MDHHS. The PACE organization enters into a three-party agreement with the Centers for Medicare and Medicaid Services and the Michigan Department of Health and Human Services (MDHHS). Prospective PACE organizations must complete a feasibility study which includes providing evidence the PACE organization will either be cost neutral or save money for long term care services provided by the State in the service area. Prospective PACE organizations may be a for-profit or not-for-profit private or public entity that is primarily engaged in providing PACE services. The PACE service package must include all Medicare and Medicaid covered services, and other services as determined necessary by the interdisciplinary team. PACE programs provide social and medical services primarily in an adult day health center, supplemented by in-home and referral services in accordance with the participant's needs.
Pace program professional#
The PACE organization is responsible for performing the medical/functional assessment that determines if a person meets the Medicaid LTC criteria.Īn interdisciplinary team, consisting of professional and paraprofessional staff, assesses the participants' needs, develops care plans and delivers all services, including acute care services, hospital services and if necessary nursing facility services. The PACE organization will also help the person obtain required information and verification. The PACE organization will assist a person in applying for Medicaid and with initial asset and income assessments. Comparison of Home and Community Based Long Term Care Programs.The PACE organization receives referrals from providers in the community who believe a person meets Medicaid eligibility and LTC eligibility criteria. Must not be concurrently enrolled in a Health Maintenance Organization (HMO).Must not be concurrently enrolled in the Medicaid MIChoice waiver.Must be able to live safely in the community (not residing in a nursing facility) at the time of enrollment.Must live within the approved geographic area of the PACE organization.Must be at least 55 years of age or older.Medically qualified, must meet Medicaid's LTC eligibility criteria.Participants must meet the following criteria: The Program of All-Inclusive Care for the Elderly (PACE) is a capitated benefit authorized by the Balanced Budget Act of 1997 (BBA) that features a comprehensive service delivery system and integrated Medicare and Medicaid financing for frail, elderly individuals that meet Long Term Care (LTC) level of care criteria.įor most PACE participants (enrollees), the comprehensive service package permits them to continue living at home while receiving services rather than being institutionalized. Resuming Standard Operations for Case Management and Home and Community Based Services - NEW Michigan's stay at home order has been lifted, learn about each phase of the MI Safe Start Plan MDHHS advises review of " Actions for Caregivers of Older Adults During COVID-19" and supporting Frequently Asked Questions (FAQ) document. Learn about our responses to Coronavirus and find the latest program guidance. Program of All-Inclusive Care for the Elderly (PACE)