PACE is a joint Medicare/Medicaid program for older adults and people over age 55 living with disabilities. This program provides community-based care and services to people who otherwise need nursing home level of care.
PACE was created as a way to provide you, your family, caregivers, and professional health care providers flexibility to meet your health care needs and to help you continue living in the community.
PACE programs feature an interdisciplinary team of professionals who give seniors the coordinated care they need. These professionals are experts in working with older people. They work together with seniors and their families (if appropriate) to develop the most effective plan of care.
PACE provides all the care and services covered by Medi-Cal and Medicaid, as authorized by the interdisciplinary team, as well as additional medically-necessary care and services not covered by Medicare and Medi-Cal. We invest in transportation so you can see your primary care doctor when you need and access specialists when necessary. We provide meals in our center so you can have a nutritious, healthy option that is catered to your dietary needs. We provide a place for you to spend time to socialize with friends, learn new skills or participate in community activities.
You can join PACE if you…
- You are 55 years of age or older
- You live in the service area of Gary and Mary West PACE
- You meet California state requirements for nursing home level of care
- You are able to live safely in the community with the help of PACE services
With PACE, the focus is on you – the participant. You have a team of health care professionals who are dedicated to helping you make health care decisions. Your team is experienced in caring for aging adults like you and cares about what your family needs are too. The PACE team usually cares for a small number of people. That way, they get to know you, what kind of living situation you are in, and what your preferences are.
Since the Gary & Mary West PACE program offers a complete array of medical and personal services, you must discontinue use of IHSS services. You’ll find the PACE program to provide many more services than IHSS and a much bigger benefit.
Absolutely! You and your family participate as the team develops and updates your plan of care and your goals in the program. PACE organizations support your family members and other caregivers through training, support groups, and respite care to help families keep their loved ones in the community.
The focus of every PACE organization is to help you live in your community and stay in your own home for as long as possible. With PACE, you can live at home but receive extra help to make sure your needs are met. To meet this goal, PACE organizations focus on preventive and palliative care, delivered in the PACE center and at home.
PACE organizations provide care and services in the home, the community, and the PACE center. Many PACE participants get most of their care from staff employed by the PACE organization in the PACE center, but they have contracts with many specialists and other providers in the community to make sure that you get the care you need. To make sure you can get to a PACE Center, PACE organizations provide all medically-necessary transportation to the PACE center for activities or medical appointments. You can also get transportation to appointments in the community.
What you pay for PACE depends on your personal financial situation. If you qualify for Medicare, all Medicare-covered services are paid for by Medicare. If you also qualify for your state’s Medi-Cal program, you will either have a small monthly payment or pay nothing for the long-term care portion of the PACE benefit. If you don’t qualify for Medicaid, you will be charged a monthly premium to cover the long-term care portion of the PACE benefit and a premium for Medicare Part D drugs. However, in PACE there is never a deductible or co-payment for any drug, service, or care approved by the PACE team.
With PACE, a person’s ability to pay will never keep them from getting the care they need.
PACE organizations offer Medicare Part D prescription drug coverage. If you join a PACE program, you’ll get your Part D-covered drugs and all other necessary medication from the PACE program. Keep in mind, if you are in a PACE program, you don’t need to join a separate Medicare drug plan. Your prescriptions will be delivered to your door and/or available for pick up at the PACE center.
Call us or complete the online form to tell us about yourself and your needs. The enrollment process includes gaining access to your previous medical records and a chance for you to sit down for separate interviews with all the members of our health team, including physicians, nurses, home health, social workers and physical therapists. We also do a home visit to learn more about your living arrangements. We want to learn about you and your full suite of needs so we can help determine the plan that is right for you. The enrollment process typically takes a couple of weeks, since we want to have detailed conversations with you so you can provide the information you need to make the best decision.
Every person’s needs are assessed on an on-going basis and the plan will change as your needs change. The day health center provides a meaningful chance to check-in with your team and for them to monitor your ongoing health and wellness. You may even make some great new friends! The care team will work closely with you and your family to determine a schedule that makes the most sense for you. You will only come in as often as you need.