Program of All-Inclusive Care for the Elderly (PACE)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.
For most PACE participants (enrollees), the comprehensive service package permits them to continue living at home while receiving services rather than being institutionalized. Participants must meet the following criteria:
- Medically qualified, must meet Medicaid's LTC eligibility criteria
- Must be at least 55 years of age or older
- Must live within the approved geographic area of the PACE organization
- Must be able to live safely in the community (not residing in a nursing facility) at the time of enrollment
- Must not be concurrently enrolled in the Medicaid MIChoice waiver
- Must not be concurrently enrolled in a Health Maintenance Organization (HMO)
The PACE organization receives referrals from providers in the community who believe a person meets Medicaid eligibility and LTC eligibility criteria.
The PACE organization will assist a person in applying for Medicaid and with initial asset and income assessments. The PACE organization will also help the person obtain required information and verification.
The PACE organization is responsible for performing the medical/functional assessment that determines if a person meets the Medicaid LTC criteria.
An 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. 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.
The PACE service package must include all Medicare and Medicaid covered services, and other services as determined necessary by the interdisciplinary team.
Prospective PACE organizations must be a not-for-profit private or public entity that is primarily engaged in providing PACE services. 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.
The PACE organization enters into a three-party agreement with the Centers for Medicare and Medicaid Services and the Michigan Department of Community Health (MDCH). A contract is also signed between the PACE organization and the MDCH.
Becoming a PACE Organization
It may take up to two years to complete the process to become a PACE organization. Organizations should understand and complete the following general steps:
- Potential organization researches Federal regulations and information available from the National PACE Association to assess the feasibility of becoming a PACE organization.
- Potential organization completes a feasibility study.
- Potential organization submits a letter of intent and the feasibility study to MDCH (address listed below).
- Potential organization prepares and submits a PACE application to MDCH.
- MDCH contacts CMS Central Office to notify them of the possible addition of PACE sites.
- MDCH evaluates the organization and approves the application as appropriate.
- MDCH submits the formal application to CMS along with the MDCH assurance that the entity is considered to be qualified as a PACE organization and is willing to enter into a PACE organization agreement with the entity.
- Readiness Review occurs with an MDCH site visit.
- Within 90 days of formal application, CMS approves, denies, or requests additional information.
- Once CMS approves, MDCH and CMS enter into a PACE organization agreement with the organization.
- The PACE organization contracts with MDCH.
- The PACE organization proceeds to enroll beneficiaries.
Any entity seeking to become a PACE organization in Michigan may contact MDCH regarding state-specific requirements.
Current PACE Providers
Michigan has eight PACE centers:
Center for Senior Independence Center for Senior Independence
Detroit Northwest Rivertown PACE Center
7800 W. Outer Dr. 250 McDougall St.
Detroit, MI 48235 Detroit, MI 48207
The area served by the Center for Senior Independence is in the following list of zip codes in Wayne, Macomb, and Oakland counties: 48015, 48017, 48021, 48025, 48026, 48030, 48033, 48034, 48035, 48066, 48067, 48070, 48071, 48072, 48073, 48075, 48076, 48080, 48081, 48082, 48088, 48089, 48091, 48092, 48093, 48101, 48120, 48122, 48124, 48125, 48126, 48127, 48128, 48134, 48135, 48138, 48141, 48146, 48150, 48152, 48154, 48164, 48173, 48174, 48180, 48183, 48184, 48185, 48186, 48192, 48193, 48195, 48201, 48202, 48203, 48204, 48205, 48206, 48207, 48208, 48209, 48210, 48211, 48212, 48213, 48214, 48215, 48216, 48217, 48218, 48219, 48220, 48221, 48223, 48224, 48225, 48226, 48227, 48228, 48229, 48230, 48234, 48235, 48236, 48237, 48238, 48239, 48240, 48242, 48322, 48323, 48331, 48334, 48335, 48336.
200 West Michigan Ave. 445 W. Michigan Ave.
Battle Creek, MI 49017 Kalamazoo, MI 49001
269-441-9300 or 877-284-4071 269-488-5460 or 800-488-5860
The area served by CentraCare is all of Calhoun and Kalamazoo counties and the following zip codes in Van Buren County: 49009, 49010, 49026, 49055, 49065, 49067, 49071, 49078, 49079, 49087.
1471 Grace St., SE
Grand Rapids, MI 49506
616-913-2006 or 800-610-6299
The area served by Care Resources is all of Kent County and the following zip codes in Ottawa County: 49428, 49418, 49435, 49534, 49544.
560 Seminole Rd.
Muskegon, MI 49444
231-733-8686 or 1-888-204-8626
The area served by LifeCircles is Muskegon County and the following zip codes in Ottawa County: 49403, 49404, 49409, 49417, 49448 and 49456.
PACE of Southwest Michigan
2900 Lakeview Ave.
St. Joseph, MI 49085
The area served by PACE of Southwest Michigan is all of Berrien County and the following zip codes in Cass and Van Buren Counties: 49013, 49022, 49031, 49038, 49043, 49045, 49047, 49057, 49064, 49079, 49085, 49098, 49101, 49102, 49103, 49104, 49106, 49107, 49111, 49112, 49113, 49115, 49116, 49117, 49119, 49120, 49125, 49126, 49127, 49128, 49129, and the Van Buren County portions of 49056, 49065, 49067, 49090.
Huron Valley PACE
2940 Ellsworth Rd.
Ypsilanti, MI 48197
The area served by Huron Valley PACE is all of Washtenaw County and the following zip codes in Wayne, Monroe, Oakland and Livingston counties: 48111, 48116, 48117, 48131, 48159, 48160, 48161, 48162, 48164, 48165, 48166, 48167, 48168, 48170, 48174, 48178, 48179, 48187, 48188, 48189, 48191, 48242, 48374, 48375, 48377, 48390, 48393, 49270.
Information regarding PACE can be obtained by contacting:
Integrated Programs Management Section
Medical Services Administration
PO Box 30479
Lansing, MI 48909
Additional information regarding the PACE can be found on the following internet site:
- National PACE Association - http://www.npaonline.org/