The Program of All-Inclusive Care for the Elderly (PACE)

The Program of All-inclusive Care for the Elderly (PACE) is a managed care model of acute and long-term care that integrates the provision and financing of medical and long-term care services. The PACE model is centered on the belief it is better for the well-being of seniors with chronic care needs and their families to be served in the community whenever possible.
The goal is to maximize the participant’s autonomy and ability to reside in their community while receiving quality care at lower cost relative to the Medicare, Medicaid and private-pay traditional payment systems.
 

PACE programs assume full financial risk for participant’s care without limits on dollars or duration and are responsible for a full range of needed services. 

Background 

Cherokee Elder Care (CEC), Oklahoma’s first PACE organization opened its doors in August of 2008 in Tahlequah Oklahoma. CEC is the first PACE organization sponsored by a Native American tribe in the nation. In January of 2015Oklahoma opened two additional centers; Life PACE located in Tulsa and Valir PACE Foundation located in Oklahoma City.  

Eligibility and Enrollment 

  • 55 years or older 
  • live in the catchment area of the PACE program,  
  • live safely in the community at the time of enrollment  
  • eligible for nursing home care by the appropriate state agency. 

The financial eligibility criteria and determination process is consistent with the state’s Home and Community Based Services (HCBS) program, wherein income is equal to or less than 300% of SSI Medicaid coverage. 

Funding 

PACE receives Medicare and Medicaid capitation payments (dual capitation) for all participants eligible for services. Persons financially ineligible for Medicaid pay that amount privately (out-of-pocket). 

PACE programs assume full financial risk for participant’s care without limits on dollars or duration and are responsible for a full range of needed services. 

Service Delivery 

An interdisciplinary team, consisting of professional and paraprofessional staff and the participant, assesses and discusses the participant’s needs.  The team develops a care plan and thereafter delivers services which are integrated for a seamless provision of total care. 

Primary care, social work and restorative therapy are a few of the services PACE provides. PACE provides long term care services, such as, transportation, meals and personal care.  Participants can receive these services at the PACE center, at home and in the hospital. 

By delivering all needed medical and supportive services, the program is able to provide the entire continuum of care and services to seniors with chronic care needs. Use of preventative and rehabilitative services can stabilize chronic conditions and prevent or lessen complications of disease, thereby enhancing participants' lives. 

The PACE Benefit Package 

The PACE benefit package for all participants, regardless of the source of payment, includes all Medicaid-covered services, as specified in the State's approved Medicaid plan: 

  • Adult day care that offers nursing; physical, occupational, speech and recreational therapies;  meals; nutritional counseling; social work and personal care  
  • Medical care provided by a PACE physician familiar with the history, needs and preferences of each participant  
  • Home health care and personal care  
  • All necessary prescription drugs  
  • Social services  
  • Respite care  
  • Nursing home care when necessary  
  • Acute Hospital care  
  • Medical Specialty services  

Funding 

PACE programs assume full financial risk for participant’s care without limits on dollars or duration and are responsible for a full range of needed services. 

PACE receives Medicare and Medicaid capitation payments (dual capitation) for all participants eligible for services. Persons financially ineligible for Medicaid pay that amount privately (out-of-pocket). 

Contact 

For information, please contact:   

Kysha Demas
Phone: 405-522-7139

Fax: 405-530-7106 
Email:
Kysha.Demas@okhca.org 

Shakina Johnson 
Phone: 405-522-7402 
Fax: 405-530-7259 
Email: Shakina.johnson@okhca.org 

Josh Bouye
Phone: 405-522-7408
 
Fax: 405 -530 -7754
Email: Josh.Bouye@okhca.org             

    

PACE organizations: 

Cherokee Elder Care
Phone: 918-453-5554
Tahlequah, OK 
Email
: eldercare@cherokee.org 

Life PACE
Phone: 918- 664-9000
 
Tulsa, OK

Email: www.LIFEPACE.org 

Valir PACE Foundation |
Phone: 405 - 609-3600
 
Oklahoma City, OK 
Email: www.valir.com