Qualifications
If you’re 55 years of age or older, you may qualify for our program.
The Rhode Island Department of Human Services (DHS) will ask for financial information on both spouses, even if only one is applying for PACE services. Once DHS reviews the information you have provided, they will calculate whether there is a cost-share and, if there is, how much it will be using their own guidelines.
Individuals that have Veterans Health Benefits are eligible to apply for PACE, however, they must surrender Veterans benefits and providers if they join the program. It’s always a good idea to compare the benefits and services that you are currently receiving to those that PACE provides to see if this program is right for you.
Some PACE participants do own their own homes. Those participants can continue to live in their homes while enrolled in PACE. However, DHS will require you to sign a lien on your property if you are the owner. Upon your death (and the death of your spouse, if you have one) DHS may take some of the proceeds of your estate to cover the costs of your care.
Because this is a major financial decision, PACE recommends consulting with an elder care attorney to discuss the process and how it will affect your own estate planning. Free or “pro-bono” legal services are available to seniors through the generosity of the Rhode Island Bar Association’s Lawyer Referral Service & Elderly Pro Bono Program by calling (401) 421-7799.
Yes. Car ownership isn’t an obstacle to joining our program.
Any assets over $4000 will need to be “spent-down” prior to Medicaid picking up any cost for the PACE program. However, PACE participation can be used as a spend-down to meet this requirement. Ask your enrollment specialist for up-to-date private pay rates.
Your cost share is determined by DHS through the Medicaid program. If you don’t have a cost-share, your medications will be provided to you at no charge. If you do have a cost-share, the price of your medications will be included in that cost-share. There will be no additional co-pay for prescriptions.
Process
You’ll have to choose a PACE primary care physician when you join. However, if there’s a specialist that you trust who contracts with PACE, you’ll be able to keep them. Ask your PACE enrollment specialist if your preferred specialist is on our list.
First, we will speak with you to see whether you meet program qualifications. Our participants are age 55+ and they live in Rhode Island. You also need to be living safely on your own in the community when you enroll, but people residing in nursing homes, hospitals or homeless shelters are not eligible.
The second step involves meeting with one of our enrollment associates in your home. They’ll ask you some questions to see if you may qualify, to ensure you’re safe and to determine some of the supports you may need if you become a PACE participant. Finally, they’ll help you complete an application and ask for your written permission to move forward with the process.
You’ll also need a medical assessment to be completed by one of our medical providers to determine your needs.
The information you provide, along with the results of your medical evaluation, will be submitted to the Rhode Island Department of Human Services for review. They’ll determine whether you qualify for PACE and whether you’ll have a cost to participate in the program.
Once your assessment and paperwork have been submitted, the Department of Human Services will determine if PACE will be a good fit for you at this time. It typically takes between 30 and 90 days for them to review materials. Individuals who are approved by DHS can begin PACE on the first day of the following month.
Day Center
Most participants enjoy visiting our day centers, but participation is certainly not required. The activities and services offered in Westerly, East Providence, Woonsocket and Newport are available for those participants who need them. An assessment will be completed within 30 days of your enrollment to determine if you’re eligible to attend.
PACE has four day centers, and they are located in Westerly, East Providence, Newport and Woonsocket. Individuals who qualify will be picked up at their home in a PACE provided vehicle. When you arrive, you’ll be provided a light breakfast, followed by activities that meet your interests and abilities. A variety of educational, recreational, and physical activities are available that include art lessons, poker games and chair yoga. Mid-day, you’ll receive a nutritious lunch, and, later, a snack before returning home.
If you’d like to see what kinds of activities are available, we’d be glad to provide you with a monthly schedule.
The second step involves meeting with one of our enrollment associates in your home. They’ll ask you some questions to see if you may qualify, to ensure you’re safe and to determine some of the supports you may need if you become a PACE participant. Finally, they’ll help you complete an application and ask for your written permission to move forward with the process.
You’ll also need a medical assessment to be completed by one of our medical providers to determine your needs.
The information you provide, along with the results of your medical evaluation, will be submitted to the Rhode Island Department of Human Services for review. They’ll determine whether you qualify for PACE and whether you’ll have a cost to participate in the program.
No. We tailor our experiences to your preferences. If you’d prefer to listen to music in a quiet room or garden outside, there are many options and quiet spaces available. Your participation in group activities is not a requirement.
Quite possibly. Just ask your enrollment specialist for the list of day centers that contract with PACE to see if your participation at that location will qualify.
Benefits
If you attend a PACE day center, you might be able to see your physician right here, on site. If you need a specific medical test or have an appointment with a specialist, PACE will typically provide transportation to medical appointments.
Yes, if your assisted living facility is contracted with PACE. Ask your enrollment specialist for a list of assisted living facilities that are affiliated with our organization.
PACE tailors its programs to meet the needs of each individual participant. If your assessment reveals that you need help preparing nutritious meals, you’ll be eligible to receive assistance.
If a participant is assessed and deemed eligible, respite care is available for participants’ caregivers.
We do not provide 24-hour home health services or overnight home health care.
Routine medical questions like prescription refills can be sent through our patient portal. Responses will be sent within one business day. Non-emergency medical questions, like when you have mild discomfort, are nauseous or have the flu, can be addressed 24 hours a day by phone. Of course, we always advise participants who need emergency care because they are experiencing symptoms like chest pains or seizures to call 911 immediately.