Support PACE Expansion and Enrollment

Proposal Presented for the Master Plan for Aging (#59)

Disclaimer

Throughout the MPA process, more than 100 proposals were developed thanks in particular to thousands of hours of work by external stakeholders and members of the public. These proposals and the MPA Council commentary are being submitted to the Governor and shared with policymakers and the public to inform policymaking. These proposals represent a starting point for discussion. Further discussion is necessary between relevant state agencies and stakeholders to both refine these proposals and assess which may be appropriate to adopt and implement.

 

Summary

Consider regulatory, budget, and programmatic actions to increase Program of All-inclusive Care for the Elderly (PACE) enrollment by increasing accessibility and awareness of PACE.

 

Justification

PACE is a proven model for the provision of care and services to dually eligible older adults in the setting of their choice, ensuring improved equity to services without the need for long-term care facility placement. Implementing opportunities for PACE enrollment and program expansion may provide more older adults with the care they need without facility placement and its base capitation rates may provide the state with a Medicaid Return on Investment.

 

Full Proposal

Implement initiatives to increase Program of All-inclusive Care for the Elderly (PACE) enrollment by increasing accessibility and awareness of PACE:

  • Aligning the eligibility determination timeline for HCBS with institutional care by developing a standardized, common, conflict free process to make sure eligibility for Community based long term services and supports (CBLTSS) takes the same amount of time as for nursing home care.
  • Promoting PACE as a care option during the hospital discharge planning process, within the Conflict Free Enrollment and Evaluation Center (NY Connects), and other “front doors”.
  • Allowing PACE organizations to submit enrollments to Medicaid at any time of the month, instead of the current cut-off, which is the 20th of the month.
  • Ensuring that PACE centers and related home care agencies are eligible for Statewide Health Care Facility Transformation grants.
  • Have regulations and the streamlined licensure process for PACE under Article 29-EE fully implemented by the final Master Plan on Aging report.

 

 

MPA Council Commentary

To encourage growth of this innovative and successful approach to patient care, the Department of Health would work with the Public Health and Health Planning Council (PHHPC) and PACE industry associations on implementation. Funding components of the proposal would be subject to the annual budget process and the availability of resources.