Partnership with Your PACE Enrollment Specialist
The enrollment specialist will meet with you and your family or
caregiver in your home to provide a detailed understanding of our program. We will
also make sure that if you need help applying for Medicaid, the stress and
burden are taken off of you and your loved ones.
The enrollment specialist will
assess your eligibility, schedule a visit to the PACE Center where
you'll meet our staff, and complete the rest of the needed assessments.
Once the care plan and
remaining paperwork are approved by our staff and the potential participant,
enrollment will be completed and submitted to the federal Centers for Medicare & Medicaid Services (CMS) for final approval. Enrollment is voluntary, and you can leave the
program at any time.
Steps as Part of the Enrollment Process
Pre-Screen
- The enrollment specialist (ES) will go through a list of
pre-screening questions to help determine if an individual qualifies for PACE.
- If the individual meets certain criteria, a home visit
by the ES will follow.
Enrollment Specialist Home Visit
- The ES will do a home visit to continue the screening
process and complete a level of care.
- If a caregiver is involved regularly with the
individual, the meeting should include them as well.
Home Care Coordinator/Occupational Therapist Home Visit
- During this visit, the individual is assessed by the home care coordinator and the occupational therapist to determine the needs
of the individual and if they can live safely in their environment while they're
enrolled in the PACE program.
Tour of Facility and Last Assessments
- During the time the individual comes in for their tour,
additional assessments will be completed.
- Assessments from a dietitian, physical therapist, recreational
coordinator, provider, master's level social worker, and clinic nurse
will need to be completed.
- If an individual is unable to complete the assessments during the visit, a future clinic date or in-home date will be
scheduled.
Preliminary Plan of Care/Finish Enrollment
- Based on the assessments, a preliminary plan of care is
developed and presented to the individual for approval.
- If approved, the agreement to enroll is signed and
the paperwork is submitted to CMS for approval.
- Participation in the PACE program starts on the 1st of the month.
