¿Califico para PACE?

An inquiring participant, family member or friend can call for information or make a referral to St. Paul’s PACE (Program of All-inclusive Care for the Elderly). When contact with the potential participant is made, one or our Enrollment Coordinators will talk with you to obtain some basic information regarding your needs, then will refer you to an Enrollment Specialist to talk through your unique situation and concerns. We will cover a variety of areas, including discussion of medical and memory issues, to help determine if the person is eligible for PACE services. We will talk about what is and isn't working well at home, gaps in care, and whether there is an interest in using our many services. We will also ask questions about finances, as this can help us determine if the individual is eligible for Medi-Cal, which can fully fund our services. During the course of our conversation, we will get a better picture of whether or not St. Paul’s PACE is a good fit for you, and we will help with locating other community options if it is not. If criteria are met and there is interest, we will schedule an Initial Home Visit.

The home visit will be scheduled with the potential participant as soon as possible. The Enrollment Specialist will review the PACE program and answer any questions or concerns. We will discuss your medical history and community support, as well as verify your insurance. We will also complete a Release of Information form to allow the St. Paul’s PACE medical team to understand your medical needs.

The Enrollment Nurse will meet with you at one of our Medical Centers or in your home to complete an assessment, helping to determine your unique medical and mental health needs. The St. Paul’s PACE team will then meet to review individual findings to determine if the potential participant’s medical needs and safety requirements meet the level of care provided by the St. Paul’s PACE program. The team is required to certify that the potential participant meets the state eligibility requirements for PACE. Once certified, the Enrollment Specialist will call you and extend an invitation to join the program. If the team is unable to certify PACE eligibility, the Specialist will call and send written information regarding how to appeal the decision as well as present alternative support options.

The Enrollment Specialist will arrange to meet with you to sign paperwork to complete the enrollment process. We will discuss the date that St. Paul’s PACE services will begin and the specifics of the transition to St. Paul’s PACE care.