WAC 182-513-1230 Program of all-inclusive care for the elderly (PACE).
Effective February 20, 2017
- The program of all-inclusive care for the elderly (PACE) provides long-term services and supports (LTSS), medical, mental health, and chemical dependency treatment through a department-contracted managed care plan using a personalized plan of care for each enrollee.
- Program rules governing functional eligibility for PACE are listed under WAC 388-106-0700, 388-106-0705, 388-106-0710, and 388-106-0715.
- A person is financially eligible for PACE if the person:
- Is age:
- Fifty-five or older and disabled under WAC 182-512-0050; or
- Sixty-five or older;
- Meets nursing facility level of care under WAC 388-106-0355;
- Lives in a designated PACE service area;
- Meets financial eligibility requirements under this section; and
- Agrees to receive services exclusively through the PACE provider and the PACE provider's network of contracted providers.
- Is age:
- Although PACE is not a home and community based (HCB) waiver program, financial eligibility is determined using the HCB waiver rules under WAC 182-515-1505 when a person is living at home or in an alternate living facility (ALF), with the following exceptions:
- PACE enrollees are not subject to the transfer of asset rules under WAC 182-513-1363; and
- PACE enrollees may reside in a medical institution thirty days or longer and still remain eligible for PACE services. The eligibility rules for institutional coverage are under WAC 182-513-1315 and 182-513-1380.
- A person may have to pay third-party resources as defined under WAC 182-513-1100 in addition to the room and board and participation.