How To Start A PACE Program

Developing a PACE program is a complex and lengthy process involving the state government, the federal government, and the program sponsor(s). It is not for the faint of heart or for those seeking immediate results. Fortunately, the CalPACE and National PACE Associations have many resources to assist in the development of new PACE programs. A visit to the NPA website is the critical first step.

In addition to the NPA resources, learning from existing PACE programs in California who have gone through the process is a valuable resource. The best way to interact with them is to become a CalPACE Associate. Learn more about the benefits of becoming a CalPACE member here or call (855) 921-PACE for more information and to discuss your plans.

The Center for Medicare & Medicaid Services (CMS) has prepared a helpful video tutorial on PACE application requirements.

After getting a good understanding of what is involved in the PACE development process, you may want to consider the following questions as you decide how to proceed:

  • Do you want to go it alone, or form a partnership with other entities who want PACE in the community?
    A variety of models of PACE development can be successful. Programs have grown out of adult day care centers, federally qualified health centers, large religious-affiliated entities, hospitals and various other health or elderly related entities. Partnerships have proven effective, while going it alone remains an option. Partnerships spread the risk, the start-up costs and the community buy-in, while going it alone yields greater control and future return.
  • Is there a program near you that might be able to expand to serve you?
    This is always worth considering, as expansions of existing programs are easier and faster than a new startup.

The Process in California

So you’ve decided to move forward. Now what?

The Letter of Intent

State and federal regulations require prospective PACE providers to “define” a service area which must be approved by the state and CMS. This is done by submitting a letter of intent to the state PACE Program Manager which specifies the counties or portions thereof (usually by zip codes) that you anticipate serving. At a minimum, you should have knowledge of the market, a grasp of the feasibility, and confidence of your capacity and commitment to develop a program before requesting the service area. A technical assistance provider can assist with this process, if necessary.

Who Is the State Contact?

Elva Alatorre
Integrated Systems of Care Division
Department of Health Care Services
Phone: (916) 713-8317
Email: elva.alatorre@dhcs.ca.gov
Address: PO Box 997413, MS 4502, Sacramento, CA 95899-7413

Technical Assistance Providers

Technical assistance (TA) is very important to PACE start-ups, so you will want to carefully choose the TA provider who is right for you. CalPACE programs are glad to share their experiences with these providers, and you can find out more about qualified PACE consultants at NPA’s website.