The PACE program in Michigan: what it is, and how it differs from Home Help

The short answerPACE, the Program of All-Inclusive Care for the Elderly, is a Medicare and Medicaid program that operates in Michigan, paid for by both together. It is for people 55 and older who meet Medicaid's long term care level of care and live in an area a PACE organization serves. One PACE team plans and delivers the care, mostly at an adult day health center. Home Help is a different program: your county MDHHS office assesses daily tasks and sets paid time, and the person chooses a caregiver. Only the State and the PACE organization decide who qualifies.

If you are looking for help for a parent, PACE may come up alongside Home Help and the MI Choice Waiver. This guide sets out what PACE is, who MDHHS says it is for, how it differs from Home Help, and who to call. We have kept to what Michigan's own pages say, and we say so where we could not confirm something.

What PACE is

MDHHS describes PACE as a benefit authorized by the Balanced Budget Act of 1997, with one service system and Medicare and Medicaid funding combined, for frail, elderly people who meet Medicaid's long term care level of care. For most participants, MDHHS says, PACE lets them keep living at home while receiving services, rather than moving into a facility.

A team of professional and paraprofessional staff assesses each participant's needs, writes the care plan and delivers the services, including acute care, hospital care and, if needed, nursing facility care. MDHHS says PACE provides social and medical services mainly in an adult day health center, with in-home and referral services added as the person needs them. The package must include everything Medicare and Medicaid cover, plus other services the team decides are needed.

Who PACE is for

MDHHS lists these criteria. A person must:

• meet Medicaid's long term care eligibility criteria;
• be 55 or older;
• live within the approved area of a PACE organization;
• be able to live safely in the community, and not be living in a nursing facility, when they enroll;
• not be enrolled in the MI Choice Waiver at the same time;
• not be enrolled in a Health Maintenance Organization (HMO) at the same time.

Participants must live within the approved area of a PACE organization. Ask which organization, if any, serves your parent's address.

How you start

MDHHS says PACE organizations receive referrals from providers in the community who believe a person meets the Medicaid and long term care criteria. The PACE organization helps the person apply for Medicaid, including the first look at income and assets, and helps gather the paperwork. It also does the medical and functional assessment that decides whether the person meets the long term care criteria.

How PACE differs from Home Help

• Who decides the care. In Home Help, an Adult Services Worker from your county MDHHS office ranks seven personal care tasks and five household tasks and sets paid time for those ranked 3 or higher. In PACE, the PACE organization's own team plans the care.
• Where care happens. Home Help is help in the home with the listed tasks. PACE is mainly delivered at an adult day health center, with in-home services added when needed.
• Who gives the care. In Home Help, the person who needs care chooses the caregiver, and in some cases that can be a family member. In PACE, the team delivers the services.
• What it covers. Home Help covers the listed daily tasks. PACE must include all Medicare and Medicaid covered services, plus other services the team decides are needed, through one organization.
• Age. MDHHS sets 55 as the minimum age for PACE.

What we could not confirm

The MDHHS PACE page we read does not tell us whether a person can use PACE and Home Help at the same time, which areas of Michigan have PACE today, how long enrollment takes, or whether a family member can be paid under PACE. Please do not rely on us for those. Ask the PACE organization that serves your area, and ask your county MDHHS office about Home Help.

Where Already Caring fits

Already Caring is preparing to work with Michigan Home Help and is not yet taking clients. We do not provide PACE services, and we cannot tell you which program fits your parent. To compare Home Help with the other in-home program, see MI Choice Waiver or Home Help. If Home Help is the route you choose, our guide to who qualifies and how to apply lists the steps.

Common questions

What is the PACE program in Michigan?

MDHHS describes PACE, the Program of All-Inclusive Care for the Elderly, as a benefit with integrated Medicare and Medicaid financing for frail, elderly people who meet Medicaid's long term care level of care. For most participants it lets them keep living at home while receiving services.

Who can join PACE in Michigan?

MDHHS lists these criteria: meet Medicaid's long term care eligibility criteria, be 55 or older, live within the approved area of a PACE organization, be able to live safely in the community and not be living in a nursing facility when enrolling, and not be enrolled in the MI Choice Waiver or an HMO at the same time.

How is PACE different from Home Help?

With Home Help, a county MDHHS Adult Services Worker assesses daily tasks and sets paid time, and the person chooses a caregiver. With PACE, one PACE organization's team assesses needs, writes the care plan and delivers the services, mostly at an adult day health center, with in-home and referral services added as needed.

How do I apply for PACE?

MDHHS says PACE organizations receive referrals from community providers, and that the PACE organization helps a person apply for Medicaid and does the assessment for long term care. Contact the PACE organization that serves your area and ask how to start.

Can my parent have PACE and Home Help at the same time?

We could not confirm this from the MDHHS PACE page, so we do not say. Ask the PACE organization and your county MDHHS office. MDHHS does say a person cannot be in PACE and the MI Choice Waiver at once.

This is general information, not legal, medical or benefits advice. Whether someone qualifies depends on the State's and the PACE organization's decision for that person. Rules change, so confirm with MDHHS. Already Caring is a private company and is not part of MDHHS, Medicare or the State of Michigan.