Programs of All-Inclusive Care for the Elderly

Growing PACE

So there is no PACE program in your community. What are your options? How do you get started?
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-hearted or for those seeking immediate results.  Fortunately, the NC PACE Association and the National PACE Association have many resources to assist in the development of new PACE programs.  A visit to the NPA website is the critical first step. 

The next best way to learn about PACE is from others who have gone through the process, and the best way to interact with them is to participate in the state and national associations. Much information is available to everyone on-line, while membership provides more opportunities for education and in-depth assistance, including NPA’s annual national conference. 

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?
The North Carolina PACE Association has demonstrated that 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 NC

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. (It is possible that the state requirements for granting service areas may become much more rigorous in the future.) 

Who Is the State Contact?

The PACE Program Manager for the state of North Carolina is WRenia Bratts-Brown. She is the state representative you will interact with most frequently, both before and after opening. She receives the initial Letter of Intent indicating which areas you want serve with your new PACE program, and she will conduct pre-opening reviews and make recommendations for approval of your program. After you open, she will work with you closely on program implementation.

WRenia Bratts-Brown, MSW, MHA
N.C. Department of Health and Human Services
Program Manager, CAP/DA & PACE, Division of Medical Assistance
(Physical Address) 1985 Umstead Drive Raleigh, NC 27603
(Mailing Address) 2501 Mail Service Center Raleigh, NC 27699-2501
(Office) 919.855.4371
(Fax) 919.733.2632
Wrenia.bratts-brown@dhhs.nc.gov

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

Two consultants who work for PACE Technical Assistance Centers and have been used by at least two PACE sites in North Carolina are John Tucker and Dorothy Ginsberg. 

Here’s contact info for John and Dorothy:

John Tucker, MHA
Director
Palmetto Health Senior Consulting
15 Richland Medical Park
Suite 203
Columbia, SC 29203
(803) 434-4427

Dorothy Ginsberg, Senior PACE Consultant
AEC Consulting (An Altitude Edge Company)
6640 Gunpark Drive #200 Boulder, CO 80301
Direct: 720.204.3274  |
Mobile: 267.229.2429  | 
dginsberg@altitudeedge.com
www.aecconsultingsolutions.com