So there is no PACE program in your community. 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 of heart or for those seeking immediate results. Fortunately, the North Carolina 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.
The next best way to learn about PACE is from others who have gone through the process. 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 annual conferences. You don't have to be a full-fledged program to take advantage of an Exploring Membership for your organization. Contact NC PACE Association
for more information and to discuss your plans.
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?
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.
Who Is the State Contact?
The PACE Program Manager for the state of North Carolina is James Nicholas. He is the state representative you will interact with most frequently, both before and after opening. He receives the initial Letter of Intent indicating which areas you want serve with your new PACE program, and he will conduct pre-opening reviews and make recommendations for approval of your program. After you open, he will work with you closely on program implementation.
James Nicholas, MSW
PACE Unit Manager
Division of Medical Assistance, Long Term Services and Supports
North Carolina Department of Health and Human Services
Mailing Address: 2501 Mail Service Center, Raleigh, NC 27699-2501
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