We have some good news: Legislators want to expand PACE (Programs of All-Inclusive Care for the Elderly) to reach more frail elders in unserved areas.

The North Carolina General Assembly has directed the NC Department of Health and Human Services to submit no less than three options for expansion, including alternatives that involve statewide expansion and expansion by zip code specific service areas to a legislative committee by December 1, 2018.

This requirement, and several others, was included in the 2018-2019 State Budget. (See page 98.)

Why is this a big deal? It’s the first time since 2013 that the possibility of bringing PACE to new areas is real. It opens the door for reaching the 60+ counties that currently are not served by PACE.

And the need for PACE will only grow over time. Thousands of older North Carolinians need long-term care due to chronic illnesses. Twelve percent of North Carolina’s population is 65+ with nearly 150,000 residents 85+. Bringing PACE into additional counties and adding zip codes in most existing service areas will benefit these people.


Most older adults want to live at home for as long as possible. PACE allows citizens who are 55+ and eligible for nursing home care to stay at home – where they receive comprehensive, coordinated care from a team of providers – rather than moving to a nursing home.

Legislators are moving in the right direction by recognizing the needs of senior citizens who tend to be more comfortable at home, closer to families, friends, and loved ones.

Regulatory Relief in Sight?

The new legislation also identified the need to review and potentially ease regulations on PACE programs.

Currently, there is considerable duplication in the state’s regulations impacting PACE, and regulators still struggle with how and where PACE fits in the existing health care framework.

Easing the regulatory burden on PACE programs would yield cost savings, enabling faster and further program growth.


The Association is committed to working with the General Assembly and the Administration for the expansion of PACE in North Carolina. As policymakers look for ways to improve health care and rein in costs, they will undoubtedly recognize PACE as a model of care which benefits all.

Want PACE in your community? Learn how to contact your legislators here.