Raleigh Report: State Policy and PACE

The Association continues to work toward its goals of expansion and regulatory relief. Our excitement over the news that two of our programs had been awarded new service areas at the end of 2018 was dashed when the state revoked those awards in early 2019. Upon review of the application process during an appeal, the state determined that the Request for Applications (RFA) was so flawed the only option was to redo the entire process. A new RFA for existing programs was issued in late May, and we should know by the end of the summer where expansion will be allowed (assuming no additional administrative snafus). This will be the first awarding of new service areas since the original 11 programs were approved. The Association is eager to increase the availability of PACE to additional frail elderly throughout the state. Currently, residents in only 35 of North Carolina’s 100 counties have access to PACE services, and rural areas are particularly underserved.

The Association has also pursed a comprehensive agenda of regulatory reform in the current session of the North Carolina General Assembly. North Carolina is one of the few states to still require a license for PACE to provide home care services as well as certification as an adult day center. As education about the PACE model of care continues with legislators and regulators, progress is being made toward potential relief from the duplicative and ill-fitting regulations. It is a long, slow process, however, which may not play out until the second half of this legislative biennium in 2020. 

Meanwhile, the Association continues to work with the state on the utilization of PACE in assisted living facilities and to rectify ongoing issues related to accurate and timely payment. We are also monitoring the implementation of Medicaid managed care in North Carolina, with an eye toward eventual inclusion of dually-eligible individuals in the next few years.