Providence PACE Washington
Providence PACE Washington
As a PACE program, eligibility criteria is mandated by the Centers for Medicare and Medicaid Services (CMS). Individuals are eligible if they are:
- Age 55 or older
- Living in or willing to relocate to our service area (see below)
- In need of support services as defined by the state of Washington or Oregon
- Able to live safely in a community setting
- Medicaid eligible or willing to pay private fees, which is equal to the current Medicaid rate
- Willing to receive all needed health care, including primary care and specialist physician services (other than emergency services) from the PACE organization or from a provider authorized by the PACE organization
View the ZIP codes in our service area.
What you pay depends on your financial situation. If you financially qualify for Medicaid services, you may pay a monthly participation fee depending on your income. Those who do not qualify financially for Medicaid pay the PACE private pay premium. There are no co-payments or deductibles. PACE covers all necessary medical and social services, and the premium rate does not change based on your changing needs.
All authorized services are covered in full for Providence PACE participants. PACE participants must receive all needed health care, including primary care and specialist physician services (other than emergency services) from the PACE organization or from an entity authorized by the PACE organization. PACE participants may be fully and personally liable for the costs of unauthorized or out-of-PACE services. Emergency services are covered and may be provided by a non-PACE provider.
PACE participants live in many different settings, including private residences and licensed facilities. Providence PACE contracts with many assisted living communities and adult family homes throughout our service area. Please call and ask to speak to an enrollment specialist for more details.
Webpage is current as of 3/13/2020
We serve individuals who are:
- At least 55 years old
- Living within the Providence PACE service area which includes most of King County; please call for information
- Eligible for Medicaid, Medicare or able to pay privately
- In need of nursing facility level of care as determined by a DSHS social worker – this generally means needing assistance with activities of daily living such as bathing, grooming, dressing, hygiene, ambulation, transfer support and medication management
Contact one of our locations and ask to speak to the Intake Representative who will arrange for you to visit the Providence PACE Center. Round trip transportation will be provided and you will have the opportunity to meet our staff and other participants. The visit to the Providence PACE Center will help you make an informed decision about joining our program. You can fill out our secure online referral form if you would like to request more information.
If you are currently on Medicaid and enrolled in the CFC/COPES program, your participation will likely remain the same. Providence PACE follows the same financial guidelines as the CFC/COPES program. Providence PACE accepts private pay as well. Please call for more details.
Participants with Medicare and/or Medicaid do not lose their coverage, but authorize Providence PACE to administer their benefits. This means that you maintain benefits covered by Medicare and/or Medicaid and become eligible for additional benefits offered by Providence PACE. There are no hidden costs or deductibles. There are no co-pays for prescriptions, incontinence supplies, and some non-prescription medications are covered as well. Individuals who are currently enrolled in a managed care health plan must disenroll and agree to receive services exclusively through Providence PACE in order to get these benefits.
No one lives at Providence PACE. Most participants live in adult family homes, assisted living or in an independent home with a caregiver. The primary goal of the program is to help qualified individuals remain in their own home for as long as possible.
Attending the day health program is optional. Homebound participants or those who cannot attend the health and social center are seen by their primary care team at home. Doctors, nurses, therapists, social workers and others will make house calls per the participant's care plan or as needed.
Within the PACE model, the primary care providers play a key role in the coordination of integrated acute and long term care. People who join Providence PACE are asked to change their primary care provider to one of ours. We have board certified geriatricians at the PACE Center full time Monday through Friday.
If you need to see a specialist, such as a cardiologist or a pulmonologist, our providers will make the arrangements and Providence PACE will provide the transportation. PACE contracts with many specialists at the Minor & James Clinic, the Polyclinic and Swedish Hospital.
Providence PACE will do everything possible to keep you in your own home. However, if you are no longer able to remain safely in your home, Providence PACE will help you find an adult family home or assisted living facility. You would still continue to come to the center on a regular schedule so that you can receive your medical care, therapies and other services.
Providence PACE is a program of choice, and you may disenroll from the program if you wish. The Providence PACE Social Worker will assist you in returning to the services you were receiving before enrolling at Providence PACE
Providence PACE has many home care workers who work exclusively with PACE participants. Providence PACE also contracts with many home care agencies. If your home care situation is stable and you are happy with the services you are already receiving, Providence PACE will try as much as possible to keep that service intact. If you are unhappy with your current home care services, Providence PACE will arrange for a different home care worker.
Probably not. The Providence PACE home care coordinator will meet with you and/or your family to determine what tasks need to be done and when home care services are needed. Your center attendance and the support you may receive from family members will also be considered when calculating the number of chore hours you need. Because Providence PACE will provide and coordinate all of your services, there is more flexibility in providing you with home care services during the times when you need it most.
All medically necessary care and services are covered in full for PACE enrollees. This means doctor visits, lab tests and diagnostics, all necessary prescription and over-the-counter medications, medical supplies and equipment, and more. There are no co-pays or deductibles. PACE covers all the care and services offered by Medicare and Medicaid, plus any additional medically necessary care you and your PACE team may decide you need.
An interdisciplinary team of professionals, with special knowledge in caring for seniors, provides all of the coordinated care you or your loved one needs. They will work together with you and your family (if appropriate) to develop your most effective care plan.
Services include (but are not limited to):
- Primary medical care by physicians and nurse practitioners with expertise in geriatric and/or hospice and palliative care
- Specialty medical care such as cardiology, orthopedics and pulmonology
- Dental, hearing, vision and foot care
- Mental health services
- Care management and Social Work services
- Physical, occupational and speech rehabilitation therapy
- Home health services
- Recreational and therapeutic activities
- Prescription and over the counter medications
- Medical equipment and supplies
- Inpatient hospital care and outpatient surgery
- Laboratory tests and procedures
- Emergency services
- Adult day services, social activities and lunch
- In-home care and services
- Transportation
- And much more
Homebound participants or those who cannot attend the health and social centers are seen by their primary care team at home. Doctors, nurses, therapists, social works and more will make house calls per the participants care plan or as needed.
Webpage is current as of 11/7/2019
The PACE model was founded on helping seniors continue to live in their own homes. By offering varying levels of support, in-home care is available to participants who desire to continue living in their own homes and are able to do so safely with help from PACE.
In-home care plans are customized to each participant’s unique needs, and may include:
- Meal preparation
- Grocery shopping
- Housekeeping
- Medication reminders
- Personal care, such as bathing, dressing and grooming
Our home care coordinator works closely with trained, professional caregivers to provide a seamless experience and ensure quality care. Along with in-home support, PACE participants also have regular access to our health and social centers for medical services, care management, and activities and exercise. Transportation to and from the health and social centers and all medical appointments are provided. The PACE team also helps participants transition to other levels of care, should the need arise.
Webpage is current as of 11/7/2019
Our PACE centers are the heart of the Providence PACE community. This is where our participants come together for the medical, recreational and therapeutic services that make PACE stand apart from other programs for older adults. Located throughout King County, our centers maintain Providence's high standards of care while fostering independence.
At each PACE location, participants enjoy a number of activities throughout the day. Pet, art and music therapies are popular events; as are gathering to discuss current events; explore religious studies; and engage in creative outlets. During their visit, participants also enjoy a nutritious lunch.
What makes all PACE programs unique is that each center has an embedded medical clinic. So, while participants attend the center for activities and lunch, they also have access to their primary care team. Physicians or nurse practitioners; pharmacists; physical, speech and occupational therapists; social workers and more make up the primary care team at each center. Other primary care services available at the health centers include psychiatry, optometry and foot care.
When a participant needs medical care beyond what is available at our on-site clinic, our PACE team coordinates scheduling the appointment, providing transportation and managing all needed follow up.
Webpage is current as of 11/7/2019
Your tax-deductible donation to our Area of Greatest Need Fund will directly support the elderly participants and programs offered at the Providence PACE Center in Seattle.
As a Providence PACE volunteer, you help participants maintain their health and independence in their community. Providence PACE participants live throughout King County.
Contact Us Online
Providence PACE is a PACE program. Those enrolled with PACE receive complete medical care, medications, medical supplies, adult day care, in-home care, care coordination, transportation and more. All the care and services covered by Medicare and Medicaid are included, when authorized by your health care team. Most PACE enrollees are eligible for both Medicare and Medicaid benefits, but this is not a requirement.