TRU PACE (Program of All-inclusive Care for the Elderly)

EligibilityTRU PACE serves seniors from all walks of life. Our program can enroll individuals who meet the following eligibility requirements:At least 55 years oldLiving in our PACE service areaCertified by the state of Colorado as needing nursing facility care, andAble to live safely in the community with PACE services at the time of enrollment.TRU PACE participants must receive all needed healthcare, including primary care and special physician services (other than emergency services) from TRU PACE contracted providers. TRU PACE participants may be fully and personally liable for costs of any unauthorized out-of-network services.6-Step Enrollment ProcessStep 1: Contact TRU PACEWhen you call our center (translation services available), we will explain our program services, program eligibility requirements and any costs of TRU PACE. We can help you see if TRU PACE would be a good fit for you or a loved one. We will schedule an in-home visit with our enrollment specialist.If you do not currently receive Medicaid benefits, you may be eligible and we can help you apply.Step 2: Home VisitOur Enrollment Specialist will meet with you and a loved one in your home to discuss your needs and TRU PACE. We will discuss PACE financial coverage and begin paper work for our program. We will need documents signed such as a release of your medical records from your current care provider. Our Enrollment Specialist will schedule a second visit called an in-home assessment with a few members of our healthcare team. Paperwork will also be submitted to the county and they will contact you about a functional assessment. (They assess whether you meet the Skilled Nursing Level of Care.)Step 3: In-Home AssessmentOur healthcare team members will come and visit you in your home. They will ask you more questions about your healthcare needs, medical history, and your living situation. This will help us determine what type of care plan you will need. They will also ask you questions about your medications and how you are feeling physically. During this visit, they will schedule your TRU PACE Center visit.Step 4: TRU PACE Center VisitWe would like you to come and visit our PACE Center. You will have lunch, get a tour, and visit with additional members of our healthcare team. Each team member will conduct an assessment and will put together a personalized plan of care for you.Step 5: Meet at Your HomeOnce all of the assessments, paperwork and financial applications have been completed, the Enrollment Specialist will meet with you in your home. They will present to you and your loved ones your personalized plan of care as a PACE participant. If you agree, you will sign your Enrollment Agreement.Step 6: Welcome to TRU PACEYou are now a TRU PACE participant and you will start on the first day of the following month. WELCOME!TRU PACE participants may disenroll at the end of any month.How do I pay for TRU PACE services?TRU PACE is designed to combine a seniors Medicare and Medicaid funds. When pooled together, they can provide creative, integrative, and holistic services to the participants. All eligible seniors (55+) are welcome to participate even if they do not receive Medicare or Medicaid. If a senior does not have Medicaid, we will help you see if you are eligible for it. Some seniors who are not eligible for Medicaid may pay for that portion out of pocket as well as a Medicare Part D premium.Eligible for Medicaid = Medicaid pays for this program (participant pays nothing). *Eligible for Medicare only = Participant pays the Medicaid portion plus Medicare Part D. Eligible for Medicare and Medicaid = Participant pays nothing.*Not eligible for Medicaid or Medicare = Participant pays the self-pay rate.*The only exception is if the individual lives in or moves to supportive housing (assisted living or nursing home), in which case there is a co-pay to that facility.*If you are permanently placed in a Long Term Care facility, you may be responsible for a portion of your care (instead of skilled nursing).

TRU PACE is for nursing home eligible seniors who meet the guidelines for enrollment. Its designed for seniors with limited access to other important services that traditional healthcare does not provide.Our TRU PACE PhilosophyTRU PACE provides a person-centered approach to care. Our philosophy is based on balancing the medical, emotional, physical and social needs of seniors in our program.This holistic (or All-inclusive) plan of care will not only identify what we believe the participant needs but also what they may want.The Interdisciplinary Team (IDT) customizes each participants plan of care to reflect his or her personal needs. The IDT is made up of a physician, social worker, physical and occupational therapists, a dietician, home care nurse, clinic nurse, transportation coordinator, personal care attendant, center director, and a recreational therapist. Well include the participant and family members in the development and approval of the plan of care.TRU PACE participants must receive all needed healthcare, including primary care and special physician services (other than emergency services) from TRU PACE contracted providers. TRU PACE participants may be fully and personally liable for costs of any unauthorized out-of-network services.History of PACEPACE began in the early 1970s by On Lok Senior Health Services in San Francisco, CA in order to enable the Chinese community to care for its elders without placing them in nursing facilities. With the success of On Lok and subsequent replication projects, Congress authorized PACE as a permanent Medicare provider and Medicaid state option in the Balanced Budget Act of 1997.Learn more about PACE from Medicaid and Medicare.TRU PACE Service Area

Program of All-inclusive Care for the Elderly(PACE) are programs that provide comprehensive health services for individuals age 55 and over who are sufficiently frail to be categorized as "nursing home eligible" by their state's Medicaid program. Eligibility for PACE requires that individuals be 55 years old or older, certified by the state to need nursing home-level care, reside near a PACE program, and be able to live safely in the community. Services include primary and specialty medical care, nursing, social services, therapies (occupational, physical, speech, recreation, etc.), pharmaceuticals, day health center services, home care, health-related transportation, minor modification to the home to accommodate disabilities, and anything else the program determines is medically necessary to maximize a member's health.How PACE works:PACE programs become the insurance and the health care provider and are directly responsible for providing all health services and manage all aspects of their participants healthcare. PACE is paid through Medicaid and Medicare combined (dual eligible) or private pay on a monthly basis.Most PACE patients have multiple diagnoses, with an average of over 7 diagnoses per member. Among the most common are cardiac problems,diabetes,hypertension, andvascular disease. PACE programs tend to provide high levels of preventive services, such as very frequent check-ups, exercise programs, dietary monitoring, programs to increase strength and balance, etc.PACE programs organize their services in a "PACE Center". These Centers have a Day Center, medical clinic, social services and rehabilitation services, along with administrative staff, all in one site. Members attend centers from rarely to 5 days a week, depending on their care plans. Care planning is done with the member, his or her care team, and appropriate family members; most members attend about 2 days per week.Editor's note: This article was submitted by Leslie Mader, M.A. Leslie is the Business Development Specialist for TRU PACE based in Lafayette, CO. She may be reached at 303-665-0115 or lesliemader@trucare.org.

TRU PACE (Program of All-Inclusive Care for the Elderly) coordinates and provides all needed preventive, primary, acute, and long-term care services so that older individuals can continue living safely in their community. TRU PACE is an innovative model that enables individuals who are 55 years old or older and certified by the state to need nursing-home-level care to live as independently as possible. TRU PACE will help participants and their family members navigate the complicated issues associated with aging.To participate with TRU PACE, an individual must live in Boulder County or Southwestern Weld County (see our map of TRU PACE service areas) and live safely in the community. At the heart of TRU PACE is our Interdisciplinary Team (IDT) who will manage each participants plan of care. Our PACE site is where our IDT is located as well as our medical clinic, rehabilitation services, home health coordination, social work, recreational therapies, social activities, and much more.Eligibility Requirements:TRU PACE serves seniors from all walks of life. Our program can enroll individuals who meet the following eligibility requirements:At least 55 years old:Living in our PACE service areaCertified by the State of Colorado as needing nursing-home-level care, andAble to live safely in the community with PACE services at the time of enrollment.Learn more about the PACE program by visiting the National PACE Organization:TRU PACE participants must receive all needed healthcare, including primary care and special physician services (other than emergency services) from TRU PACE contracted providers. TRU PACE participants may be fully and personally liable for costs of any unauthorized out-of-network services. TRU PACE participants may disenroll at the end of any month.