(1) The program of all-inclusive care for the elderly (PACE) provides long-term services and supports (LTSS), medical, mental health, and chemical dependency treatment through a department-contracted managed care plan using a personalized plan of care for each enrollee.
(3) A person is financially eligible for PACE if the person:
(a) Is age:
(i) Fifty-five or older and disabled under WAC 182-512-0050
(ii) Sixty-five or older;
(b) Meets nursing facility level of care under WAC 388-106-0355
(c) Lives in a designated PACE service area;
(d) Meets financial eligibility requirements under this section; and
(e) Agrees to receive services exclusively through the PACE provider and the PACE provider's network of contracted providers.
(4) Although PACE is not a home and community based (HCB) waiver program, financial eligibility is determined using the HCB waiver rules under WAC 182-515-1505
when a person is living at home or in an alternate living facility (ALF), with the following exceptions:
(a) PACE enrollees are not subject to the transfer of asset rules under WAC 182-513-1363
(b) PACE enrollees may reside in a medical institution thirty days or longer and still remain eligible for PACE services. The eligibility rules for institutional coverage are under WAC 182-513-1315
(5) A person may have to pay third-party resources as defined under WAC 182-513-1100
in addition to the room and board and participation.
[Statutory Authority: RCW 41.05.021
, P.L. 111-148, 42 C.F.R. §§ 431, 435, and 457, and 45 C.F.R. § 155. WSR 17-03-116, § 182-513-1230, filed 1/17/17, effective 2/17/17.]