PACE

What is PACE?

Program of All-inclusive Care for the Elderly

PACE is a Program of All-Inclusive Care for the Elderly.

This is a long-term care program for older adults who wish to live at home but qualify for nursing home care. They need assistance in order to maintain their health, complete day-to-day activities and remain safe for as long as possible.

As part of the program, all medical care is provided or coordinated by our team.

Primary care services are provided by the physician at our health center. Other medical services may also be provided at the center, at the patient's home or at an off-site location. 

Transportation to and from medical appointments is included.

In addition to medical care, we offer a day center, with recreational and social activities. This allows you to receive personal care and supervision during the day. 

As a LIFE member, you will access many of our services at the LIFE Center in Lackawanna, located on the campus of the OLV Senior Neighborhood at 55 Melroy Ave, Lackawanna, NY 14218

How often you visit the center and for how long depends on your personal circumstances and medical needs. Visits typically range from one to five days per week.

The LIFE Center is open Monday through Friday from 8:30 a.m. to 4:30 p.m.

Services at the LIFE Center include:

  • Physician services
  • Nursing
  • Rehabilitation therapies (physical, occupational and speech therapies)
  • Social work services
  • Spiritual care
  • Nutritional services
  • Personal care such as showering or bathing  
  • Recreational and educational activities
  • Round-trip transportation to and from the center 
  • Language Assistance Notice

Provider Network

Our network includes Western New York specialists who provide care at their office locations. They offer: 

Outpatient Medical Services

  • Medical specialty services, such as cardiology and ophthalmology
  • Dental care
  • Mental health services
  • Eye care, including exams and glasses
  • Foot care
  • Hearing exams and hearing aids
  • Alcohol and substance abuse services
  • Diagnostic tests and lab services

Transportation to and from appointments is provided. Aides may accompany patients to their appointments if necessary.

Hospital Inpatient & Emergency Services

Home Health Care

  • Nursing, rehabilitation therapies, social work and home health aide and personal care services
  • Consumer Directed Services (CDPAS) 
  • Durable medical equipment and all needed supplies

Nursing Home Services

  • Short-term rehabilitation
  • Respite
  • Long-term care, if needed

Prescription Drugs (delivered to participants' homes via courier)

Care Providers

Primary care services are provided by the primary care providers at our health clinic. If care is needed in a hospital or from a specialist, members are required to use a physician or hospital in our provider network.

If you are currently receiving care from someone who is not in our network of providers, we will coordinate any changes so that you continue to receive the care you need with our network providers when you join the program.

Eligibility

You may be eligible to join PACE if you are:

  • Age 55 or older
  • Resident of Erie County.
  • Eligible for Medicare and / or Medicaid, or willing and able to pay the portion of the LIFE premium that is not covered by the participant’s insurance
  • Uniform Assessment System (UAS) completed by New York State to determine eligibility for nursing facility level of care
  • In need of the long term care services of the plan for at least 120 days.
  • Able to live safely in the community with the services of the plan

If the individual has active Medicaid and meets the basic criteria of age and residence within Erie County – they are referred to Maximus - New York Medicaid Choice (NYMC)/CFEEC to determine eligibility for nursing facility level of care and/or Community Based Long Term Care Services. To schedule an assessment Conflict Free Evaluation and Education Center (CFEEC) at 1-855-222-8350

Health Coverage and Costs

We cover all services that are paid for by Medicare and/or Medicaid. You will receive a LIFE insurance membership card, which tells other providers that you have chosen to join the program.

Membership Costs

We pay for all authorized services for patients eligible for both Medicare and/or Medicaid.

If you do not have Medicaid or if you are completely private pay, you will be charged a monthly premium. We will be happy to explain costs, if there are any, when we meet with you.

Catholic Health LIFE participants may be held liable for costs for unauthorized or out-of-network services.

How to Enroll

If you are interested in finding out more information to become a member, we can be reached toll free at 1-855-671-3341 or TTY (716) 819-5227.

After we receive your call:

  1. We will schedule a visit either at your home or at our center for a tour. During this visit, you will meet with a member of the Catholic Health LIFE intake team and will be provided with our enrollment guide book and provider list. The intake staff will provide an overview of services and answer any questions you may have.
  2. If you have active Medicaid and meet the basic criteria of age and residence within Erie County, you will be referred to Maximus - New York Medicaid Choice (NYMC)/CFEEC to determine eligibility for nursing facility level of care and/or Community Based Long Term Care Services. To schedule an assessment with the Conflict Free Evaluation and Education Center (CFEEC), please call 1-855-222-8350
  3. If you are deemed eligible by New York Medicaid Choice and you would like to pursue enrollment with Catholic Health LIFE (PACE), we will schedule an intake assessment in your home.
  4. Next, you will meet with member of the Catholic Health LIFE Interdisciplinary Team and they will develop a plan of care specific to your needs.
  5. If you are eligible and choose to enroll, you will sign an enrollment agreement. Your membership usually becomes effective on the first day of the month after the enrollment is completed.

Membership is voluntary. If you choose to end your membership, the LIFE team will work with you to insure a smooth transition of your health insurance and health related services. For further details regarding your rights after disenrollment, please follow the link below:

Post Disenrollment Fact Sheet (PDF)

Submit a Grievance

If you have a complaint or concern regarding the care you or a patient is receiving please complete and submit a Catholic Health LIFE Program Grievance Form 1603C.

LIFE Grievance and Appeal Fact Sheet (PDF)

LIFE Grievance Form (PDF)

LIFE Appeal Form (PDF)

Appointment of Representative

If you would like someone to represent you in your dealings with Medicare, you must sign and submit a written statement to Social Security. You may use Appointment of Representation CMS Form 1696 for this purpose.

Appointment of Representation CMS Form 1696 (PDF)

Non-Discrimination Statement

To view our non-discrimination statement click here.

Website is pending CMS review
Updated 11/19/2018