Providence ElderPlace: Washington
Providence ElderPlace is a PACE program. Those enrolled with ElderPlace 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 ElderPlace enrollees are eligible for both Medicare and Medicaid benefits, but this is not a requirement.
As a PACE program, ElderPlace 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 ElderPlace private pay premium. There are no co-payments or deductibles. ElderPlace 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 ElderPlace 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.
ElderPlace participants live in many different settings, including private residences and licensed facilities. Providence ElderPlace 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
Who is eligible and how can I join ElderPlace?
We serve individuals who are:
- At least 55 years old.
- Living within the Providence ElderPlace 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 ElderPlace 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 ElderPlace 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.
How much does it cost to join?
If you are currently on Medicaid and enrolled in the CFC/COPES program, your participation will likely remain the same. Providence ElderPlace follows the same financial guidelines as the CFC/COPES program. Providence ElderPlace accepts private pay as well. Please call for more details.
What happens to my Medicare/Medicaid coverage when I join?
Participants with Medicare and/or Medicaid do not lose their coverage, but authorize Providence ElderPlace 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 ElderPlace. 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 ElderPlace in order to get these benefits.
Does anyone live at Providence ElderPlace?
No one lives at Providence ElderPlace. 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.
Can I join without going to the day health program?
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.
Why do I have to change my primary care provider?
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 ElderPlace are asked to change their primary care provider to one of ours. We have board certified geriatricians at the ElderPlace Center full time Monday through Friday.
What happens if I need to see a specialist?
If you need to see a specialist, such as a cardiologist or a pulmonologist, our providers will make the arrangements and Providence ElderPlace will provide the transportation. ElderPlace contracts with many specialists at the Minor & James Clinic, the Polyclinic and Swedish Hospital.
What happens if I am no longer able to stay in my home?
Providence ElderPlace 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 ElderPlace 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.
What happens if I join Providence ElderPlace and I don't like it?
Providence ElderPlace is a program of choice, and you may disenroll from the program if you wish. The Providence ElderPlace Social Worker will assist you in returning to the services you were receiving before enrolling at Providence ElderPlace
If I join Providence ElderPlace, can I keep my home care worker?
Providence ElderPlace has many home care workers who work exclusively with ElderPlace participants. Providence ElderPlace 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 ElderPlace will try as much as possible to keep that service intact. If you are unhappy with your current home care services, Providence ElderPlace will arrange for a different home care worker.
If I join Providence ElderPlace, will the number of home care hours I have been approved for remain the same?
Probably not. The Providence ElderPlace 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 ElderPlace 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 ElderPlace 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) the following:
- 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
- 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 ElderPlace.
In-home care plans are customized to each participant’s unique needs, and may include:
- Meal preparation
- Grocery shopping
- 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, ElderPlace 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 ElderPlace 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 ElderPlace community. This is where our participants come together for the medical, recreational and therapeutic services that make ElderPlace 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 ElderPlace 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 ElderPlace 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 ElderPlace Center in Seattle.
As a Providence ElderPlace volunteer, you help participants maintain their health and independence in their community. Providence ElderPlace participants live throughout King County.