Program of All-Inclusive Care for the Elderly (PACE) Expansion

Request for Information For
Program of All-Inclusive Care for the Elderly (PACE)
Release Date: July 27, 2026
Responses Due By: 4:30 PM CST/September 4, 2026
NOTE: This Request for Information (RFI) is solely for information and planning purposes and does
not constitute a solicitation. This information will be reviewed and discussed by the state agency and
may result in the advertisement of a formal and competitive Request for Proposal for any or all of
the services included in the RFI.
Only information which is in the nature of legitimate trade secrets or non-published financial data
may be deemed proprietary or confidential. Any material within a response to this RFI identified as
such must be clearly marked and will be handled in accordance with the Louisiana Public Records
Act. R.S. 44:1-44 and applicable rules and regulations.

Table of Contents
Section I. Overview ......................................................................................................................... 3
Section II. Goals and Objectives ....................................................................................................... 3
Section III. Background .................................................................................................................... 4
Section IV. Detailed Requirements .................................................................................................. 6
Section V. Performance Requirements ............................................................................................. 7
Section VI. Submission of Information and Inquiries ........................................................................ 8
The Louisiana Department of Health (LDH) reserves the right to request additional information. In the
event it becomes necessary to revise or withdraw the RFI for any reason, the Department shall provide
addenda and/or supplements to potential respondents on its website at
https://ldh.la.gov/news/category/7.
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Section I. Overview
LDH, Office of Aging and Adult Services (OAAS) is interested in collecting information from potential
vendors to develop a Program of All-Inclusive Care for the Elderly (PACE) in areas not currently served
by a Louisiana PACE program (See Section II below for areas currently served by PACE programs). Each
responder is solely responsible for preparing and submitting their response in accordance with the
instructions in this RFI. This RFI is for planning purposes only and should not be construed as a Request
for Proposals (RFP).
This is a solicitation for information. This information will be reviewed and discussed by the State
agency and may or may not result in an offer. The responder bears all costs associated with responding
to this RFI, or opening and operating a PACE Center. LDH assumes no obligation to reimburse any costs
incurred in preparing a response to this RFI.
The provisions of the Louisiana Public Records Act (La. R.S. 44.1 et. seq.) apply to this RFI. Pursuant to
this Act, all proceedings, records, contracts, and other public documents relating to this RFI shall be open
to public inspection. Respondents are reminded that while trade secrets and other proprietary
information submitted in conjunction with this RFI may not be subject to public disclosure, the
respondent must claim protections at the time of submission of its response. Respondents should refer
to the Louisiana Public Records Act for further clarification.
Section II. Goals and Objectives/Purpose
The purpose of this RFI is to identify and obtain information about the development, design, and
planning for the Program of All-Inclusive Care for the Elderly (PACE) in Louisiana.
PACE is a Medicare and Medicaid program that provides comprehensive medical and social services to
eligible people ages 55+, who require nursing home level care but would like to remain in the
community. PACE operates under a collaborative three-way relationship involving the Centers for
Medicare & Medicaid Services (CMS), individual states, and PACE organizations. PACE organizations
provide all Medicare-covered services and all Medicaid-covered services included in the state's Medicaid
plan, as well as other services and supports deemed necessary by the PACE organization's
interdisciplinary team. For most participants, this comprehensive service package enables them to
remain in the community rather than receive care in a nursing home. Financing for the program is capped
using a capitated model, which allows providers to deliver all services participants need rather than only
those reimbursable under Medicare and Medicaid fee-for-service plans.
LDH is interested in expanding PACE throughout the state. Currently there are PACE organizations
serving the Greater New Orleans area, the Greater Lafayette area, East Baton Rouge Parish, West Baton
Rouge Parish, Avoyelles Parish and Rapides Parish; a PACE organization is pending in the greater
Shreveport area. Each PACE center provides services to specifically identified parishes or zip code areas,
with each PACE provider serving its own exclusive area. A current list of the parishes and zip codes served
by each Louisiana PACE organization is available on LDH's PACE webpage at https://ldh.la.gov/office-of-
aging-and-adult-services/PACE.
In 2024, LDH contracted with Myers and Stauffer to conduct a market analysis identifying areas of
Louisiana that would most benefit from a PACE Center. This RFI, together with the market analysis, will
inform LDH's approach to PACE expansion in Louisiana.
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LDH expects that PACE providers serving Louisiana residents will:
* Adhere to all applicable state and federal regulations;
* Have the ability and willingness to accept and serve nursing home residents who are eligible for
PACE and wish to move into the community;
* Identify a rural area (as defined by the Rural Health Transformation Hub,
https://www.ruralhealthinfo.org/am-i-rural#/) as part of the service area;
* Work to establish affordable housing opportunities, whenever feasible; and
* Provide all reports and requested documents to LDH staff within the timeframe established by
LDH.
Section III. Background
About PACE
PACE is an innovative model of community-based care that enables individuals who are 55 and older and
certified as meeting nursing facility level of care to live a healthy life in the community for as long as
possible. PACE is a service delivery model that began in San Francisco, California in 1973. Congress first
authorized a national PACE demonstration in 1986. In 1997, Congress authorized Medicare to pay for
PACE services and added PACE as an optional Medicaid state plan benefit, giving joint administration
and oversight of the program to CMS and states. The first Louisiana PACE Center opened in New Orleans
and began providing services in 2007.
The Federal PACE regulation establishes basic PACE eligibility requirements. Individuals must meet the
following criteria:
* Be at least 55 years old;
* Reside in the service area of the PACE organization;
* Meet the state criteria for nursing facility level of care; and
* Be able to live safely in the community at the time of enrollment.
Participation in PACE is voluntary and enrollees may disenroll at any time. However, enrollment and
disenrollment always occur on the first day of a month.
National surveys show that older adults prefer to remain in their own homes and communities as they
age, and PACE accomplishes this at approximately half the cost of out-of-home placement. Just as
importantly, PACE provides and coordinates all services covered under both Medicaid and Medicare,
thus reducing the fragmentation of healthcare delivery for this highly vulnerable population. PACE has
flexibility to provide non-traditional healthcare related services that address the social determinants of
health, such as access to social activities, healthy foods, or even pest control services if a participant
needs them to be safe and healthy in their home. PACE accepts full financial risk for all services
determined necessary to address the social, emotional, medical and physical needs of their participants.
PACE programs offer pre-paid, capitated, coordinated, and comprehensive health care services in a
specific geographic area designed to meet the following objectives:
* To enhance the quality of life and autonomy for frail, older adults;
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* To maximize the dignity and respect for older adults;
* To enable frail, older adults to live in the community as long as medically and socially feasible;
and
* To preserve and support the older adult's family unit.
The PACE provider's interdisciplinary team; consisting of the participant, participant family, and
professional and paraprofessional staff; assesses participant needs, develops a plan of care, and
monitors delivery of all services, including home care, acute care and nursing facility services within an
integrated system for a seamless provision of wrap-around healthcare. Typically, PACE organizations
provide social and medical services in an adult day health center supplemented by clinical, in-home and
other services, as needed.
The financing model combines payments from Medicare and Medicaid, allowing PACE to provide all
needed services rather than be limited to those reimbursable by Medicare or the Medicaid fee-for-
service systems. PACE organizations assume full financial risk for beneficiary care without limits on
amount, duration or scope of services. PACE providers can also accept private pay for those not eligible
for Medicaid and/or Medicare. PACE is obligated to provide the same level of support, which includes
all Medicare and Medicaid services available in Louisiana, to each participant regardless of the
participant's funding source.
Typical PACE services include, but are not limited to, the following:
* Adult day health care that offers nursing; physical, occupational and recreational therapies;
meals; nutritional counseling; social work and personal care;
* Primary medical care provided by either a PACE physician, a community-based physician, a
physician assistant or a nurse practitioner familiar with the history, needs and preferences of
each beneficiary, all specialty medical care, and all mental health care;
* Interdisciplinary team members' assessments and treatment plans;
* Home health care, personal care, homemaker and chore services;
* Restorative therapies, including physical therapy and occupational therapy;
* Diagnostic services, including laboratory, x-rays, and other necessary tests and procedures;
* Transportation to and from the PACE Center and other medical appointments;
* All necessary prescription drugs and any authorized over-the-counter medications included in
the plan of care;
* Social services;
* All ancillary/specialty health services, such as audiology, dentistry, optometry, podiatry, speech
therapy, prosthetics, durable medical equipment, and medical supplies;
* Respite care;
* Emergency room services;
* Acute inpatient hospital stays; and
* Nursing facility care, which can be short-term stays or for convalescent care, as needed.
In addition to being the provider of all service and support needs, PACE is also the health insurer and is
obligated to follow the federal regulations that apply to PACE acting as such. PACE is at full financial risk
for enrolled participants, which includes having the capability to cover catastrophic health events
encountered by the PACE participants.
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LDH Vision for PACE
LDH's OAAS operates several Medicaid home and community-based programs to serve older adults and
others who acquire a disability in adulthood, including the Community Choices Waiver, the Adult Day
Health Care Waiver, Long-Term Personal Care Services, and PACE. These programs provide home and
community-based services (HCBS) that help individuals remain in their homes and communities by filling
gaps in the services and supports otherwise available to them.
Louisiana is working to rebalance its long-term services and supports system to provide greater access
to non-institutional, home and community-based services. According to AARP's 2024 Home and
Community Preferences Survey, 75% of adults age 50 and older want to remain in their current homes,
and 73% want to remain in their communities, as they age. Expanding PACE services throughout
Louisiana is an OAAS priority because PACE gives more people meaningful access to this kind of person-
centered, wrap-around home and community-based services, and because PACE is well-positioned to
support OAAS's broader efforts to help nursing facility residents transition back into the community.
PACE fits within this broader effort. Since 2009, OAAS has actively transitioned over 3,600 individuals
from nursing facilities to community settings through the CMS Money Follows the Person (MFP)
Demonstration Grant, with a re-institutionalization rate of less than 6% within the first year of transition.
In 2018, LDH also entered into an agreement with the U.S. Department of Justice (DOJ) that requires
LDH to transition nursing facility residents with Serious Mental Illness (SMI) back into the community.
PACE offers another pathway for these transitions: it is an important option for people who would prefer
to live in the community rather than a nursing home, and OAAS's nursing facility transition programs will
work closely with PACE providers throughout the transition process.
Section IV. Detailed Requirements
Responders are asked to clearly and concisely describe how the responding organization envisions
development of a PACE program in an identified area(s) of Louisiana. At a minimum, the response must
include the following information about the responder's own proposed PACE Center(s):
1. Location, number, and timing of the proposed PACE Center(s). Identify the specific location(s) where
the responder proposes to open a PACE Center and the area(s) that center will serve, and explain why
each area was chosen. State how many PACE Centers the responder proposes to open and the proposed
timeframe for opening each Center.
2. How the proposed PACE Center(s) would serve rural areas. Describe how the responder's proposed
PACE Center(s) would serve rural areas within its identified service area(s), including outreach and
service delivery strategies for rural residents. (LDH note: PACE is included among the services eligible for
incentive funding through Louisiana's Rural Health Transformation grant, which respondents may wish
to consider in developing their rural service strategy.)
3. How the proposed PACE Center(s) would assist nursing facility residents transitioning to the
community. Describe the responder's capacity to enroll and effectively serve individuals transitioning
from nursing facilities back to life in the community, including individuals with serious mental illness
(SMI) who meet all PACE eligibility requirements, and describe how the responder would integrate
mental health services into participants' care plans. The PACE model's active, wrap-around care
coordination aligns well with the needs of this population. OAAS transitions as many as 300-400
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individuals from nursing facilities each year and expects PACE organizations to have the resources and
systems needed to serve this population, working closely with LDH Transition Coordinators and others
who assist with nursing facility transitions.
4. How the proposed PACE Center(s) would assist with affordable housing. Many people transitioning
from nursing facilities into the community are in need of housing. Describe how the responder would
develop or work with housing developers or existing housing opportunities to help address the
affordable housing needs of individuals transitioning from nursing facilities into the community.
In addition to the above required information, OAAS is inviting RFI responders to provide the following
information, as applicable:
* Organization's mission and history of serving the aging adults with disabilities and/or chronic
conditions.
* Organization's history of serving individuals that have a serious mental illness.
* Key partners needed by a PACE provider, and an indication of how those partners and others
providers needed for the PACE provider network could be developed.
* Financial package including financial statements for the previous 3 years and financial
projections for the next 5 years.
* A marketing/outreach plan to provide relevant information to the population eligible for PACE.
* A financial plan showing infrastructure costs and other start-up costs needed.
* Specific buildings/areas where the Center could be located to best serve the population and an
indication of why that area was chosen.
* A discussion of needed resources to assist people in nursing homes that want to transition into
a life in the community.
* Any experience your organization has operating a PACE facility, including information about the
current PACE centers under the organizations umbrella.
* Identify the challenges envisioned in opening a PACE Center specific to the identified location.
* Experience in the area of affordable housing and how that experience will help to support a
successful PACE organization and its participants.
Section V. Performance Requirements
The PACE Organization that works with Louisiana and CMS to open a PACE Center in Louisiana is
expected to comply with federal and state regulations below:
* Code of Federal Regulations at 42 CFR Part 460 (eCFR :: 42 CFR Part 460 -- Programs of All-
Inclusive Care for the Elderly (PACE)
* Louisiana Regulations at LAC Title 50 XXIII (LAC Title 50 TOC)
* Applicable Louisiana licensing regulations found in LAC Title 48 (LAC Title 48 Book 1 and LAC
Title 48 Book 2).
Other resources with more information regarding PACE and PACE services:
* CMS website at https://www.medicaid.gov/medicaid/long-term-services-
supports/pace/programs-of-all-inclusive-care-for-elderly-for-states
* National PACE Association at http://www.npaonline.org
* Myers and Stauffer at https://myersandstauffer.com/what-we-do/
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Section VI. Submission of Information and Inquiries
All questions regarding this RFI should be directed to:
Jeanne Abadie
PACE Program Manager
Louisiana Department of Health
Office of Aging and Adult Services
OAASContracts@la.gov
Respondents should submit an electronic copy of the response and/or questions to
OAASContracts@la.gov to the attention of Jeanne Abadie, PACE Program Manager and reference PACE
RFI in the subject line.
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