Who Is Eligible?

Anyone can call for information or make a referral to LifeCircles. When contact is made:

• A social worker will talk through your unique situation and concerns. We will cover a variety of areas, including discussion of medical and memory issues to help determine if the person is likely eligible for PACE services. We will talk about what is and isn't working well at home, gaps in care, and whether there is an interest in using our many services. We will also ask questions about finances, as this can help us determine if the individual is eligible for long-term care Medicaid, which can fully fund our services.
• During the course of our conversation, we will get a better picture of whether LifeCircles is a good fit and will help with other community options if it is not. If criteria are met and there is interest, we will schedule an Initial Home Visit. If eligibility criteria are not met, you are welcome to call again in the future to speak with us about your changing needs.

The home visit will be scheduled with the potential participant and a caregiver as soon as possible. We will review the PACE program, answer questions and concerns, and if needed, will assist in applying for Medicaid. During the initial visit, we will review the PACE program, answer questions or concerns and, if needed, assist with applying for Medicaid. For information on what documentation is needed for a Medicaid application, please call us with questions, and take a look at this checklist. Our Enrollment Coordinator is happy to help complete and submit the application. We will also complete the following:

• A discussion of family or community support, including recording emergency contact information.
• An in-depth discussion of medical history and current medical status.
• Further screening for the Michigan Nursing Home Level of Care Determination.
• Signing a Medical Release of Information to allow our medical team to review your recent records.
• A safety assessment of your living situation.

These members of the team will want to better understand your needs and goals. They may use some screening tools to learn more about you. They will also be looking at your caregiver's needs and goals as well. They will work to have a good understanding of your home environment and your unique situation.

Soon after the second visit, we will schedule a time for the potential participant and a family member to come to the LifeCircles Day Center to meet with members of our team. Transportation can be provided by LifeCircles. This visit is an opportunity for the potential participant and other members of the team to meet. It is a great time to ask questions of the staff, see the program in action, and voice any concerns. Time with us may include:

• A tour of the facility and time spent in our Day Center.
• An opportunity to meet staff and talk with LifeCircles program participants.
• A meeting with our Medical Team. Current medical concerns will be discussed. The potential participant and family are encouraged to share their goals for medical care, and wishes for Advance Directives.
• Meetings with members of the Interdisciplinary Team, which may include a Nurse, Recreational Therapist, Physical and Occupational Therapist, Pharmacist, Dietician, Day Center Coordinator and Transportation staff.
• Conversations about the potential participant’s wishes and desires for life, including what he or she would like to accomplish and what we can do to support the goals occur.  Active participation is needed to help develop a meaningful partnership.

The Team will meet to review individual findings to determine if the potential participant’s medical needs and safety requirements meet the level of care provided by LifeCircles. The team is required to certify that the potential participant meets the state eligibility requirements for PACE. Once certified, the Enrollment Coordinator will call and extend an invitation to join the program. If the team is unable to certify PACE eligibility, the Enrollment Coordinator will call and send written information regarding how to appeal the decision, and alternative support options.

The Enrollment Coordinator will schedule a time to sign paperwork to complete the enrollment process. We will discuss the date that LifeCircles PACE services will start and the specifics of our partnership with the new participant and their family member.