Most health centers will be serving elders with disabilities in their normal adult clinics. Some may wish to
set aside special clinic times for the elderly including those with disabilities and special needs. Set-aside
times can allow for somewhat longer patient visits which are helpful in treating elders with long histories
and multiple chronic problems. Some health centers may also choose to set up additional services as part of
their approach to primary care for the elderly. These may include adult day health care, home health care,
assisted living, and nursing homes.
Several community health centers operate a PACE program, a home and community based service that
allows severely disabled elders who are eligible for nursing home placement to remain in the community.
PACE is usually based in adult day health centers and operates as a small Medicare Advantage capitated
managed care plan at risk for providing all Medicare and Medicaid covered services including long
term care and acute hospital care. Primary care services are also provided by the PACE program in a
clinic setting utilizing employed or contracted medical providers.
ADHC is a community-based health and long term care service aimed at elders or adults who are disabled
enough to be in a nursing home or at risk of nursing home placement. When coordinated with other health
center services, particularly primary care clinic services, ADHC can be critical in allowing elders to avoid
nursing home placement and helping informal caregivers to continue providing care over an extended period.
Participants live at home and are brought into the center from 3 to 5 days a week.