Rural PACE (Program of All-Inclusive Care for the Elderly) Provider Grant Program

To provide services in a geographic service area that is, in whole or in part, a rural area that has received a site development grant under this Section.

Agency - Department of Health and Human Services

The Department of Health and Human Services is the Federal government's principal agency for protecting the health of all Americans and providing essential human services, especially to those who are least able to help themselves.

Website Address

Program Accomplishments

The Centers for Medicare and Medicaid Services (CMS) grant program, Programs of All-Inclusive Care for the Elderly (PACE) in rural service areas, was initiated through the Deficit Reduction Act of 2005 (DRA) and follows the New Freedeom Initiative to develop and provide additional care options in the community while providing more efficient and coordinated care through Medicare and Medicaid. The new Rural PACE Provider Grant Program will provide funds to support the coordination of comprehensive care for some of the most vulnerable Medicare and Medicaid beneficiaries living in rural areas within thirteen states across the country. Each site received $500,000 to establish a PACE program in their area. CMS awarded the maximum number of grants authorized by the DRA to expand patient-based care to a greater number of people with Medicare and Medicaid who live in rural areas.

Uses and Use Restrictions

All funds granted should be expended solely for carrying out the approved projects in accordance with Section 5302 of the Public Law 109-171.

In the Deficit Reduction Act, a rural PACE provider site is defined as a PACE provider that has been approved to provide services in a geographic service area that is, in whole or in part, a rural area that has received a site development grant under this section.

Thus, the statute definition of a rural area as defined in section 1886(d)(2)(D) of the Social Security Act states that a rural area would be a county that is not part of a Metropolitan Statistical Area (MSA)(as defined by the Office of Management and Budget) as established for Medicare Inpatient PPS payments.

Eligibility Requirements

Applicant Eligibility

This grant opportunity is open to (1) any PACE provider that demonstrates meeting the required definition as set out in the Social Security Act and; (2) is eligible to serve in a rural area as a rural PACE pilot site as defined in the Social Security Act.

To meet the qualification of a PACE provider, an applicant must meet the definitions established in sections 1894(a)(3) or 1934(a)(3) of the Social Security Act.

The Act defines a PACE provider as being a public or private, nonprofit entity organized for charitable purposes under 501(3)(c) of the Internal revenue code of 1986; and has entered into a PACE program agreement with respect to its operation of a PACE program as defined in 1894(a)(2) and 1924(a)(2) of the Social Security Act.

In addition to meeting the definitions of a PACE provider, the law also requires that each potential applicant meet the full statutory definition of a rural area.

Beneficiary Eligibility

The medical, social and long-term care needs are met under this initiative and will benefit the elderly Medicaid beneficiaries who reside in rural areas.


Each provider organization may only submit one application per county of interest by the due date. All additional applications submitted for this solicitation that are in excess of this requirement or that are received after the submission date will not be reviewed by CMS.

Aplication and Award Process

Preapplication Coordination


This program is excluded from coverage under E.O.


Application Procedures

CMS will publish grant solicitation on in early June of each fiscal year. Information about the Rural PACE grant may be accessed at A complete electronic application package, including all required forms for this grant is available at Standard application forms and related instructions are also available from Nicole Nicholson, Centers for Medicare and Medicaid Services, Office of Operations Management, Acquisition and Grants Group, C2-21-15, Central Building, 7500 Security Boulevard, Baltimore, MD 21244-1850. Telephone: (410) 786-5158 or by E-mail:

Award Procedures



The due date for applications under this grant announcement is tentatively scheduled for June 21 of each fiscal year. Applications will be considered as meeting the deadline if they are received in CMS on or before the due date.


Section 5302 of Public Law 109-171, the Deficit Reduction Act of 2005.

Range of Approval/Disapproval Time






Assistance Considerations

Formula and Matching Requirements


Length and Time Phasing of Assistance


Post Assistance Requirements




In accordance with the provisions of OMB Circular No. A-133 (Revised, June 24, 1997).



Financial Information

Account Identification



FY 07 $0; FY 08 $5,000,000; and FY 09 est $2,500,000.

Range and Average of Financial Assistance

Floor: $0; Ceiling $750,000 for pilot sites and $500,000 for outlier cost for FY 2006.

Regulations, Guidelines, and Literature

Section 5302, Public Law 109-171, the Deficit Reduction Act of 2005.

Information Contacts

Regional or Local Office


Headquarters Office

Nicole Nicholson, Office of Operations Management, Acquisitions and Grants Group, Centers for Medicare and Medicaid Services, 7500 Security Boulevard, Mail Stop C2-21-15, Baltimore, MD 21244-1850. Telephone: (410) 786-5158.

Criteria for Selecting Proposals


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