PACE Program Texas: Eligibility, Locations, and What It Covers for Dementia Care

The Program of All-Inclusive Care for the Elderly (PACE) is one of the most comprehensive long-term care models available in the United States — a single provider handles medical care, personal care, social activities, transportation, and prescription drugs under one roof. For families managing a parent with dementia, PACE can eliminate the patchwork of separate providers, separate billing, and separate coordination that makes caregiving so exhausting.

The problem in Texas is geography. PACE is extremely limited in where it operates.

Where PACE Is Available in Texas

As of 2026, Texas has only three certified PACE sites:

• Bienvivir Senior Health Services — El Paso
• The Basics at Jan Werner — Amarillo
• Silver Star Health Network — Lubbock

Each site serves a defined geographic service area. If your parent does not live within that area, they cannot enroll. There is no statewide waitlist or referral system — if the nearest PACE site is 300 miles away, it is not an option.

This means the vast majority of Texas families — including those in Dallas-Fort Worth, Houston, San Antonio, and Austin — do not have access to PACE. For those in El Paso, Amarillo, or Lubbock, it is worth serious consideration.

Who Qualifies for PACE

Eligibility requirements are the same across all three Texas sites:

• Age 55 or older
• Meet the nursing facility level of care — the same clinical threshold used for Medicaid long-term care, determined by a Medical Necessity and Level of Care (MN/LOC) assessment
• Live in the PACE site's designated service area
• Be able to live safely in the community at the time of enrollment (with PACE supports)

Both Medicaid-eligible and Medicare-eligible individuals can enroll. People who qualify for both (dual-eligible) pay nothing out of pocket for covered services. Those with Medicare only may pay a monthly premium to cover the long-term care portion that Medicaid would otherwise fund. Private-pay enrollment is also possible at some sites, though the monthly cost can exceed $4,000.

What PACE Covers

PACE operates on a capitated model — the provider receives a fixed monthly payment per enrollee and delivers all necessary services. There are no deductibles, copayments, or prior authorizations for covered services.

The standard PACE package includes:

• Primary and specialty medical care — physician visits, lab work, diagnostic imaging
• Prescription drugs — managed by the PACE pharmacy team
• Adult day health services — structured daily programming at the PACE center, typically 2-5 days per week
• Personal care and home health aides — bathing, dressing, meal preparation at home
• Physical, occupational, and speech therapy
• Social work and counseling
• Nutritional counseling and meals — both at the center and delivered to the home
• Transportation — door-to-door rides to the PACE center and all medical appointments
• Hospital and nursing facility care when medically necessary
• Respite care for family caregivers

For dementia care specifically, the adult day health component is particularly valuable. It provides structured social and cognitive stimulation during the day while the family caregiver works, and the PACE team monitors medication compliance, nutrition, and behavioral changes in a clinical setting.

PACE vs. STAR+PLUS HCBS Waiver

For most Texas families, the realistic alternative to PACE is the STAR+PLUS Home and Community-Based Services (HCBS) Waiver. Here is how they compare:

The key advantage of PACE is integration — one team knows your parent, manages all their care, and there is no coordination burden on the family. The key disadvantage is that it only exists in three Texas cities.

What to Do If PACE Is Not Available in Your Area

If your parent lives outside the PACE service areas, the main alternatives for community-based dementia care in Texas are:

1. STAR+PLUS HCBS Waiver — register on the Interest List immediately (call 1-877-782-6440 or Texas 2-1-1)
2. Community First Choice (CFC) — an entitlement program with no waitlist that covers personal assistance for Medicaid-eligible individuals at nursing-facility level of care
3. CCAD/CCSE programs — state-funded, non-Medicaid home care and adult day services for those who do not qualify for Medicaid but meet income limits
4. Day Activity and Health Services (DAHS) — adult day programs that provide structured daytime care, typically $1,500–$2,500/month private pay

Each of these has different eligibility rules, income limits, and application processes. The Texas Dementia and Memory Care Guide covers all of them — including Miller Trust setup for families above the $2,982 income cap, MERP estate recovery protection, and facility vetting checklists — in one structured reference.

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