PACE bundles all of a frail senior's medical and daily care into one program so they can stay home. Here's how it works in San Diego and who qualifies.
By Diane Whitfield, CSA · July 08, 2026
PACE stands for the Program of All-Inclusive Care for the Elderly. It is a national model, run in California through the Department of Health Care Services, that wraps every piece of a frail senior's care into one organization: doctors, specialists, prescriptions, physical and occupational therapy, a day center, transportation to and from it, meals, and even in-home help. Instead of a family stitching together a primary-care doctor, a Medicare drug plan, an IHSS caregiver, and a ride service, PACE becomes the single team responsible for all of it.
The trade a family makes is that PACE becomes the senior's whole care network. Members generally must use the PACE program's doctors and its contracted specialists rather than keeping outside physicians. In exchange, an interdisciplinary team meets regularly to manage that one person's care, which is exactly the kind of coordination that tends to fall apart when a frail senior is juggling several unconnected providers.
In San Diego County, PACE is delivered by St. Paul's PACE, a nonprofit that has operated day centers in the region for years, including locations in the central San Diego area, El Cajon, and Chula Vista. A member typically attends a day center on a schedule set by their care team, receives medical visits and therapy on site, eats a meal there, and rides PACE transportation door to door. On other days, care and support can come to the home.
Because St. Paul's PACE controls the whole picture, it can respond quickly when something changes, adding home visits after a fall, adjusting medications, or arranging equipment, without a family having to chase separate approvals. For a senior who qualifies for a nursing-home level of care but wants to stay in the community, this coordinated model is often what makes staying home realistic rather than aspirational.
Four things generally have to be true to enroll in PACE. The person must be 55 or older, live in the PACE program's service area, be certified by the state as needing a nursing-facility level of care, and be able to live safely in the community with PACE's help at the time they join. That last point matters: PACE is built to keep someone out of a nursing home, so the assessment is looking at whether its services can bridge the gap safely.
Cost depends on a senior's coverage. Someone who has both Medicare and full-scope Medi-Cal, a large share of PACE members, usually pays no monthly premium and no copays for care the team authorizes. A senior with Medicare but not Medi-Cal typically pays a monthly amount for the long-term-care portion, and private pay is possible. Because Medi-Cal eligibility drives the cost so heavily, it is worth confirming a parent's Medi-Cal status before assuming what PACE will run.
Enrollment in PACE runs through the program itself, so the practical first step is to contact St. Paul's PACE directly for an eligibility screening, or to call San Diego County Aging & Independence Services at 800-339-4661, which can explain PACE alongside other options like IHSS and the Medi-Cal Assisted Living Waiver. Veterans should also loop in the VA San Diego Healthcare System at the La Jolla campus, since VA benefits and PACE eligibility are worth reviewing together.
PACE is not the right answer for everyone. Families who want to keep a trusted longtime doctor, or whose parent needs a residential setting now rather than home-based care, may be better served by assisted living or memory care. If you are comparing PACE against moving into a licensed community, check any facility's license and citation history yourself at the state Community Care Licensing site, ccld.dss.ca.gov, for San Diego County. A free local senior advisor can help you weigh PACE against residential options and tour communities if that turns out to be the better fit.
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