One of the most surprising things about Kansas PACE is how closely each care team works together.
Every day, the team meets, either in person or on video calls, to talk about participants’ needs. They share updates, plan next steps, and make changes quickly. Teamwork helps PACE participants stay safe, healthy, and at home.
Who Is on the Care Team at Kansas PACE?
The care teams in Kansas PACE include professionals from 11 different fields. Each person brings special knowledge, and they work together every day to make sure nothing is missed.
Each team serves 200 to 300 participants. This is much less than a typical healthcare system, where one doctor might have 2,000 to 3,000 patients.
These people are part of your care team:
Primary Care Doctor
The doctor checks your health, reviews test results, and makes sure your medications are right for you.
Nurse
The nurse keeps track of your daily health. The nurse checks your blood pressure, medications, and how you are feeling. If something changes, the nurse alerts the rest of the team right away.
Social Worker
The social worker helps with paperwork, benefits, and family concerns. The social worker also listens and helps you cope with stress or changes in your life.
Physical Therapist
The physical therapist helps you stay strong and move safely. They teach you exercises to improve balance, walking, and strength.
Occupational Therapist
The occupational therapist helps you strengthen your arms, hands, and fingers so daily tasks like dressing, eating, and bathing become easier again.
Dietitian
The dietitian makes sure you are eating enough and getting foods that match your health needs. They help you learn which foods support your conditions, like heart disease or diabetes.
Home Care Nurse
The home care nurse arranges help in your home. They make sure aides visit when needed and that the care you get at home matches your PACE plan.
Recreation or Activity Coordinator
The activity coordinator plans programs at the PACE Center that keep you active and social. They help you join games, art, exercise, or music that you enjoy.
Transportation Manager
The transportation manager oversees the drivers who take you to the PACE Center and to appointments. Drivers check in every day. If they notice that you’re not feeling well, having trouble getting ready, or that your home seems unsafe, they tell the transportation manager, who alerts the care team.
Center Director
The center director makes sure the PACE Center runs smoothly. They handle meals, safety, and schedules and make sure the team has what it needs to care for participants.
PACE Clergy or Counselor
Some PACE centers also include a chaplain or counselor who supports your emotional and spiritual health, if you wish.
The Teams Meets Every Day
- They review updates from nurses, home aides, transportation, and therapy.
- They talk about new doctor visits, medicine changes, or health concerns.
- If a participant fell, missed meals, or seems more tired, the team discusses it that day.
Because the teams meets daily, they can act fast.
If you need more help at home, a new medication, or a different schedule, the change happens right away.
A Full Review Every Six Months
- At least twice a year, the care team reviews every participant’s full care plan.
- They look at health, home care, meals, and transportation.
- They check if goals have changed and if the plan still fits.
- If someone has a hospital stay or a major health change, the team does a review sooner.
PACE doesn’t wait for problems to get worse. It adjusts care before that happens.
Working With Your Specialists
The PACE care team also talks with your outside doctors, called specialists.
These may be heart doctors, lung doctors, kidney doctors, or others. And this includes the PACE dentist, hearing aide specialist, and eye doctor.
The care team keeps in touch with them to get updates. Together, they decide what care is best for you and what matters most to you. This way, everyone involved in your care is on the same page.
Why the PACE Care Team Works
- Most healthcare programs only meet once in a while.
- PACE is different.
- The care team talks every day, knows what’s happening at the center and at home, and makes fast decisions.
- When everyone shares information, small problems don’t get missed.
- That teamwork helps participants stay safe and independent longer.
Learn More about Kansas PACE organizations
If you live in Kansas and want care that’s organized and complete, call us to learn about PACE in your area.
Every participant has a care team that meets daily, reviews care plans every six months, and works together on medical, social, and home care needs.
That teamwork is what makes PACE different.
