demonstrate to the Secretary that the provider 
has a plan to partner with— 
(i) each area agency on aging serving 
the area that the provider is approved to 
serve; or 
(ii) if there is no area agency on aging 
serving such area, the applicable State 
Unit on Aging. 
(C) 
AMOUNT
PER
AWARD.—A 
grant 
awarded under subparagraph (A) to any indi-
vidual PACE pilot site shall not exceed 
$1,000,000. 
(D) NUMBER OF AWARDS.—Not more than 
30 PACE pilot sites shall be awarded a grant 
under subparagraph (A). 
(E) USE OF FUNDS.—Funds made avail-
able under a grant awarded under subpara-
graph (A) may be used for the following ex-
penses only to the extent such expenses are in-
curred in relation to establishing or delivering 
PACE program services in a rural area or un-
derserved urban area: 
(i) Feasibility analysis and planning. 
(ii) Interdisciplinary team develop-
ment. 
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(iii) Development of a provider net-
work, including contract development. 
(iv) Development or adaptation of 
claims processing systems. 
(v) Preparation of special education 
and outreach efforts required for the 
PACE program. 
(vi) Development of any special qual-
ity of care or patient satisfaction data col-
lection efforts. 
(vii) Purchase or lease of a building. 
(viii) Modifications to a building. 
(ix) To cover the cost of reinsurance 
during the grant period. 
(x) Establishment of a working capital 
fund to sustain fixed administrative, facil-
ity, or other fixed costs until the provider 
reaches sufficient enrollment size. 
(xi) Startup and development costs in-
curred prior to the approval of the PACE 
pilot site’s PACE provider application, new 
center application, or service area expan-
sion application by CMS. 
(xii) Any other efforts determined by 
the PACE pilot site to be critical to its 
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successful startup, as approved by the Sec-
retary. 
(F) SITE
DEVELOPMENT
GRANT
ELIGI-
BILITY.— 
(i) GRANT
ELIGIBILITY.—A PACE 
provider shall only be eligible to receive a 
grant under this subsection if the provider 
is not a for-profit PACE provider. 
(ii) LIMITATION
ON
ELIGIBILITY
TO 
PROVIDERS
IN
3-WAY
PACE
PROGRAM 
AGREEMENTS.—A PACE provider shall 
not be eligible for a grant under this sub-
section unless the provider has entered into 
an agreement, consistent with sections 
1894 and 1934 of the Social Security Act 
(42 U.S.C. 1395eee, 1396u–4), and regula-
tions promulgated to carry out such sec-
tions, among the PACE provider, the Sec-
retary, and a State administering agency 
for the operation of a PACE program by 
the provider under such sections. 
(2) TECHNICAL
ASSISTANCE
PROGRAM.—The 
Secretary shall establish a technical assistance pro-
gram to provide— 
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(A) outreach and education to State agen-
cies and provider organizations interested in es-
tablishing and expanding PACE programs in 
rural areas or underserved urban areas; and 
(B) technical assistance necessary to sup-
port PACE pilot sites. 
(3) APPROPRIATION.—There is appropriated to 
the Secretary $30,000,000 to carry out this sub-
section, to remain available until expended. 
(c) EVALUATION
OF PACE PROVIDERS SERVING 
RURAL OR UNDERSERVED URBAN SERVICE AREAS.—Not 
later than 60 months after the date of enactment of this 
Act, the Secretary shall submit a report to Congress, in-
cluding the Special Committee on Aging of the Senate and 
the Committee on Finance of the Senate, containing an 
evaluation of the experience of PACE pilot sites in rural 
areas and underserved urban areas. 
(d) STATE EXPANSION GRANTS.— 
(1) IN GENERAL.—The Secretary shall establish 
a process and criteria to award State expansion 
grants to qualified State agencies in States that do 
not currently have PACE providers. 
(2) AMOUNT PER AWARD.—A State expansion 
grant awarded under subparagraph (A) to any State 
agency shall not exceed $100,000. 
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(3) USE
OF
FUNDS.—Funds made available 
under a State expansion grant awarded under para-
graph (1) may be used for the following expenses 
only to the extent such expenses are incurred in re-
lation to establishing a PACE program in the State: 
(A) Expenditures related to the develop-
ment of a capitated payment rate model, includ-
ing appropriate risk adjustment, for making 
payments to PACE providers under a PACE 
program agreement. 
(B) Expenditures on any other efforts de-
termined by the State Medicaid agency to be 
critical to the successful implementation of a 
PACE program in the State, as approved by 
the Secretary. 
(4) APPROPRIATION.—There are appropriated 
to the Secretary $2,000,000 to carry out this sub-
section, to remain available until expended. 
(e) AMOUNTS IN ADDITION TO PAYMENTS UNDER 
SOCIAL SECURITY ACT.—Any amounts paid under the au-
thority of this section to a PACE provider shall be in addi-
tion to payments made to the provider under section 1894 
or 1934 of the Social Security Act (42 U.S.C. 1395eee; 
1396u–4). 
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