A Better Path to Aging at Home
Harbor Health’s Elder Service Plan (ESP) is a Program of All-Inclusive Care for the Elderly (PACE). ESP gives participants and their families peace of mind. With one trusted team coordinating care, there’s less stress and more support for what matters most: quality of life, independence, and compassionate care every step of the way.
How do PACE services benefit you and your loved one?
Harbor Health’s PACE plan provides coordinated care to help older adults with complex medical and social needs continue living in their homes or communities rather than a nursing home, when safe to do so with our program’s services and benefits. Our care model integrates medical, behavioral, and social services so participants get the care they need without juggling multiple providers or appointments.
The services offered by our PACE plan address the unique needs of each participant and care for the whole person.
Harbor Health's Elder Service Plan Services
Medical Care
Primary Medical Care
Regular visits and on-site access to doctors, nurses, and specialists who know your full health history, improving preventive care and chronic condition management. When we refer you to a specialist, we coordinate the care and the care is paid for as a covered benefit of our PACE plan.
Care Coordination
Our interdisciplinary team manages every aspect of care in partnership with you and your loved one. We schedule appointments, manage medications, share among providers, and respond quickly to changes in health. The goal is to reduce your stress, increase access, and prevent gaps in care.
Prescription Medications
Prescriptions and support to help participants take the right medications at the right time. The goal is to reduce hospitalizations and medication errors.
Rehabilitation Services
Physical, occupational, and speech therapy help participants regain strength, mobility, and independence after injury or illness.
Support for Daily Life
Adult Day Health Center
The ESP Day Center offers a welcoming, supervised space. Participants receive nursing care, attend medical or dental visits, enjoy nutritious meals, socialize with peers, and participate in engaging activities. The services at the day center enhance mental, emotional, and physical well-being for participants – and offer caregivers time for themselves.
Personal Care Services
Assistance with daily tasks like bathing, dressing, and grooming helps participants stay safe and comfortable at home.
Transportation
Reliable transportation to and from our ESP day center, medical appointments, and other care services removes barriers to access.
Nutrition Services
Meal planning, dietary support, and healthy meals at home or at the PACE Center promote better nutrition and well-being.
Emotional and Social Well-Being
Mental Health Services
Counseling, therapy, and psychiatric care support emotional health and help participants cope with stress, isolation, or memory concerns.
Social Services and Activities
Social workers help with everything from housing support to caregiver coordination, while the ESP Day Center provides social engagement and recreational activities that improve mood and connection.
Specialized and Compassionate Care
Dental, Hearing, and Vision Care
Routine and preventive care helps participants maintain overall health and avoid complications.
Hospital and Nursing Home Coordination
If a hospital or nursing home stay is needed, ESP manages the process and supports smooth transitions back home.
End-of-Life Support
Palliative and hospice care provide comfort, dignity, and support for participants and their families during the final stages of life.
How do I pay for PACE services?
PACE is funded through a combination of Medicare, Medicaid, and sometimes private funds. Whether you pay for Harbor Health’s PACE plan depends on your Medicaid eligibility.
Our enrollment team can check your eligibility and let you know if a payment is needed to join the plan.
For a complete overview of all Harbor PACE services, click here to see the enrollment agreement.
PLEASE NOTE: Except for emergency care, once someone is enrolled in PACE, all the care they receive must be approved by their interdisciplinary team. If the participant receives care that is not approved by the interdisciplinary team, they may be held financially liable.
Not sure if you qualify? Click the button below to learn about enrollment.
Elder Service Plan Referral Form
Harbor Health’s Elder Service Plan (ESP) will be your sole provider for primary care and specialty care (other than emergency services). Care is provided directly by ESP or a provider we approve. ESP participants may be fully and personally liable for the costs of unauthorized or out-of-ESP program services. H2218_Web_09-25-2025 Pending CMS review.