by Lisa C. Lindley, PhD, RN, FPCN, FAAN

March 2025

Pediatric concurrent hospice care allows children with life-limiting conditions to receive both curative and hospice treatments simultaneously. This approach ensures that children and their families have access to comprehensive care without having to forgo potential life-prolonging treatments. Implementing this model involves collaboration between state Medicaid administrations, hospices, and hospitals. Here’s a detailed guide on how to implement (or reimplement) pediatric concurrent hospice care effectively.

Steps for State Medicaid Administration

1. Policy Development:

• Legislative Support: Advocate for legislative changes to include pediatric concurrent care in state Medicaid plans.
• Guidelines and Protocols: Develop clear guidelines and protocols for the implementation of concurrent care services.

2. Funding and Reimbursement:

• Funding Allocation: Ensure adequate funding is allocated for concurrent care services.
• Reimbursement Models: Establish reimbursement models that cover both curative and hospice treatments.

3. Provider Training:

• Education Programs: Implement training programs for healthcare providers on the principles and practices of pediatric concurrent care.
• Continuous Education: Offer ongoing education opportunities to keep providers updated on best practices.

Steps for Hospices

1. Service Integration:

• Collaborative Agreements: Form agreements with hospitals and other healthcare providers to offer integrated services.
• Care Coordination: Develop systems for seamless coordination of care between hospice and curative treatment providers.

2. Staff Training:

• Specialized Training: Provide specialized training for hospice staff on pediatric concurrent care.
• Interdisciplinary Teams: Create interdisciplinary teams that include physicians, nurses, social workers, and counselors.

3. Family Support Services:

• Counseling Services: Offer counseling and emotional support services to families from the time of diagnosis.
• Respite Care: Provide respite care options to give families temporary relief from caregiving duties.

Steps for Hospitals

1. Program Development:

• Concurrent Care Programs: Establish dedicated pediatric concurrent care programs within the hospital.
• Interdepartmental Collaboration: Foster collaboration between departments such as oncology, cardiology, and palliative care.

2. Patient Identification:

• Early Identification: Identify eligible patients early in their treatment process to ensure timely access to concurrent care services.
• Referral Systems: Develop efficient referral systems to connect patients with hospice services when needed.

3. Quality Improvement:

• Monitoring Outcomes: Implement systems to monitor patient outcomes and continuously improve the quality of care provided.
• Feedback Mechanisms: Establish feedback mechanisms for families to share their experiences and suggestions for improvement.

Conclusion

Implementing pediatric concurrent hospice care requires a coordinated effort between state Medicaid administrations, hospices, and hospitals. By developing supportive policies, ensuring adequate funding, providing specialized training, and fostering collaboration among healthcare providers, we can create a comprehensive care model that meets the unique needs of pediatric patients and their families.