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Summary Report of Concurrent Care for Children

Special Report: Part II

Part 2 of 6 in a Special Report on Concurrent Care for Children

Exploring what each state defined as, “disease-directed therapies/treatments/services,” appeared to be the most logical way of beginning our investigation. Of course, it is essential to have definitions on which to refer to so that we may better understand the application of concurrent care on a statewide level. Each definition is quite similar to the next, but it is important to recognize that some definitions are more specific in the examples they give. To best understand how the specifics of each definition influence its role in legislation let us begin with one highly specific definition that can then be contrasted with the more generalized definitions other states have provided. Arizona presents an all-encompassing definition of the end of life concept and is perhaps the most thorough definition that was found out of all 50 states. This definition is comprised of four parts including physical and behavioral health medical treatment, referrals to community resources, practical supports and curative care alongside hospice care for members under age twenty-one. Treating the underlying illness, relieving pain and relieving stress are all included as part of the management of physical and behavioral health. Pastoral support, counseling services, and legal services are all included as part of community resources. The state guidelines acknowledge that practical support provided by a family member, friend or volunteers are not billable, but recognize that these supports are essential to achieving quality-of-life. Housekeeping, personal care, food preparation, shopping, pet care, and non-medical comfort measures are listed as examples of practical support. These guidelines contextualize the environment and support conducive to health and life while suffering from a terminal illness. Other states, such as California, simply define curative services as those given with the goal of long-term cure or a disease-free state. Delaware, Florida and Ohio describe curative care as, “a blended package of curative and palliative services,” those which are “medically necessary to correct or ameliorate a defect, a condition, or a physical or mental illness,” and a “curative treatment of the terminal condition for which hospice care was elected or a related condition,” respectively.