Pediatric Palliative Care

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Pediatric Palliative Care
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AB 1745

• Requirements
• Pediatric Palliative Care Benefit
• Waiver application
• Pilot project
• Services
• Eligible population
• Providers
• Evaluation
• Length of time for pilot
• Determination of effectiveness

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AB 1745

• Timelines
• Submit waiver to Federal CMS within 12 months
• Implement within 12 months of approval by Federal
  CMS

4
Our Vision

• Waiver administration
• Pilot project structure
• Patient population
• Available benefits
• Geographic areas
• Case management
• Data collection
• Evaluation

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CCS Program

• Eligibility
• Under 21 years of age
• Medical condition
• Financial
• Residential
• Case management
• Authorization and payment of services
• Medi-Cal providers

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CCS Program

• Benefits
• Medically necessary health care services
• Special Care Center Services
• Multispecialty, multidisciplinary teams
• Physicians
• Nurse specialists
• Social workers
• Dietitians
• Care coordination
• Family-centered care

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CCS Program

• Benefits
• Services in the home
• Home health agency services
• Skilled nursing
• Home health aides
• Physical and occupational therapy
• Social worker
• DME
• Medical Supplies
• Pain management/symptom control

8
CCS Program

• Constraints
• Hospice Benefit
• Eligibility

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Other states

• Florida
• Colorado
• Washington

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Constraints?

• Hospice statute
• Geographic distribution