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The Florida CHI PACC®Model
Agency for Health Care Administration, Florida Department of Health, Florida Hospices and Palliative Care, Inc.
A Children's Hospice International Program for All-Inclusive Care for Children and their Families® (CHI PACC®)
Modeled after the Children's Hospice International Program for All-Inclusive Care for Children and their Families®(CHI PACC®) and underwritten by the U.S. Government grant to Children's Hospice International for its CHI PACC®Program.
Extensive and continuing attention by Florida's hospice programs and Florida's Children's Medical Services Program in the Department of Health indicates that the services available to children with life-threatening conditions are not meeting the needs of those children and their families. A study conducted in 1999 reported that 50% of the hospice programs in Florida felt that the needs of terminally ill children were not addressed to their satisfaction. At that time, only 18 hospice programs of the 36 surveyed provided a full hospice program for children.
As a result, The Florida Agency for Health Care Administration (AHCA) formed a public/private partnership that includes AHCA's Medicaid Program, the Florida's Department of Health's Children's Medical Services Network (CMSN) and Florida Hospices and Palliative Care (FHPC). The CHI Program for All Inclusive Care for Children (CHI PACC®) became the model adopted to address the healthcare needs of children with life threatening conditions. Florida is one of six states currently working to implement a CHI PACC®demonstration program. Florida's CHI PACC®model is called Partners in Care (PIC) Together for Kids.
The mission of PIC is to enable children with life-threatening conditions and their families to have an enhanced quality of life through a combination of medical and supporting services that are accessible, continuous, compassionate, comprehensive, culturally sensitive and family/caregiver centered. The program's vision is to identify and remove barriers that prohibit access to concurrent curative and comfort care. And, to support the families and caregivers of these children as they work to manage their lives given the circumstances brought about by the child's illness.
In June, 2005, the federal Centers for Medicare and Medicaid Services (CMS) approved Florida's 1915(b) Medicaid waiver application for children in the state's Medicaid managed care program (most Medicaid children with special health care needs in Florida are enrolled in managed care provided by the Children's Medical Services Network).
The two-year waiver will allow Florida to implement the PIC program, based on the CHI PACC® model, by waiving Medicaid hospice laws that prohibit the use of hospice services while patients are seeking curative care, and by expanding Medicaid coverage for supportive services.
PIC palliative care services will be available to children ages 0-21 with life-limiting conditions, and their families. Benefits will include support counseling, respite, specialized personal and nursing care, pain and symptom management, expressive therapies such as music, art and play for young children, and bereavement support. Each child and family will have a primary nurse care coordinator who will coordinate services between the child's primary and specialty care physicians, the hospice and the family. The program will be launched in seven areas in the state, and is expected to expand to other areas by the end of June, 2007. PIC will serve up to 940 Medicaid children during the waiver period.
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