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Published byAdelia Rosanna Simpson Modified over 9 years ago
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Pediatric Palliative Care Eligibility Criteria
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Waiver Eligibility Life-limiting CCS eligible medical condition, with a complex set of needs
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Waiver Eligibility Conditions for which curative treatment is possible, but may fail Advanced or progressive malignancy Complex and severe congenital or acquired heart disease
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Waiver Eligibility Conditions requiring intensive long- term treatment focused on maintaining quality of life Severe immune deficiencies Cystic fibrosis Muscular dystrophy Respiratory failure
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Waiver Eligibility Conditions in which treatment is exclusively palliative after diagnosis Progressive metabolic disorders Severe forms of osteogenesis imperfecta Certain chromosomal abnormalities
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Waiver Eligibility Conditions involving severe, nonprogressive disability or causing extreme vulnerability to health complications Extreme prematurity Neurologic sequalae of infectious disease or trauma Several cerebral palsy
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Determining Eligibility Complex set of needs? Case management and Coordination of medical services and Meeting three of the following six circumstances
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Immediate medical need(s) in a time of crisis Coordination with family member(s) and providers required in more than one setting
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A life-limiting medical condition that impacts cognitive, social, and physical development A medical condition with which the family is unable to cope
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A family member(s) and/or caregiver who needs additional knowledge or assistance with the client’s medical needs Therapeutic goals focused on quality of life, comfort, and family stability
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