Partners in care: together for kids: Florida's model of pediatric palliative care.
BACKGROUND
Many children with life-limiting illnesses in the United States could benefit from pediatric palliative care. However, national, state, and local barriers exist that hinder provision. One national barrier is the Medicare hospice reimbursement regulation that limits the provision of government subsidized hospice care to the final 6 months of life. In response to the critical need to provide palliative care earlier in children's illnesses, Florida became the first state to develop and implement an innovative model of care that provides services from the point of diagnosis onward, thereby waiving the 6-month reimbursement rule. In July 2005, the Partners in Care: Together for Kids program began. The program relies on partnerships between state-employed care coordinators who identify the children for possible enrollment and hospice staff who provide home and community-based services.


OBJECTIVE
Our objective was to describe Florida's experiences in designing, implementing, and operating the program.


METHODS
Surveys were conducted with parents, hospices, and state agencies. Enrollment trends were identified using administrative data.


RESULTS
As of January 2008, 468 children have been enrolled in the program. Approximately 85% of parents report they are satisfied with the program and 95% of parents would recommend the program.


CONCLUSIONS
Florida's program is the first in the nation to provide government-subsidized pediatric palliative care from the point of diagnosis onwards. Lessons learned from Florida's experiences will help guide other states and health plans that desire to implement a similar model of care.
Knapp
Caprice A
CA
Department of Epidemiology, University of Florida, Gainesville, Florida 32610, USA. cak@ichp.ufl.edu
Madden
Vanessa L
VL
Curtis
Charlotte M
CM
Sloyer
Phyllis J
PJ
Huang
I-Chan
IC
Thompson
Lindsay A
LA
Shenkman
Elizabeth A
EA
D002648:Child; D003299:Cooperative Behavior; D005380:Financing, Government; D005431:Florida; D019538:Health Care Surveys; D006738:Hospices; D006776:Hospitals, Pediatric; D006801:Humans; D019982:Organizational Case Studies; D010166:Palliative Care / Q000458:organization & administration*; D010372:Pediatrics; D016730:Program Development