In-home nursing support for medically fragile children

Medically Complex Nursing Services Rule

Parents and Providers as Providers

• A nurse to provide direct care
• A nurse to help develop, monitor and implement a family-centered care plan
• Authorization of durable medical equipment and supplies

To be eligible, a child must:

• Be younger than 21
• Have active Vermont Medicaid
• Be living with complex medical needs that require continual assessment and intervention by a nurse

Anyone in the child’s circle of support might suggest Pediatric High-Tech Nursing, but health care providers (like doctors or nurse practitioners) make the referral.

Medical providers can make referrals at any time. Ideally, though, providers make referrals well before children are discharged from the hospital or rehabilitation facility. That way, supports are available as the child transitions home.

Pediatric High-Tech Nursing is provided by a Medicaid-contracted home health agency, such as the Visiting Nurse Associations around the state, or by a nurse who is directly enrolled with Vermont Medicaid in a family-managed model.

See the Family-Managed High-Tech Nursing Manual for more information about the family-managed model.

Families and caregivers work with the home health agencies and Visiting Nurse Associations to set the schedule and make sure that the staff is the best match to meet their child’s needs.

• Pediatric High-Tech Nursing Referral Form
• Vermont Medicaid enrollment and billing guide for independent nurses (family-managed model).

• High-Technology Nursing Services Provider Manual
• Reimbursement Rate