Palliative Care

To be eligible, a child must:

• Be under age 21
• Have active Vermont Medicaid
• Be living with a serious life-limiting or life-threatening illness or condition

The Pediatric Palliative Care program is made up of five main services available to a child and family:

• Care Coordination – Someone to help make, and put into place, a family-centered care plan

• Family/Caregiver Training – Training to family members and caregivers about how to provide complex care

• Expressive Therapies – Certified art, music, play, dance/movement or child life specialist to help the child and family members creatively express themselves

• Skilled Respite – Short term relief for caregiver relatives provided by a nurse based on medical need

• Family Grief Support/Bereavement Counseling – Counseling for the family to help during the child’s life and for up to six months in the event the child passes away

Anyone in the child’s circle of support can request the Pediatric Palliative Care Program for a child. Health care providers (like doctors or nurse practitioners), however, make the referral.

Medical providers can make referrals at any time. It is best, though, that the provider makes the referral around the time of diagnosis. That way, supports are available early as the family learns about new needs and feelings they may have.

Pediatric Palliative Care Program services are provided by specially-trained teams at Medicaid-contracted home health agencies and Visiting Nurse Associations around the state. These teams may include nurses, social workers and therapists.

Families and caregivers work with the home health agencies and Visiting Nurse Associations to set up and access the supports that best meet their child’s needs. As their needs change, their care plan, and the supports they choose, can change too.

• Provider Information Sheet
• Pediatric Palliative Care Referral Form
• Dana Farber Institute/Boston Children’s Hospital’s Pediatric Pain and Symptom Management Guidelines—2014
• Books for Children, Parents and Providers

• Family Information Sheet
• Resources for Families
• Books for Children, Parents and Providers

Introduction to the Pediatric Palliative Care Program

• Pediatric Palliative Care Program Provider Manual
• Monthly Service Reporting Form
• Appendix A: Reimbursement Rates
• Interdisciplinary Team Meeting Note
• Intake and Needs Assessment
• Plan of Care
• Care Conference Meeting Note
• Pediatric Palliative Care Bereavement Log
• Expressive Therapy Referral Form
• Additional Services Request Form