National Commentary

Moran’s News Commentary: Managing Children’s Complex Health Care

Too many children suffering from serious illness are having difficulty receiving the complex care they need. But a relatively new development in comprehensive treatment for many of these sick kids offers hope for better days. Titled the Children’s Program of All-inclusive, Coordinated Care (ChiPACC for short), this program, developed by Children’s Hospice International, provides each enrolled child an individualized treatment plan that includes specialists from across the health care spectrum.

Children are much more likely than adults to move in and out of terminal phases multiple times. To address the changing needs of these children, ChiPACC creates a comprehensive care plan, combining hospice services, counseling, and respite, with presently-available Medicaid curative care and supportive services like family counseling.

Unfortunately, while ChiPACC has been shown to be highly effective, it is not available to all Medicaid-enrolled children. Nearly 30 percent of children with life-threatening illnesses qualify for Medicaid, yet only five states currently offer ChiPACC services. Advanced, comprehensive medical care should be available to all of our children, not just those whose families have private health insurance.

To remedy this deficit of care, last week I introduced H.R. 4147, legislation to improve the care and treatment for seriously ill children by improving access to ChiPACC for children qualifying for Medicaid. My bill would allow states to bypass a years-long application process to include ChiPACC in the state’s Medicaid program.

The five states currently offering ChiPACC services are Florida, Colorado, California, New York, and North Dakota. Illinois and New Jersey are working their ways through the waiver process. The treatment to Medicaid-eligible children suffering from serious illnesses in the remaining 45 states, including Virginia, results in inconsistent care. Because so many Medicaid eligible children lack adequate guidance in coordinating all of their medical needs, shifting to ChiPACC services eliminates the use of the Emergency Room as the primary care facility for this population and will reduce the cost of Medicaid services while improving medical outcomes.

H.R. 4147 makes it easier and quicker for states to provide the best possible care to its young people. There is nothing partisan about protecting and preserving the health of our children and I hope this legislation gains support from my colleagues. Parents need and deserve help in managing their seriously ill child’s complex care.


Rep. James Moran (D) is Virginia’s 8th Congressional District Representative in the U.S. House of Representatives.