Home-Based Palliative Care for Medically Complex Children

C.S. Mott Children’s Hospital is committed to partnering with primary care providers and pediatric specialists to provide home-based care, advance care planning and 24/7 phone availability for medically complex children and their families.

Our Partners for Children program is a community-based pediatric palliative care service for children with complex medical care needs and conditions. Launched in August 2018, in the program is a partnership with Hospice of Michigan, made possible by a grant from Michigan Health Endowment Fund.

Partnering for better care

There are hundreds of Michigan children with complex conditions who receive care from multiple specialists such as neurologists, orthopedic surgeons, otolaryngologists, rehabilitation specialists, gastroenterologists, lung specialists, pediatric surgeons, urologists and mental health providers.

Many of these children have limited mobility, take more than nine medications daily and depend on technology to help them to survive and integrate themselves into their families and communities. In addition, medically complex children often have a combination of feeding tubes, respiratory devices and mobility aids.

Partners for Children was modeled after a successful experience in California, and is designed to:

  • Partner with a patient’s primary care provider to support care
  • Bridge the gap between various specialists and providers
  • Prevent, shorten or help coordinate hospital stays
  • Reduce emergency room visits, and facilitate coordination of care with your providers when an ER visit is necessary
  • Reduce patient and family stress, depression and anxiety
  • Focus on the patient’s quality of life

What you can expect from your Partners for Children experience

The Partners for Children team is here to support your family in a number of ways, including offering the following services:

  • Visits with family in your home, and assisting with important specialty clinic visits
  • Facilitating overall symptom management
  • Helping develop a daily and/or emergency care plan
  • Working with your family to identify short and long term goals
  • Supporting conversations with school personnel
  • Connecting your family to available community resources
  • Coordinating care across medical specialties and clinics

Partners for Children provides 24/7 phone availability and support for existing patients with urgent medical questions.

Who can benefit from Partners for Children

Partners for Children is currently available for publicly insured children (generally children on Medicaid) with multiple medical problems requiring care from three or more pediatric specialists, whose care is not currently coordinated by an existing comprehensive care program at U-M.

Your U-M Partners for Children team

Your family will be matched with a primary nurse practitioner to act as a team coordinator, getting to know your child, your family, your primary care practitioner, and your specialists.

You will also be paired with a social worker to assist with identifying community resources, support decision-making, and provide emotional support.

In addition, our board-certified palliative care physicians will be part of your team and support your nurse practitioner throughout your journey.

Appointments & Information

A primary care provider or a specialist may recommend a patient for enrollment by emailing [email protected] or by calling 734-763-9418.