Prescribed Pediatric Extended Care Eligibility Application
Introduction
The Prescribed Pediatric Extended Care (PPEC) program provides an opportunity for children with chronic health care needs to receive care in their own homes or other community settings, instead of in a hospital or skilled nursing facility. To be eligible for PPEC services, a child must: 1) Be under the age of 21; 2) Have a chronic health condition that requires skilled nursing care and/or rehabilitation services; 3) Be Medicaid-eligible; and 4) Have a care plan that is approved by the child’s pediatrician. If you believe your child meets these criteria and would benefit from PPEC services, please complete the attached application and return it to your local Department of Health and Human Services office.
What is the Prescribed Pediatric Extended Care Program?
The Prescribed Pediatric Extended Care (PPEC) program provides home-based, medically necessary health care services to children with complex medical needs who are not able to be cared for at home without skilled nursing or other intensive health care services. The program is designed to provide a cost-effective alternative to hospitalization or institutionalization for these children.
To be eligible for the PPEC program, a child must:
Be under the age of 21
Have a chronic illness or condition that requires skilled nursing or other intensive health care services on an ongoing basis
Be unable to be adequately cared for at home without these services
Not be receiving these services through another Medicaid-funded program, such as the Home and Community Based Services Waiver Program
Not be eligible for Medicare
Who is eligible for the program?
The Prescribed Pediatric Extended Care (PPEC) program is available to children under the age of 21 who have a medical condition that requires skilled nursing care and/or rehabilitative services on an extended basis. In order to be eligible for the program, a child must:
1. Be a resident of the state of Florida
2. Have a chronic medical condition that requires skilled nursing care and/or rehabilitative services on an extended basis
3. Be unable to receive the necessary care and/or services in their home or community
4. Meet the financial eligibility criteria for Medicaid
If you believe your child may be eligible for the PPEC program, you can begin the application process by contacting your local PPEC provider.
How to apply for the program
To apply for the program, you will need to submit an application form and supporting documentation. The form can be found on the website of your state’s health department.
In addition to the application form, you will need to submit:
• Proof of residency in the state where you are applying
• A letter from a licensed healthcare provider verifying that your child has a chronic medical condition that requires extended care
• A copy of your child’s most recent medical records
Once your application is complete, it will be reviewed by a team of experts who will determine if your child is eligible for the program. If approved, you will be notified and provided with further instructions on how to proceed.
What benefits are available through the program?
If your child has a chronic medical condition that requires ongoing care and supervision, you may be eligible for Prescribed Pediatric Extended Care (PPEC) services. PPEC can provide your family with much-needed support, including:
-In-home nursing care
-Respite care
-Case management
-Parent training
-Therapy services
PPEC can help ease the burden on families caring for medically complex children, and can improve the quality of life for both the child and the family. To learn more about the program and to see if you are eligible, please visit the PPEC website.
Conclusion
Completing the Prescribed Pediatric Extended Care (PPEC) Eligibility Application is the first step in determining if your child qualifies for PPEC services. The application must be completed by a licensed physician, and it asks for information about your child’s medical diagnosis, prognosis, and current level of care needs. Once you have submitted the completed application, a team of PPEC specialists will review it and determine if your child is eligible to receive PPEC services. If you have any questions about the application process or what type of information you need to provide, please contact our office and we would be happy to assist you.