How PPECCs Help Children With Complex Medical Needs — and Their Families
Key Highlights:
- Prescribed Pediatric Extended Care Centers (PPECCs) combine skilled medical care with opportunities for children with complex needs to learn, play, socialize, and make developmental progress.
- PPECCs also can support parents and caregivers by helping them have time to work, study, or manage other priorities while staying connected to their child’s care.
- Partnerships between PPECCs and health plans can help expand access to coordinated, person-centered care while supporting families’ whole health.
For Demisha Walton, bringing her daughter home from the hospital was both a milestone and the start of a new challenge. Born with a medical condition that requires her to rely on a ventilator to breathe, 2-year-old Ryleigh needs complex care and a close eye on her around the clock. Walton had support from her parents, but the early days were especially challenging.
“It was hard trying to figure out how to work, do school, and be a parent to this beautiful baby,” Walton said. “It was a lot of trying to figure out how I'm going to keep us afloat and get help at the same time where it's safe and it's not confined in the house.”
A private-duty nurse helped with Ryleigh’s care at home. But the real turning point came after Walton enrolled Ryleigh at a Prescribed Pediatric Extended Care Center (PPECC) in Dallas. The center provides skilled care for children with complex medical needs alongside opportunities to learn, play, and socialize.
Another part of its mission: supporting family members who need time to work, study, or rest. “It came right on time,” Walton said.
What Is a PPECC?
A PPECC can be thought of as a children’s daycare with specialized medical support. Though program names and structures can vary, approximately a dozen states are home to such centers, which are typically staffed by nurses and other health professionals trained to care for children with complex medical needs — such as tube feeding, tracheostomy care, seizure management, or ventilator support. State Medicaid programs cover PPECC services for many children at no out-of-pocket cost to their families.
PPECCs are “really a best-kept secret” that more people need to know about, said Aron Head, executive director of the STAR Kids program in Texas for Wellpoint, the Elevance Health-affiliated Medicaid plan that supported Ryleigh’s enrollment at Sunshine Pediatric Day Center. “What I hear back from caregivers once they've experienced a PPECC is that they love it. They don't know how they lived without it.”
PPECCs support a whole-health approach to care and hold promise for the children who attend them, the parents who rely on them, and the states and health plans that partner with them.
“One of the values of the PPECC is that tenured and experienced staff gets to know the child, and they understand what the child needs and they have a whole individual care plan,” Head said. “It's both cost-effective and better for the child.”
A Health Plan Partner That Makes Progress Possible
Walton sees Sunshine’s positive impact on Ryleigh in small but profound ways. It’s in how she sits or rolls around on her bed, or when she uses her hands as instruments of innocent, joyful destruction.
“With us being isolated for so long, I want her to interact with people,” Walton said. “She’s learning that she can clap. She's seeing other babies hold things, throw things. She's knocking everything off of the table.”
The stimulating environment at a PPECC can help children adapt behaviorally and socially to life outside of home care or a neonatal intensive care unit. As they grow more comfortable around nurses, therapists, and other kids, the centers also offer opportunities for advances in their physical health. On-site therapy, for example, may help a child transition away from a feeding tube or a ventilator, or learn to move more independently.
“We have wonderful speech therapists, physical therapists, and occupational therapists. And the magic is they all work together under one roof as an interdisciplinary team to deliver care,” said David Maymon, founder and CEO of Sunshine, which operates multiple centers in Texas and Pennsylvania.
That collaboration extends beyond the center’s walls. Spreading the word about PPECCs is a priority for Head at Wellpoint, and the health plan’s work with Sunshine serves as an example of how payers and providers can come together to expand access to high-quality, person-centered care.
Another plus: PPECCs can keep health plans apprised of social factors that may be influencing a child’s or family’s health, so the plan can work to connect members with resources like access to nutritious food or transportation.
“Wellpoint from day one has been a true partner to PPECCs here in Texas,” Maymon said.
The same sentiment rings true for Walton, who said the health plan has been “on top of everything.” She now has more flexibility with her work schedule and more time to spend on studying to become a pharmacy technician. She received support from Wellpoint at the right time, and it helped lead her and Ryleigh to exactly the right place.
“It’s working, so that’s amazing for me — for us,” Walton said.
Frequently Asked Questions
What Are PPECCs?
Prescribed Pediatric Extended Care Centers, or PPECCs, can be thought of as children’s daycare centers with specialized medical support. The centers are typically staffed by nurses and other health professionals trained to care for children with complex medical needs, including those who require tube feeding, tracheostomy care, seizure management, or ventilator support. They can be found in approximately a dozen states.
Who Can Benefit From a PPECC?
PPECCs are designed for children with complex medical needs who may benefit from skilled nursing care alongside opportunities to learn, play, socialize, and receive services such as speech or physical therapy and educational programming.
How Can PPECCs Help Parents and Caregivers?
PPECCs can help parents and caregivers maintain employment, pursue their education, or address other priorities that support their family’s well-being while allowing them to stay informed and involved in their child’s care and activities.
How Do Health Plans Work With PPECCs?
Health plans can work with PPECCs by partnering with them to expand access to coordinated, person-centered care. PPECCs can also help keep health plans apprised of social factors affecting a child or family so the plan can help connect members with resources such as nutritious food or transportation. State Medicaid programs cover PPECC services for many children at no out-of-pocket cost.