Since its inception in 2010, the Concurrent Care for Children Provision of the Affordable Care Act has enabled seriously ill pediatric patients and their families to access comprehensive, supportive hospice services while simultaneously receiving ongoing treatment-directed therapies. Although this groundbreaking federal legislation has resulted in improvements in care for vulnerable pediatric patients, the implementation of the law has varied from state to state through Medicaid programming. The pediatric professional community is called to consider how Medicaid services can more effectively be delivered by leveraging legislative mandates and collaborative relationships between clinicians, Medicaid administrators, and policy makers. In this article, we examine ways concurrent care has been executed in 3 different states and how key stakeholders in care for children with serious illness advocated to ensure effective implementation of the legislation. The lessons learned in working with state Medicaid programs are applicable to any advocacy issue impacting children and families .

自 2010 年成立以来，《平价医疗法案》中的儿童并行护理条款使重病儿科患者及其家人能够获得全面的、支持性的临终关怀服务，同时接受持续的以治疗为导向的治疗。尽管这项开创性的联邦立法改善了对弱势儿科患者的护理，但通过医疗补助计划，该法律的实施因州而异。儿科专业社区被要求考虑如何通过利用立法授权和临床医生、医疗补助管理人员和政策制定者之间的协作关系来更有效地提供医疗补助服务。在本文中，我们研究了在 3 个不同州执行同步护理的方式，以及如何倡导护理重病儿童的主要利益相关者以确保有效执行立法。与州医疗补助计划合作的经验教训适用于任何影响儿童和家庭的宣传问题。