(1) serious illnesses and health conditions that 
are potentially life-threatening place significant 
stress on both the child and family; 
(2) palliative care relieves children’s symptoms 
such as pain, fatigue, anxiety, nausea, and sleep 
problems, and may be provided at any age or stage 
of serious illness, and has been shown to enhance 
the quality of life for both the child and family; 
(3) many critical barriers to end-of-life care for 
children exist under the current health care system, 
including the limitation of hospice care under the 
Medicaid program to children expected to live six 
months or less, a prognosis that medical profes-
sionals and families are reluctant to make; 
(4) the Children’s Program of All-inclusive Co-
ordinated Care (referred to in this Act as 
‘‘ChiPACC’’) provides all-inclusive care for children 
with life-threatening conditions and their families 
from the time of diagnosis and— 
(A) fills a gap in coverage under the Med-
icaid program of integrated, multi-disciplinary 
services that are reasonable and necessary for 
the palliation and management of seriously ill 
children; 
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(B) serves a population that includes chil-
dren who are not yet hospice eligible; and 
(C) provides greater coordination of pallia-
tive and curative services for children through-
out the course of their illness or condition, 
which may begin at the time of diagnosis; 
(5) some States have opted to provide services 
targeted to this population through waivers under 
subsections (b) and (c) of section 1915 of the Social 
Security Act (42 U.S.C. 1396n), each of which re-
quires the approval of the Centers for Medicare & 
Medicaid Services of the initial waiver application 
and any subsequent renewal of such waiver; 
(6) since 2005, the Secretary of Health and 
Human Services has approved home and community- 
based service waivers under section 1915(c) of such 
Act (42 U.S.C. 1396n(c)) to operate ChiPACC in 
five States; 
(7) in States operating ChiPACC under such a 
waiver— 
(A) the respective State’s Medicaid pro-
gram achieved significant cost savings through 
a reduction in inpatient care and an increase in 
less expensive outpatient care; 
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(B) access to CHIPACC services in such 
States reduced more costly utilizations of other 
services; and 
(C) services provided through ChiPACC 
are less costly to the State’s Medicaid program 
because ChiPACC facilitates children receiving 
palliative care at home rather than receiving 
such services in an inpatient hospital setting; 
and 
(8) allowing States the option to implement 
ChiPACC through a State plan amendment would— 
(A) give States the ability to make such 
program a part of a State’s Medicaid program 
while avoiding the lengthy waiver process; and 
(B) give States the flexibility to establish 
and design its program to fit the needs of the 
respective State. 
SEC. 3. OPTIONAL MEDICAID COVERAGE OF CHILDREN’S 
PROGRAM OF ALL-INCLUSIVE COORDINATED 
CARE. 
(a) CHILDREN’S PROGRAM OF ALL-INCLUSIVE CO-
ORDINATED CARE.—Title XIX of the Social Security Act 
(42 U.S.C. 1396a et seq.), as amended by section 9813 
of the American Rescue Plan Act of 2021, is further 
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amended by inserting after section 1947 the following new 
section: 
‘‘SEC. 1948. CHILDREN’S PROGRAM OF ALL-INCLUSIVE CO-
ORDINATED CARE. 
‘‘(a) STATE OPTION.— 
‘‘(1) IN GENERAL.—Beginning on January 1, 
2022, a State, at its option as a State plan amend-
ment, may elect to provide for ChiPACC services 
under this title to ChiPACC eligible individuals who 
choose to enroll in a children’s program of all-inclu-
sive coordinated care. In the case of an individual 
who chooses to enroll in such a program— 
‘‘(A) the individual shall receive ChiPACC 
services (as described in subsection (c)), includ-
ing but not limited to services under the State 
plan; and 
‘‘(B) the health care providers furnishing 
services under such program shall receive pay-
ment for providing such services in accordance 
with the terms of the State plan. 
‘‘(2) PROCESS FOR DETERMINING ELIGIBLE IN-
DIVIDUALS.—If a State elects to establish a limita-
tion under paragraph (2), the State shall establish 
a process, as described in subsection (e), for deter-
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mining criteria for which individuals who may be en-
rolled in the State’s ChiPACC. 
‘‘(3) STATE ADMINISTRATION.—The ChiPACC 
shall be administered by the single State agency as 
described in section 1904(a)(5). 
‘‘(4) MATCHING
RATE.—The Federal medical 
assistance percentage for ChiPACC coordination, 
and services shall be that otherwise applicable to 
medical assistance for the State. 
‘‘(b) CHIPACC AND OTHER TERMS DEFINED.—In 
this section: 
‘‘(1) CHILDREN’S PROGRAM OF ALL-INCLUSIVE 
COORDINATED
CARE; CHIPACC.—The terms ‘chil-
dren’s program of all-inclusive coordinated care’ and 
‘ChiPACC’ mean a program of coordinated care for 
ChiPACC eligible children that is established by a 
State under this section and that meets the following 
requirements: 
‘‘(A) OPERATION.—The State shall provide 
for the operation of the program directly, serv-
ing as ChiPACC coordinator (as defined in 
paragraph 3), or through arrangements with 
one or more other entities that will serve as 
ChiPACC coordinators. 
‘‘(B) COMPREHENSIVE BENEFITS.— 
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