Published
PPEC or after-school care? What each one actually covers
A question we get every August, usually from a parent who has just been told an ordinary after-school program cannot take their child.
What a PPEC is
Prescribed Pediatric Extended Care: a licensed, non-residential medical setting where Medicaid-eligible children with medically complex conditions get skilled nursing, personal care, therapies and caregiver training during the day. Birth through age 20, up to twelve hours a day when approved, on a physician's prescription with a written plan of care and prior authorisation.
Why a daycare said no
Licensure and staffing. A child on a ventilator, with a trach, on continuous feeds, or needing rescue medication generally cannot be safely served by staff who are not nurses. That is the gap PPEC exists to fill — it is not the daycare being difficult.
Two things families miss
Medicaid transportation to and from a PPEC is often covered. Ask before you assume you have to drive. And therapies delivered on site can replace four separate appointments spread across the county — which is hours of your week back.
If you are touring
Ask the nurse-to-child ratio by room at 7am and at 4pm. Ask whether an RN is on site at all times or an LPN with an RN on call. Ask them to walk you through the first ninety seconds of a respiratory emergency. Ask about staff turnover in the last year, honestly. And ask whether you can drop in unannounced — the answer should be yes.