The American Academy of Pediatrics has called for an adequately funded and trained workforce of home healthcare providers, including physicians, advanced practice providers, registered nurses, licensed practical nurses, certified nursing assistants, aides, therapists and family caregivers, among others.
The American Academy of Pediatrics updated its recommendations for pediatric home healthcare financing in a policy statement published in the December 2025 Pediatrics.
The statement, “Financing of Pediatric Home Health Care,” observes that a common misunderstanding of pediatric home health care is that it exists to support parents. Instead, home health care is both medically necessary and legally entitled care for the medically vulnerable child, as explained in the policy statement, written by the AAP Section on Home Care and Committee on Child Health Financing.
Children who once may not have survived birth are now surviving, and they require more significant care. More children with medical complexity are being cared for at home, often with the help of medical equipment such as feeding tubes, oxygen, or ventilators allowing them to be with family in lieu of a hospital setting.
The AAP advocates for accessible, high-quality pediatric home healthcare, including the development of pediatric-specific home health care regulations, eligibility guidance, and pediatric-focused metrics.
Home healthcare is a key part of the child’s journey as they grow and eventually transition to adult care and systems.
The policy calls for adequately funded and trained workforce of home healthcare providers including physicians, advanced practice providers, registered nurses, licensed practical nurses, certified nursing assistants, aides, therapists and family caregivers, among others.
A summary of those recommendations follows:
Pediatric home healthcare (HHC) should follow a clear, family-informed care plan, with clinicians determining and adjusting services based on medical need—not algorithms. Federal agencies should strengthen oversight, clarify EPSDT obligations, ensure equitable service allocation, and establish an ombudsman to monitor complaints, denials, missed shifts, and quality. Adequate payment, workforce expansion, provider and family-caregiver training, and flexible consumer-directed programs are essential. States should improve scope-of-practice rules, support paid family caregiving, ensure accessible DME, and incentivize interoperability. CMS should fund innovative care models, standardize data, evaluate equity, and expand research to improve quality, access, and outcomes in pediatric HHC.
Policy statements created by AAP are written by medical experts, reflect the latest evidence in the field, and go through several rounds of peer review before being approved by the AAP Board of Directors and published in Pediatrics.
