Medically Fragile and EPSDT Program


For Children up to 21 years old, who meets the eligibility for the Medically Fragile Wavier Program, who have a high level of dependence on medical technology such as ventilators, tracheostomies, oxygen, feeding tubes, dialysis, and intravenous medication and require total care for all their daily needs are identified as medically fragile. The family is included in every aspect of care; from planning their child’s daily care to policy development at a State level.

J&J Home Care works with the Medically Fragile Program providing Skilled Nursing, Therapy, Home Health Aides, Homemakers and personal Care Attendants.  The services in the community and through the Medically Fragile EPSDT and Medically Fragile Waiver, support families in their decision to care for their child who is medically fragile in their home.

The determination of whether or not a child needs in-home care isn’t necessarily made based on the child’s diagnosis, instead it’s decided based on the medical fragility of the child.  The child is considered medically fragile if he or she has an ongoing or chronic illness which has lasted at least one year or which has required a hospital stay of one month or longer.  Generally he or she would require daily medical treatments and monitoring, and are dependent on a medical device or assistive technology.

Some examples of children who would qualify for home nursing care are:

  • Premature Infants: most premature infants (24 – 32 weeks) have complications that would qualify them for home nursing;
  • Respiratory-compromised children: bronchopulmonary dysplasia, traumatic brain injury complications, syndrome- related complications, tracheostomy either permanent or temporary;
  • Cardiac-compromised children: syndrome-related complications, congenital anomaly, etc.; Neurologically-compromised children – seizure disorder, syndrome-related, Cerebral Palsy, seizure control devices;
  • Ventilator Dependent Children
  • Gastronomy - children who require feeding either via NJ tube or G Button. 

J&J Home Care, Inc. can provide home care for medically fragile children from 0 – 21 years of age. J&J Home Care, Inc. works more like Private Duty Nursing instead of intermittent care which is the case in geriatric home health.  When we are talking about Private Duty, we are talking about skilled nursing care provided in the patient’s home on an hourly basis.  This could be as little as 4 hours a day or up to 24 hours a day, depending on the needs of the child.  Home nursing is a continuation and an extension of the nursing care that was received in the NICU.  Skillful observations, medical treatments, charting, medication management, and caregiver education are just some examples of what skilled nursing can do in the home.