Palliative care is the medical subspecialty focused on preventing, treating, and relieving the pain and other debilitating effects of serious and chronic illness.
Palliative care is provided by a specially trained team of doctors, nurses and other specialists who work together with a patient’s other doctors to provide an extra layer of support. It is appropriate at any age and at any stage in a serious illness and can be provided along with curative treatment.
Patients and families are often unaware of the Palliative Care benefit, but they are likely to want Palliative Care if it is appropriately described to them by their provider.
What is Palliative Care in Medi-Cal?
Palliative Care Benefit Eligibility
L.A. Care Medi-Cal and L.A. Care Medicare (HMO-DSNP) members are eligible for Palliative Care.
Palliative Care Criteria
- Increased use of hospitals or emergency departments for disease and symptom management.
- Advanced or late stage of illness and not enrolled in hospice.
- May be receiving curative treatment and/or treatment is no longer effective.
- Member is willing to try in home or outpatient management prior to using the Emergency Room.
- Member is willing to participate in advance care planning.
Eligible Conditions for Palliative Care:
- Advanced Cancer
- Chronic Obstructive Pulmonary Disease (COPD)
- End Stage Liver Disease (ESLD)
- Congestive Heart Failure (CHF)
- Other Advanced Life-Limiting Conditions
How to Make a Referral
1. Complete the Universal Palliative Care Referral & Screening Tool Form
- PCP/Specialist signature or attached MD order is preferred but not required.
- You may download the form here, or access on our Forms and Manuals web page.
2. Attach pertinent history, medical records, test results for clinical review.
3. Submit to MLTSS
- Fax: 213-438-4866 or
- Email: mltss@lacare.org