The Family CNA Model: Supporting Families and Improving Care for Children With Medical Complexity

Below is an excerpt from a paper on the Family CNA Model developed by Manatt Health, with support from Team Select Home Care and in partnership with Family Voices, Health Leads, and the Lucile Packard Foundation for Children’s Health. Click to read the full paper and analysis. 

There is an urgent need to expand access to care delivery models that keep children with medical complexity in their homes and out of costly hospital or institutional settings, while supporting families’ financial security. A small but growing number of state Medicaid programs are adopting the Family Certified Nursing Assistant (CNA) model to do just that.

The Family CNA model trains and reimburses family members—including parents, guardians, siblings, aunts, uncles, and grandparents—to provide certain types of home care for children with medical complexity that would otherwise be provided by a registered nurse (RN), a licensed practical nurse (LPN), or a non-family CNA. This care includes low acuity in-home nursing tasks, such as medication administration, gastronomy tube (G-tube) care, or catheter care. Family CNAs are licensed or certified health care professionals that work in concert with other providers on a child’s care team, including RNs and LPNs who provide supervision and perform high-acuity tasks, to support their child’s medical needs and activities of daily living at home.

This paper enumerates the unique benefits of the Family CNA model including helping to address workforce shortages, improving the continuity and quality of care, and strengthening families’ agency. The paper also identifies actions that federal and state policymakers can take to better support family caregivers and expand access to the Family CNA model.