Pediatric Care: How Chapters Health System Helps

by | Feb 24, 2022

Learn about pediatric palliative and hospice care at Chapters Health System and how they can help manage complex diseases in children.

A picture can speak a thousand words. For Emily and Gabriel Calcines, their family photo tells a story. The story of their strong and courageous son named Luke, who overcame more health challenges in the first two years of his life, than many people face in a lifetime. Soon after he was born, doctors diagnosed Luke with Vein of Galen, heart failure and pulmonary hypertension, among other complications. More than seven specialists became involved in Luke’s care. His family soon turned to to pediatric care services at Chapters Health System.

Calcines family photo

Gabriel Calcines (left), Luke Calines (center), and Emily Calcines (right) pose for a family photo.

“We decided for Chapters Health Pediatric Palliative Care to also be involved in his care in order to help us navigate all of the specialists while still putting the main focus on the big picture of Luke’s plan of care and what was best for his long-term care,” said Emily.

Through Luke’s story, and the experiences of a nurse practitioner, you can learn how the pediatric programs at Chapters Health System can make a difference for any child touched by life-limiting illness.

Pediatric Care Continuum

At Chapters Health, there is a continuum of care for all patients, guiding them at every step of their health journey. This continuum treats three types of children: those with chronic or complex conditions who require palliative care, those with serious conditions who are not yet eligible for hospice and those needing end-of-life care.

Children can receive palliative care, hospice care and bereavement services, all from clinicians and team members specialized in working with young patients. Those team members include board-certified physicians, advanced practice registered nurses (APRNs), chaplains and licensed mental health counselors.

In addition, two affiliates, LifePath Hospice and Good Shepherd Hospice, provide palliative care through Partners in Care: Together for Kids Program in Hillsborough, Highlands and Polk counties.

Pediatric Palliative Care

This is the type of care Chapters Health provided Luke. It is for children who do not yet qualify for the hospice benefit but require regular care to manage symptoms. It focuses on addressing the symptoms, easing pain, adding comfort and improving quality of life in the youngest.

“He was very critically ill as a child with his Vein of Galen diagnosis and required a ton of medical support and intervention,” said MariBeth Allen, APRN for Chapters Health Palliative Care. “Several institutions had to get Luke to a point where he could start to recover. From that recovery is where we got involved and helped with his symptom management when he got home, which was a long road. He has been able to overcome so much with his parents and care team.”

Maribeth Allen, APRN, visits with family of pediatric patient.

Maribeth Allen, APRN with Chapters Health Palliative Care, visits with the family of a pediatric patient at the Temple Terrace clinic.

Allen said her team still sees Luke every two weeks or so to make sure his symptoms are managed and identify any additional social support the family needs. Luke’s mother said that support has made all the difference.

“Luke is now a thriving two-year-old, and we are so grateful to Chapters Health for their professional medical expertise and their unending compassion to support us during very stressful times,” said Emily.

“Stories like Luke are very special because I think it eliminates the stigma of palliative care, which is we only take care of children who are dying,” said Allen. “We take care of a lot of children who are thriving, going to school every day, and you would never know that they have complex conditions.”

Expert care from talented clinicians is not the only benefit of pediatric care with Chapters Health. Patients at Chapters Health are introduced to an organization full of supportive volunteers and team members who seek to make life easier for patients. One example is a holiday gift drive-thru event Allen and her palliative care team organized for patients and families just two months ago. Patients and families were treated to snacks, gifts and a lot of love from volunteers and team members.

“Allowing these kids and their families to have a few moments of normalcy and celebration of the holiday was so special to see and experience,” said Allen. “Although I care for them daily, it was still incredible to be able to take the medical hat off for a moment and just celebrate each of them for who they are.”

Maribeth Allen, Chapters Health Palliative Care APRN, participates in Christmas gift drive for pediatric patients.

Maribeth Allen (left), APRN for Chapters Health Palliative Care, helps deliver gifts to pediatric patients at St. Joseph’s Children’s Hospital in Tampa.

Referring physicians benefit as well from the education and spiritual support palliative care provides to families, allowing them to make more informed decisions with regard to complex disease management. According to 14 studies, published in the Cambridge University Press, pediatric palliative care also resulted in less visits to intensive care units and less intense end-of-life care once the disease progressed.

Pediatric Hospice Care

What is the difference between pediatric palliative care and pediatric hospice care? Hospice is a philosophy of care reserved for patients who are expected to live six months or less if the disease follows its expected course and the patient has ended curative treatments. However, a patient can still maintain their hospice benefits even if they live longer than six months and many do. Palliative care is available to pediatric patients, regardless of life expectancy.

What if a family is considering transitioning from palliative care to hospice?

“Part of what we do is continual evaluation of when a patient is showing progressive decline,” said Allen. “We would have a conversation with the family to discuss hospice care and explain how that might be easier. That allows for the element of someone to come into the home and provide hands-on care.”

Like any hospice patient, pediatric patients would benefit from all levels of hospice care, including routine hospice care, continuous care, respite care and inpatient care.

Chapters Health System is committed to serving the needs of its patients, families, caregivers, health providers, partners and communities.

For more information, please call our helpful Chapters Health team at 1.866.204.8611 or Contact Us.

Austin Mudd

Austin Mudd

Austin Mudd, Media Relations Specialist at Chapters Health System, is responsible for external communications for the nonprofit organization. Email: [email protected]

About Us

Established in 1983 as a community-centered, nonprofit entity, Chapters Health has grown exponentially through its radical approach to healthcare that leverages a one-of-a-kind system to support patients, families, and caregivers across the country, while remaining grounded in the mission of taking care of patients, or taking care of those who do®.

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John J. Whyte, MD, MPH

CEO and Executive President,
American Medical Association

John Whyte, MD, MPH serves as the CEO and Executive Vice President of the American Medical Association, the nation’s largest physician organization.

Prior to the AMA, Dr. Whyte served as the Chief Medical Officer at WebMD, leading initiatives that expanded strategic partnerships, created new business opportunities, and positioned WebMD at the forefront of digital health innovation. He was a pivotal force in evolving WebMD’s digital platforms from content delivery engines to powerful tools connecting consumers directly to care, establishing critical new revenue models. He is a recognized leader in healthcare delivery and regulation and is consistently named as one of the Top 20 Health Influencers.

Before joining WebMD, Dr. Whyte served as Director of Professional Affairs and Stakeholder Engagement at the U.S. Food and Drug Administration’s Center for Drug Evaluation and Research. There, he spearheaded groundbreaking initiatives to modernize clinical trial design, expand diversity in research, and advance the regulatory use of real-world evidence — efforts that continue to impact patient-centered drug development today.

Earlier, as Chief Medical Expert and Vice President of Health and Medical Education at Discovery Channel, Dr. Whyte launched educational programming that captured both medical and mainstream audiences, successfully aligning mission-driven health education with corporate funding strategies and building new multimedia brand identities.

At the Centers for Medicare & Medicaid Services (CMS), Dr. Whyte played a pivotal role in formalizing Medicare’s national coverage decision process, directly shaping payment policies and advancing innovative models to improve healthcare outcomes. His experience at CMS demonstrates a deep understanding of health policy, reimbursement strategies, and the critical intersection of clinical innovation and payment models.

A board-certified internist, Dr. Whyte completed his MD at Hahnemann University School of Medicine, his residency at Duke University Medical Center and earned his MPH in Health Policy and Management at Harvard University. He previously served as a health services research fellow at Stanford University. An accomplished author, Dr. Whyte has written extensively for both professional and consumer audiences, including five best-selling book

Andrew Molosky on podcast

Dr. Venki Ramakrishnan

Nobel Laureate

Venki Ramakrishnan is an American and British molecular biologist who shared the 2009 Nobel Prize in Chemistry. He currently works at the world-renowned MRC Laboratory of Molecular Biology in Cambridge, England and from 2015-2020, he served as President of the Royal Society, one of the world’s oldest scientific organizations. He is best known for his work on protein synthesis, the process by which genetic information is used by the ribosome to make the thousands of proteins that make life possible. This process is fundamental to all life and its dysfunction leads to many diseases as well as to aging. He is a member of the US National Academy of Sciences and was knighted by the British government in 2012. In 2022, he received one of Britain’s highest civilian honors, the Order of Merit, which is restricted to 24 people across all fields.

In addition to his academic work, Ramakrishnan is a science partner of the venture capital fund Ahren Innovation Capital, and on the boards of the AI-based drug development company, Isomorphic Labs, and the British Library. He recently co-founded RNAvate, an RNA therapeutics company based on stable, next-generation RNA molecules. In the public arena, he played a leadership role when he was president of the Royal Society, including dealing with the consequences of Brexit and helping convene the Society’s response to provide advice during the covid pandemic and did a significant amount of public engagement including articles in the press and appearances on national media.

Ramakrishnan is the author of two popular books: Gene Machine (2018), a very frank scientific memoir about the race for the structure of the ribosome that led to the Nobel Prize; and Why We Die: The New Science of Aging and the Quest For Immortality (2024), which looks at the biology of aging and efforts to combat it.

Andrew Molosky on podcast

Marwa El-Menshawi, MD, MPH

Chief Operating Officer, PACE Chapters Health System

Marwa El-Menshawi, MD is the Chief Operating Office for Hope PACE. She is a triple board-certified physician, specializing in Family, Geriatric and Hospice Medicine. Dr. El-Menshawi's focus is on improving the lives of those affected by advanced age and serious illness through innovation in high complexity and value-based care. She has almost 20 years of clinical, academic and healthcare leadership experience.

Dr. El-Menshawi is a member of the American Academy of Family Medicine and the National PACE Association. She serves on the Mayor's Committee for Livability and Healthy Aging, focused on serving the community through advocacy and education, recommending and promoting programs and initiatives that benefit older adults.

Dr. El-Menshawi earned her Medical Doctorate as a Magna Cum Laude graduate from the University of Alabama School of Medicine and was awarded the distinguished membership into the Alpha Omega Alpha medical honors society, along with multiple academic achievement awards including the American Medical Women's Association Glasgow-Rubin Achievement Citation, the Merck Manual Award and the Peacock Teaching Fellowship. She completed her residency in Family Medicine and Certificate of Added Qualifications in Geriatric Medicine following a Geriatrics Fellowship at Advent Health in Orlando, FL. She serves as a Clinical Assistant Professor of Geriatrics at the Florida State University College of Medicine and an Assistant Professor of Family Medicine at the University of Central Florida College of Medicine.

Andrew Molosky on podcast

Andrew Molosky

President and CEO, Chapters Health System

Andrew Molosky is the President and Chief Executive Officer of Chapters Health System, the country's defining chronic illness organization, comprised of more than 30 different companies and programs, including the nation's largest nonprofit hospice network, PACE, value-based care such as CareNu, a Medicare Advantage plan, managed services organizations, technology solutions, advanced illness offerings, and more.
Established in 1983 as a community-centered, nonprofit entity, Chapters Health has grown exponentially through Molosky's innovative approach to healthcare, becoming a national leader recognized by Great Places to Work, Fortune, USA Today, and others for being a top place to work.
As a leading voice in healthcare, Molosky is routinely engaged as a consultant, speaker, and mentor. Molosky is modeling and leading across several industries concurrently.
Molosky has more than 20 years of experience spanning an array of geographies and organizations, including publicly traded, privately held, and nonprofit. He completed his undergraduate work at the University of Toledo and his Master of Business Administration from the Ken Blanchard College of Business at Grand Canyon University, additionally holding his Fellowship from the American College of Healthcare Executives.

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