Complex Medical Care Program

Helping Children with Medically Complex Conditions and Their Families through Coordination of Services and Access to Resources

Having a child with complex medical needs can transform family life into a seemingly endless flurry of doctors’ appointments and hospital visits. It can challenge and overwhelm even the most dedicated families, stretching resources — time, energy, finances — to their limits.

SLUCare Physician Group's Complex Medical Care Program at SSM Health Cardinal Glennon Children’s Hospital offers relief for families of medically complex children. Under the direction of SLUCare physicians, our team brings together the resources families need to coordinate and optimize treatment for young patients, improving care and reducing the number of hospital and emergency room visits.

How do we help?

Children in the program have a team of health care professionals working on their behalf to support their physical and psychosocial needs. Our purpose is not to replace the care your child receives through a primary care physician or specialist. Rather, we add an extra layer of support to coordinate and streamline treatment for the benefit of both the patient and family.

Our Services

  • Seeing patients in clinic as a team to offer more complete care, resulting in fewer office visits and copays
  • Developing and maintaining an individualized care plan that documents your child’s condition(s), medications, psychosocial needs, and treatment history for quick, easy reference by all providers involved in your child’s care
  • Creating an alert system that flags medically complex patients upon arrival at the hospital so the complex care team can be engaged in the child's care
  • Streamlining appointments and transition of care among outpatient clinics, hospitals, long-term pediatric care facilities and home health providers
  • Helping families navigate the non-clinical aspects of having a medically complex child, such as managing school forms, work notes and insurance claims

Our Team

During a complex care visit, your family will meet with a variety of team members, including:

  • The SLUCare pediatrician managing your child’s team
  • Complex care nurses
  • Social worker
  • Dietitian
  • Care coordinator

Other specialists who may see your child as needed include:

  • Physical or occupational therapists
  • Respiratory therapist
  • Wound care specialty nurses
  • Palliative care specialists
  • Clinical pharmacist
  • Mental health specialist

Who Qualifies for the Program?

The Complex Medical Care Program is designed for children ages 10 and younger who receive medical treatment from four or more specialty physicians. Patients qualify if they have three or more inpatient hospital stays per year or spend 20 or more days in the hospital annually. Most patients have a rare genetic condition, birth injury or other traumatic injury.

Many children enter our program after spending time in the neonatal intensive care unit (NICU) or pediatric intensive care unit (PICU). Some are referred by their primary care providers or specialists. Others find their way in through support groups.


SLUCare Complex Medical Care Program Location

SSM Health Cardinal Glennon Children’s Hospital
1645 S. Grand Blvd.
St. Louis, MO 63104
314-268-6492

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