Austin loses in-home pediatric hospice as Dell Children's ends program

For families in Central Texas, Friday marks the end of the region's only program that brought hospice care directly to the bedside of a dying child. Dell Children's Medical Center is closing its Hospice at Home program, shifting services to an outpatient clinic setting. This change forces parents to transport medically fragile children to a facility rather than receiving specialized support at their own residence.

The hospital stated that care will now be provided through the Comprehensive Care Clinic, which serves children with complex diagnoses. Dell Children's noted that complex care referrals are already underway and that individualized transition plans have been created for each patient to support uninterrupted care. Despite these assurances, the closure leaves Central Texas without a dedicated provider for in-home pediatric hospice.

Shannon McLennan, a mother from Leander, learned about the change two weeks ago. She said she was not provided with a specific transition plan for her daughter, Oli, but was told the decision related to Medicaid hospice certification. In Texas, hospice agencies must hold licenses as Home and Community Support Services Agencies and maintain contracts for Medicaid reimbursement. Oli has a gene deletion affecting her sight and is suffering from intestinal failure. She has been enrolled in Dell Children's hospice care since March.

Because Oli is 19, she is eligible to transition to Hospice Austin, which operates an adult program but no longer has a pediatric division. McLennan, a nurse who previously worked at Dell Children's, expressed frustration on Instagram. She argued that expecting parents to take dying children to a clinic is unrealistic. 'I can't even get my daughter in a car,' she said. She noted that parents often hesitate to administer morphine for pain control or understand the dying process, making home-based assistance critical.

Dell Children's has not publicly explained the specific reasons for the closure, despite inquiries regarding staffing, certification, or funding. The program launched in 2022 after neonatologist Dr. Patrick Jones arrived from Memorial Hermann Health System in Houston, where he founded a similar system. Dr. Jones left Dell Children's in March to work for a neonatology group covering Ascension Texas hospitals. Dr. Tyler Badding assumed the hospice and palliative care role but is now listed under the hospital's palliative care program.

A 2025 report from the National Alliance for Care at Home identified staffing as the primary barrier to pediatric hospice care. The report found a shortage of doctors and nurses trained in this field and noted that costs and reimbursements played a larger role in 2025 than in previous years. Pediatric hospice care is not mandated by insurance, and 60.1% of children requiring such services are covered by Medicaid, which often offers lower reimbursement rates than private insurance or Medicare.

Hospice Austin, a nonprofit that previously partnered with Dell Children's, does not currently employ a pediatrician. The organization stated it is aware of the community need and is discussing how to support those needs. Texas Children's Hospital and St. David's Children's Hospital, both operating in Austin, do not have hospice programs. The Abigail E. Keller Foundation is raising $6 million for a pediatric palliative care and hospice center in Texas, but it is not yet an in-home service. Melissa Keller, whose daughter Abbey died in 2019, said the foundation is beginning to offer social workers to assist local families.

McLennan hopes Texas Children's or Hospice Austin will restart pediatric programs in the area. She emphasized that the Dell Children's team was dedicated to Oli's care and did not deserve to be disbanded. The foundation's center, named Abbey House, aims to provide a home-like setting for care, as there are currently only seven such facilities in the United States, with none in Texas.