Our Vision / Abbey House
Texas’ first pediatric respite and hospice facility
A Difficult Truth- Texas Families Need Support
Children need Hospice and Respite Care – Although a child-focused (pediatric) hospice would benefit children and families, research indicate that very few of these homes exist. Currently, there are only 5 in the United States. The number of children that can benefit from a children’s respite and hospice home is considerable. There are approximately 85,000 medically fragile children in the State of Texas, with over 7,500 in Central Texas living with a life-limiting illness.
Caring for these children takes a tremendous physical and emotional toll on their families. Respite care (rest) is not available for the parents of these children when they are not being cared for in a hospital or at home.
A children’s respite and hospice care home bridges the gap between a home and a hospital for many families. It provides a home-like environment designed exclusively for children and young adults. It gives the primary guardian a break from the demands of continuous daily care, a chance to relax and even gives them an opportunity to reconnect with their other children.
It will also give families a tranquil and peaceful place to take their child to spend their last days in a private, comfortable setting that is specifically for children. This is a time for families to cherish the limited time they have with their child making memories. It gives families an option other than the hospital or at home (which can be extremely emotional to siblings). This will fill a void previously unmet.
Most medically fragile children living with life-limiting conditions who need constant 24-hour care have difficulty accessing support, which can result in unnecessary pain and suffering and excruciating strains on families and communities.
It will take a community to make this happen. It is time to help the families currently waiting to use this home right now.
Texas Can Lead in Pediatric Palliative Care
Building a Pathway for Pediatric Palliative Care Centers
Contact Information
Melissa Keller
Founder & President
Abigail E. Keller Foundation
mkeller@aekellerfoundation.org
A Growing Need for Texas Families
Families caring for children with life-limiting conditions provide intensive, round-the-clock care with little relief. Yet, most Texas communities offer no access to skilled overnight respite, leaving families overwhelmed physically, emotionally, and financially.
Children with medical complexity represent less than one percent of the pediatric population but account for a disproportionate share of healthcare utilization. Texas is home to 85,000 medically complex children, including 7,500 in Central Texas, many requiring coordinated, interdisciplinary support.
Why Pediatric Care Must Be Different
Children are not small adults. Pediatric palliative care requires an interdisciplinary, family-centered model that supports the child, parents, siblings, and caregivers addressing medical, psychosocial, emotional, spiritual, and practical needs.
Adult-oriented licensing and reimbursement structures create barriers to developing community-based pediatric respite,hospice, and palliative care programs.
The Missing Piece in Texas
Texas offers excellent pediatric healthcare, but no licensing pathway exists for community-based Pediatric Palliative Care Centers (PPCCenters). Current categories hospitals, skilled nursing facilities, assisted living facilities, hospice units, and PPECs were not designed to deliver the full spectrum of family-centered pediatric support in a home-like setting.
Families consistently identify overnight respite, pediatric palliative care support, care coordination, family services, and end-of-life accommodations as critical unmet needs.
A New Policy Framework Is Emerging
States across the country, modernizing regulations to support pediatric-specific care models. In 2025, Iowa became the first state to establish a dedicated PPCCenter license through Mason’s Law. Other states are now exploring similar approaches.
These models strengthen family caregiving capacity, support children at home, and reduce reliance on higher-cost healthcare settings aligning with Medicaid and system-wide efficiency goals.
The Abbey House Vision
Since 2019, the Abigail E. Keller Foundation has supported Texas families caring for medically fragile children. Abbey House will be Texas’ first PPCCenter: a community-based, home-like environment offering short-term overnight respite, pediatric palliative care support, therapeutic spaces, caregiver relief, family services, and end-of-life accommodations.
PPCCenters complement not replace hospitals, hospice providers, home health agencies, and community organizations.
Policy Opportunities for Texas & Moving Forward Together
A pediatric-specific licensing pathway for PPCCenters
Regulations that reflect the unique needs of medically complex children
Sustainable reimbursement models for pediatric respite and palliative care
Partnerships that expand access and improve system efficiency
Texas can lead the nation in supporting medically fragile children and their families. We invite policymakers, agencies, healthcare leaders, providers, researchers, philanthropic partners, and community stakeholders to explore how Texas can build a compassionate, community-based care pathway.
Meet Aide: In Her Words, A Story of Hope and ‘What If’
In the words of Aide Benson, a bereaved mom of a medically complex child, Christopher. “Every family with a medically fragile child carries an unseen weight—sacrifices, exhaustion, and the haunting question of ‘What if.’
In the words of Aide Benson, a bereaved mom of a medically complex child, Christopher. “Every family with a medically fragile child carries an unseen weight—sacrifices, exhaustion, and the haunting question of ‘What if.’
Abbey House is the answer to that question. It’s a place where love, care, and compassion transform the impossible into the bearable. Abbey House will give families like Aide’s a chance to breathe, to focus on one another, and to find hope in the hardest moments.
Together, we can turn ‘What if’ into ‘We did it’.
The Abigail E. Keller Foundation board of directors and Dr. Patrick Jones Dell Children’s Palliative/Hospice Director, recently had the opportunity to visit Crescent Cove pediatric respite/hospice home in Minneapolis.
What a wonderful facility supporting medical fragile and terminally ill children and their families. Such an inspiration in our work to open one here in Texas.
The Abigail E. Keller Foundation is proud to be affiliated with:
