There is a large gap in the available pediatric hospice/concurrent care services in the Fresno, Madera, and Merced County regions. With an additional hospice available in the area, this would decrease the burden on the local children’s hospital and move care to the family's home. The additional hospice also allows children to enroll earlier to establish rapport, and provide discussions of goals, wishes, and fears; all while optimizing symptom management, ultimately avoiding cumbersome unnecessary ER visits, hospital admissions, and end-of-life discussions.