First 5 Center Proposes Early Childhood Home and Community-Based Services Medi-Cal Benefit: A Crucial Step in Supporting California Families Across the Care Continuum

Babies bring big change to families and all parents can benefit from emotional, physical, and educational supports to help them with the transition. Over the past few years California has made important strides to improve the continuum of maternal and child health services, from prenatal care to postpartum and beyond. Most recently, in February 2025, California’s Department of Health Care Services released its Birthing Care Pathways Report, a policy roadmap for pregnant and postpartum care in Medi-Cal. Driving these efforts are the persistent sobering health disparities impacting families of color, with Black families most acutely affected. Experts link these outcomes to racism, lack of cultural congruence in health care, and limited access to high-quality services. These realities underscore the urgent need for broader, culturally resonant, community-based supports—such as home visiting—to help all families thrive.

New Medi-Cal Benefits to Support Perinatal Families

California’s Medi-Cal program has recently added many new Medi-Cal benefits to reimburse important services, including doula services, community health worker services, and dyadic services. The focus, approach, and services in each benefit are slightly different, but each can play an essential role for Medi-Cal families during the perinatal period. Left out of this list however, is home visiting, which is currently funded by a mix of state, federal and First 5 dollars, and can only reach a small portion of the families who could benefit. The exclusion of a specific home visiting benefit in Medi-Cal leaves a gap in perinatal supports for families interested in services to support their parenting journey, attachment with their child, and promote their child’s health and development.

What Are Home Visiting Services?

Home visiting connects families with trained professionals—nurses, early child development specialists, and other community-based providers—who provide crucial support and promote positive infant health and development. These providers screen for postpartum depression, encourage and facilitate well-child visits, connect families with needed social services, and provide emotional support. When home visiting programs use culturally responsive and community-driven approaches they have the potential to address racial and ethnic disparities and improve maternal and early childhood outcomes.

Expanding the Home Visiting Landscape Through an Early Childhood Development-Focused Medi-Cal Benefit

In our latest two briefs, The First 5 Center reviews existing home and community-based perinatal supports offered to California families and proposes how California could expand the home visiting landscape through Medi-Cal. Our research outlines a proposal for a new Medi-Cal benefit that would provide universal parenting supports for Medi-Cal members. Our vision is to create a floor of access for early childhood supports for low-income families, widening beyond our current home visiting infrastructure and evidenced-based programs. This work can support the state’s interest in expanding access to home visiting services for Medi-Cal members, as outlined in the Birthing Care Pathways Report. By creating an early childhood home and community-based services benefit, California can build on the progress made through community health worker services and doula benefits and help all families receive consistent, continuous care before, during, and after birth.