Santa Clara County wants more family home care visits

Santa Clara County may be able to serve more vulnerable children through home visits by tapping into new Medi-Cal funding.

The state revamped Medi-Cal in 2022 to establish more coordinated, holistic care through an initiative called California Advancing and Innovating Medi-Cal (CalAIM) led by the Department of Health Care Services. As a result, providers can bill Medi-Cal for services that aren’t considered traditional medical care. The Santa Clara County Board of Supervisors in January directed staff to explore using CalAIM to fund family home visits, as well as expand the age range of children who can receive this benefit.

Home visits can look different for every family, but are meant to support parents and children during early stages of development by bringing resources straight to their door. During a visit, the individual might help foster healthy parent-child relationships by providing parents with child-rearing tips, conduct health assessments or connect families to additional county resources. Therapists and nurses may also make home visits to give more targeted assistance.

More than 6,900 Santa Clara County families receive home visit services, though officials said there is greater need. The visits cost $35 million annually — $12 million of which is funded by the county, and the rest through a combination of private and public dollars. By leveraging potential CalAIM funding, the county can sustain current home visiting programs and potentially expand services.

“The long-term benefits of expanding home visiting programs are really well documented,” Supervisor Susan Ellenberg, who in 2023 directed a study to explore an expansion of these services, told San José Spotlight. “They lead to more stable, less stressed home environments. They lead to children who are better prepared to begin school, and adults and caregivers who are more confident in their own parenting skills.”

Studies show home visits help prevent incidents of child abuse and foster greater academic success. For every dollar spent on home visits, the return on investment ranges from $1.75 to $5.70.

A feasibility study conducted by First5 of Santa Clara County shows home visits programs are underutilized and underfunded by about $1 million. First5 found the areas of greatest need in the county — East San Jose, Gilroy and North County — have the lowest reach when it comes to these services. Some programs have challenges in retaining staff due to low wages, emphasizing the need for more streams of funding, according to the study.

“The programs have had to be really scrappy to make it work in terms of serving the families,” First5 Program Officer Emily Fayram told San José Spotlight.

County workers will explore the seven recommendations First5 made in the study to expand services and bring their findings back to supervisors later this year. One recommendation is the possibility of leveraging CalAIM to serve some of the approximately 4,500 newborn babies who qualify for Medi-Cal, where a provider makes several wellness visits to a family’s home to get them connected to the right resources. The county is also exploring funding doula services through CalAIM.
Keep our journalism free for everyone! “I think, especially in the environment we’re dealing with right now where families are fearful of accessing public resources, to have a program like this with a trusted messenger and a service delivery that is built on relationships, is going to be critical to keep our families engaged with the services that they need,” First5 CEO Jennifer Cloyd told San José Spotlight.