By California Children's Trust, September 2019

Whole-Family Wellness for Early Childhood: A New Model for Medi-Cal Delivery and Financing outlines a new approach for California to conceptualize, deliver, and fund a system of care for Medi-Cal eligible infants and toddlers that is grounded in family wellness. At present, California is not adequately addressing the needs of young children on Medi-Cal, allowing millions to miss out on important preventive care each year because Medi-Cal health plans do not meet the whole family’s needs.

The need for family- and community-centered care is particularly critical in pregnancy and the first five years of life, when the architecture of the brain is established and neural connections grow at the fastest rate of a person’s lifetime. During this period, the brain shapes key abilities for long-term wellness, such as forming trusting relationships, being open to learning, and regulating emotions. Healthy, loving caregivers promote healthy development in young children; thus, the whole-family context is vital.

Currently in California, the Medi-Cal system focuses on delivering individual services for children, outside the context of their families and communities. For example, healthcare providers and systems must determine a young child’s “psychopathology” before they offer mental health care or are reimbursed for it. Yet many clinicians do not receive training in early childhood mental health, and the diagnostic criteria are based on adult symptoms, calling accurate diagnosis into question. At the same time, young children in genuine distress due to family conflict, community violence, economic hardship, and parental mental illness may not fall under a diagnosis, but still need support.

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