If you’re a community health worker, CBO, or doula in California, you’ve probably seen it firsthand: a client managing diabetes who can’t consistently afford or access the right foods. A pregnant mother whose nutritional needs aren’t being met. Someone who shows up to every appointment but whose health isn’t improving because what happens between those appointments — at home, at the table — isn’t being addressed.

Food is medicine. And through California’s Medi-Cal program, there’s now a pathway to actually prescribe it.

Here’s what you need to know about medically tailored meals (MTMs) and medically tailored groceries (MTG) under CalAIM Community Supports, including who qualifies, how the referral works, and why CHWs and doulas are uniquely positioned to make this benefit real for the members they serve.

The chronic disease crisis makes this urgent

The numbers are hard to ignore. The 2025 Preventing Chronic Disease Report, which analyzed data from 2013 to 2023, found that roughly 6 in 10 young adults, 8 in 10 midlife adults, and 9 in 10 older Americans have at least one chronic condition. Diabetes, hypertension, heart disease, obesity, and chronic kidney disease are among the most common, and all of them can be meaningfully addressed through nutrition.

The evidence that food-based interventions work is strong. In a pilot study conducted by Pear Suite partner, Project FoodBox, in partnership with UC Irvine Health, Latino and Latina individuals with diabetes who received produce boxes and nutrition education showed an average 1% reduction in A1C levels over slightly more than five months, according to Project FoodBox. The company says that improvement is clinically equivalent to starting a new diabetes medication and reduces the risk of complications such as kidney damage, nerve damage, and vision loss by 40%. For a 13-patient cohort, Project FoodBox estimates the results translated to $52,000 in annual savings.

For maternal health, the stakes are just as high. Poor nutrition during pregnancy is directly linked to gestational diabetes, preeclampsia, low birth weight, and preterm birth. Eight in 10 pregnancy-related deaths in the U.S. are preventable, and nutrition is one of the most modifiable risk factors. A 2026 preprint study, not yet peer-reviewed, on the Food for Moms produce prescription program, launched in 2022 by Wholesome Wave, the Hispanic Health Council, and Yale Griffin Prevention Research Center, found that after 10 months, participants showed significant improvements in healthy eating readiness, fruit and vegetable intake, and household food security. This isn’t a niche concern; it’s a public health emergency with a practical intervention available right now.

What is medically tailored nutrition?

Medically tailored meals (MTMs) and medically tailored groceries (MTGs) are food-based supports designed around a person’s specific health condition, not just their food insecurity. Think lower-sodium meals for someone with high blood pressure, or higher-fiber options for someone with diabetes, to help stabilize blood sugar.

When delivered consistently, MTMs and MTGs:

• Improve clinical outcomes, for example, by lowering A1C, making blood pressure more stable, and reducing BMI
• Reduce emergency and inpatient visits
• Improve medication adherence and physician engagement
• Build independent living skills through paired nutrition education from a registered dietitian

MTMs and MTGs are not a food bank. They are a clinical intervention, and under CalAIM, they are a billable one. Since these services are provided based on medical necessity, health and nutrition education are also provided as a requirement to obtain food delivery.

Does Medi-Cal cover medically tailored nutrition?

Yes, through the Community Supports program under CalAIM. MTM and MTG are among the services available under Community Supports and are authorized through a member’s managed care plan as medically necessary.

As of July 1, 2025, updated eligibility criteria require that members:

• Be enrolled in a Medi-Cal managed care plan
• Have a nutrition-sensitive health condition, such as diabetes, heart disease, cancer, chronic kidney disease, or high-risk perinatal conditions that can be managed through medically tailored meals

It’s important to understand that MTM and MTG authorization are tied to a member’s medical condition, not food insecurity alone. A member may be food insecure and still not qualify if they don’t have a qualifying condition (though many do). Conversely, a member with a qualifying condition who is not food insecure may still be eligible. Knowing this distinction helps you refer the right members and set accurate expectations.

How does the referral process work?

The referral pathway is more accessible than many people realize, and it can come from multiple directions.

Who can make a referral?

• Community members themselves can go directly to their managed care plan and request MTM/MTG authorization without needing an intermediary. Your role as a CHW or doula is to make sure they know this option exists.
• CHWs and CBOs can identify eligible members and submit referrals directly to the managed care plan.
• Doulas supporting Medi-Cal beneficiaries can screen for qualifying conditions and refer directly to the managed care plan or to an MTM/MTG provider. This applies to postpartum mothers as well, not just during pregnancy.
• Enhanced Care Management (ECM) providers can make the referral, and MTM/MTG can be layered on top as an additional benefit.

What to expect on timeline

Set honest expectations with your members. Every MTM and MTG provider has their own processes, so verify the timeline before you communicate with the client. 

The full process from referral submission to first delivery is typically around six weeks:

• Referral review by the MTM/MTG provider: 2 to 3 business days
• Nutrition assessment: 2 to 3 business days
• Health plan authorization decision: 2 days to 4 weeks (varies by plan)
• First delivery after approval: 1 to 3 business days

Once approved, the standard service is two meals per day for 12 weeks, or one produce box per week, with the ability to renew based on continued medical necessity. Nutrition education from a registered dietitian is included throughout.

Why this matters for CHWs, CBOs, and doulas

For CHWs and CBOs, connecting members to MTMs/MTGs isn’t just good care; it’s billable care. Under CalAIM Community Supports, organizations delivering MTM and MTG services can bill Medi-Cal managed care plans for that work. That’s a direct path from grant-dependent programming to reimbursable, sustainable services. If your organization is already doing this work, MTM and MTG are an opportunity to strengthen your financial model while deepening your impact.

For doulas, this is a gap most aren’t aware of yet. While CHWs and ECM providers are often plugged into community collaboratives where this information circulates, doulas tend to be more focused on the individual and less likely to hear about it. But doulas are already addressing nutrition and healthy eating habits with their clients as part of standard support. Making MTM/MTG referrals is a natural extension of what you’re already doing, and gives you a way to document and demonstrate the impact of your social determinants of health (SDOH) work alongside your doula care.

The same Medi-Cal population you already serve under the doula benefit is the eligible population for MTMs/MTGs. That includes postpartum mothers, not just those currently pregnant, as well as mothers who have experienced miscarriage or pregnancy loss and remain enrolled in Medi-Cal managed care.

How Pear Suite supports this work

Pear Suite embeds MTM/MTG referrals directly into CHW and doula workflows, so you don’t have to manage a separate process. From within the platform, you can screen members for eligibility, submit referrals to MTM/MTG providers like Project FoodBox and Mom’s Meals, track authorization status, and document the SDOH work and nutrition support you’re providing alongside the referral.

Project FoodBox reports it has helped more than 200 members through the Pear Suite platform with a 98% engagement rate. That’s what happens when the referral pathway is built into the tools your team is already using every day.

For members who are food insecure but don’t have a qualifying condition for MTMs/MTGs, Pear Suite’s FindHelp feature, a 211-type resource integrated directly into the platform, allows you to search for food assistance programs, housing support, and other community resources in your member’s area and make warm referrals without leaving the system.

The bottom line

CHWs and doulas are often the first to see when a member’s nutrition is putting their health at risk. Now there’s a reimbursable, evidence-backed benefit to address it, and you’re already positioned to make the referral.

If you want to learn more about how two MTM and MTG providers are serving California and how you can tap into the service for your clients, watch this on-demand webinar with Project FoodBox and Mom’s Meals.