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This issue brief summarizes the recent history of pediatric palliative care in California and makes recommendations for improvement. The authors note that home-based palliative care currently is an underutilized resource for families of children with complex needs, due in part to a lack of understanding of the services by families and care providers. The authors surveyed these stakeholders to assess their understanding and identify ways to improve implementation of current policies. They recommend clarification by the Department of Health Care Services of current policies and payment options, development and promotion of effective models of care, and utilization of telemedicine as a potential way to improve access to hospital and community-based pediatric palliative care.