Maternal morbidity and mortality in the United States is an urgent public health issue, and there are stark differences by race and ethnicity. Community-based doula care is an evidence-based strategy to improve maternal health through accompaniment, health care engagement, addressing social needs, and promoting respectful care. Yet, there is a gap in access to doula care for people who are low-income or publicly insured, due to cost and availability. New York has recently joined a growing number of states providing Medicaid coverage for doula services. There are many challenges to overcome for this benefit to succeed: limited workforce capacity, minimal integration of doulas into hospitals, and reimbursement challenges. We offer a case study for integrating doula services into hospital-based maternity care: the HOPE Program (Helping Promote Birth-Equity through Community-Based Doula Care). Through community engagement, we have co-designed a model that centers the needs and experiences of birthing people and their care-giving teams. The model illustrates strategies for hospital-community engagement, tailored doula workforce expansion, and integration of doulas into clinical spaces and teams. Investment in these components will lead to a meaningful expansion of doula services to the populations around the state and country who need it most.