Community Health Workers (CHWs) are key to advancing health equity based on their relationships with communities and unique position within clinical settings. However, a lack of robust funding undervalues the essential services CHWs provide, and prevents them from becoming a sustainable workforce.
In June 2021, Governor Gavin Newsom signed a budget that includes $16.3 million to fund CHWs providing services to Medi-Cal beneficiaries. In August 2021, the Department of Health Care Services (DHCS) proposed a Medi-Cal state plan amendment (SPA) to reimburse CHWs delivering preventive services in Medi-Cal. Throughout Fall 2021, DHCS will work with stakeholders to receive feedback on the SPA, including recommendations around defining CHW services, certification, and supervision. If the SPA is approved, implementation is slated to begin January 2022.
Prior to and as part of this effort, Community Health Councils has been conducting research to create an upcoming report on the various financing mechanisms states have used to reimburse CHWs, with an emphasis on states that integrated CHW reimbursement through Medicaid SPAs or 1115 demonstration waivers.
Based on this research and conversations with partners, Community Health Councils has put forth a set of recommendations:
- Certification and licensure processes must minimize barriers to participation
- Include community-based organizations as supervising entities
- Ensure community health centers can be reimbursed equitably for CHW services
- Establish payment rates that match a living wage and promote economic justice for CHWs
This expansion of funding is a promising step forward towards greater health equity and economic justice for the CHW workforce, and Community Health Councils will continue to ensure CHWs and community partners are engaged throughout all planning and implementation processes. DHCS will be hosting additional stakeholder engagement sessions in mid-September and early-November, and advocates are encouraged to provide the feedback necessary to ensure equity is at the forefront of the policy making process.
For more information on CHWs: CHC 2017 Report – The Role of Community Health Workers
For upcoming stakeholder engagement opportunities: DHCS Stakeholder Engagement Landing Page