Community Health Workers in Enhanced Care Management and In Lieu of Services: A Model of Care Resource
Authors: Heidi Arthur, Laura Collins, Lauren Ohata, Nayely Chavez
Year: 2021
State: CA
Website link: https://nachw.org/wp-content/uploads/2023/02/CHWPsMediCalRsrcPkg4ModelCareResource.pdf
Publicly Available: Yes
Certification: CHW role scope of practice
Evidence Generation: Documentation of how CHWs can work within care teams, General other
Policy: MCO contract language and reimbursement models
Sustainable Financing: Education to HC orgs on payment options bundled etc., MCO or bundled payment reimbursement models, Reimbursement TA for FQHCs Medicaid etc.
Workforce Development: Data sharing between social services and clinical teams, Promotores
This document was developed as a resource for Managed Care Plans completing the CalAIM Model of Care Template. The chart that follows indicates the potential role that community health workers (CHWs) contracted via established local organizations can play in the Enhanced CareManagement (ECM) Core Services and In Lieu Of Services (ILOS).
This document provides insight into how CHWs can support outcomes, produce data, and build relationships necessary for program delivery and reporting and how CHW services align with billable encounters.
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