​​​​​​​​​​​​​​​​​​​​​​​​​​​​Community Health Workers​

​The Department of Health Care Services (DHCS) added Community Health Worker (CHW) services as a Medi-Cal benefit starting July 1, 2022. CHW services are an integral part of Enhanced Care Management and Community Supports offered by managed care plans (MCPs) as part of the California Advancing and Innovating Medi-Cal (CalAIM) initiative. CHW services are also available to Medi-Cal members with fee-for-service.

CHW services are preventive health services to prevent disease, disability, and other health conditions or their progression; to prolong life; and promote physical and mental health and well-being. CHW services may assist with a variety of concerns impacting MCP members, including but not limited to, the control and prevention of chronic conditions or infectious diseases, behavioral health conditions, and need for preventive services. Additionally, CHW services can help Medi-Cal members receive appropriate services related to perinatal care, preventive care, sexual and reproductive health, environmental and climate-sensitive health issues, oral health, aging, injury, and domestic violence and community violence prevention services.

CHWs may include individuals known by a variety of job titles, including promotores, community health representatives, navigators, and other non-licensed public health workers, including violence prevention professionals.

Community Based Organizations (CBOs) and Local Health Jurisdictions (LHJs) providing community health worker and/or asthma preventive (AP) services or Justice Involved services​ can enroll as Medi-Cal providers and submit their applications through the Provider Application and Validation for Enrollment (PAVE) online enrollment portal. Providers who successfully enroll are eligible to contract with MCPs to provide services to Medi-Cal members for the plan.​​

If you have any questions, please feel free to send them to CHWBenefit@dhcs.ca.gov. DHCS appreciates your collaboration and partnership on this important effort.​

Previous Informational Webinars​​​​

• The Supervising Provider/CBO CHW Technical Assistance Webinar, June 17, 2024​
• ​​Presentation​ 
  
• CHW Technical Assistance Webinar, July 16, 2024
  
• ​​​Presentation 
  
• Webinar Recording
• CHW Technical Assistance Webinar, August 27, 2024
  
• Presentati​on
  
• Webinar Recording​
  
• ​Frequently Asked Questions
• CHW Technical Assistance Webinar, December 11, 2024
  
• Webinar Recording​ (registration required)​​​

Res​ou​​rces​​​

​​​​Community Health Workers

• CHW Standing Recommendation​​​​​​
  
• State Plan Amendment (SPA) 22-0001
  
• All Plan Letter (APL) 24-006​
  
• Medi-Cal Provider Manual for the community health worker
  
• Medi-Cal Provider Manual for asthma preventive services
  

Frequently Asked Questions (FAQs)

• ​General Information (updated April 1, 2025)
  
• Billing (updated April 1, 2025)
  
• Provider Requirements (updated April 1, 2025)
  
• CHW G Codes (updated April 1, 2025)
• CHW Clinic FAQ (updated April 7, 2025)​​​​​​​

Community-Based Organizations

• Medi-Cal Provider Bulletin: Community-Based Organizations and Local Health Jurisdictions Enrollment 
• Community-Based Organizations and Local Health Jurisdictions Application Information
• ​Enrollment for Community-Based Organizations and Local Health Jurisdictions using PAVE​
• Medi-Cal Community Based Organization (CBO) Enrollment Requirements and Documentation Checklist
  
• Exploring Emerging Medi-Cal Community Care Hubs​