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 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 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 other 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.
Effective January 8, 2024, Community Based Organizations (CBOs) and Local Health Jurisdictions (LHJs) providing community health worker and/or asthma preventive (AP) services can now 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 through the Medi-Cal FFS enrollment process are eligible to contract with Managed Care Plans.
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.
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