CHW national update Iphi meeting 1 14-14


Published on

1 Like
  • Be the first to comment

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide

CHW national update Iphi meeting 1 14-14

  1. 1. CHW workforce strategy meeting January 14, 2014 Community Health Workers: National Update Carl H. Rush, MRP University of TexasHouston Institute for Health Policy
  2. 2. This session Review: what is distinctive about CHWs? Current national initiatives around CHWs Opportunities What’s in Medicaid rule changes happening in the states
  3. 3. What’s your definition of CHW? 3
  4. 4. Community Health Worker Definition American Public Health Association (1)  The CHW is a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served.  This trusting relationship enables the CHW to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery. 4
  5. 5. Community Health Worker Definition - APHA (2) The CHW also builds individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support and advocacy.  APHA Policy Statement 2009-1, November 2009 5
  6. 6. What Is Distinctive About CHWs? (1)  Do not provide clinical care  Generally do not hold another professional license  Expertise is based on shared life experience (and often culture) with people served 6
  7. 7. What Is Distinctive About CHWs? (2)  Rely on relationships and trust more than on clinical expertise  Relate to community members as peers rather than purely as clients  Can achieve certain results that other professionals can’t 7
  8. 8. Current national CHW initiatives (1)  CDC CHW policy e-learning series  OWH CHW leadership training  DOL “apprenticeable trade”  OMH Promotora/CHW initiative  DOL occupational definition  NAO-APHA-UT curriculum guidelines project 8
  9. 9. Current national CHW initiatives (2)  HHS working group on CHWs: awareness campaign?  HUD CHW Initiatives  CMS Center for Innovation    Grantee learning collaborative on CHWs State Innovation Models Rockefeller Foundation/Urban Institute study 9
  10. 10. Promoting Policy and Syste ms Change to Expand Employment of Community Health Workers (CHWs) Course Description This course is designed to provide state programs and other stakeholders with basic knowledge about Community Health Workers (CHWs), such as official definitions of CHWs, workforce development, and other topic areas. In addition, the course covers how states can become engaged in policy and systems change efforts to establish sustainability for the work of CHWs, including examples of states that have proven success in this arena. The six-session course covers CHWs’ roles and functions Current status of the CHW occupation Areas of public policy affecting CHWs Credentialing CHWs Sustainable funding for CHW positions Examples of states successful in moving policy and systems change forward The course sessions are self-paced. Completion time for each session is between 30–45 minutes. The user does not have to take each session in succession.
  11. 11. Link to CDC E-learning 11
  12. 12. Medicaid Breakthru: Preventive Services  78 FR 135 p. 42306: 7/15/13– (effective Jan. 2014) § 440.130 Diagnostic, screening, preventive, and rehabilitative service  “Preventive services means services recommended by a physician or other licensed practitioner…” (previously read “provided by”)  Brings rules into conformance with ACA  Commentary clearly reflects interest in funding services by CHWs and other “nonlicensed” providers  Payment for CHW services will no longer need to be treated as admin costs
  13. 13. Requirements to Take Advantage of Medicaid Rule Change  State must file Medicaid State Plan Amendment (in a few states this requires legislative authorization)  Must specify what non-licensed occupations are covered and qualifications (skill requirements) – not necessarily certification  Must specify what services will be paid for (CPT codes)  Must specify rates of payment and payment mechanism (FFS, MCO, bundled payment etc.)
  14. 14. Surge in state-level interest In addition to established initiatives in AK, FL, IN, MA, MN, NJ, NY, OH, TX:  New movements in AZ, CO, IL, MS, NE, NM, OR, RI, SC, WI  Recent State investigations in AR, CA, DE, GA, IA, LA, MD, MO, ND, PA, UT, VA,WA, WV
  15. 15. Updated 1/8/14 © 2014 Community Resources LLC
  16. 16. Common Elements In State Initiatives Gathering workforce data Convening leadership and “champions” General education/awareness CHW professional association/network Agreement on standards and credentialing Strategies for susrainable CHW roles
  17. 17. Recent state/local innovations with CHWs  Delaware “Health Ambassadors”  Seattle-King County CHW study  Medicaid 1115 waiver in Texas  Oregon “CCO” legislation  South Carolina Medicaid pilot  Akron OH “Accountable Care Community”  Nevada pooled funds pilot
  18. 18. CONTACT INFO Carl H. Rush, MRP Project on CHW Policy and Practice U. of Texas Institute for Health Policy PO Box 5533 San Antonio, TX 78201-0533 (210) 775-2709 (210) 241-3983 mobile