Community Health Worker (CHW) Services Benefit
| Date: | December 16, 2022 |
| To: | HPSJ Primary Care Providers, Specialists, Hospitals and Facilities |
| From: | Health Plan of San Joaquin (HPSJ) |
| Type: | Formulary |
| Subject: | Community Health Worker (CHW) Services Benefit |
| Business: | Medi-Cal Managed Care |
In accordance with All Plan Letter (APL) 22-016, https://www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2 022/APL22-016.pdf, community health worker(CHW) services are considered preventative care services and are Medi-Cal covered benefits as of July 1, 2022. An overview of CHW services is included below:
CHW services may assist with a variety of concerns impacting members, including but not limited to:
- Control and prevention of chronic conditions or infectious diseases,
- Behavioral health conditions, and
- Need for preventive services perinatal care, sexual and reproductive health, environmental and climate-sensitive health issues, oral health, aging, injury, and
- Domestic violence and other violence prevention services.
Services that CHWs provide include health education, health navigation, nonclinical screening and assessment, and individual support or advocacy.
CHWs must possess minimum qualifications including having lived experience that aligns with and provides a connection between the CHW and the member or population being served. CHWs must also meet the following minimums:
- CHW certificate
- Violence Prevention Professional certificate or;
- At least 2,000 hours of paid or volunteer positions within the previous three years
If you are interested in providing CHW services or have any questions, please call our Provider Services Team at 209-942-6340, or call our Customer Service Department at 1-888-936-PLAN (7526). You may also visit https://www.hpsj.com/alerts/ for online access to the documents shared.