Medicaid Reimbursement for Community Health Workers
The Colorado Legislature passed Senate Bill 23-002 in May 2023 to add community health worker (CHW) services as a Health First Colorado (Colorado's Medicaid program) benefit starting July 1, 2025.
HCPF will seek federal authorization from the federal Centers for Medicare and Medicaid Service (CMS) by July 1, 2024, to add CHWs as a covered benefit.
April 2024 Updates
Project Timeline
We are working to develop policy, system impacts, resources for providers, and preparations to begin conversations with CMS.
Updates
In today's newsletter, we are providing an update on the FAQ document and opportunities for CHW networking. Additional updates will be released in the future.
FAQ Document Update
HCPF staff are actively sorting questions that have been received from stakeholders and working with our partners to ensure accurate answers. Topics that will be covered in the FAQ document include:
Community Health Workers and SB 23-002
Federal Authority
Community Health Worker Training and Workforce Development
Services, Qualifying Conditions, and Medical Necessity
Accountable Care Collaborative (ACC 3.0) and Regional Accountable Entities (RAEs)
Supervision
Enrollment
Billing and Reimbursement
Documentation and Referral Requirements
Evaluation and Reporting
Miscellaneous Questions
This document will be updated on an ongoing basis as the benefit becomes closer to implementation.
Community Health Worker Networking Opportunities
Colorado Community Health Worker Community of Practice
CDPHE facilitates a quarterly Community of Practice for Community Health Workers (CHW). If you are a CHW, Health Navigator, Patient Navigator, Promotora de salud or similar role you are invited to join a network of CHWs from all over Colorado, to share best practices and identify training opportunities that fits your needs. The Community of Practice will be designed for Community Health Workers from all over Colorado who are working in health or community-based settings to learn from one another, share resources and best practices and provide you the opportunity to explore new training opportunities in your roles.
In addition, CDPHE is providing the opportunity to learn more about diabetes and cardiovascular prevention and management and how you can incorporate programs such as National DPP and DSMES into your communities.
The Community of Practice will convene on a quarterly basis and the audience is a CHW or similar role in practice or individuals interested in being a CHW. If you are a supervisor of a CHW or similar role, please consider allowing your CHWs to learn from other CHW across the state. The next CHW Community of Practice meeting will take place on May 23, 2024 at 12:00 PM. Please register at Colorado CHW Community of Practice . If you have any questions please contact Yvette Camarena yvette.camarena@state.co.us.
CDPHE Training Program Recognition Review Committee
We need your help to identify potential committee participants!
CDPHE will convene a committee to review Community Health Worker training program applications.
Past membership has included providers, current CHWs, AHEC, etc. Training program staff will not be able to serve as reviewers.
Expectations are outlined in the Community Health Worker Training Program Standards:
Participants should be familiar with the Standards
Review each application and additional documentation in a time as determined by Standards (within 30 days)
Provide feedback using a checklist or rubric
CDPHE is expecting up to 5 applications within the next year. We are looking for as many applicants as possible so that we can create multiple review committees and limit the number of applications each committee participant will need to review.
Pending approval, application review committee members will be compensated for their time.
If you or someone you know would be interested in being part of CDPHE Training Program Recognition Review Committee, please complete the reviewer application. For further questions please contact Yvette Camarena yvette.camarena@state.co.us.
Website Updates
We are actively adding new information and resources to our website to better suit stakeholders needs. All resources can be found under the "Resources" section on our webpage. New additions include:
List of Resources: these were presented at the February 27th webinar but we are making all resources readily available in a downloadable document
CDPHE Registry and Training: we received a number of questions regarding the registry and the training requirements. We are actively working with our partners at CDPHE to release new updates in the near future. In the meantime, we wanted to add their December 2023 webinar materials for reference.
Questions?
Any questions can be directed to HCPF_CHW_Benefit@state.co.us.