Initiatives

Community Health Workers, Promotores & Representatives

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Background

Community Health Workers, Promotores, and Representatives (CHW/P/Rs) have long provided critical preventive, promotive, and referral services for communities in California that have been historically marginalized and disconnected from the health system. CHW/P/Rs speak a variety of languages and serve diverse communities with diverse needs across the state. HCAI’s CHW/P/R workforce initiative, as part of the Workforce for a Healthy California initiative, aims to expand and support the CHW/P/R workforce. For further background, see Statute 18998 authorizing the CHW/P/R.

In order to sustainably expand CHW/P/R services across the state, funding for those services needs to be reliably available. To address this, starting July 1, 2022, the Department of Health Care Services (DHCS) added CHW/P/R work as a billable service to Medi-Cal.

On July 1, 2023, following a lengthy stakeholder engagement process and in line with statutory requirements, HCAI issued a guidance letter outlining the statewide requirements for: a state-issued CHW/P/R Certificate, certificate renewal, and for state-issued specialty certificates, as well as the requirements for recognizing the experience of existing CHW/P/Rs. This letter also provided statewide requirements for CHW/P/R training programs to become approved training programs.

Update

After hearing from community partners about the need for additional stakeholder engagement on the rollout of the CHW/P/R certificate program in November 2023, the California Health and Human Services Agency (CalHHS), HCAI, and DHCS announced a pause to the July 2023 HCAI guidance letter and that it would conduct a series of dialogue sessions to engage stakeholders about the CHW/P/R certificate program. The dialogues will run through Fall 2024.

The purpose of conducting the dialogues is to communicate the state’s vision for supporting and scaling CHW/P/R services in the state, and to engage community partners on how to achieve that vision. We also are seeking to hear from community partners about their concerns regarding the certificate program as set out in HCAI’s July 2023 guidance letter.

For further information about the dialogues, please see the Community Health Workers/Promotores/Representatives (CHW/P/R) Dialogue Sessions.

DHCS Medi-Cal Benefit 

The CHW/P/R Medi-Cal benefit as outlined in the CHW Provider Manual and the DHCS All Plan Letter of September 18, 2023, remains in place. As before, CHW/P/Rs that seek to support Medi-Cal members via the Medi-Cal CHW benefit must: 

  • Demonstrate minimum qualifications via 1) a certificate of completion or 2) work experience (2,000 hours); 
  • Have lived experience that aligns with and provides a connection between the CHW and the community or population being served; and, 
  • Be supervised by a licensed provider, clinic, hospital, CBO, or Local Health Jurisdiction who is enrolled in the Medi-Cal program. 

Details on these qualifications can be found in the CHW provider manual. 

Contact Us

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To receive updates regarding the CHW/P/R initiative specifically, please email CHW@hcai.ca.gov and share your name, affiliation, and email. You will be added to a listserv through which periodic updates and invitations for engagement are shared.

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