Community health workers & promotores in the future of Medi-Cal: resource package #3 : data and evaluation considerations for CHW/Ps supporting health and social care integration for Medi-Cal members
About the Project and Resource Package. As California aims to improve the quality of life and health outcomes for its residents, particularly Medi-Cal members, one strategy is to better integrate community health workers and promotores (CHW/Ps) into health care coordinated by managed care plans (MCPs) and providers. According to the American Public Health Association, a community health worker 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, or intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery." Promotores de salud, or promotoras, are a subset of community health workers who serve Spanish-speaking communities and are characterized as lay health workers with the ability to provide culturally appropriate services informed by their lived experiences. CHW/Ps have been employed across public health, medical, and behavioral health settings with different job titles and in a range of roles. The topic of CHW/P roles is covered in depth in the first resource package of this project, The Role of CHW/Ps in Health Care Delivery for Medi-Cal Members. Currently, most CHW/Ps work for Federally Qualified Health Centers (FQHCs), public health agencies, or health plans, but increasingly hospitals and health systems are exploring CHW/P interventions. CHW/Ps have an extensive history within community-based and social service organizations serving communities that are most likely to experience health inequities. In some organizations, job positions for unlicensed professionals may include shared roles with those often performed by CHW/Ps, such as case management, engagement, health coaching, health care and housing navigation, employment services, and outreach. However, in different settings these professionals may not use the titles of CHWs or promotores, which is frequently the case with behavioral health and social service providers. For this resource package, unlicensed professionals performing these roles--including but not limited to those formally titled CHWs or promotores--will be described as the community-connected health workforce to emphasize their shared characteristics and broad importance across multiple sectors. This term, community-connected health workforce, is also used to elevate the value of this workforce. This project aims to advance the role of CHW/Ps in the future of Medi-Cal, within the context of the California Advancing and Innovating Medi-Cal (CalAIM) initiative. It seeks to enhance Medi-Cal MCPs and their partners' readiness to implement effective, evidence-based CHW/P activities that advance health equity. To further this goal, the project is producing four resource packages--informed by stakeholders--containing resources and tools that support CHW/Ps' integration into programs for Medi-Cal enrollees. The packages cover the following topics: (1) Roles of CHW/Ps in improving care delivery for Medi-Cal members; (2) Training for CHW/Ps and their employers; (3) Data and evaluation considerations for CHW/Ps; (4) Program financing and sustainability.
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