1. State Community Health Worker Financing Mechanisms
Pathways to Sustainable Financing

2. CHWs’ Effect on Quality and Cost
Potential to improve quality and control or decrease cost
Role of CHW aligns with goals of community care teams, primary care providers and patient-centered medical homes
Strengthen understanding of community health needs
Enhanced cultural competence and improved communication between providers and patients

3. How do you obtain financing?

4. Show Value Connect to a problem and show how you help solve it
Demonstrate Effectiveness and Cost Savings

5. Once you obtain financing, the trick then becomes how do you sustain that financing?

6. Show Value Demonstrate Effectiveness and Cost Savings

7. Financing Mechanisms
Reimbursement considerations often begin with establishing credentialing
Encourage supportive state Medicaid payment options
Consider state and federal grants (establish pilot programs)
Work with managed care organizations and private payers on reimbursement models
Add CHWs to health care teams focused on integrated and patient-centered care
Support data collection and research on cost benefits (limited cost savings research to date)

8. Competition for the Health Care Dollar

9. State Community Health Worker Program Examples

10. Oregon
Patient Centered Medical Home Program covers services provided by certified CHWs
Key Funding—Medicaid State Plan Amendment
Example of CHW Services—Ensure patients regularly see their health care provider and receive chronic disease management (e.g., home visits to manage asthma treatment)

11. Kentucky Kentucky Homeplace, established in 1994
Employs CHWs in underserved and rural communities
Housed within the University of Kentucky (UK) Center for Excellence in Rural Health
Key Funding—Kentucky Department for Public Health contracts with UK Center for Rural Health (GRF funding)
Helps patients access health resources, including food, eyeglasses and dentures

12. South Carolina
South Carolina Department of Health and Human Services’ (SCDHHS) Health Access at the Right Time (HeART) initiative
Includes CHWs in primary care practices as community liaisons
Key Funding—Eligible primary care physician practices receive a grant from the SCDHHS
Two billing codes available for CHW services

13. Sustainable Financing Post 2016 Election
What is the future of the Affordable Care Act (ACA)?
How will ACA changes effect health policy on the state and federal level?
What is the future of CHWs and program funding?

14. Resources

15. Contact Information
Tom Dilling Legislative Liaison/Adjudication Coordinator Ohio Board of Nursing 17 S. High St., Suite 400 Columbus, OH Tel: (614) Fax: (614)