Community Health Worker Services
Would you like help navigating your health care and resources? The Alliance has Community Health Worker (CHW) services for Medi-Cal and TotalCare (HMO D-SNP) members.
A CHW is a trusted member of your community who knows your local area. They can help you get services that reflect your language and culture. They can help you:
- Get preventive health services.
- Manage or prevent health concerns. This includes behavioral health.
CHWs educate, support and help members find services. They do not provide medical care that needs a license. They do not provide rides, personal care, homemaker or childcare services. They can help you find programs that provide these services.
CHWs can help you:
- Understand your benefits.
- Connect with doctors, counselors or community programs for medical or behavioral health care.
- Manage or prevent conditions including diabetes, asthma, high blood pressure, anxiety or depression.
- Get support for food, housing, transportation, personal care, homemaker or childcare services, or other social needs. This may include connecting you to Enhanced Care Management and Community Supports if you are eligible.
- Follow up after hospital or emergency room visits. This includes getting transitional care.
- Get support related to domestic violence or other safety concerns.
Alliance members can get help from a CHW at no cost. Parents or guardians can get CHW services when they help a child under age 21. (Note: if the parent or guardian is not a Medi-Cal member, the child who is a member must be at the session.)
General eligibility
A member can get help from a CHW if they meet one or more of these criteria:
- Has a chronic health condition or a suspected mental health or substance use concern.
- Shows early warning signs of health risks. This can include high blood pressure, elevated blood sugar or lead exposure.
- Has had stressful life events or adverse childhood experiences.
- Faces known risk factors such as domestic or intimate partner violence, tobacco, alcohol or drug use.
- Has unmet social needs that affect health. This can include housing or food insecurity.
- Recently visited the emergency room, hospital, psychiatric facility or detox center.
- Missed two or more medical appointments in the past six months.
- Left jail or prison in the past six months.
- Needs help navigating the health system or coordinating resources.
- Is due for preventive services such as immunizations, dental care or well-child visits.
CHW violence prevention support
Members can get CHW violence prevention services if a licensed practitioner determines they are in any of these situations:
- Has been violently injured from community violence (such as gang violence).
- Is at significant risk of violent injury from community violence.
- Has had chronic exposure to community violence.
These services are for community violence. A CHW can also help you get support for interpersonal or domestic violence.
How do I start getting CHW services?
You can get help from a CHW in one-on-one or group settings. Services can take place in person at places like:
- Clinics.
- Hospitals.
- Homes.
- Community sites.
Some CHWs may offer services by phone or video.
Ask your doctor or care team to connect you with a CHW.
Your doctor, nurse practitioner or care team can write you a recommendation. If you qualify, you may be able to get up to six hours of CHW services each year without a recommendation from your provider.
Questions?
Call Member Services for help. For Medi-Cal members, you can call 800-700-3874 Monday–Friday, 8 a.m. to 5:30 p.m. For TotalCare (HMO D-SNP) members, you can call 833-530-9015 from 8 a.m. to 8 p.m., seven days a week (TTY: 800-735-2929 (Dial 711)).
Contact Member Services
Resources
Latest News
