Provider Digest | Issue 28

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Community Health Worker benefit, ECM/CS news + back to school checkups

Community Health Worker Benefit

The Alliance is actively recruiting organizations to provide the Community Health Worker (CHW) benefit for Medi-Cal members.

CHWs are also known as promotores, community service aides or health navigators. They facilitate equitable access to services and improve the quality and cultural competence of service delivery.

CHW perks

The benefits of providing the CHW benefit include:

  • If you are contracted and credentialed with the Alliance, you can receive reimbursement at up to 150% of Medi-Cal rates for services.
  • Eligible health care organizations can apply for an Alliance grant and be awarded up to $65,000 in Medi-Cal Capacity Grant Program funding to recruit and hire CHWs. An additional $10,000 incentive for bilingual CHWs is available. Learn more on our CHW Provider Recruitment Program page.

Apply today!

Learn more about the benefit and how to apply on our website.

As of July 1, new ECM/CS services + populations of focus

Enhanced Care Management and Community Supports (ECM/CS) are a key part of California Advancing and Innovating Medi-Cal (CalAIM). ECM/CS services are cost-effective alternatives to covered Medi-Cal services.

As of July 1, 2023, there are two newly eligible populations of focus for ECM and two new Community Supports services in Merced, Monterey and Santa Cruz counties.

Eligible for ECM as of July 1, 2023

Children and youth can now get ECM services if they meet any of the following criteria:

  • Have complex health issues and were admitted to the ED or hospital repeatedly over the last six months or year.
  • Have serious emotional or mental health conditions.
  • Already receive services through the California Children’s Services (CCS)/CCS Whole Child Model (WCM) and have additional needs.
  • Are or have been part of a child welfare program or foster care.
  • Are experiencing homelessness.

New Community Support services as of July 1, 2023

Respite Service for Caregivers and Personal Care and Homemaker Services are now available in Merced, Monterey and Santa Cruz counties.

Refer an Alliance member for ECM/CS services

Providers can refer members to ECM/CS services through the Alliance Provider Portal or by submitting the appropriate form on our website (see “How do I submit an ECM or Community Supports referral?”). You can also submit referrals over the phone.

For referral tips and a full list of ECM/CS services and eligibility, please visit our website.

Back to school checkups campaign

The Alliance is reminding parents to take their children to see their doctor before school starts.

We are running a media campaign with the theme “Add Checkups to Your Checklist,” which shares that child checkups are a great time to get caught up on needed vaccines and screenings. Through our Healthy Start program, members can earn Target gift cards for completing their children’s checkups and vaccines on time.

We are reaching out to members via channels including:

  • Digital flyers distributed at schools.
  • Digital ads.
  • Bus ads.
  • Social media (Facebook page and YouTube ads).

We also have information for members on the Checkups page of our website.

Don’t forget that primary care providers can earn Care-Based Incentives for several measures tracking rates of child checkups, immunizations and screenings.

Please join us in encouraging back-to-school checkups for Alliance members. Thank you for your partnership in providing accessible, quality health care guided by local innovation!