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Community Health Workers (CHWs) create a huge and great impact on the health and well-being of Medicaid beneficiaries and communities, For this and more the state Medicaid programs should pay for the broad kind of services that CHWs are experts in providing to the community.1 Many studies provide significant evidence that CHWs are effective in these roles, particularly when serving underserved communities, medically, socially, and with many health barriers. More than half of the 50 states planned to expand their state’s CHW workforce. With all the positive health outcomes, well-designed CHW programs have been demonstrated to save as much as $2.47 in Medicaid spending for every dollar spent.16. All of this is because CHWs promote early detection and help with the management of chronic conditions, they have a well of resources to connect individuals into social services that address a range of social determinants of health improving care coordination, and helping prevent illness or hospitalizations. Providing Medicaid financing the CHWs can control costs while improving care coordination, culturally responsive care, and other outcomes to promote health equity. Let me list some of the good outcomes the individuals and the community can receive by providing coverage to pay for CHW: Cultural Mediation Among Individuals, Communities, and Health and Social Service Systems, Providing Culturally Appropriate Health Education and Information, Care Coordination, Case Management, System Navigation, Providing Coaching and Social Support, Advocating for individual communities, Building Individual Community Capacity, Providing Direct Service, Implementing Individual, and Community Assessments Conducting Outreach Participating in Evaluation and Research “By covering the CHW services, state Medicaid programs can more effectively address social determinants of health and health inequities, positioning CHWs to ensure treatment of the whole person and advance community-level health, rather than limiting them to condition-specific activities for individual patients. CHWs can help increase savings while improving care coordination, culturally responsive care, connections to services, and other outcomes to promote health equity.” Partners in Health United States PIH.org/united-states

Why and how should CHW services be covered by Medicaid programs? Several studies have found that interventions using CHWs help to improve health outcomes among racial and ethnic minorities. Therefore, addressing the social determinants of health and health inequities should be done more effectively. CHWs can help improve disease control and reduce mental health symptoms such as depression and substance use disorder. Many state Medicaid programs use CHWs as part of their strategy to address the needs or manage the care of specific populations. States can provide Medicaid payment for CHW services through the state plan or Section 1115 demonstration authority. Section 1115 allows the Secretary of the U.S. Department of Health and Human Services (HHS) to waive almost any Medicaid state plan requirement under §1902 of the Act. The Secretary can also permit federal financial participation for costs not otherwise matchable, allowing states to cover services and populations not included in the Medicaid state plan. There are no federal Medicaid requirements for training and certification for CHWs. States that provide CHW services under the state plan are most likely to define certification and training requirements as a condition for receiving Medicaid payment. There is no reason for not implementing this Bill. Some states require Managed Care Organizations (MCOs) to provide certain CHW services, while others allow but do not require MCOs to provide such services. Medicaid payment for CHW services can be authorized under multiple state plan benefits, such as coverage under the preventive services benefit. States may also cover CHW services under other benefits, such as the outpatient hospital services benefit (42 CFR 440.20). For this benefit, states are not required to identify CHW services in the state plan. A standardized community health worker intervention aimed at addressing unmet social needs estimated a return on investment of $2.47 for every dollar invested to an average Medicaid payer (Kangovi et al. 2020). Considering the overall benefit this will bring to the community, several studies have found a 23.8 percent average reduction in annual Medicaid spending per participant during three years. This resulted in $2.6 million in net savings for the Arkansas Medicaid program (Felix et al. 2011). The special community relationships that CHWs develop can facilitate connections and build an important level of trust between the community and health care systems. CHWs may be members of communities that are typically underrepresented in healthcare settings or may be specifically qualified to provide culturally competent care (CDC n.d., Lloyd et al. 2020). Source: https://www.macpac.gov/wp-content/uploads/2022/04/Medicaid-coverage-of-community-health-worker-services-1.pdf

The National Association of Community Health Workers (NACHW) is pleased to support SB 615. Please see attached PDF for our full testimony.

Necesitamos este bill para mejorar la calidad de vida de las personas de bajos recursos

Los Promotores de Salud (CHWs) son trabajadores publicos en las comunidades quienes trabajan con miembros de las comunidades los cuales experimentan inquidades en salud. Hoy, el subcomite de Servicios Sociales en el comite de Health and Human Services tendran un voto legislativo que impactara la creación de un equipo de trabajo para estudiar los beneficios de Medicaid. Esto hace que hoy sea un dia muy especial para discutir el role e impacto de los Promotores de Salud (CHWs). Como lo dijo la Dr. Leana Wen, Comisionado de Baltimore City, "la salud publica es una herramienta podeora que balancea los niveles en general, al aleja los valores de los miedos de desconfianza y inequalities y los une a los valores de equidad y justicia"

I need you support

Please support LRIs as paid attendants and support the system that surrounds it. The service facilitators that enable consumer directed services are underfunded which leaves us unable to access the services that our children are promised. I wish I could convey how frustrating it is to navigate a broken system to get simple services for our disabled children. Our lives are difficult, but one of the most frustrating parts about it is trying to navigate the red tape for "supports" that are promised to us only to find out that they are actually inaccessible due to lack of funding and support. I'm asking you to support LRIs as paid attendants. We simply ask to be paid for the same work that anyone else would be paid to do. We have more experience, training, and motivation to do the job well, but DMAS wants us to be the "last resort." They would rather I hire anyone else. This makes no sense, especially when I have had to quit my job to care for my child. Even if I were able to find an attendant, I would not be able to go back to work because attendants have a track history of negligence, if they show up at all. Again, this seems built into the system as they are paid very little for the job being done, and often go months without pay for paperwork errors. Our children are in crisis and need your help.

Please protect disable children in Va. We need to take care of them. As parents, We can’t find attendant care, well trained. The regulation changes affect families, adds confusion. Consumed directed services are necessary to proceed our kids.

I am writing on behalf of Virginia Association Of Community Health Workers, thank you for continuing to champion Medicaid reimbursement for Community Health Workers (CHWs). We are so grateful for your support. We respectfully ask that you continue to support this important cause. Community Health Workers improve health while reducing costs. Every dollar invested in a Community Health Worker intervention returns $2.67 dollars to an average Medicaid payer within one fiscal year. Please support: SB615 Thank you again for supporting Community Health Workers.

En nombre de la organizacion de Virginia Community Health Workers], gracias por continuar defendiendo el reembolso de Medicaid para los trabajadores comunitarios de salud (CHW). Estamos muy agradecidos por su apoyo. Le pedimos respetuosamente que continúe apoyando esta importante causa. Los trabajadores de salud comunitarios mejoran la salud y reducen los costos. Cada dólar invertido en una intervención de un trabajador de salud comunitario devuelve $2,67 dólares a un pagador promedio de Medicaid dentro de un año fiscal. Por favor apoya: SB615 Budget Amendment 292 #7s Budget Amendment 288 #68h Gracias nuevamente por apoyar a los trabajadores comunitarios de salud. No dude en ponerse en contacto conmigo en [INFORMACIÓN DE CONTACTO] si puedo ser útil. Atentamente Ysabel Lovo

Me dirijo a ustedes como ciudadano de este estado expresar mi preocupacion Por saber que SB615. Sea aprobada , necesitamos mejorar el acceso a la atención medica y reconocer el papel fundamental que Desempeñan los trabajdores de la salud y comunitarias. En la prestación de servicios de salud a las comunidades

On behalf of [ORGANIZATION], thank you for continuing to champion Medicaid reimbursement for Community Health Workers (CHWs). We are so grateful for your support. We respectfully ask that you continue to support this important cause. Community Health Workers improve health while reducing costs. Every dollar invested in a Community Health Worker intervention returns $2.67 dollars to an average Medicaid payer within one fiscal year. Thank you again for supporting Community Health Workers. Please do not hesitate to contact me at [CONTACT INFORMATION] if I can be helpful. Sincerely,

On behalf of the Virginia community, thank you for continuing to champion Medicaid reimbursement for Community Health Workers (CHWs). We are so grateful for your support. We respectfully ask that you continue to support this important cause. Community Health Workers improve health while reducing costs. Every dollar invested in a Community Health Worker intervention returns $2.67 dollars to an average Medicaid payer within one fiscal year. Thank you again for supporting Community Health Workers. Please do not hesitate to contact me at (571)237-4558] if I can be helpful. Sincerely, Veronica R. Stokes

Necesitamos este bill para tener mejores oportunidades para la comunidad de bajos recursos

I, Christopher Rashad Green, thank you for continuing to champion Medicaid reimbursement for Community Health Workers (CHWs). We are so grateful for your support. We respectfully ask that you continue to support this important cause. Community Health Workers improve health while reducing costs. Every dollar invested in a Community Health Worker intervention returns $2.67 dollars to an average Medicaid payer within one fiscal year. Please support: SB615 Budget Amendment 292 #7s Budget Amendment 288 #68h

I am writing on behalf of the Virginia Association of Community Health Workers (VACHWA) to express our gratitude for your attention to the important issue of Medicaid reimbursement for Community Health Workers (CHWs). Your consideration of this matter is greatly appreciated. We respectfully ask for your continued support in advocating for this cause. Community Health Workers play a significant role in improving health outcomes and reducing costs. It has been observed that every dollar invested in a Community Health Worker intervention yields a return of $2.67 to an average Medicaid payer within one fiscal year. Thank you for your attention to the valuable work of Community Health Workers. Should you require any assistance or further information, please do not hesitate to contact me at (703) 438-1481. Best regards,

On behalf of my self , thank you for continuing to champion Medicaid reimbursement for Community Health Workers (CHWs). We are so grateful for your support. We respectfully ask that you continue to support this important cause. Community Health Workers improve health while reducing costs. Every dollar invested in a Community Health Worker intervention returns $2.67 dollars to an average Medicaid payer within one fiscal year. Thank you again for supporting Community Health Workers. Please do not hesitate to contact me at thaynes5007@email.vccs.edu if I can be helpful. Sincerely, Thomas Cory Haynes

"It is crucial to ensure that legislators and committee members understand the importance and impact this legislation has on the care provided by Community Health Workers (CHWs) to Medicaid members and many vulnerable communities across the Commonwealth of Virginia. The workgroup's creation is a necessary step toward designing an infrastructure that ensures equitable access to health information and resources for the most vulnerable individuals. As you may know, many CHW positions are funded through grants, including federal grants that are about to expire. Sustainable financing through Medicaid will help maintain and expand the CHW workforce and directly address premature leading causes of death." I am a student in this program and I am ready to work for the many underserved cititzens in my community. WE NEED YOUR HELP NOW!