SB23-002, Medicaid Reimbursement For Community Health Services, passed the Colorado House floor on Wednesday April 26th with immense bipartisan support on a vote of 62-3. The bill previously passed the Colorado Senate on April 10th on a vote of 31-4. The bill now heads to the Governor’s desk for his signature to be signed into law.
SB23-002 sets up a process to enable some of the services provided by Community Health Workers, like health education, health navigation, and referral to community-based resources, to be reimbursed by Medicaid. Colorado’s Health Care Policy and Finance (HCPF), the state Medicaid department, will conduct a stakeholder process to work through the finer details of what will be included in the State Plan Amendment (SPA), which is the federal authority needed from the Centers for Medicare and Medicaid for state Medicaid to start reimbursement of these important services. HCPF will apply for this federal authority no later than July 2024.
Community Health Worker is an umbrella term for lay public health workers who may go by many names (Patient Navigators, Promotores de Salud); the names are as diverse as the communities, sites and roles in which CHWs serve. CHWs typically deliver health education on topics including preventive services and chronic disease management, support patients in navigating the healthcare system, and accessing community based-services to address social determinants of health. Community Health Workers link communities to health and social programs to promote access to services and improve the quality and cultural responsiveness of care delivery
Evidence shows that CHWs can help improve healthcare access and outcomes, strengthen healthcare teams and enhance quality of life for people in low-income, underserved and diverse communities. The Centers for Medicare and Medicaid Services recognizes that CHWs can play an integral part in achieving health equity and categorizes their use in various disease prevention and control programs as evidence-based. Many interventions that integrate CHWs into health care delivery and public health systems are associated with reductions in chronic illnesses, better medication adherence, increased patient involvement, improvements in overall community health and reduced healthcare costs.
Despite the robust data to show the effectiveness of Community Health Worker interventions, many CHW positions are funded through short-term, time-limited grants. SB23-002 allows for one sustainable financial pathway to expand access to Community Health Workers across our state.
SB23-002 has been supported by many different individuals and organizations ranging from Children’s Hospital Colorado, the Colorado Alliance of Community Health Workers, Patient Navigators and Promotores De Salud, Rural Health Centers, Colorado Community Health Network, the Chronic Care Collaborative, Healthier Colorado, and more. SB23-002 provides a step towards sustainably expanding access to CHWs, improving health outcomes, and realizing cost savings for Coloradans. These organizations and advocates look forward to engaging in the next steps SB23-002 has set up related to the stakeholder process and implementation of the bill.
Credit: Children’s Hospital Colorado