1. Traditional Health Workers
October 26, 2015
April Johnson, MPA
Health Equity Workforce Manager

2. Overview Health Equity Workforce Introduction Purpose and Role of THWs
THW System Updates
THW Commission and Subcommittees
System Coordination
Medicaid Rule for Prescribing THWs for Preventative Services
Payment Methods

4. The Goal of the Health Equity Workforce Program is to:
Advance health equity
Help achieve the Triple Aim*…improving patient experience (including quality and satisfaction), improving population health, reducing per capita health care costs
Grow and diversify our health care and public health workforce

5. Traditional Health Workers: A Community-Based Model of Care
Community Health Workers; Peer Support;
Peer Wellness Specialist;
Personal Health Navigators; and birth
Doulas
Health and
social service
systems
Individuals and
Communities

6. Purpose of Traditional Health Workers
Reduce costs associated with health care and burden on society
Understand and address the social determinants of health
Address health disparities in culturally- appropriate ways
Take a less siloed approach to health care

7. Role of the THW
A Traditional Health Worker (THW) is a frontline health professional who applies his or her unique understanding of the experience, language and/or culture of the populations he or she serves in order to carry out one or more of the following roles:
Providing culturally-appropriate health education, information and outreach in a variety of settings such as homes, clinics, hospitals, schools, shelters, local businesses, and community centers;
Bridging/culturally mediating between individuals, communities and health and human services, including actively building individual and community capacity;
Assuring that people access the services they need;
Providing direct services, such as informal counseling, social support, care coordination and health screenings; and
Advocating for individual and community needs.

8. Training and Certification
Training Program Requirements
Certification Requirements
Training curriculum must meet standards required by OARs by THW type
Must be 18 Years of age
Must pass a criminal background check
Must be trained by an OHA approved training program unless grandfathering or provisionally applying
Must submit a completed application to OEI with I.D.

9. THW System Updates

10. Traditional Health Worker Commission and Subcommittees
Systems Integration
Scope of Practice
TEMPS

11. Training Evaluation Metrics Program & Scoring Subcommittee
Develop the metrics, standards & guidance needed to review and approve THW training program applications and establish the metrics, standards and guidance for continuing education requirements for all traditional health workers who wish to qualify for (re)-certification by the Oregon Health Authority.

12. Scope of Practice Subcommittee
Develop roles, expectations, and supervisory relationships as outlined in Division 180 THW Rule for Community Health Workers, Peer Wellness Specialists, Personal Health Navigators, and Peer Support Specialists Certification Curriculum Standards to faciliate appropriate hiring of THWs

13. Systems’ Integration Subcommittee
Integration of the THW workforce into the health care system by analyzing opportunities and barriers to employment and creating a strategic plan to improve health equity to underserved populations. Strategies may include outreach, training, and education of CCOs and other community based organizations, monitoring and reporting on employment standards such as wages, benefits, and scope of work

14. State Level THW System Coordination
Transformation Center
Office of Equity and Inclusion
Medical Assistance Programs
Community College Workforce Development Board
Traditional Health Worker Commission
Office of Information Systems

15. Transformation Center Coordination
THW Survey
Survey is currently fielding with CCO’s across the state.
THW Webpage
THW Toolkit
THW Stories
Videography Project
THW Registry
Securing funding for THW registry enhancements

16. THW Registry Enhancements
Health Equity Workforce (HEW) team has partnered with the Transformation Center and OIS to fund registry enhancements that will:
Collect and sort relevant data, e.g., race/ethnicity, geography, and by worker type;
Notification to THWs for recertification;
Provide HEW team with notification of newly submitted applications; and
result in an improved system for providers to locate and hire THWs.

17. CCWD Coordination Statewide Needs Assessment Survey
Incumbent Workforce Assessment
Training of CHWs

18. Medical Assistance Programs
42 CFR (c) Rule Change-
The CMS final rule published on July 15, 2013 included a change to the regulatory definition of preventive services at 42 CFR (c) of the federal Medicaid program.
Previously, preventive services could only be provided by a physician or other licensed practitioner (OLP) of the healing arts for Medicaid reimbursement
practitioners, OLPs, can provide and be reimbursed for furnishing preventive services recommended by a physician or other licensed practitioner

19. Current Funding Mechanisms
In most delivery systems THW services are funded using braided payment methods. For example, the behavioral health system uses a variety of federal, state, and local resources to fund Peer Support Specialist. Public Health has historically provided Community Health Workers in underserved communities to provide training, outreach, education and testing to stop the spread of communicable diseases and to eliminate infant mortality. These programs are grant funded and their duration is often limited due to emerging national and global health priorities.

20. Examples of Payment Models for THWs
Peer Support Specialist
Community Health Workers
Oregon providers can purchase peer services through funding sources such as:
Federal (SAMHSA, TANF, Medicaid),
State and Local Funding, Private funding; and
Drug Courts (federal, state and local funding),
and DOJ funding
Oregon providers currently purchase CHW Services with:
CDC grants (Public Health; HIV Testing and Education)
Foundation Grants (Legacy Emanuel-ER CHWs)
Provider Investment (Central City Concerns-FQHC, Housing and Behavioral Health)
CCOs (Pilot Project)

21. QUESTIONS?

22. Contact Us: April Johnson, MPA Medicaid payments for THWs:
Health Equity Workforce Manager
Don Ross
Office of Equity and Inclusion
Manager
DMAP Policy and Planning Section
Shawn Clark
Peer Delivered Services Coordinator
Addictions and Mental Health Division
THW Committee Website:
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THW Rules:
(N)THW Report:
HB3311 Report: