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The Centers for Medicare and Medicaid Services (CMS) approved Washington State’s community health worker (CHW) State Plan Amendment on November 27. This amendment allows community health workers to provide preventive services to Apple Health (Medicaid) clients.
What is a community health worker?
Community health workers are frontline public health professionals who are trusted community members or have a unique understanding of the community being served. They act as a liaison between health and social services and the community, facilitating access and improving the quality and cultural competence of service delivery.
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This approval establishes Apple Health’s community health worker benefit making community health workers more accessible to clients enrolled in Apple Health across Washington. This marks a crucial milestone in the Health Care Authority's (HCA) ongoing efforts to enhance community health care, advance health equity, and support integration of community health workers in health care settings.
Next steps
HCA is developing rules under WSR 24-15-085 which outline the details of the benefit, such as:
- Provider requirements
- Client eligibility
- Covered and non-covered services
By the end of the year, HCA plans to make the new draft rules available for comment by stakeholders and partners during a two-week review period. After all comments are considered, HCA will file a CR-102 (Proposed Rule Making) and schedule a public hearing for the public to provide verbal testimony or written feedback on the proposed rules. HCA holds its public hearings virtually via Zoom.
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