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DHCS Community Health Worker (CHW) Benefit

On July 1, the CHW benefit went live in both the Medi-Cal fee-for-service (FFS) and managed care delivery systems. The State Plan Amendment (SPA) for CHWs was submitted to the Centers for Medicare & Medicaid Services (CMS) on April 29, 2022, and is pending approval. DHCS published the final CHW policy on June 29 to assist providers with rolling out this new benefit. DHCS shared a draft of the Provider Manual pages for CHW services, as well as a new Provider Manual section for asthma preventive services, with stakeholders prior to finalizing them for publication. The Provider Manual pages are scheduled to be published on July 15. In addition, DHCS shared a draft All Plan Letter (APL) for CHW services with its managed care health plan partners on June 28 for comments prior to issuing the APL. Comments on the APL are due by July 12. More information about the Department’s development of the CHW benefit, including the pending SPA that was submitted to CMS, is available on CHW webpage.