Integrating and Paying for CHWs in Emerging Models of Care

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Transcript Integrating and Paying for CHWs in Emerging Models of Care

Integrating and Paying
for CHWs in
Emerging Models of Care
Health System Model Perspective
The HIV Experience
Ruth M. Rothstein CORE Center: Chicago, Illinois
• Cook County Bureau of Health Services Facility – Public
“Safety-Net”
• > 5,500 patients, 30,000 primary care visits annually
• Primarily a minority population
• >80% have incomes less than 200% FPL
• Frequent history of drug use, incarceration
The Evolution of HIV
• From a death sentence to chronic disease
• 1995: The Year Everything Changed
• A recently published study contains some very
good news for people living with HIV. It
suggests that the life expectancy for a person
newly diagnosed with HIV, with no symptoms,
has jumped from seven years to 24.
Community Response
• Care Givers (Buddies)
• Health Literacy and Education
• Outreach
• Navigation
• Advocacy
Federal Response
• Ryan White Care Act (Care, Treatment)
• Center’s for Disease Control (Prevention)
• SAMSHA (Substance Abuse Mental Health)
• NIH (Research)
Consumer/Community Engagement
National HIV/AIDS Strategy (NHAS)
Affordable Care Act (ACA)
Ryan White Programs
Request for Proposals (RFP) How are clients
engaged?
Consumer Advisory Boards (CAB)
Quality Improvement Committees
Workforce opportunities, Peer Educators,
Patient Navigators, Outreach workers, Health
Educators…
CORE Center Model
• Peer Educators (Clinical settings)
• Patient Navigators (In-patient and outpatient)
• Community Outreach Workers (Seek, Link and
Retain)
• Multiple federal payer sources (All time
limited)
• All reduce barriers to care, support early and
sustained treatment. (HIV Viral Suppression,
Advocacy, Health Literacy)
Emerging Opportunities
• Eliminates pre-existing conditions barriers
(Increased access to Health Services)
• Increasing Value of CHW Experience
• Workforce development (Redeployment of
Peers as CHW’s)
• Exploring partnerships with community
colleges ( MXC and SSC Peer cohorts)
• Advocacy/ Education to CCHHS
• Address billing challenges (CodingReimbursement rates)
Thanks!
Peter McLoyd
Ruth M. Rothstein CORE Center
Consumer Development and Advocacy
Coordinator
312-572-4649
[email protected]