Member approved December 14, 2023

WHEREAS, MPHA recognizes and supports the American Public Health Association (APHA)’s policy resolutions on Community Health Workers (CHWs)¹; and

WHEREAS, MPHA recognizes and supports the APHA definition of CHWs which includes the idea that they “facilitate access to services and improve the cultural competency of service delivery”²; and

WHEREAS, CHWs engage in culturally sensitive systems navigation in diverse settings, striving to improve access to integrated health services, assist in navigating systems, connect individuals with covered services, foster information sharing within the care team, ensure continuity of care, and ultimately enhance health outcomes, promote health equity, and reduce costs; and

WHEREAS, Centers for Medicaid and Medicare Services (CMS) is expanding reimbursement for CHWs for Medicare services in 2024, including Community Health Integration services addressing social determinants of health (SDOH) needs interfering with a medical diagnosis/problem, and Principal illness Navigation which includes patient care navigation as a part of the treatment of a high-risk disease/diagnosis^3,4,5,6; and

WHEREAS, many states proposed and CMS has approved Medicaid reimbursement beyond “patient education” including system navigation, linking people with medical care and addressing social determinants of health⁷; and

WHEREAS, the Legislative Action Committee (LAC) of the Minnesota Community Health Worker Alliance (MCHWA) has studied this issue and believes that it reflects the work done by CHWs in Minnesota.

NOW, THEREFORE, BE IT RESOLVED that the Minnesota Public Health Association supports:

1. The MCHWA position that State Medicaid reimbursement should be expanded beyond patient education to include system navigation;

2. Additional legislative and administrative public policies, which increase reimbursement and expand current Medicaid reimbursement for CHWs to services including the connection of individuals with covered services, efforts to improve access to integrated health services, support for navigation systems, sharing information within the care team and ultimately enhance health outcomes, promote health equity and reduce costs.

1. “Support for Community Health Workers to Increase Health Access and to Reduce Health Inequities” American Public Health Association website Policy Number: 20091 Date: Nov 10 2009
   https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2014/07/09/14/19/support-for-community-health-workers-to-increase-health-access-and-to-reduce-health-inequities

2. “Community Health Workers Member Sections” American Public Health Association Website
   https://www.apha.org/apha-communities/member-sections/community-health-workers/

3. “Calendar Year (CY) 2024 Medicare Physician Fee Schedule Final Rule”, CMS.gov website Nov 02, 2023
   https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2024-medicare-physician-fee-schedule-final-rule
   

4. ”Medicare and Medicaid Programs; CY 2024 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Advantage; Medicare and Medicaid Provider and Supplier Enrollment Policies; and Basic Health Program” Federal Register website 11/16/2023
   https://public-inspection.federalregister.gov/2023-24184.pdf
   

5. Amy DeGroff, Susan White, Stephanie Melillo, William E. Rorie, Carmita-Anita C. Signes, and Paul A. Young “Use of Community Health Workers and Patient Navigators to Improve Cancer Outcomes Among Patients Served by Federally Qualified Health Centers: A Systematic Literature Review” Katherine B. Roland, Erin L. Milliken, Elizabeth A. Rohan, Health Equity. Dec 2017.61-76
   https://www.liebertpub.com/doi/full/10.1089/HEQ.2017.0001
   

6. Kristen J. Wells, Janna R. Gordon “The Wiley Encyclopedia of Health Psychology: Patient Navigation/Community Health Workers” 02 September 2020
   https://onlinelibrary.wiley.com/doi/abs/10.1002/9781119057840.ch193
   

7. Sweta Haldar and Elizabeth Hinton, State Policies for Expanding Medicaid Coverage of Community Health Worker (CHW) Services, Kasier Family Foundation Website Jan 23, 2023
   https://www.kff.org/medicaid/issue-brief/state-policies-for-expanding-medicaid-coverage-of-community-health-worker-chw-services/