This story has been updated.
The House of Representatives on Wednesday unanimously passed a bill — later approved by the Senate — that included a last minute amendment that, among other measures, taps the Department of Social Services to design and implement Medicaid reimbursement for community health workers.
But the amendment does not specify a date by which reimbursement must begin.
The Senate passed the original bill without the community health worker provision, which was included in an amendment added Wednesday morning. The Senate approved the amended bill by consent in the final hours of the session.
“If we can get this passed, it will be a major victory for public health. We learned in the pandemic how important community health workers are in closing health disparities,” said Sen. Matt Lesser, D-Middletown, co-chair of the Human Services Committee, when the measure passed the House.
The Human Services committee passed two bills this session aimed to make services provided by community health workers reimbursable by Medicaid. Neither made it to the floor for a vote, and, until now, the measure seemed unlikely to pass.
The provision ultimately ended up tacked onto Senate Bill 989, which establishes certain reforms in nursing homes. The bill at one point featured a requirement that nursing homes provide air conditioning in every resident room, though that did not make it into the final version.
The bill includes a measure allowing nursing homes to transport non-ambulatory residents to their family members’ homes under certain conditions and convenes a task force to study the state’s nursing home waitlist requirements and suggest revisions.
What do community health workers do?
Community health workers, also known as outreach workers, health coaches, patient navigators and promotores de salud, help people navigate health care and social services. They have an encyclopedic knowledge of all the resources available to residents in need, and they are experts in navigating the obstacles that can come up when trying to access them.
Currently, the funding for their roles is piecemeal and largely sustained through grants, which can be insufficient and unreliable. Medicaid reimbursement would provide a reliable stream of funding that will enable organizations to hire more community health workers full-time.
“Community health workers are the epitome of health equity. Dramatic improvements in health results when CHWs support and advocate for clients who live in the same town and share the same race, ethnicity, and other aspects of their identity,” stated Ayesha Clarke, executive director of Health Equity solutions, calling the House passage a “step forward.”
Health Equity Solutions and the Community Health Workers Association of Connecticut spent a year talking to community health workers about the best way to structure Medicaid reimbursement for their work. Those conversations shaped the language included in the legislation.
A large body of research shows that community health workers improve outcomes for patients. One California study showed that community health workers increased treatment acceptance by 79% among Latino adults with depression and diabetes or heart disease. Another in Florida showed they increased the likelihood of a follow-up appointment after an emergency room visit by 14% among a group of elderly adults with chronic illness.
Fifteen states around the country, including Massachusetts, provide Medicaid reimbursement for CHW services. In another 10 states, managed care organizations — health systems that treat the vast majority of patients with Medicaid in many other states — either provide reimbursement for CHW services or employ them directly.
Correction
A previous version of this story said that SB 989 included a requirement that nursing homes provide air conditioning in every resident room. That mandate did not make it into the final draft of the bill.