The General Assembly made a fundamental commitment to the health of Connecticut families in 2023, enacting legislation requiring the state to reimburse for services provided by community health workers to Medicaid enrollees. Yet, more than two years later, Connecticut’s Medicaid program still does not cover community health worker services.
Delivering on that long-overdue commitment is an urgent priority to improve our state’s health and economic vitality.
Community health workers play several essential roles in our state’s health care system. Many promote healthier choices by sharing information with their communities about healthy eating, measures families can take to mitigate childhood asthma attacks, or how to reduce other disease risks. This public health promotion role is likely most familiar to the public from community health worker community engagement efforts, which contributed to the COVID-19 vaccination uptake during the pandemic.
Some community health workers also work to connect uninsured people with available health coverage, improving access to care. Others bridge the gap between patient and health care provider, or even work to coordinate care across multiple providers, offering support on everything from medication management to follow-up exam scheduling. Such services are crucial now, as many Connecticut residents face new barriers to enrollment in health coverage —a problem which will worsen later due to changes required by federal law (H.R. 1).
Research and decades of experience across the country and globally have demonstrated that community health workers make our health system work better, improving the health of individuals and whole communities.
By providing the information and insights neighbors need to take charge of their own health and by helping providers and patients work better together, community health workers have driven meaningful improvements in health outcomes. Research shows that community health workers have delivered measurable gains on conditions ranging from diabetes, heart disease and high blood pressure to cancer screenings and mental health.
Community health workers often work with underserved populations including low-income and immigrant families, people of color, and older adults. Because they are members of the communities they serve, community health workers understand the assets and challenges of those communities and often bridge cultural and linguistic gaps dividing families from health care providers. And because they are trusted messengers within the community, the advice and information they provide is better received and more impactful. As a result, community health workers have been shown to reduce racial and economic health disparities and improve health outcomes for all people.
Because they encourage and facilitate prevention, effective screening, and access to care, community health workers also make the health system more efficient. That means more cost-effective care for everyone, lower health insurance costs for individuals and families, and lower health-related costs for taxpayers. In some cases, communities served by community health workers have seen cost reductions as high as $15 for each $1 invested in community health workers.
Our organizations and other allies are working right now, in partnership with the Department of Social Services (DSS), to fully implement existing state law and scale up the community health workforce in Connecticut. We are asking DSS to file a “state plan amendment” seeking federal approval to reimburse community health workers through our state’s Medicaid program, which would allow communities and providers to put community health workers in more local neighborhoods, meet the needs of more families, and make health care more cost-effective statewide.
We will also need state funding to support outreach and start-up costs for new community health worker programs—funding which will provide a significant return on investment, both financially and in health outcomes.
We are hopeful that Connecticut’s leaders will continue to support community health workers and will implement Medicaid reimbursement soon. These actions will accelerate our state’s progress toward a healthier, more cost-effective, and better future.
Rhonda Evans is Executive Director of the Connecticut Association for Community Action; Deb Polun, Chief Strategy Officer of the Community Health Center Association of Connecticut; Fernando Morales, Executive Director of the Southwestern AHEC Connecticut and Ayesha Clarke, Executive Director of Health Equity Solutions.