New funding mechanisms have positively influenced the CHW profession, both in Michigan and across the country. In January 2014, new federal regulations on Medicaid and Medicare allowed the reimbursement of recommended preventive services to be provided by non-licensed providers, which includes CHWs. This national policy created a significant opportunity for the CHW profession, by providing the opportunity for the reimbursement of preventive services that CHWs often provide, like group health education, lactation consulting and diabetes prevention programs.
In 2016, the state of Michigan entered into a Medicaid managed care contract, which required all health plans to maintain at least one full-time CHW per 20,000 patients, provide or arrange for CHW services for enrollees with complex health issues, and to establish a reimbursement method for CHW work that promoted behavioral health integration.
Over the last few years in Michigan, CHW programs have grown in popularity as an effective method of delivering affordable healthcare. In March 2015, the Michigan Primary Care Association (MPCA) partnered with the Michigan Department of Health and Human Services and the American Cancer Society to create a new CHW program in Michigan to improve cancer screening rates. This program spanned across 8 health centers and increased the number of cervical and breast cancer screenings., In 2016, this program was expanded to include colorectal and lung cancer screenings.
“MI Care Teams” were launched by the Michigan Department of Health and Human Services in 2016. This service model was created to provide support to qualifying chronically-ill Michigan residents. The influence of MI Care Teams has been far-reaching, with approximately 3,645 people in Michigan currently enrolled in the program. In this role, CHWs identify community resources, provide referrals, support chronic disease self-management and provide health education. They conduct home visits and work within the community to improve community health.
The CHW workforce in Michigan has been steadily growing and gaining recognition as an effective means of improving health in the community. According to the Bureau of Labor Statistics, there are approximately 54,760 CHWs working in Michigan. These CHWs work in various areas across the state but most can be found in Wayne, Kent and Washtenaw Counties.