Optimizing Medicaid Reimbursement Community Health Worker Delivered Evidence-Based Programming
Community health workers (CHWs) serve in numerous roles to improve the health and well-being of communities, including delivering evidence-based programs. This webinar will provide an overview of what Medicaid reimbursement avenues are available to support CHW services as well as other aspects of CHW sustainability. Speakers from Rhode Island will share the process they used to successfully create a pathway for billing CHW time for Chronic Disease Self-Management workshops. At the end of this webinar, we will encourage all attendees to learn more about the role of CHWs in their state and how that could fit into a reimbursement opportunity.
Carl Rush
Senior Technical Advisor
National Association of Community Health Workers
Carl H. Rush, MRP (he, his) has specialized in policy and workforce development for community health workers (CHWs) since 1996. He has advised CHW policy initiatives in more than 25 individual states; he is currently advising on Medicaid SPA discussions for CHW services in seven states. He was a lead author on HRSA’s 2007 CHW National Workforce Study, and co-lead on the CHW Core Consensus (C3) Project (2013-16). Carl completed two national policy studies with the CDC, on CHW certification and workforce development (WD) strategy (2014-17), and is advising CDC’s new follow-on study of WD policy. He is a consultant to National Academy for State Heath Policy (NASHP) on their current CHW policy learning community TA project, and the Envision (CDC 2110) TA effort for “2109” grantees. He was on a steering committee (2015-19) that became the inaugural Board of Directors for the National Association of CHWs (NACHW), and is currently serving as a policy consultant to NACHW under contract.
Nancy Silva
Senior Director, Health Initiatives
RIPIN
Nancy Silva, MBA, CCHW, is the Senior Director of Health Initiatives at RIPIN. For over 15 years, Nancy has paved the way for Community Health Workers (CHWs) in RI.
Nancy is an elected member of the RI Certification Board of Directors. Nancy is a member of the Community Health Worker Association of RI (CHWARI), the National Association of Community Health Workers (NACHW), and the Armenian International Women’s Association. Nancy has spoken locally and nationally on the integration and utilization of Community Health Workers to improve health outcomes.
She is co-chair of the Payment and Sustainability workgroup as part of the RI Department of Health's CHW Network Strategy and Roadmap for Community Health Workers in RI.
During her tenure at RIPIN, Nancy developed programs designed to improve the health of Rhode Islanders utilizing CHWs. Most recently, Nancy is a 2022 Administration for Community Living awardee for a novel approach to sustaining evidence-based interventions using CHWs.
Sharon Williams
Founder and CEO
Williams Jaxon, Consulting, LLC
Sharon R. Williams is the founder and CEO of Williams Jaxon, Consulting, LLC, a business development and training firm focused on support for community organizations, government agencies and health organizations serving Medicare/Medicare consumers. Sharon’s experience includes executive leadership in both the traditional health care and the Home and Community Based Services industries. She is a seasoned and results oriented executive with a passion for the delivery of high quality, culturally competent, comprehensive and cost effective health care services for publicly funded consumers. Sharon was CEO at CareSource Michigan, a top 100 ranked health plan with Medicaid and Medicare product lines. Additional leadership experiences include Vice President roles at Coventry, Amerigroup and OmniCare. She has also served as COO for one of the nation’s leading Area Agencies on Aging. Sharon is a consultant with the National Council on Aging (NCOA). She conducted the research and construct for the soon-to-be-released CDSME marketing video. Additionally, she administers NCOA’s Community Integrated Health Council and the 2017 Network Development Learning Collaborative.
Sharon has been affiliated with leading industry organizations such as America’s Health Insurance Plans (AHIP), Medicaid Health Plans of America (MHPA), National Association of Area Agencies on Aging (n4a), National Association of Health Services Executives, Meals on Wheels America (MOWA), and the Association for Community Affiliated Plans (ACAP).