Funding /ROI

ARTICLE – New England Journal of Medicine – Realizing the Value of Community Health Workers – New Opportunities for Sustainable Financing – Community Health Workers (CHWs) can play an important role in improving the quality and value of health care. As trained frontline health workers who are trusted members of — or closely connected to — the population they serve, CHWs generally share a culture, language, and community with their clients. They help address underlying inequities in health care access and quality by participating in culturally congruent interventions, including outreach, advocacy, education, counseling, and linkages to social services.

  • ACA CMS Rule Change
  • Waivers  1115
  • Global Payments
  • Reinvesting ROI
  • Grants
  • CDC  1305, 1422
  • OMH

Forbes Magazine identifies Community Health Workers as Medical Concierge highlighting the ROI of Community Health Workers

Community Health Workers are recognized as the professional group best suited to functioning as “Medical Concierge” CHW are ideally suited to implementation of the triple aim of increasing access improving quality and reducing costs! As Community Health Workers, of many different job descriptions, we have known this for many years. But I think as a best kept secret Community Health Workers are out of the box…I hope this is the beginning of a tipping point in the USA medical care delivery system towards a focus on primary, secondary and tertiary prevention “WELLNESS”



CalSEARCH RFA 14-5545

 Leveraging Managed Care to Support Community Health Workers and Promote Population Health Astho (Recorded Sept. 9, 2015)

Association of State and Territorial Health Officials (ASTHO)

This webinar discusses ways Managed Care can be used to impact community health workers and population health. Participants will learn about the importance of effective Medicaid partnerships, how states can use MCO contracts as a policy and financing lever, and effective models incorporating MCOs. Speakers include Sue Moran, Senior Deputy Director at Michigan Department of Health and Human Services and Dodie Grovet, Clinical Programs Training Manager at Molina Healthcare Inc.

Ashtho Brief: Expanding Access for Preventive Services: Key Issues for State Public Health Agencies  ( 2015,  6 pgs – Contact Address: 2231 Crystal Drive, Ste 450, Arlington, VA. Telephone  202-371-9090

Return on Investment (ROI)

Commonwealth Fund: Transforming Care:  December 17, 2015 Issue

In Focus: Integrating Community Health Workers into Care Teams

Community health workers who help patients navigate the health care system and work to address their social and economic needs have rarely been fully integrated into care teams. This issue reports on health care organizations that have integrated community health workers into multidisciplinary teams, which appears to be a factor in their success. 

By Martha Hostetter and Sarah Klein

Science-in-Brief: A Cost Analysis of a Rural Community Health Worker Program

This resource is asynopsis of the article, “A Cost Analysis of a Rural Community Health Worker Program in Rural Vermont” published in June 2013 in the Journal of Community Health. In this article, the authors described the cost analysis conducted as a part of the first phase of a comprehensive evaluation of a CHW program in rural Vermont. This CHW program helps people access social and economic services to improve their life conditions and thus reduce the risk of or effectively manage chronic conditions.

Science-in-Brief: Cost-Effectiveness of Nurse Practitioner/ Community Health Worker Care to Reduce Cardiovascular Health Disparities

This resource is asynopsis of the article “Cost-Effectiveness of Nurse Practitioner/ Community Health Worker Care to Reduce Cardiovascular Health Disparities”  published in April 2013 in the Journal of Cardiovasuclar Nursing. In this article, the authors summarize the outcomes and cost-effectiveness analysis of a CVD risk reduction program (the intervention) delivered by NP/CHW teams versus enhanced usual care in improving cholesterol, blood pressure, and hemoglobin (Hb) A1C levels (a measure of diabetes control) among patients in federally qualified community health centers located in major cities.

Peers for Progress: Global Evidence for Peer Support: Humanizing Health Care

Trust For America’s Health: Million Hearts

CDC Logo

Centers for Disease Prevention and Control (CDC)


Director of Public Health Policy in the Office of Health Reform at the U.S.
Mayra Alvarez MPA

Mayra E Alvarez

Mayra E Alvarez

J. Nadine Gracia, MD, MSCE Deputy Assistant Secretary for Minority Health & Director of the Office of Minority Health

Photo of J. Nadine Gracia, MD, MSCE, Deputy Assistant Secretary for Minority Health & Director of the Office of Minority Health

National Promotores Initiative (NPI)

Gloria González, PhD, MA
Public Health Advisor
Division of Policy and Data
Office of Minority Health
U.S. Department of Health and Human Services
Phone: 240- 453-6184

Members of the NPI Steering Committee 


Lupe Gonzalez-Hernandez, Director of Health Programs
Esperanza Community Housing Corporation
Los Angeles, CA

Margarita Holguin, Director
Chula Vista Community Collaborative
Chula Vista, CA

Maria Lemus, Executive Director
Visíon y Compromiso
El Cerrito, CA


Genoveva Martinez, Program Coordinator
Migrant Health Promotion
Weslaco, TX

Rosamaria Murillo, Director of Special Initiatives
Texas Department of State Health Services
Austin, TX

Advancing Community Health Worker Practice and Utilization: The Focus on Financing ( 2006 89 pages)

NFME and UCSF Center for Health Professions study on financing for CHW 2006
NFME and UCSF Center for Health Professions study on financing for CHW 2006

Dr. Mutha can be reached at:
Center for the Health Professions
University of California, San Francisco
3333 California St., Suite 410
San Francisco, CA 94118
Telephone: (415) 502-4991

State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors and Promote School Health (1305)

 This Funding Opportunity Announcement (FOA) supports statewide implementation of cross-cutting approaches to promote health and prevent and control chronic diseases and their risk factors. Four chronic disease prevention programs (Diabetes; Heart Disease and Stroke Prevention; Nutrition, Physical Activity, and Obesity; and School Health) are included in this FOA. Collectively, these programs represent activities and intervention strategies that draw from each of the four chronic disease domains. For information on the Chronic Disease Prevention and Health Promotion Domains, see below.
There are two components to this FOA. The first is a non-competitive basiccomponent that will be awarded to all 50 states and the District of Columbia if they submit a technically acceptable application. The second is a competitive enhancedcomponent that will provide funding for up to 25 states. All states and the District of Columbia are eligible to apply for the competitive enhanced component. The enhanced component will be objectively reviewed and scored. The five-year project is expected to begin on July 1, 2013.

Before health care reform:

Small business needs:…it was difficult for a small organization like ours with only 3 employees at the time to find affordable health insurance packages.

Workforce: it was difficult to find funding to hire community health workers to serve our community.

Health care reform is important to me because:

Small Business Needs: After the passage of ACA , our organization was happy to know that because of healthcare reform, small businesses would receive tax subsidies for providing health coverage for their employees, and we were glad to find that this provision extended to nonprofit 501c3 organizations. We were also able to find affordable options and became able to provide full coverage for medical, dental and vision.

Workforce: Our organization also had received an increase in funding from our partner (an academic institution our organization partners with for a CBPR grant) which enabled our organization to hire 3 additional Community Health Workers whose health coverage we could support. This increase in funding could be attributed to the need to further build the CHW workforce in community settings, given the fact that several sections of ACA recognize CHWs’ crucial role in achieving important health care reform goals. For instance, with the ACA’s emphasis on community-based preventive care, community-based health teams, and patient-centered medical homes, CHWs become vital to the restructuring of the delivery of primary healthcare. The federal grant that supports our academic-community partnership calls for strategies that build sustainable interventions to address health disparities. This type of investment helps provide resources for our organization’s staffing, benefits, facilities costs and was one step towards sustaining our CHW program in a community-based organization setting.


The National Health Care for the Homeless Council…”This publication is designed to complement other Council efforts to promote CHW programs, such as Community Health Workers in Health Care for the Homeless: a Guide for Administrators, by providing an overview of federal and state policies governing CHW programs and providing recommendations for how HCH projects can fully leverage public and private funds to implement CHW programs.”

Workforce Innovation and Opportunity Act (WIOA) Roll Call Vote on passage of H.R.803, as amended Passed 95-3 JUN 25, 2014  At 3:13pm, the Senate began a 10-minute roll call vote on passage of H.R.803, Workforce Innovation and Opportunity Act (WIOA), as amended.

Funding Opportunity Announcements (FOA): Navigator FOA pre-application conference calls

The Centers for Medicare & Medicaid Services (CMS) has announced the availability of funding, totaling $60 million, to support Navigators in Federally-facilitated and State Partnership Marketplaces in 2014-2015.  The funding opportunity announcement is open to eligible individuals, as well as private and public entities, Indian tribes, tribal organizations, and urban Indian organizations applying to serve as Navigators in states with a Federally-facilitated or State Partnership Marketplace. It is open to new and returning Navigator applicants.

  • NAVIGATOR APPLICATION CLOSES: July 10, 2014 by 1:00 p.m. Eastern Daylight Time


You can access the funding opportunity announcement  and FAQs  or  here or you can visit and search for CFDA # 93.332 

 Navigator FOA Pre-application conference call: FINAL call: Tuesday, July 1, 2014 from 1:30-3:00 p.m. Eastern Daylight Time

Audience URL:
Title: Navigator Funding Opportunity Announcement Pre-Application Webinar 7-1-14

Report to Congress: The Centers for Medicare & Medicaid Services’ Evaluation of Community-based Wellness and Prevention Programs under Section 4202 (b) of the Affordable Care Act 

(See more details at CMS State Budget Amendment needed)

Over the next several days, CDC is announcing the availability of six new funding opportunity announcements (FOAs) to advance the nation’s chronic disease prevention and health promotion efforts. 

  • All six FOAs address one or more of the leading risk factors for the major causes of death and disability in the United States: tobacco use, poor nutrition, and physical inactivity.
  • A number of the FOAs also address key health system improvements and community supports to help Americans manage their chronic conditions such as high blood pressure and pre-diabetes.
  • All the FOAs involve partnerships at the national, state, or local level because public health cannot solve these problems alone. 

Through these FOAs, CDC is concentrating resources on key risk factors and major diseases that contribute substantially to suffering, disability, and premature death among Americans. Together, the six FOAs form a mutually reinforcing set of activities designed, in synergy, to reach the overall goals of reducing:

  • Rates of death and disability due to tobacco use by 5%.
  • Prevalence of obesity by 3%.
  • Rates of death and disability due to diabetes, heart disease, and stroke by 3%. 

Individually, each FOA contributes uniquely to these goals by:

  • Working through unique awardees (e.g., state health departments, national organizations).
  • Delivering interventions to unique populations (e.g., racial and ethnic minorities, populations with very high obesity rates).
  • Emphasizing specific interventions (e.g., health system improvements, environmental approaches).
  • Implementing interventions in specific places (e.g., large cities, tribes).
  • Addressing specific risk factors, disease management, or both (e.g., tobacco use, obesity, high blood pressure). 

(DP14-1417) Partnership to Improve Community Health (see CDC website: and

(DP14-1418) National Implementation and Dissemination for Chronic Disease Prevention (see and CDC website


(DP14-1419PPHF14): PPHF 2014 Racial and Ethnic Approaches to Community Health (REACH) financed in part by Prevention and Public Health Funding (see

DP14-1421PPHF14): A Comprehensive Approach to Good Health and Wellness in Indian Country (see

(DP14-1422) State and Local Public Health Actions to Prevent Obesity, Diabetes and Heart Disease

State and Local Public Health Actions, a new 4-year, $70 million/year program that builds on efforts initiated in 2013, intensifies work in 18 to 22 state and large city health departments to prevent obesity, diabetes, heart disease, and stroke and reduce health disparities among adults through a combination of community and health system interventions.  States will sub-award half of their funds to support implementation activities in 4-8 communities in their states. Community strategies will build support for lifestyle change, particularly for those at high risk, to support diabetes and heart disease and stroke prevention efforts. Health system interventions and community-clinical linkage strategies will aim to improve the quality of health care delivery and preventive services to populations with the highest hypertension and prediabetes disparities. These efforts will be supported by state/jurisdiction-level leadership and coordination and technical assistance to selected communities. Activities will complement but not duplicate those funded under the State Public Health Actions (DP13-1305) initiative. Click here to view the FOA:

Web Forum—Moving Community Prevention Forward: New Funding Opportunities to Advance Community Health and Equity

Monday June 23 10:00 AM to 11:30 AM Pacific  /1:00 PM to 2:30 PM Eastern


Six new funding opportunities from the Centers for Disease Control and Prevention offer a variety of stakeholders — including public health departments, national and community based organizations, community coalitions, school districts, local housing and transportation authorities and American Indian tribes — the opportunity to continue building healthier, more equitable communities with federal support.

Please join us for a Web Forum on June 23rd from 10:00 AM to 11:30 AM Pacific,1:00 PM to 2:30 PM Eastern, co-hosted by Prevention Institute, the American Public Health Association, Convergence Partnership, PolicyLink, Public Health Institute and Trust for America’s Health, to learn about the following opportunities:

  • Partnerships to Improve Community Health: “Supports implementation of evidenced and practice-based strategies that address previously identified community gaps and needs within a defined jurisdiction to reduce the prevalence of chronic disease and related risk factors.”
  • National Implementation and Dissemination for Chronic Disease Prevention: “Supports national organizations and their chapters/affiliates in building and strengthening communities’ abilities to implement community health improvement strategies.”
  • Racial and Ethnic Approaches to Community Health (REACH): “Seeks to strengthen existing capacity to implement locally tailored evidence and practice-based population-wide improvements in priority populations experiencing chronic disease disparities and associated risk factors and support implementation, evaluation, and dissemination of strategies.”
  • PPHF 2014: State and Local Public Health Actions to Prevent Obesity, Diabetes, and Heart Disease and Stroke: “Supports implementation of population-wide and priority population approaches to prevent obesity, diabetes, and heart disease and stroke and reduce health disparities in these areas among adults.”
  • A Comprehensive Approach to Good Health and Wellness in Indian Country: “Offers support to prevent heart disease and prevent and manage type 2 diabetes and associated risk factors, such as tobacco use, physical inactivity, and unhealthy diet in American Indian tribes and Alaskan Native villages through a holistic approach to population health and wellness.”
  • Programs to Reduce Obesity in High Obesity Areas: “Funds up to 6 Land Grant Colleges and Universities located in states with counties with an adult obesity prevalence of over 40%.”

During the Web Forum, attendees will be provided with an overview of the new funding opportunities, discussion of strategies and efforts to build a system of prevention and clinical integration, and ways to advance equity through community engagement. Participants will also learn strategies to ensure robust communications are provided to key audiences including policymakers.



Peter Long Ph.D Blue Cross Blue Shield Foundation CA Video

Peter Long the President and CEO of Blue Cross Blue Shield Foundation of CA talks about bold new strategies to partner with Community agencies to prevent domestic violece and improve the social determinants of health. BCBS is a supporter of the CHW?P model in CA

National Academy for State Health Policy (NASHP)

IdentIfIcatIon and assessment of chIldren and Youth wIth specIal health care needs In medIcaId managed care: approaches from three states  (California, Michigan, and Massachusetts) By Joanne Jee; Julien Nagarajan February 2014

Summary: …In California, Michigan, and Massachusetts—to identify and assess Children and Youth with Special Health Care Needs in Medicaid managed care…. (CYSHCN)…Page 16 has a good table comparing the three states, p17-19  promising Practices

Addressing Rising Health Care Costs Workshop Summary -A pioneering meeting of advocates seeking to address health care costs. (Robert Wood Johnson Foundation RWJF/ConsumersUnion)


CMS Webinar: Frontier Community Health Integration Project Demonstration – Introduction

On January 31, the Centers for Medicare & Medicaid Services (CMS) announced the Frontier Community Health Integration Project Demonstration. This new demonstration aims to develop and test new models of integrated, coordinated health care in the most sparsely-populated rural counties with the goal of improving health outcomes and reducing Medicare expenditures. Eligibility is restricted to Critical Access Hospitals in Alaska, Montana, Nevada, North Dakota, and Wyoming.

The CMS Innovation Center will host a webinar on Tuesday, February 11, 2014 from 2:30 – 4:30pm ET to provide an overview of the demonstration and the application package. Subject matter experts from the CMS Innovation Center and the Health Resources Services Administration (HRSA) will provide details and answer questions.

What:  Webinar: Frontier Community Health Integration Project Demonstration – Introduction

When: Tuesday, February 11, 2014;  2:30 – 4:30pm ET

Health Profession Opportunity Grants 

Authorized by the Affordable Care Act, the Health Profession Opportunity Grants (HPOG) program provides education and training to TANF recipients and other low-income individuals for occupations in the health care field that pay well and are expected to either experience labor shortages or be in high demand.

Welfare to Work-Train CHW and transform people from being the problem to being the solution!
Welfare to Work-Train CHW and transform people from being the problem to being the solution!

California Proposition 63, Income Tax Increase for Mental Health Services (2004)

California Proposition 63, or the Mental Health Services Act, was on the California general election ballot on November 2, 2004 as an initiated state statute, where it was approved.Proposition 63 levies an additional 1% tax on incomes of $1,000,000 or greater to fundamental health service programs beginning January 1, 2005. Approximately 25,000 to 30,000 taxpayers were to be directly affected by the tax, generating an estimated $750 million in revenue during fiscal year 2005-06. At the time of the election, California income tax rates ranged from 1% to 9.3%, depending on a taxpayer’s income level.The initiative was written by then Assemblyman Darrell Steinberg and Mental Health lobbyist Sherman Selix.( Used for funding Consumer advocacy and Peer Support Specialists)