Information for Health Systems, Providers and THWs

On this page, health system personnel, providers, and THWs will find helpful information and guidance documents on ways for THWs to be integrated into health care services and programs.

We regret to inform you that due to unforeseen circumstances, we are canceling the upcoming webinar titled Provider Eligibility, Enrollment and Billing TA., originally scheduled for Thursday, December 5^th 9:30am-10:30am.

CLS Services Postposed to February 2025

The Culturally and Linguistic Specific Services enhance payment program for Traditional Health Workers implementation has been postponed to late February 2025. OHA will communicate timelines as it becomes clear. Inquiries can be sent to Medicaid.Programs@odhsoha.oregon.gov

RAC: THW Culturally and Linguistically Specific Services Enhanced Payment Program

PURPOSE: To inform the community of an upcoming program for Medicaid THW providers to provide culturally and linguistically specific services to Medicaid members.

Active recruitment ongoing for Rules Advisory Committee (RAC) members. Interested parties should contact Lily Sintim at Lily.Sintim@oha.oregon.gov or 971-276-5559 (voice/text).

OHA welcomes all participants. If you have any questions about accommodations or need any assistance to participate like such as translation, please email or call no later than two (2) business days before the meeting: Lily Sintim at Lily.Sintim@oha.oregon.gov or 971-276-5559 (voice/text). All relay calls are accepted.

THW CLS Services Community Engagement PPT.pdf

OHA's Traditional Health Worker Toolkit 

The Traditional Health Worker Toolkit includes the following topics:

•     THW Overview and 101
•     THW Scopes of Practice 
•     Benefits of Integrating THWs 
  
•     Integrating and Retaining THWs
•     Health Care Delivery System Contracting with Community Based Organizations 
•     Recommendations for Supporting and Supervising THWs 
•     Best and Promising Practices Resources

THW Statewide Needs Assessment Reports

• Advancing Health Equity for Childbearing Families in Oregon: Results of a Statewide Doula Workforce Needs Assessment
• Community Health Workers: Integral Members of Oregon's Health Workforce
• CHW Workforce Assessment
• Oregon's Peer-Delivered Services Workforce Needs Assessment
  

CCO 2.0 Traditional Health Workers Guidance Documents

• Recommendations for Coordinated Care Organization THW Liaison Position Description

• *Newly updated: OHA-OEI-CCO-2.0-THW-Minimum-Reporting-Requiremnts-Template.xlsx

Best and Promising Practices

• Wraparound Best Practice Guide Version 1.0 
• CHW Core Consensus C3 Final Report
• Multisector Intervention Report: CHW for Patients with Chronic Disease
• Best and Promising Practices: Integration of Community Health Workers into Clinical Settings
• Behavioral Health Collaborative Report and Recommendations
• Guidelines for THW Doulas Serving OHP Members 
  
• Healthcare Workforce Retention Toolkit
  

 Payment Models

• Final Payment Model Grid by Worker Type with Disclaimer
• Recommendations for THW Payment Models (Core Principles), Inventory of Existing Birth Doula Payment Models
• Recommendations for THW Payment Models (Core Principles), Inventory of Existing Community Health Worker (CHW) Payment Models
• Recommendations for THW Payment Models (Core Principles), Inventory of Existing Patient Health Navigator (PHN) Payment Models
• Recommendations for THW Payment Models (Core Principles), Inventory of Existing Peer Support Specialist (PSS) Payment Models
• Recommendations for THW Payment Models (Core Principles), Inventory of Existing Peer Wellness Specialist (PWS) Payment Models
• Oregon Community Health Workers Association: Contracting Model
• Traditional Health Workers Commission - Presentation: Fee-for-Service Billing for CHW Services
• Provider enrollment and billing for peer-delivered services
• Doula Billing FACT SHEET 
  

ILOS guidance documents now available on the OHA ILOS website. In Lieu of Services (ILOS) are services determined by the state to be medically appropriate and cost-effective substitutes for covered services or settings under the State Medicaid Plan. The guidance documents include benefits ad criteria of ILOS, coding guidance, ansers to CCO questions and a comparison between OHA spending initiatives. We hope these documents will provide clarity and guidance in how your CCO can utilize ILOS.

For more information about Traditional Health Workers, see relevant links:

• THW Legislation and Rules  
• THW Resources 
  
• Register for RAC for Rule Change Meeting 410-130-0015 Doula Procedure Code Change HERE
  
• Doula Billing Code Changes Zoom Meeting