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.

CLS Services Postponed

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

THW CLS Services Community Engagement PPT.pdf

Traditional Health Worker billing and payment guidance webinars

Contact: Summer Boslaugh (summer.h.boslaugh@oha.oregon.gov)

Participants will learn about two new guidance documents on traditional health worker (THW) billing processes, including developing sustainable funding models for THW programs.

• Webinar: THW billing guidance for CCOs

This webinar will feature Eastern Oregon CCO sharing about their THW program, including outreach and educational efforts to increase billing for THW services in clinical and non-clinical settings. 

• May 1, 11 a.m. – 12 p.m.
• Register here
• Audience: CCOs

• Webinar: THW billing guidance for community-based organizations

Thursday, May 8 at 11 am - 12 pm

This webinar will feature PacificSource's THW team sharing about their programmatic payment model for THW services in community-based settings. 

• May 8, 11 a.m. – 12 p.m.
• Register here
• Audience: THWs and community-based organizations 
  

Highlight Event: OHA CCO Procurement and Call for Community Engagement Focusing on Traditional Health Workers
The Oregon Health Authority (OHA) is preparing for the upcoming procurement process for Coordinated Care Organizations (CCOs) and is seeking valuable input from the community to ensure that traditional health worker priorities of OHA align with the needs of Oregonians. Community engagement is vital in shaping the future of CCOs and their ability to improve health outcomes across Oregon.

The THW program and OHA's Community Engagement Workstream invites you to participate in this important feedback process. Your insights will assist in the areas to guide procurement priorities and ensure community input is forefront.

Register to attend one of the virtual Zoom meetings below. Translation services will be available in Spanish. For other accessibility accommodations, please reach out via email to Chakila Scott at chakila.m.scott@oha.oregon.gov no later than 48 business hours before the scheduled meeting. Feedback on specific areas/themes for these meetings is viewable during the sign-up.

Anuncio: Adquisición de CCO de la OHA y Llamado para la Participación Comunitaria Centrada en los Trabajadores de la Salud Tradicionales

La Oregon Health Authority (OHA por sus siglas en inglés) se está preparando para el próximo proceso de adquisición para las Organizaciones de Atención Coordinada (Coordinated Care Organizations, CCO por sus siglas en inglés) y quiere escuchar los comentarios valiosos de la comunidad para asegurarse de que las prioridades de la OHA estén alineadas con las necesidades de las personas que viven en Oregon. La participación de la comunidad es muy importante para crear el futuro de las CCO y su habilidad para mejorar los resultados de la salud en todo Oregon.

El programa de Trabajadores de la Salud Tradicionales (Traditional Health Workers, THW por sus siglas en inglés) y el Grupo de Trabajo de Participación Comunitaria de la OHA le invitan a participar en este importante proceso de comentarios. Sus ideas ayudarán en las áreas para guiar las prioridades de las adquisiciones y a asegurar que la participación de la comunidad sea lo más importante.

Regístrese para asistir a una de las reuniones virtuales por Zoom que se indican abajo. Habrá servicios de traducción disponibles en español.  Para otras adaptaciones de accesibilidad, envíe un correo electrónico a Chakila Scott a chakila.m.scott@oha.oregon.gov a más tardar 48 horas hábiles antes de la reunión programada. Los comentarios sobre áreas/temas específicos se pueden ver al registrar.

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