Integrating and Paying for CHWs in

Emerging Models of Care    Health System Model Perspective

The HIV Experience

Ruth M. Rothstein CORE Center: Chicago, Illinois

• Cook County Bureau of Health Services Facility – Public “Safety-Net”• > 5,500 patients, 30,000 primary care visits annually • Primarily a minority population • >80% have incomes less than 200% FPL• Frequent history of drug use, incarceration

The Evolution of HIV

• From a death sentence to chronic disease• 1995: The Year Everything Changed• A recently published study contains some very

good news for people living with HIV. It suggests that the life expectancy for a person newly diagnosed with HIV, with no symptoms, has jumped from seven years to 24.

Community Response

• Care Givers (Buddies) • Health Literacy and Education• Outreach• Navigation• Advocacy

Federal Response

• Ryan White Care Act (Care, Treatment)• Center’s for Disease Control (Prevention) • SAMSHA (Substance Abuse Mental Health)• NIH (Research)

Consumer/Community EngagementNational HIV/AIDS Strategy (NHAS) Affordable Care Act (ACA)

Ryan White Programs

Request for Proposals (RFP) How are clients engaged?

Consumer Advisory Boards (CAB)Quality Improvement CommitteesWorkforce opportunities, Peer Educators,

Patient Navigators, Outreach workers, Health Educators…

CORE Center Model

• Peer Educators (Clinical settings) • Patient Navigators (In-patient and outpatient)• Community Outreach Workers (Seek, Link and

Retain) • Multiple federal payer sources (All time

limited) • All reduce barriers to care, support early and

sustained treatment. (HIV Viral Suppression, Advocacy, Health Literacy)

Emerging Opportunities

• Eliminates pre-existing conditions barriers (Increased access to Health Services) • Increasing Value of CHW Experience• Workforce development (Redeployment of

Peers as CHW’s)• Exploring partnerships with community

colleges ( MXC and SSC Peer cohorts) • Advocacy/ Education to CCHHS• Address billing challenges (Coding-

Reimbursement rates)

Thanks!

Peter McLoyd

Ruth M. Rothstein CORE Center

Consumer Development and Advocacy Coordinator

312-572-4649

pmcloyd@cookcountyhhs.org