Connecticut Community Health Workers Await Medicaid Reimbursement Funding

Connecticut’s Unfulfilled Promise: Community Health Workers Await Promised Medicaid Reimbursement

For years, dedicated Community Health Workers (CHWs) across Connecticut have been the frontline champions for our most vulnerable residents. They navigate complex healthcare systems and provide essential support that reaches far beyond the traditional doctor’s office.

A landmark 2023 law promised to solidify funding for their vital services through Medicaid reimbursement. Still, anyone following CT news probably feels the familiar frustration: the promise remains unfulfilled.

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Countless CHW positions now hang by the thread of short-term grants. This impacts communities from Hartford to New Haven and everywhere in between.

The Promise and the Peril: A Legislative Gap

In 2023, Connecticut lawmakers took a big step with Public Act 23-186. The law mandated that Medicaid cover services provided by Community Health Workers.

This was a pivotal moment, finally recognizing the invaluable role these professionals play. They connect people with care, help with insurance appeals, schedule appointments, deliver groceries, and even assist with housing and benefit applications.

But the legislation passed without a specific implementation date. Worse, it didn’t include any dedicated funding.

That oversight has created a frustrating bottleneck. The initiative can’t move forward in a meaningful way.

Advocates got their hopes up this year. They believed funding had been secured through the budget-deficit-in-years-comptroller-warns/”>2026 budget process, thanks to action by the Appropriations Committee.

But in a disappointing twist, the final budget—agreed upon by leaders from Stamford, Bridgeport, and elsewhere—excluded those necessary funds. Now, CHW programs remain stuck with the unpredictable world of short-term grants.

It’s a precarious model. Long-term planning and service expansion become nearly impossible.

Think about the families in Waterbury or the outreach efforts in Waterbury—stability is directly tied to these unreliable grants.

Advocates Step Up: Bridging the Capacity Gap

State officials, including folks from the Department of Social Services (DSS), have pointed to a lack of internal capacity as a barrier. They said they couldn’t conduct detailed financial analyses or draft the state plan amendment for federal approval—both essential steps for securing federal Medicaid matching funds.

That’s when the tireless CT CHW coalition, made up of passionate people working in communities from Norwich to Danbury, decided to step up.

Coalition members took on the massive job of drafting both the financial analysis and the state plan amendment themselves. Their analysis landed on a recommended Medicaid reimbursement rate of $33 per 30-minute service.

They also outlined estimated one-time implementation costs of $1 million, with ongoing annual expenses of $3 million. It’s a proactive approach that shows just how committed they are to making CHW Medicaid reimbursement real.

The data they presented makes a strong case for the economic feasibility and clear benefit of this investment.

A National Trend and a Local Hurdle

Across the country, more states are recognizing the value of CHW services. At least 20 states already reimburse CHWs through their Medicaid programs.

Advocates say following this proven model would let Connecticut stabilize existing CHW jobs. It could also expand these crucial services to underserved populations, including folks in Groton and Mystic.

The current administration says it’s complying with Public Act 23-186 and highlights ongoing work with the legislature on a balanced budget.

Separately, the state has allocated $2 million from its Emergency State Response Reserve. This money is set aside for CHW outreach to help residents navigate changes to Medicaid and SNAP benefits, prompted by federal legislation.

While that’s certainly helpful, it doesn’t solve the bigger issue. Systemic, ongoing Medicaid reimbursement for CHW services is still missing.

The Path Forward: Demanding Action and Accountability

The CT CHW coalition has formally requested meetings with both the Department of Social Services and the Office of Policy and Management.

They’re not backing down. Their stance comes from a real conviction that the state isn’t following the 2023 law.

Now, the coalition is pushing for a clear, actionable roadmap toward full Medicaid reimbursement. They want to make sure Community Health Workers get the recognition, respect, and funding they deserve.

You can feel the tension. People across Connecticut are waiting for a real answer.

Here is the source article for this story: CT community health workers still waiting for Medicaid support

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