California mandates annual analysis of community health worker services in Medi-Cal

On March 18, 2025, California lawmakers introduced Assembly Bill 403, aimed at enhancing the effectiveness and accessibility of Community Health Worker (CHW) services under the Medi-Cal program. This legislation seeks to address gaps in outreach and education efforts conducted by Medi-Cal managed care plans, ensuring that these services are effectively reaching diverse populations across the state.

The bill mandates the California Department of Health Care Services to conduct an annual review of outreach and education initiatives related to CHW services. Furthermore, it requires the department to perform a comprehensive analysis of the CHW services benefit, with the first report due by July 1, 2027. This analysis will assess CHW capacity and the needs of Medi-Cal beneficiaries, disaggregating data by geographic region, race, ethnicity, language, age, and other sociodemographic factors. It will also evaluate the utilization of CHW services and the demographics of both CHWs and the beneficiaries they serve.

Key provisions of AB 403 include a detailed examination of the types of services provided by CHWs, the number of eligible Medi-Cal beneficiaries, and the diversity of CHWs in terms of race, ethnicity, and language. The bill aims to ensure that the CHW workforce reflects the communities they serve, thereby improving cultural competence in service delivery.

Debate surrounding the bill has highlighted the importance of CHWs in bridging gaps between health and social services, particularly for underserved populations. Supporters argue that the annual analyses will provide critical insights into the effectiveness of CHW services and help identify areas for improvement. However, some critics express concerns about the potential administrative burden on the Department of Health Care Services and the need for adequate funding to support these initiatives.

The implications of AB 403 are significant, as it aims to enhance health equity by ensuring that Medi-Cal beneficiaries receive culturally competent care tailored to their specific needs. By requiring detailed demographic analyses, the bill seeks to inform policymakers about the effectiveness of CHW services and guide future funding and resource allocation.

As California continues to grapple with health disparities, AB 403 represents a proactive step toward improving access to essential health services for all Medi-Cal beneficiaries, particularly those from diverse backgrounds. The outcomes of the mandated analyses will likely shape the future of CHW services in the state, influencing both policy and practice in community health.