Medi-Cal: community health worker services.

Assembly Member Ortega's proposal to enhance oversight of Medi-Cal's community health worker (CHW) services would establish annual reviews of managed care plans' outreach efforts and create detailed reporting requirements for the State Department of Health Care Services. The legislation mandates comprehensive analyses of CHW services, with the first report due by July 1, 2027.

The Department would analyze CHW capacity and beneficiary needs across geographic regions, examining service types, referral patterns, and provider demographics. The reports must include data on the number of eligible beneficiaries, contracted CHWs by employer type, and total Medi-Cal reimbursements for CHW services. This information would be disaggregated by race, ethnicity, language, age, and other demographic factors to present a detailed picture of service delivery and access patterns.

To maintain data quality and protect privacy, the legislation specifies that demographic information must meet statistical significance thresholds, and all reporting must exclude personally identifiable information. The Department would submit these analyses to the Legislature and publish them on its website, creating a public record of CHW service utilization and outcomes within the Medi-Cal system.