November 2018 - June 2019
The demonstration project will test and evaluate a potentially financially sustainable model wherein participating health plans each dedicate one or two of their CHWs to participate in a comprehensive neighborhood-focused CHW program in Cody Rouge. CHWs from each of the Medicaid health plans have undergone shared training conducted by the Michigan Community Health Worker Alliance (MICHWA). During the demonstration project, they will proactively reach out to selected enrollees who are identified as having suboptimal utilization patterns, conduct a comprehensive assessment of domains shared across all plans with identified enrollees from their plans, and provide follow-up support to each enrollee as necessary to meet social, medical, and/or behavioral needs. A Cody Rouge-based community organization, the Joy-Southfield Community Development Corporation, will provide office space in the event that a CHW needs a neutral office space in which to meet with a client, and the Detroit Health Department will provide ongoing mentorship and booster support for shared problem-solving and discussion in bi-weekly and/or monthly meetings among all participating CHWs across plans.
