Publications / Understanding California’s Community-Connected Workforce

Understanding California’s Community-Connected Workforce

Key takeaways

  • Three New Medi-Cal benefits. California recently added coverage for community health workers/promotores/representatives (CHW/P/Rs), doulas, and peer support specialists as formal Medi-Cal benefits in 2022–23, recognizing their vital role in addressing health disparities and social drivers of health.
  • Shared approach but distinct roles. While all three workforces share a person-centered approach and draw on lived experience to build trust with clients, each has unique qualifications, supervision requirements, and covered services under Medi-Cal:
    • CHW/P/Rs focus on chronic conditions and preventive health
    • Doulas provide pregnancy and birth support
    • Peer support specialists support mental health and substance use disorder recovery
  • Growing impact. These workforces are evolving from traditional community-based roles to becoming integral parts of California's health care system, creating opportunities for collaboration while raising important questions about maintaining service quality and workforce sustainability as they adapt to formal Medi-Cal requirements.

California has taken bold steps to expand access to community-based care through Medi-Cal by adding coverage for three critical workforces: community health workers/promotores/representatives (CHW/P/Rs), doulas, and peer support specialists. These trusted providers are transforming how care is delivered to California’s most vulnerable populations. CHCF brought representatives from these workforces together to learn more about how they intersect with each other in policy and in practice. These publications illuminate what we learned and help to clarify the similarities and differences between them in Medi-Cal.

Download these complementary resources to understand how these workforces are reshaping California’s health care landscape:

  • Comparing Three Medi-Cal Benefits: Community Health Workers, Doulas, and Peer Support Specialists (Fact Sheet)
    A detailed side-by-side comparison of how these three benefits work under Medi-Cal, including provider requirements, billing codes, and service definitions. Essential reading for providers, plans, and administrators implementing these programs.
  • Understanding Community Health Workers, Doulas, and Peer Support Specialists in Medi-Cal (Fact Sheet)
    A concise overview of how these three workforces are defined under Medi-Cal and how their roles intersect and differ. Perfect for those seeking a quick understanding of these new benefits.
  • Understanding and Alignment Among CHW/P/Rs, Doulas, and Peer Support Specialists (Issue Brief)
    An in-depth exploration of how these workforces view themselves, their shared challenges and opportunities, and their vision for the future. Based on convenings with workforce representatives, this brief offers rich insights into how these providers are working to advance health equity.

Together, these resources provide a comprehensive look at California’s emerging community-connected workforce and its potential to transform care delivery for Medi-Cal members.