By Les Gura
When North Carolina in 2019 moved more than half a million Medicaid recipients from a fee-for-service system to managed care, it meant big changes for the community engagement team within Wake Forest Baptist’sDivision of FaithHealth.
Since 2013, as many as six “Supporters of Health” had spent time in the community connecting with people after their discharge from the hospital, as well as proactively connecting with people prior to clinical encounters.
Their goal was to help people find the means they needed to stay healthy, such as ensuring they followed up with obtaining medication or getting to their next scheduled doctor’s appointment. The work often was logistical; supporters of health helped individuals obtain or find ways to obtain food, housing, transportation and financial assistance, if needed. In addition, the Supports of Health provide people a listening ear, emotional and spiritual support, and offer hope through challenging life and health experiences.
The move to managed care for Medicaid patients meant that Supporters of Health and other key members of the community engagement team, notably FaithHealth “Connectors,” now had to work with various health system and health plan care management teams to provide whatever identified assistance patients needed.
Jeremy Moseley, associate vice president of the Division of FaithHealth and head of community engagement efforts, says he and his team worked for months to integrate their work with the new system.
Then came the COVID-19 pandemic—and an entirely new set of challenges.
Moseley says his team members now work with a variety of agencies, including care management teams and entities and community partners such as organizations and Curamericas Global, whose North Carolina operation oversees a network of community health workers throughout North Carolina, on both basic health and COVID-19 issues confronting Medicaid clients.
Curamericas accomplishes its work in North Carolina through Community Based Organizations, or CBOs. FaithHealth is a specific CBO serving seven counties: Forsyth, Guilford, Surry, Randolph, Gaston, Davidson and Wilkes. One of the requirements is that it collaborate with local health departments and use NCCARE360, a state-led and created online resource portal.
An important component is the pursuit of new funding and working with agencies dedicated to ensuring health for all. These include: the Northwest Community Care Network, which delivers Medicaid managed care in the Triad region; the N.C. Office of Rural Health, which partnered with Curamericas Global; and faith-based partners.
Moseley says CBOs in North Carolina have reached 80,000 people overall, and North Carolina is one of just four states to deploy community health workers to assist people impacted by COVID -19. The incoming administration of President-elect Joe Biden has expressed interest in learning more about the success of the program, he says.
Community engagement efforts specifically target isolated individuals, connecting them to community resources and primary care when necessary and focusing on neighborhoods whose residents are traditionally considered “marginalized.”
Moseley says special efforts also have been made to recruit new workers to focus in the Hispanic community, and also in Gaston County, which has been a hot spot for COVID -19 infection. Team members also have been working in recent weeks to increase their vaccinat ion education work, receiving mandatory training and then sharing their knowledge to encourage vaccination.
Overall, he says that despite the pandemic, he has been pleased with the way his team has adapted to both the new Medicaid model and handling the pandemic.
“I think the simple fact that we have kept the body of work together is important,” Moseley says. “Every component we designed is still functional. The connection with the community, the compassion shared with people, and the longstanding trust we have been able to build locally has just really been phenomenal.”