Sarah Lawrence – Page 10 – Community Health Worker Association of RI

EOHHS Announcement

June 28, 2025June 25, 2025

On Behalf of EOHHS,

Hello,

The Secretary of the Rhode Island Executive Office of Health and Human Services (EOHHS) has under consideration one (1) amendment to Medicaid regulation. The regulation with proposed amendments and the reason for the amendments are summarized below.

Medicaid Payments and Providers, 210-RICR-20-00-1

In response to emerging concerns related to potential fraud, waste, and abuse (FWA) and the health and safety of Medicaid beneficiaries, the Rhode Island Executive Office of Health and Human Services (EOHHS) is proposing updates to the Community Health Worker (CHW) program to strengthen oversight, safeguard beneficiary health and safety and Medicaid funds, and ensure the continued integrity of the program.

EOHHS has identified a need to enhance provider screening and improve documentation and billing standards to better align with federal and state program integrity requirements . As part of this effort, CHW providers will be designated as high-risk provider for the purposes of enrollment, which will include additional screening measures to protect the health and safety of Medicaid members and promote the appropriate use of Medicaid resources.

These updates are necessary to maintain compliance with federal Medicaid standards and to preserve continued access to federal funding.

*Note: An emergency promulgation with the proposed changes is currently in effect and this promulgation is intended to supersede the emergency version when complete.

The proposed rule is accessible on the R.I. Secretary of State’s website: Welcome to the Rhode Island Code of Regulations – Rhode Island Department of State (ri.gov), the EOHHS website: www.eohhs.ri.gov, or available in hard copy upon request (401 462-2598 or RI Relay, dial 711). Interested persons should submit data, views, or written comments by July 25, 2025 to Katy Thomas, RI Executive Office of Health & Human Services, Virks Building, 3 West Rd, Cranston, RI 02920 or Kathryn.thomas@ohhs.ri.gov.

In accordance with R.I. Gen. Laws 42-35-2.8, an oral hearing will be granted if requested by twenty-five (25) persons, by a governmental agency or by an association having at least twenty-five (25) members. A request for an oral hearing must be made within ten (10) days of the publication of this notice.

Info on Changes to CHW Reimbursement by Medicaid

January 5, 2026June 9, 2025

Things are happening fast! This page attempts to present the most updated shareable information from allies in one place – rather that waiting for the next newsletter to come out. Email updates to chwari@laurablackwell.com

Links to Official INfo – Updated 1/5/26

The Medicaid Program Provider Update issued 1/2/26 is here.
Provider Email 11/21/25 Medicaid Provider Manuals Updated 11/19/25 English, Spanish
State Fiscal Year 2027 Requested Budget Proposal for EOHHS, proposing the cutting of the CHW benefit by Medicaid (see pages 4 and pages 160-162)
Gainwell Email “CHW Claims May Be Subject to Recoupments” 10/10/25 (posted in newsletter here)
Gainwell Emails Extending Dates to 12/1/25 from 10/1/25 (posted in newsletter here)
Slides from Medicaid Info session 8/28 in English & Spanish
Gainwell Email with Background Check Instructions 9/4/25 (See bar below)
Medicaid Provider Manual 4.2 released 8/14/2025 Spanish
CHW Group Enrollment Application Now Available – Action Required by October 1, 2025 Email Announcement 8/6/25 See Bar Below for English and Spanish
EOHHS Response to Comments- CHW SPA 7/25/25
CHWARI’s newsletter announcement 7/28/25
Classification as High-Risk Providers – Email Announcement 6/25, Proposed Rule
State Plan Ammendement (SPA) published 05/09/2025
EOHHS page: CHW Services | EOHHS.

RI Medicaid CHW Benefit History

With input from its Advisory Council, CHWARI has compiled this brief explanation of both the history of the RI CHW Medicaid Benefit as well as its status as of November 2025.

Summary of the RI Medicaid CHW Benefit’s History

CHW definition quoted from the Rhode Island Department of Health (RIDOH) website:

“Community Health Workers (CHWs) are frontline, public health professionals who often have similar cultural knowledge, practices, and beliefs, chronic health conditions, disabilities, or life experiences as other people in the same community. CHWs are also known by other professions and job titles (e.g. … promotores de salud, coaches, lay health advisors, peer navigators, etc.) and many CHWs may be cross-trained and hold multiple certifications and disciplines in other areas of healthcare, mental health, and behavioral health.”

Nationwide, studies have revealed a significant return on investment and improvement in health outcomes when CHWs provide services. In 2022, after years of advocacy by many organizations including RIDOH, a CHW benefit was included in the RI State Medicaid Plan. This was a huge win for CHWs and for Rhode Island’s most vulnerable and under-served populations. Including a CHW Medicaid Benefit has been cited as a way for states to make their CHW workforce sustainable. We are grateful to the engaged allies who worked in partnership with CHWs for decades to remove barriers to care for individuals and families. Aligned with RI’s Health Equity Zones (HEZ), Rhode Island is widely recognized as a national model for CHW integration.

The original RI Medicaid CHW benefit allowed for a very broad scope of practice that appeared to reflect the essence of CHW practices and allowed for meeting client needs in authentic ways. As referenced in the above award-winning CHW logo created by RIDOH, CHWs could support clients by being ‘a bridge to better health,’ by connecting them to services, accompanying them to appointments, addressing food access and helping apply for benefits. There was no set daily limit for CHW services, allowing CHWs to navigate families from crisis to safety in real-time. They could bill Medicaid independently or as part of a larger organization for 18 months while they worked toward certification, allowing them to be paid for their time as they earned the necessary 1000 hours required for certification, rather than volunteer. As it has become standard of care to screen for health-related social needs, Medicaid provided a pathway for CHWs to be reimbursed for the work they do in addressing these needs with “Z-Codes” that allowed individuals to self-identify as having unmet health-related social needs. RIDOH provided a “Standing Order” to assist smaller organizations in streamlining the referral process. These flexible regulations allowed CHWs to provide immediate help to their community (link to CTC RI Article), though the absence of early oversight and quality control mechanisms failed to respond to client vulnerabilities. During this time, Rhode Island was cited multiple times at the national level as a positive example of an effective and thriving CHW workforce. (NEJM, APHA, )

The Rhode Island CHW workforce grew significantly, especially as many CHWs began operating and billing Medicaid independently. Many CHWs were motivated to work independently to earn a higher wage than they might at organizations with larger overhead; CHWs are historically an under-compensated workforce with many positions earning below a living wage. This direct reimbursement also allowed them to address the needs of their community authentically, immediately, and in their own language. Building on their own lived-experience, community connections, cultural competence, and professional expertise, they “met people where they were at” and established relationships that provided pathways to care for our most vulnerable residents. The majority of these new small businesses were owned by BIPOC (Black, Indigenous, and People of Color) CHWs with lived experience related to Social Determinant of Health (SDOH) challenges.

It is unclear how the standards were monitored in the initial year of implementation to assess the efficacy of billing or to troubleshoot areas of concern proactively. In early 2025 significant billing fraud was detected within a small subset of the broader CHW workforce. Meanwhile, the majority of CHWs and organizations billing Medicaid for CHW services worked in good faith to adhere to all defined regulations while serving Rhode Islander’s with integrity, passion, cultural sensitivity and humility. While any fraud is unacceptable, these incidents represent a minority of claims and should not overshadow the integrity and impact of the broader CHW workforce.

After three years of implementation and the detection of fraud beginning in the third year of the project, one cannot help but question if a more proactive and timely assessment of practices could have helped to avoid the current situation of fraud and negative attributions to the CHW workforce. It is heartbreaking to think of the hard work and collaboration that went into gaining approval for Medicaid billing for CHWs only to have it culminate in the current state of affairs that will surely decimate a critical workforce and reduce the availability of supports and services for the vulnerable populations CHWs serve.

In May of 2025, significant reductive changes were announced to the RI CHW Medicaid Benefit. For example, a daily limit of two hours was set for reimbursable services. CHWs argued that two hours is not nearly enough time to complete un-interruptible tasks like the intake of an unhoused family in crisis. “Collateral services” such as assistance applying for benefits were eliminated. Z-Codes and Standing Orders were eliminated. The ability to bill Medicaid as an independent CHW was eliminated. CHWs and allies advocated thoughtfully for revisions to the changes, in vain. Many independent CHW businesses closed as a result. Multiple established agencies and medical practices either paused billing Medicaid for CHW services, or eliminated their CHW workforce. These sweeping restrictions dramatically reduce service flexibility and reimbursement capacity – changes that punish compliant CHWs, organizations, and clients alike.

In September of 2025, the EOHHS released a revised Fiscal Year 2027 Restrictive Budget that threatens to cut the RI CHW Medicaid Benefit entirely. What happens next remains to be seen.

The challenges faced by the CHW Medicaid benefit stem not from a lack of community integrity, but from a lack of sustained administrative partnership. Strengthening this partnership through oversight, guidance, and evaluation can help rebuild trust and ensure that RI’s investment in CHWs achieves its full potential. In the current climate of myriad challenges to community health, we need this critical workforce more than ever.

-The Community Health Worker Association of Rhode Island

10/29/25

Writing Your Own Comment

New Template

CHWARI has put together this comment template (a word .doc will download) (updated 11/18/25) for you to download and start from, if helpful.

Read Before You Speak
Before commenting – we encourage you to READ THE CHANGES. The State Plan Ammendment (SPA) is here. Their main web page is here: CHW Services | EOHHS. The CHW Medicaid Provider Manual was last update in June and is here: CHW-Medicaid-ProviderManual-V4.1-FINAL-2025-05-30.pdf) This document provides the details about what is and is not covered as a Medicaid billable service for CHWs.

Keep it Brief & Example-Based
When you are commenting, we recommend you cite specific examples of an experience where, if you had been restricted by the new guidelines, a client would have had a negative health outcome.

Comments Submitted – December 2025

Here are the letters shared in as part of the Annual 1115 Waiver Public Forum Comment Period in December of 2025. This forum is an opportunity for the public to comment on Medicaid as a whole.

Do you have one to share? email chwari@laurablackwell.com

CHWARI/IEH’s Letter

As part of Rhode Island College’s Institute for Education in Healthcare, CHWARI submitted this letter in support of the CHW workforce.

Excerpt: Since these restrictive changes went into effect in May, multiple CHW organizations have closed, leaving their vulnerable clients disconnected from their bridge to the health system. It is our understanding that major organizations are re-thinking their usage of CHWs as the restrictions relating to reimbursement are prohibitive. We believe that it is likely that the changes to the SPA were made to eliminate the ability to operate as an independent CHW in Rhode Island. Leaving that important subject alone for now, we implore you to realize that the ENTIRE CHW workforce is being negatively affected, including major well-respected institutions. We encourage you to re-instate the ability for CHWs to do the important work that allows other practitioners, like PCP’s and Social Workers, to operate at the top of their licenses. With the ongoing PCP crisis, eliminating a workforce that saves PCP’s time seems shortsighted. With Medicaid funding cut, eliminating a workforce that has been proven to reduce costly ER visits is counterproductive with adverse consequences for clients and fiscal implications for our care continuum.

Read full letter here!

Legal Key Partnership for Health & Justice’s Letter

Legal Key Partnership for Health and Justice (Legal Key)’s mission is to create access to legal knowledge for health and social service sectors and empower those communities to use legal problem-solving to improve wellbeing. They submitted this letter.

Excerpt (see letter itself for links to source material): Research shows that CHWs’ unique community-based approach has improved health outcomes for specific diseases, reducing emergency department utilization, reducing caregiving stress, improving patient health literacy, and saving Medicaid dollars. A 2024 evaluation by the Rhode Island Department of Health study of the impact of specialty-trained CHWs on patients with cardiovascular disease (CVD) and diabetes mellitus (DM) found that patients who received support from CHWs with specialized training in CVD and DM showed increased confidence in managing their chronic conditions.

Read full letter here!

Comments Submitted – June 2025

Here are the letters shared in response to the State Plan Ammendment in June of 2025.

Do you have one to share? email chwari@laurablackwell.com

Collaborative Document Suggesting Provider Manual Changes

CHWARI, CHWs, and many organizations collaborated on a document to suggest specific changes in the Medicaid provider manual and to strongly recommend that EOHHS establish a comprehensive community consultation process. It was submitted to EOHHS and while we have little hope that any of the suggested changes will be adopted at this time, perhaps it can be used for future advocacy efforts. View it here.

CHWARI/IEH’s Letter

As part of Rhode Island College’s Institute for Education in Healthcare, CHWARI submitted this letter in support of the CHW workforce.

Excerpt: In 2022 when the RI Medicaid State Plan was expanded to include CHW services, CHWs felt seen and affirmed. The broad parameters that informed the CHW Medicaid Program afforded ample time for individual work with clients and allowed CHWs’ engagement with clients to reflect culturally responsive practices that respected client self-determination. The original contents and fiscal structure of the 2022 CHW Medicaid Program was a resource for responding to the social determinant needs, such as homelessness, poverty, and other traumas, that contributed to clients’ medical and behavioral health challenges; CHWs responded to these immediate needs while building connections for clients with traditional systems of care to promote health and wellness of vulnerable communities. It is both ironic and unfortunate that the very things that made the CHW Medicaid Program such a strong fit for the work of CHWs have all but been stripped away in the June 2025, 4.1-version. These changes may reflect responses to the abuse and fraud of a small group of individuals; however, in contrast to the CHW and client centric approach of the 2022 program, the changes reflected in version-4.1 are so limiting that they are antithetical to the very practices central to CHWs. Moving forward with the current version is sure to cause devastation to critical resources supporting the availability of CHWs to serve RI’s most vulnerable communities.

Read full letter here!

Comment from Melissa Bubble, CCHW

Via: Brittany Church

Executive Office of Health and Human Services

3 West Rd, Cranston, RI, 02920

OR Brittany.Church@ohhs.ri.gov

From: Melissa Bubble
Community Health Worker
Community Health Network Rhode Island (CHNRI)

Jun 10, 2025

My name is Melissa Bubble, and I am a Community Health Worker with Community Health Network Rhode Island (CHNRI). I’ve been serving for a total of 2 years and counting, Professionally, Many more unprofessionally for family and friends. I am writing today to offer my feedback on the changes to CHW Reimbursement by Medicaid.

Here is one example of how a change will negatively affect beneficiaries’ health outcomes:

An activity that can no longer be billed for is: “Health Promotion & Coaching” or “Health Education” (S9445, S9446) via telehealth. The updated CHW Program Manual now limits telehealth to only “Health System Navigation and Resource Coordination” (H0038) services. Additionally, group-based CHW sessions are no longer eligible for billing through telehealth. All telehealth sessions must be synchronous (audio or video), and both the CHW and client must be physically located in Rhode Island at the time of service.

Another restriction is the monthly time cap. CHWs are limited to a maximum of 12 billable hours per client, per month. However, many clients—especially those with complex needs—require more time. Often, a significant portion of this time is spent calling resources on behalf of clients. For example, connecting with agencies like CES may require being on hold for over an hour or making repeated calls throughout the day. These efforts, while essential to client care, frequently occur without the client present and are no longer considered billable under the new guidelines.

Due to severe stress and depression, my client often goes days without eating, which has led to serious health concerns. On one particular day, had I not been available to talk her through her anxiety and calmly encourage her to eat, she likely would have skipped yet another meal. During our conversation, I helped her identify small, manageable ways to nourish herself, and we discussed healthy eating habits and nutrition basics tailored to her needs. I also ensured she would follow up with her doctor before making any major dietary changes. Supporting her in this moment helped her avoid a potential medical crisis, such as dehydration or hospitalization due to malnutrition—outcomes that would have resulted in significantly higher costs to Medicaid than the time I spent helping her stabilize and care for herself.

But this type of care takes time—often more than 2 hours in a day and certainly more than 12 hours in a month. When you restrict the time we can spend with our clients, it forces us to rush through their care and disregard their mental and emotional health. It sends the message that the client’s needs and well-being are not a priority. Much of what we do is not just about making referrals—it’s about helping people process, problem-solve, and mentally navigate life’s barriers in a way that neither a therapist nor a doctor typically can. For example, housing support is extremely time-consuming. Many clients are working or unable to stay on long phone calls, so I conduct research on their behalf while they’re busy and follow up with results when they’re available. This provides peace of mind and ensures their basic needs are met—without putting their health or job at risk.

To better support our clients’ health and reduce overall Medicaid costs, we recommend revising the current restrictions on CHW time and allowable services. Specifically, increasing the monthly cap beyond 12 hours and allowing flexibility in how those hours are used would greatly enhance our ability to provide meaningful, preventative care. This includes tasks like calling agencies on behalf of clients, doing behind-the-scenes research, and spending the time needed to support clients through crises—services that directly impact health outcomes but are not always billable under current rules.

Additionally, CHWs should be allowed to bill for telephonic and indirect services (e.g., housing searches, resource navigation, time on hold with agencies), especially when these efforts replace or prevent high-cost emergency interventions. Reinstating this flexibility would not only improve continuity of care but also reaffirm Medicaid’s investment in preventative, person-centered services that ultimately save the system money by keeping clients healthier and more stable.

In order to preserve the integrity of the Medicaid program, we request that the EOHHS takes more time before implementing these changes AND engages in a focused process to consult with stakeholders before finalizing the regulations.

Thank you for your time.

Melissa Bubble

Alliance for CHW Employers’ Comment Letter

The Alliance for CHW Employers submitted this letter for comment – with specific cited references of examples where the new standards could be changed. It is a powerful letter. Read it here.

RIPIN’s Public Comment Letter

RIPIN submitted this letter for comment – specifically addressing the section about delivery of healthcare coaching in group settings and the need for CHWs to be certified to bill Medicaid. They make excellent points. Read it here.

Legal Key’s Comment Letter

Legal Key Partnership for Health & Justice shared the comment letter they submitted to EOHHS here.

An excerpt, “Legal Key is deeply concerned that the proposed amendment would upend the ability for CHWs to operate within our health care and social care system. The current proposed amendment would create new administrative burdens for CHWs reimbursed by Medicaid to conduct their work. Requiring licensed practitioners of the healing arts to (a) determine if CHW services are medically necessary, (b) prescribe or order CHW services and (c) review “continued medical necessity” every six months creates additional demands on a workforce already at capacity.”

Thank you to them! Read the full letter here.

Partners In Health United States’ Letter

Partners In Health United States’ submitted a comment letter to EOHHS and have allowed us to share the pdf here.

An excerpt: “PIH-US is the United States arm of Partners In Health, a nonprofit, social justice organization focused on a comprehensive model of health that includes access to quality care, as well as to food, transportation and housing—all necessary components of good health. PIH-US works with CHWs and CHW partners at the local level, and aims to elevate their voices and experiences at both state and national levels. We are particularly concerned about the proposed State Plan Amendment (SPA) because Rhode Island has been a national leader in Medicaid policy for CHWs, and removing many of the best practices adopted by the 2021 SPA would leave the state’s CHWs and Medicaid enrollees less supported. We appreciate the opportunity to comment on this proposed SPA.”

Thank you to them! Read the full letter here!

Black Lives Matter RI Letter

Black Lives Matter RI has submitted a comment letter specifically refering to the ‘high-risk-provider’ classification of CHWs that has been proposed. They have allowed us to share the pdf here.

An excerpt: “We must not allow bureaucratic policies to erase the human stories of redemption, resilience, and social contribution. Many CORI-affected CHWs employed through programs like CORE, Community Health Network have demonstrated accountability, compassion, and professionalism. Their work should be recognized, not discarded.”

Thank you to them! Read the full letter here!

Key Reference Points in SPA and Medicaid CHW Provider Manual

Key Reference Points in SPA & Manual

The Alliance for CHW Employers has put together a slide deck with clear visuals noting some key changes to the SPA here.

Allies have identified the following reference points to the proposed changes:

SOME KEY UPDATES TO THE SPA

Community health worker definition. (SPA p.2)
Health-related social needs. (SPA p.3)
LPHA documentation (SPA p. 3)
Service time limitations. (SPA p. 3)
Collateral services. (SPA p. 4)

KEY AREAS OF CHANGE IN THE MANUAL (version 4.1 released in June CHW-Medicaid-ProviderManual-V4.1-FINAL-2025-05-30.pdf)

Primary diagnosis (z-codes). (Manual 7.5.3. p. 60, etc.)
Medical necessity requirements: HRSN and SDOH. (Manual v4.1, 2.2. p. 12-13)
Standing orders and general referrals. (Manual 2.3. p. 13-16).
Prohibition on marketing. (Manual 2.6. p. 18)
Allowable and prohibited activities for health system navigation and resource coordination. (Manual 3.3.2. p. 28)
Allowable place of service for CHW activities. (Manual 4.4., p 37)
Individual certification and timeline requirements. (Manual 5.1. p. 40)
CHW’s affiliation requirements. (Manual 5.2.3. p. 42) – NPI
Daily and monthly billing limits. (Manual 7.5. p. 59)

CHW Group Enrollment Application Now Available

Attention Community Health Workers (CHWs):

The group enrollment application for Community Health Workers is now available.

In preparation for the new requirements taking effect on December 1, 2025, all CHWs must comply with updated enrollment guidelines. You may now begin your group’s enrollment application on the Rhode Island Medicaid Provider Portal: Provider Enrollment – riproviderportal.org

As a reminder, to enroll and remain eligible to bill for CHW services, CHWs must:

Be affiliated with a group (individual enrollment is no longer allowed)
CHWs must complete a National Criminal Background Check (NCBC). Good Moral Character exception requests can be submitted if eligible under Medicaid CHW requirements after the completion of the NCBC.
Obtain a National Provider Identifier (NPI)
Be fully certified under the CHW RICB requirements

Do not delay. If you do not complete the enrollment process with these requirements, you will not be allowed to bill for CHW services beginning October 1, 2025.

For more information about the CHW program, including detailed policies and procedures, visit the CHW Provider Manual on the EOHHS website: https://eohhs.ri.gov/providers-partners/provider-manuals-guidelines/medicaid-provider-manual/community-health-worker [protect.checkpoint.com]

Rhode Island Medicaid

Provider Services

Gainwell Technology

301 Metro Center Blvd. Suite 300

Warwick, RI 02886

———————————————————–

Atención Trabajadores Comunitarios de la Salud (CHWs):

La solicitud de inscripción grupal para Trabajadores Comunitarios de la Salud ya está disponible.

En preparación para los nuevos requisitos que entrarán en efecto el 1 de octubre de 2025, todos los CHWs deben cumplir con las directivas actualizadas de inscripción. Ahora puede comenzar la solicitud de inscripción de su grupo en el Portal de Proveedores de Medicaid de Rhode Island:
Provider Enrollment – riproviderportal.org [protect.checkpoint.com]

Como recordatorio, para inscribirse y seguir siendo elegible para facturar servicios de CHW, los CHWs deben:

Estar afiliados a una organización o grupo (ya no se permite la inscripción individual)

Los CHWs deben completar una Verificación Nacional de Antecedentes Penales (NCBC). Después de la verification, el CHW pueden solicitar una excepción por Buena Conducta Moral, si es elegible según los requisitos de Medicaid para CHWs.
Obtener un Número de Identificación de Proveedor Nacional (NPI)
Estar completamente certificados de acuerdo con los requisitos de RICB

No te retrases. Si no completa el proceso de inscripción con todos estos requisitos, no podrá facturar servicios de CHW a partir del 1 de octubre de 2025.

Para más información sobre el programa CHW, incluidas las políticas y procedimientos detallados, consulte el Manual del Proveedor CHW en el sitio web de EOHHS: https://eohhs.ri.gov/sites/g/files/xkgbur226/files/2025-06/GW-BillingManual-EOHHSEdits–DRAFT-V4.1-2025-05-27-2_Spanish.pdf [protect.checkpoint.com]

Rhode Island Medicaid

Provider Services

Gainwell Technology

301 Metro Center Blvd. Suite 300

Warwick, RI 02886

Background Check Instructions

Attention Community Health Workers (CHWs):

Fill out the form FIRST and WAIT TO HEAR BACK BEFORE you go to the AG’s office for fingerprinting! Gainwell sent out the email below with specific instructions. We host updates like this here. Reminder – this is only for CCHWs who plan on billing Medicaid – if your organization does not bill Medicaid- this may not apply to you!

Dear Community Health Worker Provider,
As part of the new program requirements, the Rhode Island Executive Office of Health and Human Services (EOHHS) has added national background check and fingerprinting steps for Community Health Worker (CHW) providers. These requirements apply to all CHWs enrolling for the first time or revalidating their enrollment.

All CHW providers must reenroll under the new program guidance by October 1, 2025.

If you are enrolling as a new CHW provider or revalidating, you (and certain individuals connected to your organization) will need to complete a national background check, fingerprinting, and a site visit.

We want this process to be as smooth as possible for you. Please follow the steps below:

1. Who Must Complete the Background Check & Fingerprinting

All owners with direct or indirect ownership interest
All managing employees
All CHW staff members

2. Complete the Background Check Form

Before scheduling fingerprinting, you must complete and submit the Rhode Island National Background Check Application Form.

Download the form here: RI FCBC – Applicant Registration Form (PDF)
Include your CHW NPI or Provider ID
Send the completed form securely to rienrollment@gainwelltechnologies.com or fax to 401-784-3892

This step allows us to register you in the Rhode Island Civil Applicant Background (CAB) portal. Please wait till you hear back from Gainwell in Step 3.

3. Eligibility Notification

After submission, you will be notified by email if you are Eligible or Ineligible. Do not go for fingerprinting until you hear back!!!
If Eligible: You will receive instructions for scheduling your fingerprinting appointment.

Fingerprinting Location:
Attorney General Julius C. Michaelson Customer Service Center
4 Howard Avenue, Cranston, RI 02920 | 401-274-4400
Cost: $46.20 (credit/debit card only)

Bring your registration form and a valid photo ID.

4. Good Moral Character Requests

If your background check shows a finding, you may request a Good Moral Character exemption as outlined in Section 6.5 of the CHW Provider Manual.

Requests must be made in writing by the affiliated organization and/or CHW.
Include a justification based on allowable circumstances under Section 6.5.
Send securely to rienrollment@gainwelltechnologies.com.

Compliance Deadlines

October 1, 2025: All steps must be completed to avoid disruption of enrollment.
September 15, 2025: If you anticipate needing a Good Moral Character exemption, complete your background check by this date to allow time for review.

We strongly recommend that you begin this process immediately.

For questions or assistance, please email rienrollment@gainwelltechnologies.com.

Thank you for your prompt attention to these requirements and for your continued service to Rhode Island Medicaid members.

Rhode Island Medicaid Provider ServicesGainwell Technology
301 Metro Center Blvd. Suite 300
Warwick, RI 02886

Peer Specialist

June 6, 2025

Brown University Health
Charlestown
Full-time
2 Years Sobriety

See Their Listing

Summary:

The Peer Recovery Specialist provides peer support and care coordination services to adults who have behavioral health needs (mental and substance use disorders. They are a member of a multi-disciplinary team designed to provide outreach engagement and system support. The function of the Peer Recovery Specialist is to serve as a role model mentor advocate and motivator to clients sharing their personal experiences to help motivate to seek treatment prevent relapse and promote long-term recovery.

Responsibilities:

Works with general outpatient and substance use disorder clients as assigned to support adults in their mental health and substance use challenges.

Provides opportunities for individuals receiving services to direct their own recovery process.

Coaches and supports the acquisition and use of skills needed to facilitate individual recovery.

Assists clients in identifying their personal strengths abilities and needs and articulating personal recovery goals and advocating for themselves during treatment.

Promotes the identification and use of natural resources and support systems within the community accompanying them to assist is accessing services.

Facilitates the development of a sense of wellness self-worth and personal control over one�s life and recovery journey.

Acts as a role model to clients in recovery to inspire hope; share life experiences and lessons learned as a person with lived experience.

Models/mentors recovery process and demonstrate coping skills.

Assists in the orientation process for persons who are new to receiving mental health and/or co-occurring treatment.

Demonstrates cultural sensitivity and competence in trauma informed care as relevant to the needs of individuals in recovery.

Supports the individual in seeking to connect/reconnect with family friends and significant others and in learning how to improve or eliminate unhealthy relationships.

Co-facilitates meetings to nurture a peer support culture.

As requested by client fosters spiritual connections with faith-based organizations and/or participation in self-help and mutual support groups.

Adheres to the policies and procedures for recovery-oriented treatment.

Participates in supervision team conferencing department and agency meetings.

Maintains detailed accurate and timely documentation in medical record.

Follows agency policies and standards for client rights and confidentiality.

Perform other duties as assigned.

Other information:

QUALIFICATION REQUIREMENTS:

Individual who is in personal recovery from a mental health and/or substance use condition and has used services related to that recover.

High school diploma or GED

Ability to complete certification as a peer recovery specialist.

Maintained at least 2 years of sobriety or absence of drug use.

NECESSARY SPECIAL REQUIREMENTS:

Be self-identified current or former user of mental health or co-occurring services who can relate to others who have not utilized those services.

Communication with supervisor to identify potential situations/concerns.

Have demonstrated proficiency in reading and writing.

Attended trainings on relevant topics such as behavioral health substance use and chronic health conditions.

JOB KNOWLEDGE SKILL AND ABILITY:

Valid driver’s license and use of car during normal working hours or other means of transportation to complete major functions of job.

Ability to establish trusting relationships with peers.

Ability to work independently and also as an integral part of multidisciplinary team.

Be able to recognize early triggers and signs of relapse. Be able to use computer to record services or be willing to learn.

SUPERVISORY RESPONSIBILITY:

None.

Brown University Health is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status. Brown University Health is a VEVRAA Federal Contractor.

Location: GHI-Charlestown-4705 Old Post Road USA:RI:Charlestown

test post

May 12, 2025

attempt

Community Treatment Specialist

May 7, 2025

East Bay Community Action Program
Barrington
Full-time
Associates or 10 years in Behavioral Health

To see their listing – go to https://www.ebcap.org/careers-internships/careers/ and filter under behavioral health.

East Bay Community Action Program (EBCAP) is seeking a full time Community Treatment Specialists for our Behavioral Health Services Division at our 2 Old County Road location in Barrington, RI. The successful candidate will promote our Health Home clients’ ability to function independently, improve the quality of their lives, and improve their ability to access other supportive services within EBCAP and the community.

The Community Treatment Specialist will provide advocacy and/or act as a liaison in all aspects of clients’ lives including working with property owners, families, police, healthcare providers, judicial system personnel, social service providers, and other support systems designed to ensure the clients’ independence. The Community Treatment Specialist are integral members of a multidisciplinary team of care coordination, treatment planning, collaborating with EBCAP staff on individual cases, ongoing quality improvement efforts, and promoting recovery efforts within case management.

The Community Treatment Specialist requires a minimum of an Associates Degree and or 10 plus years of experience working in behavioral health.

For Full Time Employees Working 30 – 40 hours per week, EBCAP provides a comprehensive compensation and benefits package that includes heavily subsidized medical and dental insurance plans (BCBSRI), supplemental vision insurance, voluntary medical and dependent care flexible spending accounts, up to 3% company matching 403(b) retirement plan, employer-paid life insurance & long term disability, generous paid time off that includes vacation/holidays/personal days/sick time, mileage reimbursement, tuition reimbursement, opportunities for center-paid training/CEUs, employee assistance programs.

Thank you for your interest in employment opportunities at East Bay Community Action Program.

EBCAP is an equal opportunity/affirmative action employer committed to providing a diverse workplace.

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Community Health Worker II

May 7, 2025

East Bay Community Action Program
East Providence
Full-time
Associates or Bachelors & 1 Year Experience

Join our multidisciplinary Community Health Team to provide patient-centered care for individuals with complex medical, behavioral health, and social needs. As a Community Health Worker II, you’ll conduct home visits, perform assessments, and coordinate care to improve health outcomes for vulnerable populations.

Key Responsibilities
– Engage with patients through home and community visits to identify barriers to health
– Perform assessments and screenings, including for substance use (SBIRT)
– Provide care coordination and connect patients with community resources
– Support patients with healthcare navigation, appointments, and social services
– Document patient interactions and participate in care team meetings

Qualifications
– Associate’s or Bachelor’s degree in social science, public health, or related field
– Minimum 1 year of experience in health coaching, motivational interviewing or related field
– Valid driver’s license with good driving record
– Strong interpersonal and communication skills
– Ability to work flexible hours as needed
– Experience with diverse populations and cultural sensitivity

Preferred
– Bilingual in English and Spanish
– Experience with cardiovascular disease/diabetes management or substance abuse settings

Benefits (Full-time, 30-40 hours/week)
– Comprehensive medical and dental insurance (BCBSRI)
– 403(b) retirement plan with up to 3% matching
– Generous PTO including vacation, holidays, personal and sick time
– Mileage reimbursement and tuition assistance
– Professional development opportunities

Community Health Worker 1

May 7, 2025

East Bay Community Action Program
East Providence
Full-time
Associates or Bachelors & 1 Year Experience

East Bay Community Action Program (EBCAP) is seeking a Community Health Worker I to join our health team. This hybrid-eligible position works with healthcare professionals to address patients’ medical, behavioral health, and social needs.

Key Responsibilities:

Engage with patients to identify barriers to health and provide needed support
Collaborate with health center teams to prioritize patient outreach
Develop care plans and coordinate with primary care providers
Provide health coaching and resource navigation assistance
Maintain accurate documentation and participate in team meetings

Requirements:

Associate’s or bachelor’s degree in social science, public health, or related field
One year of experience in health coaching or a related area
Strong communication skills and cultural sensitivity
Computer proficiency and a valid driver’s license
Flexibility to work varied hours as needed

Preferred: Bilingual (English/Spanish), experience with healthcare providers or chronic disease management

Benefits include:For Full-Time Employees Working 30-40 hours per week, EBCAP offers:
Comprehensive medical and dental insurance plans (BCBSRI) with heavy subsidization
Supplemental vision insurance
Voluntary medical and dependent care flexible spending accounts
Up to 3% matching 403(b) retirement plan
Employer-paid life insurance & long-term disability
Generous paid time off, including vacation, holidays, personal days, and sick time
Mileage reimbursement
Tuition reimbursement
Center-paid training/CEUs opportunities
Employee assistance program

Family and Community Engagement Coordinator

April 23, 2025

Inspiring Minds
Providence
Salary: $20-$35/hr
Full Time, Temporary
Bilingual Spanish Required!

See Their Listing

Job Description

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MAIN DUTIES/RESPONSIBILITIES:

The Family and Community Engagement Coordinator is responsible for community engagement, recruitment, and partnerships within Inspiring Minds’ In-School and Out-of-School programming. This position is grant-funded for Summer 2025’s KidsBridge Summer Learning program with a possible part-time extension into the 2025-2026 school year.

KidsBridge Responsibilities

This position supports recruitment, enrollment, and attendance in our KidsBridge summer learning program. In the spring, the Family and Community Engagement Coordinator will support the recruitment of students by attending school and city events, staffing the office for walk-in registrations, and following up on enrollment paperwork. During the summer learning program, the coordinator will support families in understanding the school norms, policies, protocols, and routines to prepare themselves for their child to begin kindergarten. In addition, the Family and Community Engagement Coordinator will support the attendance data collection and follow-up to ensure the program meets agreed-upon deliverables. More than 65% of our targeted enrollment is Spanish speaking; therefore, the position requires oral and written fluency in Spanish and English.

View full job description here: https://inspiringmindsri.org/2025/03/kidsbridge-community-and-family-engagement-coordinator-summer-2025/

How to Apply

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Email resume and cover letter to jobs@inspiringmindsri.org

Field Based CHW

April 22, 2025April 22, 2025

United Healthcare
Full-time $20 to $38 per hour
CCHW & Bilingual Preferred
50% Local Travel

The Field Based Community Health Worker is responsible for assessment, planning and implementing care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care. They also Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services, and manage the care plan throughout the continuum of care as a single point of contact for the member. As a Field Based Community Health Worker (CHW), you will act in a liaison role with Medicaid members to ensure appropriate care is accessed as well as to provide home and social assessments and member education. The coordinator also addresses social determinant of health such as transportation, housing, and food access.

If you live in the state of Rhode Island, you’ll enjoy the flexibility to telecommute* as you take on some tough challenges.

Working Schedule: Monday through Friday any 8-hour shift to be determined by the hiring manager between the hours of 7 am to 6pm. This position is a field-based position with a home-based office. You will work from home when not in the field.

Location: State of Rhode Island

Local travel up to 50% and mileage is reimbursed at current government rate.

Primary Responsibilities:

Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care
Utilize both company and community-based resources to establish a safe and effective case management plan for members
Collaborate with patient, family, and healthcare providers
Identify and initiate referrals for social service programs, including financial, psychosocial, community, and state supportive services
Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members
Advocate for patients and families as needed to ensure the patient’s needs and choices are fully represented and supported by the healthcare team
Document all member assessments, care plan and referrals provided
Accountable to understand role and how it affects utilization management benchmarks and quality outcomes
You’ll need to be flexible, adaptable and, above all, patient in all types of situations
Engage members either face to face, telephonically or virtually
Work with Medicaid/Medicare population to address gaps in care, social determinates of health, and disease management
Help member set person-centered SMART goals and develop a care plan to achieve those goals with regular follow up calls and ongoing documentation of progress towards goals met
Adhere to detailed, specific documentation requirements in the member’s health record
Proactively engage the member to manage their own health and healthcare using Motivational Interviewing Skills
As needed, help the member engage with mental health and substance use treatment
Utilize strong skill sets of managing multiple tasks at a time, being self-motivated, driven toward quality results, managing time well, being very detailed oriented and organized, work well in a team and on your own, and ability to manage multiple deadlines
Perform other duties as assigned

Required Qualifications:

High School Diploma / GED (or higher) OR 5+ years of equivalent community outreach work experience
1+ years of experience with/of knowledge of the resources available, culture, and values in the community
Intermediate level of computer proficiency including the use of MS Word, Excel, Outlook, and multiple applications, with the ability to learn new and sometimes complex programs
Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI)
Ability to travel locally approximately 50% of the time and up to 50 miles round trip with reliable transportation, that will enable you to travel to client and/or patient sites within a designated area
A current and non-restricted state of Rhode Island Driver’s License and State-required insurance
Must have resided in Rhode Island or neighboring towns to the state of Rhode Island for 2+ years

Preferred Qualifications:

Bachelor’s Degree in a health-related field or social work or Health Care Administration
Community Health Worker (CHW) Accreditation
1+ years of field-based experience
Experience working in Managed Care
Experience with electronic charting
Knowledge of Medicaid/Medicare population
Fluency in Spanish and English or Portuguese and English

Soft Skills:

Strong communication and customer service skills both in person and via phone
Ability to work independently and maintain good judgment and accountability
Demonstrated ability to work well with others
Strong organizational and time management skills
Ability to multi-task and prioritize tasks to meet all deadlines
Ability to work well under pressure in a fast-paced environment
Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others
Solves routine problems on own. – Works with supervisor to solve more complex problems
Prioritizes and organizes own work to meet agreed upon deadlines
Works with others as part of a team

See Their Listing

RI CHW Conference!

April 15, 2025

Join the Rhode Island Department of Health for the CHW Voices Community Health Worker Conference: Building Bridges: Strengthening Communities and Advancing Systems Together—a celebration of the vital role Community Health Workers (CHWs) play in advancing health equity.

This inspiring event brings together CHWs and allies to:

Highlight CHW impact across systems and communities
Share real-world stories, successes, and challenges
Build cross-sector connections for collaboration and mentorship
Identify actionable steps to support and sustain the CHW workforce

Attendees will leave with new connections, practical tools, and strategies to drive change—plus inspiration from powerful peer and community-led efforts.

Whether you’re a CHW, an ally, or simply passionate about health equity, we invite you to be part of this moment.

🎉 Don’t miss it—register today!

Links to Official INfo – Updated 1/5/26

RI Medicaid CHW Benefit History

Summary of the RI Medicaid CHW Benefit’s History

Writing Your Own Comment

Comments Submitted – December 2025

CHWARI/IEH’s Letter

Legal Key Partnership for Health & Justice’s Letter

Comments Submitted – June 2025

Collaborative Document Suggesting Provider Manual Changes

CHWARI/IEH’s Letter

Comment from Melissa Bubble, CCHW

Alliance for CHW Employers’ Comment Letter

RIPIN’s Public Comment Letter

Legal Key’s Comment Letter

Partners In Health United States’ Letter

Black Lives Matter RI Letter

Key Reference Points in SPA and Medicaid CHW Provider Manual

CHW Group Enrollment Application Now Available

Background Check Instructions

East Bay Community Action ProgramEast ProvidenceFull-timeAssociates or Bachelors & 1 Year Experience

Key Responsibilities:

Requirements:

East Bay Community Action Program
East Providence
Full-time
Associates or Bachelors & 1 Year Experience