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key takeaway

State policymakers must continue to invest in the health workforce in order to meet the needs of Californians. This includes investments in community-led efforts to promote health, such as community health workers and promotores de salud.

Access to health care services is important for everyone’s health and well-being. The state’s workforce must meet the needs of Californians to achieve equitable access to timely and culturally competent health services. While state policymakers have made considerable investments in recent years to bolster the health workforce, investments in various health workforce areas still fall short.

Investments to Increase Provider Participation in Medi-Cal Are Critical

More than 15 million Californians with modest incomes — nearly half of whom are Latinx — receive free or low-cost health care through Medi-Cal (California’s Medicaid program). In order to better support the millions of Californians who rely on the state’s health safety net, policymakers have taken steps to increase provider participation in Medi-Cal.

Specifically, this year’s 2023-24 budget includes $237.4 million to increase Medi-Cal provider rates effective January 1, 2024. Rate increases are targeted to:

  • primary care, which includes nurse practitioners and physical assistants,
  • maternity care (i.e., obstetrics/gynecology physicians and doulas),
  • and non-specialty mental health services, such as for mental health evaluation and treatment.

The governor’s administration also plans for additional Medi-Cal provider rate increases in future years for hospital outpatient procedures and services, family planning services, emergency physician services, and more.

related resource

See our Report: Californians Need State Leaders to Make Health Care More Affordable to learn how state leaders can use revenues to make progress on health care affordability.

Policymakers Should Also Invest in Community-Led Efforts to Promote Health 

California is home to people with diverse cultural and ethnic backgrounds. Therefore, policymakers should invest in workforce strategies that leverage community-led efforts to improve health. This includes investing in community health workers and promotores de salud, frontline public health workers who are trusted members of their communities. They serve as liaisons between the community and health and social service providers in order to facilitate access to services and improve service delivery. Community health workers and promotores provide services in a way that is linguistically and culturally responsive to the needs of the communities they serve.

State leaders have taken initial steps to integrate community health workers and promotores into the Medi-Cal workforce. For instance, state leaders established a community health worker benefit within the Medi-Cal program in July 2022. This allows these workers to be paid for providing services to Medi-Cal enrollees. These services include:

  • health education to help patients manage chronic health conditions,
  • and health navigation to assist people access health care services.

Additional ongoing investments are needed to develop a strong pipeline of community health workers and also to ensure that workers are paid fair wages.

State Policymakers Should Increase Health Workforce Opportunities for Youth

Youth and young adults have tremendous power to improve health outcomes within their communities — both in the immediate and long term. Examples of youth supporting youth are peer-to-peer programs in school settings and peer support specialists. Research shows that peer-to-peer supports help improve mental health outcomes, decrease substance use, and reduce hospital admission rates. Policymakers should invest in peer support programs that lead to meaningful career pathways for youth and young adults. Particularly, for individuals disconnected from school or employment.

Meeting the health needs of Californians will require significant long-term investment in youth workforce development programs. In 2019, the California Future Health Workforce Commission developed a strategic plan for addressing health workforce gaps. According to a recent progress report, policymakers have made progress on many of the priority recommendations. However, state leaders can do more to recruit and train students from rural areas and other historically underserved communities to practice in community health centers.

Bottom line: State policymakers must continue to build a health workforce that meets the needs of Californians. Policymakers should also invest in efforts to make sure that the health workforce better reflects the diversity of all Californians. This includes their race/ethnicity, disability status, gender identity, and sexual orientation. Doing so will require sustained, ongoing investment.

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