WAC 182-562-0200. Client eligibility

To receive community health worker (CHW) services, a person must: (1) Be eligible for one of the Washington apple health programs listed in the table in WAC 182-501-0060 , except for the medical care services (MCS) programs; and (2) Be recommended by a physician or other licensed practitioner of the healing arts, as specified in 42 C.F.R. 440.130, following an initiating visit with one of the following criteria: (a) An unmet health-related social need (HRSN) that limits the ability to engage in health care services; (b) A positive adverse childhood experiences (ACEs) screening; (c) One serious, high-risk condition that places the client at risk of any of the following: (i) Hospitalization; (ii) Institutionalization/out-of-home placement; (iii) Acute exacerbation or decompensation; or (iv) Functional health decline or death; (d) Two or more missed health care appointments within the previous six months; (e) The client, client's spouse, or client's family member expressed a need for support in health system navigation or resource coordination services; (f) A need for recommended preventive services; or (g) A condition that requires monitoring or revision of a disease-specific care plan and may require frequent adjustment of the medication or treatment regimen or substantial assistance from a caregiver.