Welcome to the traditional health worker (THW) resources page for Jackson Care Connect providers. A traditional health worker is a person who has similar life experiences with the people they work with. They can assist members in getting services and care that support their health and wellbeing by helping with things like:
- Navigating the health system.
- Understanding benefits.
- Connecting to community resources.
- Cross-cultural communication.
- Connecting to health care providers.
There are five types of THWs licensed in Oregon:
- Doulas are trained birth companions. They provide support to pregnant people and families during pregnancy, birth and beyond.
- Peer support specialists give support services to people who are or have been in mental health or substance use treatment.
- Peer wellness specialists have personal experience with psychiatric conditions plus intensive training. They’re part of a home health team that combines mental health with primary care.
- Personal health navigators provide tools to help patients make the best health care choices.
- Community health workers are public health workers who are trusted members of a community and have a close understanding of it.
THWs can be found in community-based organizations and in primary care and behavioral health clinics. They are a free benefit to members and do not require a referral or prior authorization from Jackson Care Connect. However, organizations with THWs may have their own referral requirements to access care. Not all THWs are contracted with Jackson Care Connect or provide services to Medicaid Members. To learn more about your THW network and access for Jackson Care Connect members you serve, contact your regional THW Liaison listed below.
The OHA Office of Equity and Inclusion has identified Best and Promising Practices & Other Resources for THWs. This information is available on the OHA-OEI THW website:
This guide outlines the process and covered benefits for doulas interested in serving Jackson Care Connect members.
Get the details on becoming eligible to bill for THW services, how to submit claims and more:
Jackson Care Connect CHW Billing Guide
Jackson Care Connect External peer billing guide
Use these documents to assist with integration of THWs into your network:
Jackson Care Connect wants to help you and your patients have the best experience, which is why we help you coordinate live interpreters for patients who speak a language other than English. Click here to learn about our resources.
Non-emergent medical transportation to medical appointments is a benefit to OHP members.
TransLink Ride scheduling: 541-842-2060, toll-free: 888-518-8160, TTY 711 Website: ridetocare.com
TransLink is the non-emergent medical transportation (NEMT) program for Jackson Care Connect members. It is a benefit through OHP members’ coverage that helps them get transportation services — based on their needs — to their health care appointments including medical, behavioral health and dental appointments.
Members can contact TransLink to talk about transportation services. TransLink’s phone number is 541-842-2060, toll-free 888-518-8160.
TransLink is available only for services covered by the Oregon Health Plan. Some appointments may require members to call or get approval before trips can be scheduled. For trips beyond the Jackson Care Connect service area, members may need prior authorization to use TransLink.
Trip requests can be made as many as 30 days or as few as 48 business hours in advance of the transportation need. Same-day and next-day visits may be approved if they are medically necessary and urgent.
TransLink offers three services:
- The first is reimbursement for members who have access to a vehicle, can have a friend or family member drive them, or are staying out of area.
- The second is public transportation. Members can receive bus fare to use public transit to get to their health care appointments.
- The third service is vehicle-provided rides. This is for members who are unable to use mileage reimbursement or transit services.
Check out our Riders Guide for details about the transportation program. Feel free to share this with your patients.
If you or your patients want a printed copy of the Rider's Guide, please contact Jackson Care Connect Customer Service at 855-722-8208 or TTY 711. We will send you the printed Rider's Guide within five business days.
What is a Regional Care Team?
The Jackson Care Connect Regional Care Team (RCT) offers providers a community of resources with a single point of contact for you and your patients. The RCT works closely with providers and members – through both telephonic and community-based support – to smooth the way to better care and better outcomes. Click here to view our Regional Care Team overview in PDF format.
With care coordination through the RCT, we will deliver
the right care, at the right time, in the right place, with the right team.
Members will have a consistent care team that will collaborate across disciplines to develop and implement a member-centric care plan through telephonic, electronic or community-based interventions to resolve identified needs and promote healthy outcomes.
The RCT is made up of care coordinators with a variety of backgrounds and experience, including:
- Behavioral Health
- Substance Use Disorders
- Health system navigation
- Local community resources
- And others
How the RCT is structured:
How can the RCT help my patients?
Each patient is assigned to a care team that is familiar with the patient’s history, strengths, needs and support system. The team will:
- Reduce confusion for patients by navigating them through the health care and social services system.
- Help patients get access to the right care at the right time, and make sure they stay connected to their providers.
- Reduce barriers to patient care and treatment compliance and connect them to support services.
How can the RCT help me?
Your dedicated RCT will work closely with your clinic to:
- Smooth workflows with coordination and support for primary care, behavioral health, oral health and other network providers.
- Assist with patient transitions between levels of care, such as hospital to primary care.
- Help with provider navigation, including targeted high-risk case management.
- Engage in formulary-specific medication review and communication for support of adherence.
- Address social determinants of health.
How are RCTs assigned?
RCTs are assigned based on the county the patient’s PCP clinic is in or the county where the patient lives.
When do I call the RCT?
The RCT offers care coordination and support for patients with multiple or complex needs, such as:
- Multiple chronic conditions
- High or special health care needs
- Chronic pain needs
- In-home care needs
- Daily living or social needs
- Medication review and support
- End-of-life support
- Substance use
- Behavioral health concerns
How do I make a care coordination referral?
Online: Submit a completed Care Coordination Referral form and we’ll route it to your assigned RCT.
Email: Send your completed form to email@example.com
Fax: Print and send your completed form to 503-416-3676.
Collective (PreManage): If your clinic uses this online platform, check the RCT tag after searching for your patient.
Call: You can reach your RCT directly at 503-416-3742.
This document provides information about dental care benefits for members, including provider options and contact details.
The “Oral Health Training for Traditional Health Workers” is an OHA approved training for continuing education units available for free by CareOregon. To access the training, please navigate to the link below. Once you have completed the training, please email firstname.lastname@example.org with your name to receive a certificate of completion.
Register for this free training.