Clinical Community Health Workers Initiative Services

The Mississippi government authority is seeking clinical community health workers initiative services to support patient engagement, follow-up, and care coordination activities. The agency needs to address social determinants of health and improve cardiovascular disease prevention and management outcomes. The selected provider will help strengthen systems-level approaches to improve health equity and reduce health disparities. The scope of work covers home visits, telehealth encounters, team huddles, patient education, blood pressure monitoring, and lifestyle change program referrals. The project also requires conducting standardized screening and referral activities to address transportation, food insecurity, housing instability, insurance access, and behavioral health needs. Participating healthcare systems must utilize and support standardized bidirectional referral processes to document, track, monitor, and report referral outcomes. The agency requires the collection, monitoring, and submission of monthly and quarterly programmatic, clinical, and social determinants of health data. The project also involves examining existing organizational policies, workflows, and barriers that impact patient outcomes. The contract period will span one year, and the performance of the work must occur onsite. Only onshore bidders located in the United States are eligible to participate. Bidders must submit their proposals digitally via email or online, and the agency is currently looking for proposal submissions to determine the budget. Bidders must submit all questions no later than June 12, 2026.