Partner Agency


Learn more about the benefits to organizations interested in applying to become a Care Coordination Agency (CCA): Why join the Hub


Expectations of organizations interested in applying to become
a Care Coordination Agency (CCA) include:

  • Deploying Community Health Workers (CHWs) full- or part-time to provide active community-based care coordination to clients who live in Hamilton, Butler, Warren or Clermont counties – with a goal for servicing approximately 30-40 active clients per CHW. A minimum of 0.5 FTE is required for a CHW.
  • Providing active supervision to their CHWs by participating in supervisor and CHW trainings.
  • Maintaining fidelity to the evidence-based Pathways model.
  • Providing active care coordination services to at-risk community members including: 1) enrolling the new client in the HUB through in person meetings to assess needs and risk factors, 2) conducting monthly in person visits with the client to identify needs and opening relevant Pathways and 3) completing health and social service Pathways to address needs. CHWs must meet at least monthly with each client and provide ongoing documentation in the HUB data system.
  • Being responsible for providing/funding a secure internet enabled device (computer or tablet) and HUB data system licenses for each CHW and Supervisor.
  • Ensuring that CHWs obtain certification through an approved Ohio Board of Nursing program within the first year of employment.
  • Attending monthly Supervisor and CHW meetings hosted by the HUB.
  • Ensuring timely data entry into the HUB data system to enable HUB reporting to funders as required and to ensure reimbursement from Managed Care Plans to the agency for achieved outcomes.
  • Ensuring timely response to requests for providing documentation to the Hub as needed to enable Hub to maintain compliance.
Helping clients during COVID-19