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Community Access to Resources & Education is a program of the University of NM Community Health Worker Initiatives unit which is part of the Health Science Center -Office for Community Health.

Through this program our Unit partners with Managed Care Organizations to find and support their most difficult to reach Medicaid eligible members and connect them with resources and services.

Each participating MCO sends every month to CARENM a list of their Medicaid members that they need help locating and supporting. Then the Program Manager of CARE NM divides the list by geographical area and assigns each of our Community Health Workers (CHW) a number of individuals that they need to find and connect with resources in their respective communities.

Our CHWs are trusted members of their own communities who have received in depth training on different competencies and who work one on one with families and individuals to improve their overall health and well being.

Services provided by our CHWs

  • Find a Medicaid eligible MCO member through several means including home visits.
  • Complete an initial assessment with Member within thirty (30) days from the moment the referral is received from the MCO.
  • Develop Plan of Care with the member which may include healthcare related goals as well as goals to deal with non-medical issues that hinder his/her overall wellbeing such as lack of housing, unemployment, food insecurity, etc.
  • Contact the Member’s physician office of record, if known, and inform the physician/staff of CARE NM’s involvement with the Member.
  • Encourage the Member to develop an ongoing relationship with Member’s Primary Care Physician (PCP) for their overall health care. Offer to attend the initial appointment with PCP and assist PCP with any coordination of care requests.
  • Determine, along with the Member, why the ER is utilized frequently, if this Member has been referred because he/she is a frequent utilizer of the ER. If the Member has been referred for other reasons the CHW will start implementing the Plan of Care.
  • Educate the Member on:
    • Alternatives to the ER for non-emergency care.
    • Navigating the health care system more appropriately.
    • How and when to contact the Nurse Advice Line
    • Best ways to utilize Member’s PCP, SPC and Urgent Care facilities for non-emergency conditions.
  • Document the steps taken to assist member.


Funding comes from the MCOs who pay a set fee (Per Member Per Month) for work rendered by our CHWs.


Currently CARENM works in 14 counties and has CHWs in seven sites:

  • Albuquerque: which covers Bernalillo, Torrance and Sandoval counties.
  • Los Lunas: which covers Valencia and Socorro Counties
  • Hobbs: Which covers Lea County
  • Carlsbad: Which covers Eddy County
  • Las Cruces: Which covers Doña Ana, Sierra and Luna Counties.
  • Roswell: Which covers Chavez County
  • Santa Fe: Which covers Los Alamos, Santa Fe and Rio Arriba Counties.