Tomorrow’s Health Care System Needs Community Health Workers: A Policy Agenda

Community Health Workers (“CHWs”) are public health workers who are trusted members of the communities they serve. CHWs typically share ethnicity, culture, language, socioeconomic status, and life experiences with community members.

Health care providers are under increased pressure to meet ambitious quality of care standards, such as providing recommended preventive screenings while reducing the need for expensive emergency department visits.

To meet the new quality standards, providers must find new, low-cost ways to reach out to patients. CHWs can help clinicians fill the gap between current practice and new expectations. CHWs can help improve health outcomes and contain costs.

While the CHW model has been used successfully for many years, reliance on time-limited grant funding has created sustainability challenges. Health reform and changes to federal rules have opened new opportunities to integrate CHWs into Connecticut’s health care delivery and payment systems. In order to maximize these opportunities, the CHW policy agenda for Connecticut should include:

• Enacting legislation to establish a process for certifying CHWs, along with training and experience requirements, to document CHWs’ skills for potential employers and insurers.
• Implementing Connecticut’s State Innovation Model (“SIM”) plan to establish training programs for CHWs and CHW supervisors to improve and standardize knowledge and skills.
• Adding CHW services to the set of Medicaid-covered services and establishing a Medicaid payment rate to provide sustainable funding for these cost-effective services.
• Providing training for health care providers on how to use CHWs to help achieve practice transformation goals.
• Establishing a CHW task force to promote and coordinate this agenda.

Authors

• Katharine London, MS, is a principal with the UMass Medical School Center for Health Law and Economics
• Margaret Carey, MPH, is a senior associate with the UMass Medical School Center for Health Law and Economics
• Kate Russell, MA, is a Policy Analyst with the UMassMedical School Center for Health Law and Economics