Just five years ago, most healthcare centers and providers across the US had no idea what a community health worker (CHW) did—never mind how they might fit in with a larger multidisciplinary healthcare team.
Then the coronavirus arrived, the health of millions changed, and CHW advocates everywhere jumped at the chance to rebuild their client and patient support structure with more help for individuals.
Community health workers help people get access to the healthcare services they need. They do this through many different avenues. For example, CHWs can educate clients to make healthier lifestyle choices, inform them about routine screenings or lead them to take measures to prevent chronic illness.
Additionally, CHWs can advocate for the proper care of their patients, make accommodations for them such as transportation or language assistance, and encourage them to advocate for themselves. In short, the goal of community health workers is to improve the health outcomes for communities that may not have access to much-needed quality care.
Funding for A Multidisciplinary team with Community Health Workers
Now the term “CHW” is much more widely recognized. And so are titles like promotor, community health representative, health advisor. Many providers, health systems, and governments are looking for ways to build CHWs into their budgets and care teams.
California, for example, is pushing hard for CHWs. The current budget created a CHW benefit for the Medi-Cal program. This means that CHWs can be paid for providing benefits and services to Medi-Cal enrollees.
That’s good news for agencies with a multidisciplinary team that weren’t sure how to get CHW programs funded until now. The field is still relatively new, so the pathway was unclear.
That also happens to be the bad news. CHWs are new, which means that many health systems and providers aren’t quite sure how where CHWs fit. Administrators and program managers have many questions about what kinds of services fall under CHWs, what kind of skills their supervisors need, how much to pay them, training requirements, and how they fit in with a larger healthcare team.
Where Community Health Workers Work
A great benefit of CHWs is that they can work in so many different fields. Basically, anywhere there are at-risk communities in need of healthcare, you’ll find a community health worker initiative. On the institutional side, CHWs work as part of a multidisciplinary team in mental health facilities, assisted living facilities, nursing homes, or healthcare clinics. Sometimes, they also work in local centers like faith-based organizations.
Community health workers also work directly with the communities they serve. Depending on the program, a CHW may conduct house visits or community health outreach. In other cases, they can educate peers about programs such as health screenings or vaccination services.
However, when CHWs work in multidisciplinary teams made up of nurses, physicians, social workers, care managers, and other specialists, such as dietitians, it’s hard to know where roles and boundaries are.
This can be even more confusing because CHWs have many names. The most common include outreach worker, peer health advocate, community health representative, promotores, and more. That vagueness can carry over to understanding what and where a CHW’s duties lay.
Five ways that CHWs can work with a multidisciplinary care team without confusion.
Connect clients to support services.
CHWs can work as part of a multidisciplinary team by being the liaison between patients and services. As such, they can help with things like understanding insurance, filling applications, or scheduling appointments. Sometimes, they interpret or translate, and explain medical terms to patients.
Motivate clients to adopt more healthy behaviors.
CHWs can promote initiatives such as team fitness classes, launch campaigns to educate people on the risks of substance abuse, or coordinate food safety programs. Basically, any non-medical intervention that can improve patients’ lives through healthy choices is something CHWs can do.
Address cultural barriers.
Whether this means addressing cultural taboo regarding medically necessary procedures like STD screenings or simply facilitating a conversation in different languages, removing cultural barriers is one of CHWs’ most important roles since they generally belong to the communities they serve.
Conduct behavior health support.
The stigma surrounding mental health, a lack of access to care, and cultural biases regarding mental illness are some of the barriers to mental healthcare you may find in at-risk communities. While CHWs are not mental health professionals, they can practice trauma-informed care, serve as active listeners, make recommendations for telehealth, and stay alert for red flags when interacting with patients.
Reduce health disparities.
One of the best things a CHW can do is work to reduce health disparities. It’s important to understand that health disparities aren’t simply the result of groups of people making bad choices. Disparities are systemic, complex, and cyclical in nature. For example, groups of people who migrated to the U.S. have high rates of mental disorders and trauma due to the hardships they experienced during migration.
Racism and oppression often result in trauma-related mental illness. To make matters worse, marginalized groups of people often avoid diagnosis and treatment which further perpetuates these disparities.
Being a frontline health worker is not just about giving guidance and advice– it’s a call to action and advocacy. These people and their employers know their community members better than anyone else. This way, they understand the communities’ challenges, weaknesses, and strengths. As they educate and guide clients to achieving better health, they have the responsibility to acknowledge barriers to care and why they exist. This understanding will help them to better anticipate their client’s needs and respond appropriately and effectively.