Across the U.S., organizations are no longer asking whether community-based roles belong in health systems. That question has largely been answered.
Instead, program leaders are asking a more practical one: how do we train, support, and supervise community-based staff across different titles in a way that is consistent, effective, and sustainable within real-world constraints like funding, turnover, and time?
This shift matters because today’s community health workforce is rarely made up of one job title alone. Most programs include a mix of community health workers (CHWs), health navigators, promotores de salud, peer educators, outreach staff, and other community-facing roles. While job titles vary, the work often overlaps.
That’s why many organizations are moving away from title-based training decisions and toward shared training foundations built around CHW core roles and competencies.
A workforce that has matured
Teams that include CHWs and CHW-like roles continue to grow nationwide. Employment of community health workers is projected to grow about 11 percent from 2024 to 2034, much faster than the average for all occupations.
What has changed is how organizations are implementing and scaling community-based work. Most programs are now focused on execution: onboarding, supervision, consistency, outcomes, and integration with broader care teams and systems.
Titles vary, functions overlap
National partners describe community health workers as a broad workforce category that includes roles such as promotores de salud, community health representatives, patient or health navigators, and similar positions that bridge communities and health systems.
In practice, titles like health navigator, care coordinator, or peer educator usually describe functions, not entirely separate occupations. These functions (navigation, education, outreach, advocacy, coaching) are core components of CHW work when carried out by trusted community members with lived experience.
What matters most is whether a role includes:
- Trusted relationships with the community served
- Shared lived experience, language, or cultural background
- Responsibilities such as outreach, education, navigation, advocacy, or direct support
When those elements are present, the role often aligns with national definitions of CHW work—even if the title does not include “community health worker,” “promotor,” or “navigator.”
Why shared training foundations matter
Because titles differ but responsibilities overlap, many organizations are adopting CHW core competencies as a common training baseline across community-based roles.
Programs are asking, “What shared skills do our community-facing staff need in order to do this work well?” For example, both a health navigator and a promotor may need the same skills in communication, boundary-setting, documentation, and service coordination.
This approach helps programs:
- Create consistency across teams with multiple titles
- Support clearer supervision and performance expectations
- Reduce confusion about role boundaries and scope
- Strengthen collaboration between community-based and clinical staff
CHW core competencies at the organizational level
CHW core competencies, such as communication, relationship-building, service coordination, advocacy, education, and professional conduct, are increasingly used as organizational training frameworks, not just individual learning pathways or certificates.
Many states now recognize CHWs as a distinct occupation and tie certification, training standards, or Medicaid reimbursement to nationally recognized CHW roles and competencies, such as those outlined by the CHW Core Consensus (C3) Project. In many cases, navigators, promotores, and similar roles may qualify under these frameworks when they meet CHW definitions, even if their job titles differ.
The key is whether a role’s duties and lived experience align with how the state or payer defines CHW work.
For organizations, this means training decisions are no longer just educational. They can affect compliance, funding pathways (such as Medicaid reimbursement or value-based payment models), and long-term workforce development.
Cross-training as a program strategy
Cross-training community-facing staff using CHW core competencies creates a shared language and skill set across teams and settings. It also allows programs to remain flexible as roles evolve, funding changes, or staff move between positions.
When aligned with state CHW standards, cross-training can help organizations:
- Prepare staff for CHW certification where applicable
- Meet payer or grant expectations tied to CHW roles
- Support career pathways and retention
- Strengthen team-based care and coordination
Cross-training does not eliminate role distinctions. Instead, it provides a common foundation on which specialized responsibilities can be layered.
Moving beyond title-based decisions
Organizations that are most successful with community-based work are no longer organizing training around titles alone. They are designing systems that recognize:
- The reality of overlapping roles
- The importance of lived experience and trust
- The need for consistent supervision and expectations
- The value of shared skill frameworks across programs
In this context, CHW training is less about who can take it—and more about how organizations use it to build strong, integrated community-based teams. The next step is to map your current roles against CHW core competencies and decide which shared foundations and role-specific layers your team needs most.
Not Sure Where to Start?
If you’re reviewing roles across CHWs, navigators, and promotores, use our Training Priorities Checklist for Program Managers to identify shared skill foundations, supervision gaps, and role-specific training needs.