What are Community Health Workers?
TheAmerican Public Health Association’s widely used definition of a community health worker (CHW) is “a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. This trusting relationship enables the CHW to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery. A CHW also builds individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support and advocacy.”
CHWs may be known by many titles in Michigan, which include, but are not limited to:
- Certified Peer Support Specialist
- Community Health Advocate Community
- Outreach Worker
- Community Neighborhood Navigator
- Family Health Outreach Worker
- Outreach and Enrollment Worker Community
- Health Representative
- Recovery Coach
- Community Health Outreach Worker
- Community Health Worker Early Intervention Services (EIS) Worker
- Maternal Child Health Worker
- Promotor/a
Source: Michigan Community Health Worker Alliance (MiCHWA):About CHWs (michwa.org)
Documented Potential Benefits of CHW Programs
Source: Centers for Medicare & Medicaid Services On the Front Lines of Health Equity: Community Health Workers (cms.gov)
How is MDHHS Supporting CHW Efforts Statewide?
The MDHHS SDOH Strategy identifies CHWs as a strategic imperative to improve health outcomes and advance health equity. Extensive efforts are ongoing to better support the CHW workforce and ensure more Michigan residents are able to benefit from CHW services.
The CHW Subcommittee has put forth a set of 24 recommendations, with a number of supporting sub-recommendations, with strong consensus on a path forward for implementation:
CHW Subcommittee Final Report
The MDHHS Policy and Planning SDOH team is committed to supporting implementation of these recommendations by taking the following steps:
Priority: Create a supportive environment for the CHW workforce to thrive and make a significant impact on improving health equity and enhancing community well-being.
To support recommendations under the ‘workforce support’ priority, the MDHHS Policy and Planning Office will establish a CHW Advisory Council, comprised primarily (>75%) of current or former CHWs, to advise on the development of policies impacting the CHW workforce. The CHW Advisory Council will advise on decisions related to CHW funding, integration of CHWs into state-led programs, and the potential development of formal CHW certification policies. Additionally, the Policy and Planning Office is allocating funding to support stipends/compensation for CHW Advisory Council members, acknowledging the value of their contributions.
Priority: Better align CHW efforts by consistently sharing best practices and coordinating approaches to mitigation of barriers.
To support recommendations under the ‘alignment’ priority, the MDHHS Policy and Planning SDOH team developed a framework and will support pilot projects for Community Health Worker Integration to Improve Equity (CITIE). CITIE is an innovative, collaborative initiative that aims to address health disparities by training and integrating CHWs in communities that have been disproportionately burdened by health inequities.
Priority: Identify meaningful measures of CHW work to demonstrate value and illustrate impacts.
To support recommendations under the ‘measurement’ priority, the MDHHS Policy and Planning SDOH team will promote the adoption of common process and outcome indicators for CHW practice developed by the CHW Center for Research and Evaluation (CHW-CRE).
Priority: Build a community engagement strategy to raise awareness of the importance and impacts of CHW work.
To support recommendations under the ‘engagement’ priority, the MDHHS Policy and Planning SDOH team convened a CHW Community Feedback Forum (CHW-CFF) in August 2023. The CHW-CFF brings together community members, as well as state and local community partners to provide input on policy and program recommendations to support the CHW workforce in Michigan.It will provide relevant and diverse perspectives informing recommendations to support and sustain the CHW workforce in Michigan, while promoting awareness of CHWs and their integral role in improving health and equity.
The next CHW-CFF meeting is scheduled for August 13, 2024 from 10:00-11:30 AM. If you would like to attend, please register below:
CHW Community Feedback Forum Meeting #4 Registration
Priority: Identify and prioritize existing and potential mechanisms through Medicaid, other MDHHS programs, and other approaches to assure sustainable financing of CHW programs.
To support recommendations under the ‘sustainable financing’ priority, funding opportunities through partnerships and grants will be pursued to support the expansion of the CHW workforce and CHW trainer capacity.
Michigan Medicaid CHW Policy
Effective on January 1, 2024, Michigan Medicaid has begun reimbursing for Community Health Worker (CHW) services provided to Medicaid beneficiaries. To learn more about the policy, please visit the Michigan Medicaid CHW Policy website.
Priority: Create recommendations to support standards for CHW core competency-based training and mechanisms for certifying that training programs meet them.
To support recommendations under the ‘training’ priority, the CHW Advisory Council will advise on the development of a CHW certification policy, including the following considerations: CHW definition, core competencies, coordinating bodies, training, experience, applications for CHWs and training providers, renewal, reciprocity, whether certification should be voluntary or mandatory*, and other certification options. Barriers and potential negative outcomes to certification will be considered and solutions to address them will be prioritized.
*A majority of the CHW Subcommittee is supportive of CHW certification being voluntary, but there was no consensus; some members recommended mandatory certification.
For more information on MDHHS efforts to support CHW efforts within the SDOH Strategy, subscribe to the SDOH monthly newsletter.
