National Support for Community Health Workers
American Public Health Association (APHA)
APHA has had a CHW Special Primary Interest Group for over 20 years. In 2009 APHA recognized this group by accepting them as the CHW Section. In 2009, APHA also issued a policy statement titled "Support for Community Health Workers to Increase Health Access and to Reduce Inequities" (Policy Number 2009-1). The CHW Section also published a national CHW definition as follows:
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.
Centers for Disease Control and Prevention (CDC)
The CDC has provided leadership in documenting and acknowledging the role of CHWs. CDC's Division of Diabetes Translation report titled Community Health Workers/Promotores de Salud: Critical Connections in Communities stated "Across the scope of CDC's diabetes programs, many ties link communities to health care systems through which runs a common thread-including and honoring the advocacy and teaching skills of community members in the role of CHWs."
U. S. Department of Labor (DOL)
In its publication of the 2010 Standard Occupation Classification revisions for the Department of Labor, the Executive Office of the President included a unique occupational classification for Community Health Workers (#21-1094), which was used in the 2010 census.
Health Resources and Services Administration (HRSA)
HRSA has a history of supporting the role of CHWs. HRSA funded the Community Health Workers National Workforce Study, a comprehensive national study of the CHW workforce released in 2007 and funds a national Patient Navigator program. HRSA mandates that all of its Area Health Education Centers use CHWs for outreach to community members.
Institute of Medicine (IOM)
In its 2002 report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, IOM recognized that CHWs "offer promise as a community-based resource to increase racial and ethnic minorities' access to health care and to serve as a liaison between healthcare providers and the communities they serve." The report also asserts that CHWs are effective as, "a strategy for improving care delivery, implementing secondary prevention strategies, and enhancing risk reduction" and recommends integrating trained CHWs into multidisciplinary health care teams. In its 2010 report, A Population-Based Policy and Systems Change Approach to Prevent and Control Hypertension, the IOM recommends the CDC Division for Heart Disease and Stroke Prevention (DHDSP) should explore ways to make increased use of community health workers.
National Heart, Lung and Blood Institute (NHLBI)
In its Hypertension Awareness and Control Programs, NHLBI recommends a strategy of training and using CHWs as: 1) trainers of others; 2) to educate community members; and 3) to work as a member of a health care team to help improve adherence to clinical and educational recommendations.
United States Congress
The newly enacted Patient Protection and Affordable Care Law, defines CHWs as members of the "Health Care Workforce" and lists CHWs as "Health Professionals." In addition, the law determines that funds granted under sec. 399V, subsection (a) shall be used to support CHWs to provide outreach, promote positive health behaviors, support enrollment in health insurance, identify and enroll underserved populations to appropriate health care agencies and community based programs, and provide home visitation services regarding maternal health and prenatal care. Funding for the use of CHWs in underserved communities through the CDC also was included. The use of CHWs has been promoted by numerous other state and national agencies and organizations, including Aetna, the American Association of Diabetes Educators, American Diabetes Association, American Heart Association, American Hospital Association, American Medical Association, American Nurses Association, National Coalition of Ethnic Minority Nursing Organizations, National Conference of State Legislatures, and New York State Department of Health.
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