Community health workers: A Chicago metropolitan strategy to increase employment

The Patient Protection and Affordable Care Act (2010) recognizes that community health workers (CHWs) can play a larger role in outreach and education to improve health care access, prevention, primary care and quality of life of currently underserved communities. Evidence shows that CHWs are effective in these roles and in reducing costs of healthcare, however, CHWs often lack job stability. Strategies for improving funding and retaining CHWs include federal funding, statewide stakeholder coalitions, state certification, and third party reimbursement. Some states have pioneered state-level policies to increase the number of CHWs in underserved communities. Illinois lacks state-level CHW policies. In Chicago all CHWs do not agree on those strategies and perceive different benefits and risks in each strategy. Area CHWs are organizing a local network that is pursuing state certification and third-party reimbursement. The CEED@Chicago Coalition is pursuing an inclusive metropolitan stakeholder strategy that combines curriculum development and training, an alliance of health agencies, and a marketing campaign on benefits of employing CHWs. A metropolitan stakeholder coalition may be a first step toward a statewide coalition. Successes of the strategy so far have been to engage Latino and African-American CHWs in development of healthy eating and physical activity curriculum materials through focus groups, monthly meetings, testing materials appropriate to different communities, and collaboration with the CHW local network. Next steps will be to engage an alliance of healthcare providers to accept the portability of training in these curricula by all alliance members and to launch the marketing campaign.