Study of the community health worker workforce: A report to the Texas legislature

The presentation highlights several methodological strategies developed as part of a legislatively required study to assess the desirability and feasibility of employing community health workers (CHWs) within health care systems in Texas and to explore methods of funding and reimbursement. This work informed the Texas Department of State Health Services and Health and Human Services Commission in developing recommendations to maximize CHW employment opportunities and to expand funding and reimbursement for services provided by CHWs. The Institute of Health Policy of the UT School of Public Health in collaboration with the Department of State Health Services and Health and Human Services Commission utilized multiple methods and engaged a wide range of stakeholders. Methods included a targeted literature assessment, case examples of successfully sustained CHW services, state and national key informant interviews, eight focus workshops with CHWs and employers, an online survey of CHW employers and potential employers, and consultation with the CHW Training and Certification Advisory Committee. Survey data showed that 84% of current CHW employers and 72% of those currently not employing CHWs indicated interest in expanding the CHW workforce in their organization. Results indicated that CHW are viewed as a desirable workforce for their contribution to the organization's functions. Several study methods included evidence demonstrating the positive impact CHWs have made in increasing health care efficiency, quality and access. Examples recognized that CHW services can increase access to services and improved outcomes, including decreasing cardiovascular disease risk and increasing breast cancer screening rates. Results showed that there are financial benefits, in both the public and private sectors, to employing CHWs. Several examples of these benefits are discussed. An overview of study recommendations related to CHW professional development, workforce recognition, reimbursement, and CHW roles in health plans, Patient Centered Medical Homes, and public health is presented.