Rethinking local health department (LHD) roles in the safety net under health care reform: The central role of community health workers (CHWs)

Public Health – Seattle & King County's (PHSKC) vision of Equity and Social Justice has provided the foundational elements for the birth of a strong and vibrant work force of CHWs. PHSKC employs CHWs with varied skill sets in diverse roles locations throughout King County, including outreach workers, patient navigators, chronic disease self-management support coaches, maternity support providers, TB DOT workers and more. Throughout the history of CHW work in the department, public health staff and academic partners have conducted rigorous research to assess the effectiveness of CHWs, leading to development of best practices for CHW programs. The Department has a deep commitment to deploying CHWs to address health inequities and integrating their work with emerging approaches such as reaching the Triple Aim, implementing the client-centered Health Home, using electronic health records, evolving mobile information technologies, enhancing self-management support for people with chronic diseases, and using policy/systems/environment change to promote healthy environments. PHSKC is also highly interested in securing sustainable funding for CHWs, as much of current funding is grant-based and inadequate to the needs. This presentation will describe recent research conducted in support of a comprehensive CHW workforce plan for PHSKC, including integration with local health care reform planning, investigation of CHW employment practices in other LHDs around the country, and organization of local and statewide processes to develop CHW scope of practice and skills standards for CHWs.