Community Health Workers

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To those who are interested in the role of Community Health Workers (CHW’s) in Oregon’s health care system I wanted to bring up an issue that was discussed by the House/Senate Joint Health Transformation Committee on Wednesday evening (May 4th).

There is a provision in Oregon House Bill 3650 – the health transformation draft bill – that stipulates that the State Home Care Commission “shall recruit, train, and certify community health workers (CHW’s and personal health navigators).” The issue of being required to have community health care workers that are certified was asked by Senator Kruse – and the response was that it was not required. But there seems to be a bit of a slippery slope here in having the Home Care Commission creating a certification process to have technical skills for a position that most often requires trust and integrity in the community.

As far as I know I have not heard of any input in the CHW proposal from organizations that utilize CHW’s or community health workers themselves. Let me know if any of you have participated in developing this approach to CHW’s.

I think my biggest concern is reflected in the comparison between the Massachusetts report and the legislation proposed – the first item in the legislation defines a community health worker as “has expertise or experience in public health” (page 15) while the Mass report states “CHWs are distinguished from other health care and public health workers by the activities they perform and by their identity—typically—as members of the communities they serve. CHW roles and activities are different from, yet complementary to, the services of many other health care workers, including licensed medical clinicians and support service providers such as home health aides and personal care attendants.” (page 3)

I know that many health organizations often find the right people first and then bring them on board to train as CHW’s – I fear that this “institutionalizing” of community health workers may not be in the best interest of underserved communities, that a mainstream state agency will undercut the community role played by CHW’s. The Massachusetts report does a good job in detailing the role of community health workers and their importance to ethnic, immigrant and communities of color.

Chair Senator Monnes Anderson stated that all written comments need to be in by 5pm Thursday (May 5th). They can be directed to the Committee Staff – Rick Berkobien at rick.berkobien@state.or.us

The intent is to finish up the amendment by next Wednesday (May 11th)

Onofre Contreras

Oregon Health Action Campaign

You can see a copy of HB 3650 here. The reference to community health workers is on page 19.

You can see a copy of the Massachusetts report here.

  1. Liz Baxter
    Liz Baxter05-05-2011

    Thanks Onofre for this update and the call to action.
    If we really want a transformed health system community health workers play a critical role. They provide the bridge between medical services and community services, between medical and social services, and in the best situations are people who know the resources in the community because they are members of the community.
    Liz