Community Health Workers in Rhode Island: Sustaining a growing public health workforce in the pandemic and beyond

CHWs often have similar cultural beliefs, chronic health conditions, disabilities, or life experiences as the people in the community they service, which puts them in a unique position to help improve access to, quality of, and cultural responsiveness of service providers. They typically work with communities experiencing health inequities and perform activities, such as outreach, community education, informal counseling, social support, and advocacy. The COVID-19 pandemic has revealed and exacerbated health inequities, presenting a medical and economic crisis that CHWs are simultaneously impacted by, and working to alleviate. But even as the field has grown, and the need for CHW services has come into sharper focus, Rhode Island has not yet achieved sustainability and scale. This project follows up to a 2017 qualitative study of employers of CHWs in Rhode Island. The study’s aim was to share know-how and promising practices and to help drive action in support of the CHW workforce. The original study asked a series of essential questions: Where do CHWs work? What do they do? Who gets CHW services? How are they funded? How are they trained and sustained? How can the CHW workforce grow? Since 2017, much has changed in the community health field in the state. Rather than attempting to revisit and update the original report, we wanted to build on it by exploring three sets of essential questions: What has changed for the Rhode Island CHW field in the past few years? What lessons have we learned? How is the pandemic affecting the CHW field in the state? What (if any) consensus is emerging about how to sustain the CHW workforce? This report addresses these questions primarily through the perspective of employers and stakeholders in leadership positions, such as program directors and managers.

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