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

Authors: Brady Dunklee
Year: 2021
State: RI
Website link:
Publicly Available: Yes
Certification: CHW input in process, CHW role scope of practice, Competencies, Continuing education, Funding of certification, Lessons learned from other states, Reciprocity between states, Role of state government, Training and training programs
Evidence Generation: Documentation of how CHWs can work within care teams, Evidence-based interventions, Surveys and assessment tools to define and develop workforce
Policy: Building partnerships, General language around CHW WD, Identifying policy expertise within state, Legislative language, Lessons learned from other states
Sustainable Financing: Engaging state partners in general, Expand evidence base, How to engage and work with Medicaid, Education to HC orgs on payment options bundled etc., MCO or bundled payment reimbursement models, Reimbursement TA for FQHCs Medicaid etc., Documentation of how CHWs can work within care teams, ROI and bundled payment successes/challenges
Workforce Development: CHW training programs (not cert.), Contacts for people in other states, Data sharing between social services and clinical teams, General other (including mention of “employment practices”), Outreach campaigns to identify CHWs

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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