Community Health Workers: Integral Members of Oregon’s Health Workforce

Community Health Workers (CHWs), trusted community members who work with communities to improve health through a variety of strategies, have been integral members of the health care workforce in many Oregon communities since the 1960s. In the context of health care reform, CHWs (also called promotores/as de salud and Community Health Representatives) have received increasing recognition for their unique ability to improve health and address health inequities. In June of 2017, the Oregon Community Health Workers Association (ORCHWA) received funding from the Oregon Health Authority (OHA) and Health Share of Oregon (HSO) to conduct a needs assessment of Oregon’s CHW workforce. This statewide needs assessment used a developmental evaluation approach with a concurrent mixed methods design. It was guided by four overarching assessment questions: 1) What is the current composition of the CHW workforce in Oregon? 2) What is the current employment structure for the CHW workforce in Oregon? 3) What are the successes and challenges regarding four sets of issues? 4) What needs to be done to address problems and challenges? Common findings across data sources indicate a need to: Increase representation of CHWs in all communities affected by inequities, provide education for all (especially supervisors) about CHW roles and scope, create a coordinated, statewide infrastructure for CHW training that is based on best practices and builds capacity around the state, provide clear guidance and billing codes in order to diversify funding beyond grants, spread the CHW paradigm, which is community-focused, non-hierarchical and appreciative of life experience, throughout the health system and dominant culture systems generally.