Opportunities for Community Health Workers in the Era of Health Reform

This paper begins with an assessment of the existing impediments to and enablers of the expansion of CHW employment. These include state differences in scopes of practice, the standardization of training and certification, and liability issues. It then catalogues how the ACA and other efforts affect prospects for sustainable employment for CHWs. It looks in turn at workforce issues, insurance enrollment needs, affordability and accessibility of services, and changes in approaches to public health and prevention. Each of these issues has different implications for CHWs. The paper concludes by highlighting particular promising opportunities for CHWs in both public and private sectors. These include both ACA-mandated roles such as navigators in health insurance exchanges/marketplaces and implied roles such as helping to coordinate post-inpatient care