Building Capacity for Community Health Worker Integration: Three Key Steps State Policymakers Should Take during the COVID-19 Crisis and Beyond

The COVID-19 pandemic has been a sobering reminder of the lack of strong community connections in much of our health care delivery and public health systems. Social determinants have contributed to major racial and ethnic disparities in COVID-19 infections and deaths. And state contact tracing and COVID-19 testing efforts have failed to reach many vulnerable communities.

Community Health Workers can play a key role in responding to the COVID-19 crisis and in building communities’ resilience to future infectious disease outbreaks by reducing the burden of chronic illness and addressing the social determinants of health. However, a lack of sustainable funding is a major barrier to expanding CHW programs and integrating CHWs into the health system. Medicaid funding can address these challenges, especially within managed care and other delivery systems that use value-based payment mechanisms.

This report focuses on three key implementation steps for integrating CHWs into Medicaid and other state programs: 1) defining the workforce; 2) creating pathways for sustainable financing, and 3) maximizing impact. We include several key considerations intended to help state policymakers identify and overcome common barriers associated with integrating and operationalizing CHWs in Medicaid and other state health programs.