Both state and federal health reform have provided natural opportunities for expanded inclusion of CHWs into clinical and community-based care. Community health workers can make significant contributions to increasing access, improving health and health care, reducing costs, and addressing health disparities.
The 2006 Massachusetts landmark health reform law included a provision requiring DPH to convene a statewide advisory council to investigate the use and funding of CHWs in MA and their role in increasing access and reducing disparities. The law also asked for a report with recommendations for policies to promote a sustainable CHW workforce, including provisions for training, certification, and financing. This led to Chapter 322 (Acts of 2010), the Massachusetts CHW certification law, as well as the inclusion of CHWs in Massachusetts payment reform legislation of 2012 (Chapter 224). Two current major opportunities for CHWs in Chapter 224 are the Prevention and Wellness Trust Fund and the Health Care Workforce Transformation Fund.
Massachusetts health reform also served as a precursor to the 2010 federal health reform law, the Affordable Care Act (ACA), which included CHWs in multiple ways and identified them as health professionals. Major federal initiatives in the ACA include the CMS Innovation Center, which supports CHWs through the development and testing of innovative health care payment and service delivery models, and expanded CDC promotion of and support for CHWs.
- Chapter 58, Acts of 2006, “An Act Providing Access to Affordable, Quality, Accountable Health Care,” Section 110
- DPH Public Health Council was reconstituted in 2007 as part of health care reform and includes a seat for CHWs – “a non-health care provider appointed by the governor from a list of three persons nominated by the Massachusetts Association of Community Health Workers.”
- Chapter 224, Acts of 2012, “An Act Improving The Quality Of Health Care And Reducing Costs Through Increased Transparency, Efficiency And Innovation,” Payment Reform Legislation
- Affordable Care Act - Sections 5101, 5313, 5403
- The Center for Medicare and Medicaid Innovation (CMMI)
- New England Asthma Innovation Collaborative (NEAIC), a CMS Health Care Innovation award at Health Resources in Action (HRiA)
- “Affordable Care Act Opportunities for CHWs,” Center for Health Law and Policy Innovation at Harvard Law School
- “Integrating Community Health Workers into a Reformed Health Care System,” The Urban Institute
- “Opportunities for Community Health Workers in the Era of Health Reform,” The Urban Institute