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Sustainability and health reform

Information about sustainability and health reform for Community Health Workers (CHW) in Massachusetts and nationally

Sustainability for CHWs

Creating permanent CHW positions and stable workforce infrastructure have been challenging due to the lack of consistent, dependable funding. In Massachusetts and across the country, multiple efforts are focused on promoting sustainability. These include:

  • Expanding the evidence base on CHW contributions to positive health outcomes and containment of costs;
  • Organizing the CHW workforce to effectively advocate for the CHW role;
  • Building national consensus on CHW roles, skills and qualities.

CHWs and key partners are educating health payers and providers about the workforce, the roles they play, the benefits they bring and how to integrate them into healthcare and other multidisciplinary teams.

CHWs and health reform

Both state and federal health reform have provided natural opportunities for expanded inclusion of CHWs into clinical and community-based care.

The landmark 2006 Massachusetts health reform law included a provision requiring DPH to convene a statewide advisory council to investigate and make recommendations for the CHW workforce. One recommendation was to establish a CHW certification process, which led to the passage of Chapter 322 (Acts of 2010), the Massachusetts CHW certification law.

CHWs were also included in Massachusetts payment reform legislation of 2012 (Chapter 224), and are a key workforce in the Prevention and Wellness Trust Fund.

Massachusetts health reform served as a precursor to the 2010 federal health reform law, the Affordable Care Act (ACA), which identified CHWs as health professionals. Major federal initiatives in the ACA which promote CHWs include the CMS Innovation Center and expanded CDC support for CHWs.

Massachusetts health reform

Federal/national level health reform

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