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Rural Health Information Hub

Outreach and Enrollment Agent Model

The outreach and enrollment agent model is similar to the screening and health education model, with additional outreach and enrollment responsibilities. In this model, community health workers (CHWs) conduct intensive home visits to:

  • Deliver psychosocial support
  • Engage individuals and families in healthcare and supportive services
  • Improve maternal, infant, and child health
  • Provide education
  • Conduct environmental health and home assessments
  • Offer one-on-one advice
  • Provide navigation services
  • Make referrals

As outreach and enrollment agents, CHWs also help individuals to enroll in programs that provide healthcare and social services. CHWs that serve in an outreach capacity typically receive specialized training. CHWs may assist people who are eligible for programs but experience barriers to enrolling.

Through outreach efforts, such as home visits, CHWs can work with patients to identify issues such as social isolation and loneliness. These are critical public health challenges discussed in National Academies of Sciences, Engineering, and Medicine 2020 report, Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System. The report notes the need for education and training of the health care workforce, including CHWs, and for CHWs to work with other health professionals to address social isolation and loneliness among older adults.

The Community Preventive Services Task Force (CPSTF) recommends interventions that engage CHWs for cardiovascular disease prevention and diabetes prevention and management. The evidence reviewed by the CPSTF included interventions that engaged CHWs as outreach and enrollment agents.

Examples of Rural Outreach and Enrollment Agent Models

  • The ASPIN Network: Community Health Worker Program provided training to CHWs and certified health insurance enrollment navigators to increase access to health insurance enrollment in rural Indiana.
  • The Prevention through Care Navigation Outreach Program, implemented by the Tri-County Health Network, utilized CHWs to reduce diabetes and cardiovascular disease prevalence. The CHWs conduct outreach by meeting community members where they are: homes, libraries, churches, human services offices, and other settings. They also provide screenings, referrals, education, and peer support.

Implementation Considerations

As outreach and enrollment agents, CHWs may visit hard-to-reach populations in their homes. CHW programs implementing components of this model should consider the following:

  • Acquiring liability insurance prior to employing CHWs
  • Encouraging CHWs to be aware of their surroundings, for example, instructing CHWs to discontinue a home visit if they feel uneasy
  • Educating CHWs on eligibility requirements for relevant state and federal programs
  • Hiring bilingual CHWs to facilitate communication between non-English speaking patients and agencies or providers
  • Intervening in cases of social isolation and loneliness in older adults
  • Providing culturally competent outreach

Program Clearinghouse Examples

Resources to Learn More

Making the Connection: The Role of Community Health Workers in Health Homes
Describes the health home option for coordinating comprehensive care across all healthcare settings. Highlights the potential roles in which CHWs can help health homes improve patient outcomes and reduce cost.
Author(s): Deborah Zahn, Sergio Matos, Sally Findley, et al.
Organization(s): Health Management Associates, Inc., NYS Health Foundation
Date: 9/2012