Additional Implementation Considerations for Community Health Worker Programs
Specific implementation considerations for rural CHW programs include partnerships, policy approaches, and
technology. For information on common implementation considerations for rural health programs, see
Implementation Considerations in the
Rural Community Health Toolkit.
Many existing CHW programs have established partnerships with other community organizations and consider these
relationships to be important to success. These partners may serve as funders for rural CHW programs and provide
guidance for the program.
Potential partners for CHW programs include:
- Public health organizations
- Universities and colleges
- Health and dental plans
- Government organizations
- Community service organizations
- Volunteer groups
- Multicultural alliances and associations
- Local hospitals or clinics
- State and local health departments
- Faith-based organizations
CHWs that work with partners such as hospitals to deliver services to patients must be properly introduced to
staff at the partner organization to clarify their roles. This ensures other health workers, such as nurses or
social workers, do not perceive CHWs as a threat to their duties and understand the unique value and
contributions of CHWs.
In some instances, policy changes may be necessary to increase CHW involvement. Potential policy options may
address CHWs' provision of services, involvement in care delivery teams, implementation of certification or
training, and defining scope of practice. The National Academy for State Health Policy’s State Community
Health Worker Models webpage tracks CHW legislation at the state level. For additional policy
considerations related to sustainability, see Module
Technology is increasingly important to support CHWs, especially in certain models like the Care
Coordinator/Manager Model. Technology can improve care coordination by helping CHWs identify and track
referrals and next steps for clients and by supporting information-sharing with other providers and services.
For more information on care coordination and the use of health information technology, see the Rural Care
CHWs should receive training for any technology that they are required to use. This may include
technology for check-ins with supervisors or trainings, scheduling applications or email for interactions with
members or clients, or electronic health records or mobile applications for documentation. One program
in rural Montana was able to engage CHWs in leveraging technology during home visits to connect patients
with other members of the care team.
Resources to Learn More
Community Health Workers in Health Care for
the Homeless: A Guide for Administrators
Demonstrates to health program administrators how the CHW model of providing basic health services can be
integrated into homeless communities.
Author(s): Valesky, K.
Organization(s): National Health Care Council for the Homeless
Incorporating Community Health
into State Health Care Systems: Options for Policymakers
Identifies several state CHW programs, their key funding and the services they provide in their states.
Discusses policy options and state legislation related to the implementation of CHW programs.
Author(s): Blackman, K. &Scotti, S.
Organization(s): National Conference of State Legislators
Approaches to Integrating Community Health Workers into Health Systems: Four Case Studies
Describes the challenges and opportunities for integrating CHWs into health systems by highlighting four case
studies in Texas, Minnesota, North Carolina, and Ohio.
Organization(s): Urban Institute
to Finish: Your Toolkit to Plan and Run a Heart Health Program
Supports the implementation of a CHW program to improve heart health.
Organization(s): National Heart, Lung, and Blood Institute
States Implementing Community
Health Worker Strategies
Presents a technical assistance guide compiled from interviews with nine organizations who successfully
integrated CHWs into their healthcare teams. Offers insights and recommendations for states that are
implementing CHW programs.
Organization(s): Centers for Disease Control and Prevention
Rural Health Association Policy Brief: Community Health Workers: Recommendations for Bridging
Gaps in Rural America
Reviews the literature relevant to the development of CHW programs in rural areas. Analyzes relevant policies at
the state and national levels, discusses the challenges of implementing CHW programs, and offers recommendations
for developing programs in rural areas.
Organization(s): National Rural Health Association