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Community Resources

When planning for sustainability, many rural community health worker (CHW) programs have created strategic alliances between community organizations and public and private agencies. Some have implemented a Board of Directors or Strategic Advisory Council to guide programs. Creating a sense of ownership for the CHW program among community stakeholders has helped to build trust and to identify new opportunities to sustain activities. Community stakeholders may also help build a strong business case for the CHW program.

Community-Based Organizations

Community-based organizations may support collaborative implementation and sustainability of CHW programs. They often hire and train CHWs. They may also offer key resources and fulfill functions to bolster the success of a CHW program such as:

  • Providing CHW training facilities
  • Contributing financial resources
  • Arranging or providing transportation services
  • Facilitating CHW program sustainability through formal agreements


Some rural CHW programs have developed strong partnerships in the business community, including placement of local business leaders on their Board of Directors. Buy-in from and collaboration with the business community has helped some CHW programs to:

  • Increase awareness of program benefits
  • Identify new funding sources
  • Secure direct funding from local businesses for parts of the program

Sustainable Financing

Financial supports are critical for sustaining CHW programs. The financial strategy must connect well with other program components and must meet patients' needs. Some CHW programs are grant-funded, but they are not always sustainable. Public and private payers may support CHW programs using traditional payment models (such as fee-for-service, pay-for-performance) or alternative payment models. Some state Medicaid programs provide reimbursement for CHW services.

To review additional considerations for sustainability, see Sustainability Strategies and Sustainability Strategies for Specific Issues in the Rural Community Health Toolkit.

Resources to Learn More

Community Health Partnerships: Tools and Information for Development and Support
Recommendations for how to form business and community partnerships for on-going collaboration that will strengthen health resources available in a community.
Organization(s): National Business Coalition on Health, Community Coalitions Health Institute

Handbook for Enhancing CHW Programs: Management and Maintenance
Guidebook on the management and maintenance of CHW programs community assessment, program planning, recruitment, training, communication, team building, and evaluation.
Organization(s): Centers for Disease Control and Prevention
Date: 2010

How States Can Fund Community Health Workers through Medicaid to Improve People's Health, Decrease Costs, and Reduce Disparities
Provides an overview of benefits of utilizing CHWs in a community healthcare setting. Discusses key topics regarding sustainable funding of CHWs through Medicaid reimbursement, and identifies examples from state case studies.
Organization(s): Families USA
Date: June 2016