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Community health workers (CHWs) have been garnering greater visibility in recent years as the field has placed heightened attention toward the role of social determinants of health in reducing health disparities and achieving health equity. CHWs aim to be a closer link into the community than traditional health care providers might be able to reach. Cultural competence, language, geographic distribution, and cost all contribute to the growing success of CHWs.
As administrators, clinicians, and researchers working in primary care safety-net health systems, the authors have directly observed the benefits of including CHWs in primary care practice to help meet the health and social needs of marginalized populations. Moreover, as payment models for health care shift from clinical fee-for-service payment to broader value-based payment models, CHWs may serve a crucial role to expand the impact of primary care and build the connections among primary care, public health, and community health organizations.
This question of whether CHWs should be certified or licensed comes up frequently and as payment models provide more resources to support CHWs, the issue is becoming an important policy debate. In this article, we describe the benefits and risks of CHW licensure and certification.