CHW Advocacy and
Initiatives: National and
Regional Perspectives
Venoncia M. Baté-Ambrus, MS, PhD candidate
Director of Workforce Development & Diversity
Interim Coordinator WI CHW Alliance
Milwaukee Area Health Education Center
Definition of CHWs:
 A Community Health Worker (CHW) is a frontline public
health worker who is a trusted member of and/or has an
unusually close understanding of the community served. This
trusting relationship enables the CHW to serve as a
liaison/link/intermediary between health/social services and
the community to facilitate access to services and improve
the quality and cultural competence of service delivery.
 A CHW also builds individual and community capacity by
increasing health knowledge and self-sufficiency through a
range of activities such as outreach, community education,
informal counseling, social support and advocacy.
APHA’s CHW Section
 The Patient Protection and Affordable Care Act (ACA)
lists CHWs as members of health care teams.
 Increasing Support for Community Health Worker SelfDetermination in Training and Credentialing
 APHA CHW Section is the national leadership for the CHW
workforce
Proposed “Policy Statement”:
Guidelines for Credentialing
 CHWs characterized by trusted status among the
communities they serve, vital part of the public
health workforce.
 Demand for CHWs is expected to increase with
implementation of the ACA
 Policy is needed to support CHW leadership in
determining professional standards, with
collaboration from other public health
colleagues.
Relationship to existing American
Public Health Association (APHA)
Policy
 In 2009, the American Public Health Association
(APHA) adopted Policy Statement on CHWs
 Description was developed within the APHA CHW
Section, with national representation of CHWs and
their advocates.
 Policy addressed numerous issues related to the
community health worker (CHW) workforce. Vital
element being a statement that included a
definition of CHWs.
Proposed Policy Statement:
APHA’s CHW Section Certification
and Credentialing Guidelines

Encourages local, state, and national CHW professional associations to
organize CHWs to develop consensus about the desirability of training
and credentialing.

Calls on CHW professional groups to pursue legislation regarding CHW
training and credentialing, if appropriate for local conditions, in
collaboration with CHW advocates and other stakeholders.

Urges all entities considering creating policies regarding CHW training or
credentialing to defer to the desires of local CHWs and/or CHW
professional groups. If CHWs and other entities partner in order to pursue
policy development, a working group comprised of at least 50% selfidentified CHWs should be established.

Encourages any entity drafting new legislation regarding CHW
credentialing and training to include in the policy the creation of a
governing board comprised of at least 50% CHWs.
American Psychological Association (APA)
Div. 27: Society for Community Research &
Action (SCRA)
 Mission: SCRA is an international organization devoted to
advancing theory, research, and social action. Its members are
committed to promoting health and empowerment and to
preventing problems in communities, groups, and individuals. SCRA
serves many different disciplines that focus on community research
and action.
 Vision: SCRA will have a strong, global impact on enhancing wellbeing and promoting social justice for all people by fostering
collaboration where there is division and empowerment where
there is oppression.
SCRA Guiding Principles
 Community research and action requires explicit attention to and
respect for diversity among peoples and settings;
 Human competencies and problems are best understood by viewing
people within their social, cultural, economic, geographic, and
historical contexts;
 Community research and action is an active collaboration among
researchers, practitioners, and community members that uses multiple
methodologies. Such research and action must be undertaken to serve
those community members directly concerned, and should be guided
by their needs and preferences, as well as by their active participation;
 Change strategies are needed at multiple levels in order to foster
settings that promote competence and well-being.
SCRA Public Policy Rapid Response
Procedures
 The purpose of this process is to provide a mechanism for SCRA to
provide a quick response, as an organization, to evaluate and
potentially adopt public stances or action plans on public policy issues
of a time sensitive nature.
 On April 18, 2014 a CHW rapid response proposal was approved and
forwarded by a 5 person ad hoc policy committee to the SCRA
Executive Committee for formal division level approval. If approved it
will be shared with the APA for their approval.
 The CHW submission of rapid response CHW proposal was supported by
SCRA’s Community Health Interest Group (CHIG).
Other National & International
Associations Supporting CHWs
 American Academy of Family Physicians Foundation supports the Peers for
Progress program which accelerates and promotes best practices in peer
support as a regular part of health care and prevention around the world.
http://peersforprogress.org/
 National Association of Social Workers offers associate memberships to CHWs
which entail free chapter membership and access to free or discounted
educational products and programs.
http://www.socialworkers.org/joinBenefits/associate.asp
 Association of Black Cardiologists, Inc. offers free memberships to CHWs which
include newsletters, health education materials and annual access to 3 health
screening and monitoring events. http://abcardio.org/CHA_advocates.php
State Legislation on CHW
Certification and Credentialing
Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA 30333
Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
National Center for Chronic Disease Prevention and Health Promotion
Division for Heart Disease and Stroke Prevention
E-mail: cdcinfo@cdc.gov
Web: www.cdc.gov
Publication date: 07/2013
Region V (IL, IN, MI, MN, OH, WI):
Legislation, Policies and Initiatives
 Region V: CHW coalition leaders planning a 2015 regional CHW conference
 IL: HB 5412 & Basic/Advanced Certificates+Associate degree programs
 IN: ISDH Division of Maternal and Child Health developed IN’s first
certification for CHWs in care coordination. INCHWA formed Jul 2013
 MI: MiCHWA celebrates CHW Month in August and hopes the rest of the
state will, too, as it seeks a proclamation from the governor’s office.
 MN: Minnesota CHW Payment Statute (MS 256B.0625, Subd. 49) re: care
coordination. First state to have a Deaf CHW Project.
 OH: CHW Law 4723-26, CHWs overseen by OHIO Board of Nursing
 WI: Conducts CHW, CHW Supervisor & Best Practices in CHW Integration
trainings, assists low income CHWs via HPOG & discusses CHW legislation
National or Governmental:
References and Resources
 http://www.apha.org/membergroups/sections/aphasections/chw/
 http://www.scra27.org/about
 http://peersforprogress.org/
 http://www.socialworkers.org/joinBenefits/associate.asp
 http://abcardio.org/CHA_advocates.php
 http://www.abcardio.org/articles/cms_rule.html
 http://www.bls.gov/soc/2010/soc211094.htm
 http://nationalahec.org/
 http://legiscan.com/IL/text/HB5412/2013
Local and Regional CHW Coalition:
References and Resources
 IL: http://chwnetwork.wordpress.com/
 IN: http://www.chwisc.org/Indiana.html http://inchw.betterme.info/
 MI: http://www.michwa.org/
 MN: http://mnchwalliance.org/ http://www.deafchw.org/
 OH: http://www.med.wright.edu/chc/programs/ochwa
 WI: http://www.milahec.org/
 WI HPOG:
http://www.wfdc.org/documents/HPOGRandomAssignmentBrochure7.24.13.pdf
Thank you for your interest
 Contact information:
Venoncia M. Baté-Ambrus, MS, PhD candidate
Outreach Consultant
Suburban Primary Healthcare Council
Access to Care Program
708.531.0680 ext. 236
venonciab@sphcc.org
http://www.accesstocare.org/