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“Community Health Worker” (CHW) is a
term inclusive of many job titles, such
as community health advisors, lay health
advocates, promotoras, outreach
educators, community health representatives,
peer health promoters and educators, etc.
The common general attribute is that the
CHWs are members of, or have a close relationship
to, the community served. They generally
are lay members of an underserved community
who work in association with the health
care system to offer interpretation and
translation services, provide culturally
appropriate health education and information,
assist people in getting the health services
they need, provide informal counseling
and social support, advocate for individual
and community health needs, and provide
direct services such as first aid and
blood pressure screening.[37]
In 2004, a report by The Center for Health
Professions indicated that California
Assembly Bill (AB) 1963 was being considered
by the California Legislature to encourage
the use of promotores to address
health concerns in rural and agricultural
settings. While promotores would
be defined as “trained” CHWs, training
components were not addressed.[38]
Although several groups offered their
support for the bill, AB 1963 was vetoed
by the governor of California in September
2004.[39]
A few existing reports attempt to quantify
the number of CHWs working in California.
In a 1992 report, survey results indicated
that there were a total of 1,645 CHWs
working in California.[40]
A more recent report indicates that there
were 504 CHWs working in the San Francisco
Bay area alone[41]
(covering eight counties). The Community
Health Worker National Workforce Study
(described below) will compute a set of
estimates for paid CHWs using data from
the U.S. Census Bureau’s Public Use Microdata
Sample (PUMS) and Staffing Patterns data
from the Bureau of Labor Statistics for
every State in the country. In addition,
an estimate of the number of volunteer
CHWs will also be calculated at the State
and national level. Results from the
National Community Health Advisor Study
(1998) indicated that there were at least
12,500 CHWs working throughout the United
States.
The Community Health Worker National
Workforce Study, which began on October
1, 2004, under a 2-year contract by the
RCHWS at The University of Texas Health
Science Center at San Antonio with the
U.S. Department of Health and Human Services
(HHS), Health Resources and Services Administration
(HRSA), Bureau of Health Professions,
is aimed at drawing an accurate profile
of the CHW workforce. The study consists
of a thorough analysis of the quality
and size of CHW employment and potential
job market.
Data on the number of paid and volunteer
CHWs, their duties, work conditions, compensation,
training/education and career opportunities
are collected, organized, verified, and
explained. The study also examines related
issues, such as training and credentialing
standards, the availability of funding
streams for education and compensation
as well as current State/Federal policy
trends and options. The final report
will provide a national profile and detailed
assessments of the CHW workforce in four
States that will inform policy and strategic
interventions on existing application
of CHW capabilities in improving access,
reducing disparities, and enhancing quality
improvement and cost-containment efforts.
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