Building a Workforce

Financing for In-home Asthma Care Logo

Community Health Workers (CHWs) advocate, facilitate and organize access to health and social services. Well-supported CHWs who perform home visits and help connect people with asthma and their families to clinical care offer great potential to cost-effectively improve health and reduce community asthma disparities.

New opportunities are emerging within Medicaid to reimburse non-medical providers delivering preventive care services, such as home visiting CHWs. Programs can prepare now for reimbursement by considering the training and certification options, requirements and possibilities for CHWs and other home visiting staff.

Training & Credentialing

Explore Online Training Programs

Access online courses and search for classrom learning opportunities through the National Healthy Homes Training Center and Network.

Search for CHW Training Programs
Use the CHW Training Programs Resource to find local and national CHW training and certification.

Learn About Credentialing
Community Health Worker Credentialing: State Approaches
Center for Health Law and Policy Innovation, Harvard Law School, 2014.
The connection between insurance reimbursement and credentialing is significant, as insurance plans may require credentialing to pay for CHW services. Many CHWs are concerned that credentialing will create barriers to entry for the individuals best suited to the job. This report reviews policies in different states. There is no single correct approach. With sufficient stakeholder engagement, each state can develop policies tailored for its community.

CHW Home Visitor Skills and Knowledge Assessment Tool

Boston Public Health Commission, 2013. This action guide lists evidence-based steps and resources that CHWs can use to improve patient outcomes and the overall value of CHW services.

Community Health Workers: Roles and Opportunities in Health Care Delivery System Reform
John E. Snyder, U.S. Department of Health and Human Services, January 2016. This report reviews select health services research findings on Community Health Worker (CHW) utilization that are relevant to U.S. policymakers and considers the key challenges to fully realizing the potential for CHWs to improve health care delivery. 

Implementing CHW Programs

Minnesota CHW Alliance

Minnesota Community Health Worker Alliance developed a website with tools and recources to help you successfully integrate community health workers into your childhood asthma care team. Visit the Alliance's website for information on financing CHWs, recruiting and hiring, sample job descriptions, supervising CHWs and more.

Best Practice Guidelines for Implementing and Evaluating CHW Programs in Health Care Settings Sinai Urban Health Institute, 2014

Health care organizations increasingly seek to adopt the CHW model as a way to provide comprehensive care to patients and community members. There is also uncertainty about how to implement the CHW model to achieve better patient outcomes, higher quality of care, and lower health care costs. The Sinai Urban Health Institute in Chicago, IL embarked on a two-year project to create the Community Health Worker Best Practice Guidelines with the aim of addressing the gaps in knowledge about how to effectively implement the CHW model.

Home Visit Program Models

Washington State Department of Health: Three-Visit Model
Washington State Department of Health, 2011. This tool kit was created to inform organizations who may be interested in starting or redesigning an asthma home visit program about the three-visit model and Washington's experiences using it.

Best Practices for Implementing and Evaluating Community Health Worker Programs in Health Care Settings
Sinai Urban Health Institute in Chicago, IL, 2014.
There is a growing movement among health care organizations to adopt the CHW model into their system as a way to provide comprehensive care to patients and community members. At the same time there is uncertainty about how to implement the CHW model to achieve better patient outcomes, higher quality of care, and lower health care costs. With generous funding from the Lloyd A. Fry Foundation, the Sinai Urban Health Institute in Chicago, IL embarked on a two-year project (2011-2013) to create the Community Health Worker Best Practice Guidelines with the aim of addressing the gaps in knowledge about how to effectively implement the CHW model.

More Resources

NCHH Building Systems to Sustain Home-Based Asthma Services

Strengthen your program's efforts to build the systems, infrastructure, and financing needed to put home-based asthma services in place in your area using this eLearning platform. Explore the following modules to learn more:

NCHH's resources for developing a home visit workforce include information on certifications, standards and reimbursement, and access to training, including the National Healthy Homes Newtwork and Training Center.

Podcasts: Podcast Spotlight: Listen to Dr. Tryra Bryant-Stephens, Children's Hospital of Philadelphia, discuss The Role of the Community Health Worker in Asthma Control.
This podcast spotlights how CHWS CHWs have been prepared and managed to improve pediatric asthma control across the community.

Episode 3: Community Health Workers
Patricia Peretz, Wilvia Bito,and Yamilca Alardo. Washington Heights-Inwood Network for Asthma (WIN for Asthma)
This podcast highlights the vital role of a CHW in serving populations with the largest disparities in asthma outcomes. A mother, an asthma program manager and a CHW describe the most important gaps that are bridged between home and clinic settings when a CHW is involved.

Episode 11: Working Toward Reimbursement: Building a Network of Community Health Workers
Kevin Kennedy, Managing Director and Environmental Hygienist, Center for Environmental Health, Children's Mercy Hospital & Clinics
Learn how Children's Mercy is establishing a network of CHWs across Kansas and Missouri to provide programs with easy access to certified CHWs and deliver improved, cost-effective asthma care. Learn about Mr. Kennedy's process for obtaining buy-in from Medicaid, and the important role this Network will play when a reimbursement model is established in Kansas and Missouri.

Collaborating to Control Asthma in Chicago's Public Housing Using Community Health Workers Webinar
Melissa Gutierrez Kapheim, Sinai Urban Health Institute and Andy Teitelman, Chicago Housing Authority
Helping Children Breathe and Thrive in Chicago Public Housing (HCBT) was an innovative pilot program between Sinai Urban Health Institute and the Chicago Housing Authority in six Chicago public housing developments. Recruited from the housing properties, CHWs help families of children and adults with asthma by addressing environmental triggers in the home, connecting them with health and social services, and teaching them asthma self-management skills. Learn tips on how to collaborating with a public housing authority and lessons from implementing this program.

The Role of the Community Health Worker in Asthma Management Webinar
Nancy Sutton, Asthma Control Program, Rhode Island Department of Health Jean Zotter, Asthma Control Program, Massachusetts Department of Public Health
Listen as speakers present five readiness steps for CHW reimbursement, including: 1) promoting a common definition of CHWs; 2) integrating standardized asthma education training into CHW training; 3) securing partnerships and developing collaborations across an integrated care system; 4) ensuring workforce standards for CHW services; and 5) developing cost-benefits models to evaluate the financial impact of CHWs on healthcare systems and policies.

Highlighted Best Practices and Insights from Community Health Worker (CHW) Literature Review
Maine CDC, Department of Health and Human Services, Division of Population Health, John Snow, Inc
This literature review highlights approaches used among CHW interventions that demonstrated effectiveness in terms of improving service quality, cost-savings, and/or improving health and quality of life outcomes. As CHW interventions are gaining greater recognition as a promising element of healthcare reform, the research summarized is hoped to shine a light on promising practices for implementation in the state of Maine. Given limited research, important elements for replication and the range of outcomes that may be expected are only starting to emerge. Some mixed findings exist that further research by the larger field of researchers may eventually help to illuminate. For example, the central importance of home visiting and other face-to-face interactions was emphasized in the ICER 2013 Report, specifically that 75% of successful CHW models they reviewed along with their expert review team came to consensus on the importance of home visiting. However this is not found consistently to be imperative across subsequent studies for all conditions. With such caveats in mind, the literature does point to models that can be drawn upon that may be relevant for advancing the Maine Community Health Worker Initiative and the pilot CHW programs the Initiative supports.

Building systems to sustain home-based asthma services

Build your dream team by learning to identify the staff needed to deliver home-based asthma services. Visit Building Systems to Sustain Home-Based Asthma Services—Assembling a Qualified Workforce.

 Click here to view Module 5 Excerpt: Intensity of Home-Based Asthma Services.