Sixth National Conference on Quality Health Care for Culturally Diverse Populations: Preconference Sessions Effective Management of Community Health Workers and Promotores de Salud

Preconference A-5 Effective management of community health workers and promotores de salud

Effective Management of Community Health Workers and Promotores de Salud
Sunday, September 21, 2008: 9:00 AM-12:00 PM, Minn Marriott, 8th Floor - Spring Park Bay
Community Health Workers, commonly known by many job titles (notably Promotor(a) de Salud), are a growing force in public health and health care services to minority communities, yet many organizations know little about how to manage them most effectively.   Numerous organizations including the IOM, the AMA and APHA have endorsed a greater role for CHWs in reducing disparities and improving access for underserved communities.

Several States have moved to standardize the occupation; a proposal is before the Labor Department to create a job classification for CHWs; a provider code has been created for CHWs by the National Uniform Claims Committee; a recent HRSA workforce study estimates the CHW workforce at over 120,000 in 2005.  The State of Minnesota recently received CMS approval for broad-based Medicaid reimbursement of providers for CHWs’ services.

Yet most CHWs are employed in small, short-term, grant-funded projects which do not capitalize on their full potential.  Training is mostly idiosyncratic to the employer and focused on narrow project objectives.  While there are many experienced and successful supervisors of CHWs around the country, many others are unprepared when they take on these responsibilities.

Successful management and supervision of CHWs requires an understanding of the range of their capabilities; the essential attributes of a good candidate for hiring; successful recruitment and selection strategies; generic skill requirements and training resources; the needs of CHWs around stress, boundaries and ethical challenges; methods for quality assurance in CHW practice; and appropriate recognition and career advancement strategies.  Skill development, for example, should include cultural competence, even though CHWs are generally hired for their personal experience of the culture of the community served: today’s communities are ALL becoming more diverse, and few CHWs work exclusively with people of the same cultural background.

This workshop will survey these topics and invite participants to create their own plans for more successful integration of CHWs into their organizations.  We will also review emerging national guidelines for CHW education and capacity-building, and expanded roles for CHWs in research and evaluation.  The difficult topic of CHWs as language interpreters will also be addressed: without adequate preparation for the interpreter role, CHWs may find themselves out of their vocabulary “comfort zone,” and may also experience role conflicts.

Brief versions of this workshop have been presented to audiences of health educators, nurses and health care administrators, and the presenter has worked with local, state and national organizations on effective strategies for employment of CHWs.

  • Effective Management synopsis.doc (32.5 kB)
  • Presentation Information:

    Program: Preconference Sessions
    Primary Category: Organizational Cultural Competence
    Subtopics: Clinical interactions, Mental health services, Social services, Patient education, Community health education, Health literacy, Health professions school programs, Training trainers, Ancillary staff programs, Implementing the CLAS standards or other cultural competence frameworks, Implementing disparity reduction programs, Organizational plans, policies, management strategies, Workforce diversity, Quality improvement, Partnerships with community organizations, Organizational internal policies, Standards (performance, organizational), chronic illness, oral health, Disparity reduction, Access in underserved communities, eg, rural, urban, Disease specific focus, Racism, sexism, discrimination, Emergency preparedness

    Region Addressed by Presentation: National
    Organization: Health Care System
    Population/Demographic: All
    Keywords: community health worker, promotora, outreach, interdisciplinary care team

    Carl H. Rush, MRP , Community Resources LLC, San Antonio, TX
      Community Resources LLC
      PO Box 5533
      San Antonio TX, USA 78201

      Phone: 210-745-0560
      Fax: 866-906-3850
      Email Address:

      Biographical Sketch:
      Carl Rush is a consultant who has specialized in the CHW field for 11 years. His clients include: National Council on Aging, American Dental Association, University of Michigan, California Endowment, Community First Health Plans, and the new USDHHS initiative on serving the Hispanic elderly. He was also recently a lead author on HRSA’s CHW National Workforce Study, and convened a conference to draft a national CHW research agenda. He recently directed the New Jersey CHW Institute, and was coordinator of the CHW program at Northwest Vista College in San Antonio, where he also delivered cultural competence training to healthcare executives. He is Secretary of the CHW Interest Group of APHA, and serves on the Policy Committee of the American Association of CHWs. Carl was a founding member (and current Co-Chair) of the San Antonio Health Literacy Initiative. He holds a Master of Regional Planning degree from Cornell University.