Do State Community Health Worker Laws Align with Best Available Evidence?

• Published in: Journal of community health Vol. 41; no. 2; pp. 315 - 325
• Main Authors: Barbero, Colleen, Gilchrist, Siobhan, Chriqui, Jamie F., Martin, Molly A., Wennerstrom, Ashley, Veur, Jennifer Vander, Prewitt, Kim, Brownstein, J. Nell
• Format: Journal Article
• Language: English
• Published: New York Springer Science + Business Media 01-04-2016; Springer US; Springer Nature B.V
• Subjects: Academic Achievement; Agenda Setting; Child Health; Clinical Competence; Community and Environmental Psychology; Community health care; Community Health Workers; Community Relations; Databases, Factual; Ethics; Evidence; Evidence-Based Medicine; Health care; Health Care Costs; Health care policy; Health Personnel; Health Policy; Health Promotion; Health Promotion and Disease Prevention; Health Services; Humans; Internal Medicine; Labor Force; Medical personnel; Medicine; Medicine & Public Health; ORIGINAL PAPER; Outreach Programs; Patient Education; Public Health; Social Services; United States; Community health worker; Health law; Health policy; Evidence-informed policy
• ISSN: 0094-5145; 1573-3610
• DOI: 10.1007/s10900-015-0098-x

Community health workers (CHWs) are expected to improve patient care and population health while reducing health care costs. Law is a tool states are using to build a supportive infrastructure for the CHW workforce. This study assessed the extent existing state law pertaining to the CHW workforce aligned with best available evidence. We used the previously developed Quality and Impact of Component (QuIC) Evidence Assessment method to identify and prioritize those components that could comprise an evidence-informed CHW policy at the state level. We next assessed the extent codified statutes and regulations in effect as of December 31, 2014 for the 50 states and D.C. included the components identified in the evidence assessment. Fourteen components of an evidence-informed CHW policy were identified; eight had best, three had promising, and three had emerging evidence bases. Codified law in 18 states (35.3 % of 51) pertained to the CHW workforce. Fifteen of these 18 states authorized at least one of the 14 components from the evidence assessment (maximum: nine components, median: 2.5). The most frequently authorized component was a defined scope of practice for CHWs (authorized by eight states) followed by a standard core competency curriculum and inclusion of CHWs in multidisciplinary health care teams (each authorized by six states). States could consider the components presented in this article when developing new or strengthening existing law.