Publications / Understanding California’s Community Health Worker/Promotor Workforce: A Deep Dive into CHW/P Employer Perspectives

Understanding California’s Community Health Worker/Promotor Workforce: A Deep Dive into CHW/P Employer Perspectives

As the community health worker/promoter (CHW/P) profession continues to grow and develop in California, it is important to understand employer perspectives on the role. Doing so provides context for industry needs and for supply and demand.

Based on 29 interviews with 31 people across 27 unique employers of CHW/Ps in California, this report describes employers’ perspectives on many facets of the profession, including training, primary roles and skills, billing, recruitment and retention, and future directions. Some of the key findings included these:

  • Job requirements were not consistent across employers, and most employers did not require CHW/P-specific training before hiring.
  • There were mixed opinions about whether CHW/Ps should be certified. Some believed that certification could help define an already ill-defined role. Others believed that it could create barriers (e.g., financial and time constraints) to entering or remaining in the profession.
  • Several employers aligned CHW/Ps’ core skills and competencies with the CHW Core Consensus (C3) Project, a national CHW-led effort to define CHW roles and skills.
    Some interviewees commented on the potential benefits to bill for CHW/P services through California’s State Plain Amendment and CalAIM (California Advancing and Innovating Medi-Cal). These benefits included improving access to preventive care, showing return on investment for the profession, and creating more demand for the role. Other interviewees acknowledged potential downsides, including the potential to overmedicalize the profession and to exclude CHW/Ps who do not work in health care settings.
  • Interviewees expected the number of CHW/Ps to grow and hoped to see more clearly defined career ladders and more respect for the profession.

These employer interviews yielded a rich set of data from the employer community. They identified what is working well with CHW/P employment and identified issues for further discussion and policy development.

This report is part of a series that aims to paint a more complete picture of the CHW/P workforce in California, as well as challenges and opportunities related to training and employment. Explore the full series. 

About the Authors

Jacqueline Miller, BA, is a senior research data analyst with the Philip R. Lee Institute for Health Policy Studies (IHPS) at UCSF and is affiliated with Healthforce Center at UCSF. IHPS is an interdisciplinary collection of concerned researchers who share a mission — to improve health and transform health care in the United States by working across competing interests, collecting evidence, informing policy, and improving practice.

Susan Chapman, RN, PhD, MPH, is a professor of social behavioral sciences in the School of Nursing at UCSF and is a faculty affiliate of IHPS and Healthforce Center at UCSF.

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