MCPs and their partners often experience challenges related to defining CHW/P roles and recruiting CHW/Ps. Some of these challenges are described below, along with potential considerations for how organizations can navigate these barriers. For additional detail, access “Common Challenges and Ingredients for Success” (PDF) in the “Establishing Roles and Recruiting CHW/Ps” section of the Resource Guide.

• Creating flexibility within a structured framework. When defining CHW/P roles, employers will need to balance more prescribed responsibilities with creating the flexibility for CHW/Ps to do what they know best — developing trust with members based on shared life experience. Narrowly defining their roles and activities to focus on more clinical tasks “dilutes the very strength for which they were hired.”
• Considering human resources and policy constraints. Employers must balance developing job qualifications that do not create barriers for talented potential CHW/Ps with internal human resource requirements. Certain minimum qualifications related to employment history or language, technical, or other skills may restrict people from applying who would bring valuable skills in connecting with members and the community. As MCPs prioritize hiring CHW/Ps with lived experience, human resource staff need to recognize that many Medi-Cal members and their communities are impacted by mass incarceration, and a criminal record should not be a barrier to employment. One solution some health care entities have used is to contract with CBOs for CHW/P programs to avoid the constraints of large health care systems. MCPs will need to champion policy changes and provide guidance to decrease hiring barriers.
• Integrating a new role into interdisciplinary teams. It can be challenging to incorporate a new team member role into an existing interdisciplinary team with predefined roles and responsibilities. The task of reexamining and redistributing job duties can be arduous and sometimes contentious given “turf issues” related to interdisciplinary team roles. MCPs should engage all program partners, including CHW/Ps, to carefully define program requirements and team composition and roles to best address the needs of prioritized populations.

I feel as though CHWs do not get the credit that we deserve. We talk to doctors and nurses and connect to the plans and housing authorities all day, all while also communicating with our patients. The medical field may not realize how much we do to assist individuals.

^{—California CHW/P}