Community Health Workers-- A Local Solution to a Global Problem By Sara Selig | 11 Sep, 2013

Hi All,

I thought people might be interested in this recent article in the New England Journal of Medicine if you didn't see it:




Sonya Shin Replied at 8:17 PM, 25 Sep 2013

Need your help! The policy decision below would advance the position of CHWs as formally-recognized health care workers!

National campaign to ask the US Department of Labor to adopt the APHA definition of community health workers (CHWs)

Dear community health worker or community health worker supporter,

The American Public Health Association (APHA) Community Health Worker Section needs your help very briefly! We are launching a national campaign to ask the US Department of Labor to adopt the APHA definition of community health workers (CHWs) that was created by CHWs and their supporters from all over the country.

This is very important for several reasons:
1. The definition currently being used for the Standard Occupational Classification code excludes some CHWs who work outside of health care agencies. This results in an undercount of the workforce, which has implications for funding and recognition of the valuable work CHWs do.
2. This is our only chance for the next 10 years to change the definition. Standard Occupational Codes can be changed only once every decade. If we do not act now, the US Department of Labor will continue to use a definition that does not fit many CHWs.

What you can do to help:
1. Write a quick letter, using the attached template. You can write on behalf of your agency, your CHW association, or simply as an individual. Feel free to adapt the letter as you see fit! It should not take long.
2. Submit your letter to by September 30th and let us know you sent it!

Below is a letter template. Please pass along the letter and text below (or feel free to personalize/modify as you see fit). Thanks!


APHA CHW Section Policy Chair

Ashley Wennerstrom, PhD, MPH
Instructor of Clinical Medicine
Director, Louisiana Community Health Worker Training Institute
Tulane University School of Medicine
1555 Poydras St., Suite 853
New Orleans, LA 70112
Phone: 504-988-4007
Fax: 504-988-8252

(A separate copy of the Campaign letter can also be found in the APHA CHW Section library- see link to left)


Your Address Info
12409238409 Street
City, State ZIP
September 10, 2013

Edward Salsberg, MPA
Director, National Center for Health Workforce Analysis
Department of Health and Human Services
Health Resources and Services Administration
Bureau of Health Professions
Via email to:

Dear Mr. Salsberg:

I am writing on behalf of the Your Organization Here to request that the Department of Labor Bureau of Labor Statistics (BLS) adopt the nationally recognized APHA definition to describe the unique Standard Occupational Classification (SOC) #21- 1094: Community Health Workers (CHWs) when revisions are considered this year.

There are currently various CHW definitions in use by the federal government, which leads to confusion. This has been considered by CHWs and stakeholders through the APHA Community Health Worker Section for many years and led to the creation of the nationally developed and endorsed APHA definition. It is particularly important in this era of health reform as awareness is growing for the contributions CHWs provide to help achieve the "triple aim," and as states consider ways of financing non-medical preventive services, that the official SOC definition provide a CHW definition that is inclusive of the full CHW scope of practice to help inform public policy and emerging innovations. The APHA CHW definition is:

Community Health Workers (CHWs) are frontline public health workers who are trusted members of and/or have an unusually close understanding of the community they serve. This trusting relationship enables CHWs to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery. CHWs also build individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support and advocacy.

Insert language about your agency endorsing this definition, if applicable; also, language related to why your group/agency endorses this and its impact, if applicable.

My agency/organization has attached information related to CHWs in my state/area, if applicable; describe briefly, if applicable.

Background information on your agency/group, including mission-related information, key focus areas, connection to CHWs, impact on CHWs in your state/area, connection to APHA CHW Section, if applicable.

There is currently a national trend among state and local CHW associations toward embracing the APHA definition, including in my state/agency, if applicable. It is important to note that the BLS CHW definition currently in use is weighted toward CHWs who function within health care systems. Unfortunately, it excludes a large portion of the field that works in other areas including violence prevention, environmental justice, food security, employment, education, housing, and general community-based services. The APHA definition, in contrast, includes these sectors. This is particularly important in light of developing efforts to establish stable financing for the field, including developing policy changes within Medicaid such as the recent CMS announcement allowing Medicaid payment for preventive services provided by non-clinicians such as CHWs. Insert health and human services sectors that CHWs in your state/area work in, if applicable.

We strongly encourage you and your colleagues to adopt the nationally recognized APHA definition of CHW as the official definition attached to the CHW SOC (21-1094). .