Who are CHWs?

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    Community Health Workers are… 

    Community Health Workers are professionals who are front-line public health workers and trusted members of the community they serve. They have a deep understanding of the community within rural and urban environments. They possess cultural humility skills and have received standardized job-related training. They have expertise in health and social services and build relationships with those they serve, which creates a strong partnership where information, referrals, coaching, and skill-building can be shared to increase individual and community capacity. 

    CHWs serve as a service extender and a bridge to clinics, hospitals, and social agencies to provide and navigate culturally appropriate health services.   Some of these services include informal counseling, social support, health screenings, and care coordination. CHWs increase self-sufficiency, well-being, and positive health outcomes by focusing on social determinants of health as well as outreach, engagement, and working with the community, community education, supportive guidance, self-management, coaching, and the provision of social support and advocacy. They work to reduce social and racial disparities in health care and improve health outcomes and the quality of care and quality of life. 

    While you can find definitions of CHWs from the American Public Health Association and other organizations, the definition above was created by our Advisory Board in 2022. At MACHW, we know our work needs to center Community Health Workers and their voices. 

    Slightly abbreviated version: 

    Community Health Workers (CHWs) are trusted members of the community who serve as front line public health workers. They possess lived experience and a deep understanding of the community, allowing them to navigate social services, healthcare systems, and community resources. CHWs build strong partnerships with patients and their communities, providing information, referrals, coaching, and skill-building to increase community capacity. 

    CHWs connect [patients/clients/communities?] to clinics, hospitals, and social agencies, to deliver culturally appropriate health services. Their services include informal counseling, social support, health screenings, and care coordination. By focusing on social determinants of health, engaging with the community, providing education and guidance, and promoting self-management and advocacy, CHWs improve self-sufficiency, well-being, and positive health outcomes while reducing disparities in healthcare. 

    While there are various definitions of CHWs, the above definition was created by our Advisory Board in 2022. At MACHW, we prioritize centering CHWs and their voices in our work. 

    The Umbrella of CHW Work 

    In Massachusetts, as in the rest of the country, CHWs go by many different titles! Some examples include:  

    • Outreach Worker 
    • Outreach Educator 
    • Health Educator 
    • Community Health Educator 
    • Patient Navigator 
    • Enrollment Worker 
    • Family Advocate 
    • Peer Advocate 
    • Peer Leader 
    • Promotor or Promotora de Salud 
    • Family Support Worker 
    • Public Health Advocate 

    Just because your official job title isn’t “Community Health Worker,” doesn’t mean you aren’t one! Refer to the definition here. 

    Core Competencies 

    MACHW works closely with the Department of Public Health (DPH) to maintain and evolve standards of practice, including core competencies. You can see the current core competencies on DPH’s website. These core competencies are foundational to CHW practice. 

    MACHW is advocating adding Behavioral Health as a core competency since providing mental health support to clients and families is central to CHW practice. We are hopeful this will become the eleventh core competency by 2024. 

    Code of Ethics 

    The Code of Ethics (“Code”) shall serve as a guide to Community Health Workers (“CHWs”) for day-to-day decision-making while practicing public health workers. Its purpose is to clarify the mission, values, and principles of the profession and to link these to specific standards of professional conduct. This Code shall complement, rather than replace, other employer policies.  

    Adherence to the Code is expected for:  

    1. The admission and continues membership in the Massachusetts Association of Community Health Workers (“MACHW”) 
    2. The maintenance of Certification from the MA Board of Certification of CHWs at the MA Department of Public Health.  

    Code of Ethics:

    Client Advocacy. I will:

    1. advocate for and support all clients, so that their rights and safety are protected and maintained;
    2. respect my clients’ values and beliefs;
    3. incorporate my clients’ values and beliefs into the care I provide; and 
    4. strive to gain and maintain the trust of my clients.  

    Scope of Care. I will:

    1. be truthful to my clients and employer about my skills, qualifications, and certifications, including any limitations on the services I can provide;  
    2. refer clients to other qualified professionals for services I cannot provide.

    Confidentiality. I will:

    1. respect and maintain the confidentiality of all clients, including information shared verbally, as well as information in client’s records; and
    2. follow all local, state, federal, and employer regulations regarding confidentiality.  

    Professionalism. I will:

    1. maintain professional boundaries at all times;  
    2. not participate in any illegal activity;
    3. not engage in any sexual or romantic relationship with a client or a client’s relative;
    4. not accept money, gifts*, or any compensation from a client for services performed; and
    5. not accept compensation for client referrals.

    *you may accept homemade gifts, as they are expressions of gratitude in many cultures.  

    Expanding Knowledge and Education. I will:

    1. actively network with other professionals and organizations, to best match my client’s preferences and needs to health and social services in their region/city/town/neighborhood; and
    2. strive to expand my professional knowledge base and competencies through education and participation in professional development programs.

    Care of Everyone. I will:

    1. respect the rights, dignity, and worth of all people; and
    2. never deny services to someone due to that person’s race, religion, nationality, culture, gender, physical characteristics, age, sexual orientation, or gender identity.

    Committing to Community Health Work. I will:

    1. be loyal to and advocate for CHWs and the work they do at the local, state, national, and international levels.

    Medical Interpretation. I will:

    1. be honest with my employer and clients about my skills to provide medical interpretation and only interpret two-way conversations between a client and a provider if I am trained as a medical interpreter.* 

      *Medical interpretation is defined as converting information from one language to another verbally-between a non-English speaking patient and a health care provider.

      Wellness and Safety. I will:

          1. be honest with myself and my employer when a client requires care that is too emotionally difficult for me; and,  
          2. strive to maintain a safe environment for myself, my colleagues, and those I serve.

          Employer’s Policies. I will:

          1. support my employer and all of my employer’s policies and regulations. If a conflict arises between my employer and this Code of Ethics, I will appropriately raise my concerns with my employer.

            MACHW (2018), unauthorized reproduction, dissemination, or re-use, in whole, or in part, is prohibited.  

            Demographics 

            As of 2021:  

            86% of CHWs are in full time, paid employment 

            16% are certified 

            45% have worked in the field for 3-10 years 

            79% identify as female 

            50% identify as Black, Indigenous, and/or People of Color 

            At least 46% speak another language fluently 

            Source: https://www.frontiersin.org/articles/10.3389/fpubh.2022.1043668/full