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Having looked at the range of CHW activities and models of care, we will now discuss the kinds of organizations that employ CHWs.
Few CHWs are actually employed directly by state governments, although this situation may change. At present, CHWs are more often employed by programs supported by the state. A number of states have prominent programs, generally funded under Medicaid waivers, in which CHWs assist in education and care coordination in maternal and child health. In New York, this program is actually called the Community Health Worker Program. The widely respected “Kentucky Homeplace” program offers CHW services in rural Appalachia to improve access to care. The program has received significant state appropriations for a number of years. Other state-funded CHW programs operate in fields such as reproductive health and immunizations.
A range of health care organizations employ CHWs, including community health centers, hospitals, managed care organizations, community-based organizations, and specialty vendors that deal with Medicaid enrollment and chronic disease management.
