Building a consensus on community health workers' scope of practice: lessons from New York

Abstract

Objectives: We evaluated efforts in New York to build a consensus between community health workers (CHWs) and employers on CHWs' scope of practice, training standards, and certification procedures.

Methods: We conducted multiple-choice surveys in 2008 and 2010 with 226 CHWs and 44 employers. We compared CHWs' and employers' recommendations regarding 28 scope of practice elements. The participatory ranking method was used to identify consensus scope of practice recommendations.

Results: There was consensus on 5 scope of practice elements: outreach and community organizing, case management and care coordination, home visits, health education and coaching, and system navigation. For each element, 3 to 4 essential skills were identified, giving a total of 27 skills. These included all skills recommended in national CHW studies, along with 3 unique to New York: computer skills, participatory research methods, and time management.

Conclusions: CHWs and employers in New York were in consensus on CHWs' scope of practice on virtually all of the detailed core competency skills. The CHW scope of practice recommendations of these groups can help other states refine their scope of practice elements.

FIGURE 1—

Rankings of community health workers (CHWs) and employers of the most important contributions of CHWs: New York, 2008–2010. Note. An asterisk indicates that an item was included in both the 2008 and 2010 surveys (CHWs, n = 221; employers, n = 40). Other items were included in 2010 only (CHWs, n = 119; employers, n = 21).