Proposed Community Health Worker Legislation Extends the Power of Primary Care
Primary care physicians (PCPs) play a critical role in managing and coordinating patient care, but their impact can be limited within the confines of the traditional PCP-patient relationship, typically within the four walls of a clinic. This is where community health workers (CHWs) step in, bridging the gap between patients and healthcare services, particularly for high-risk and high-need individuals.
CHWs are a vital yet often unrecognized and underappreciated extension of primary care, supporting vulnerable populations where health literacy and access to healthcare are historically low. CHWs’ impact goes far beyond the walls of the clinic, reaching into the lives and environments of patients to provide essential support and care. They are uniquely positioned to address the social determinants of health (SDOH) that significantly impact health outcomes. They can provide hands-on support, working directly with patients to navigate complex healthcare systems, access essential services, and improve health behaviors. By actively engaging with patients in their communities, CHWs can identify and address barriers to care that may otherwise go unnoticed, such as lack of transportation, language barriers, or financial constraints.
Elation’s Support of the Community Health Workers Access Act
That’s why Elation, along with hundreds of other organizations, are in support of proposed legislation that provides sustained funding to community health workers (CHWs), the CHW Access Act (CHWAA): S.3892.
According to the organizers, the National Association of Community Health Workers and Partners In Health, the CHWAA would improve reimbursement for CHWs, Promotoras, and Community Health Representatives (CHRs) in Medicare and Medicaid while expanding access to community-based services for enrollees in these major health programs. The bill would provide reimbursement and access without copays for two new categories of CHW services in Medicare: 1) services to prevent illness, reduce physical or mental disability, and restore an individual to the best possible functional level; and 2) services to address social needs through education and referrals to health care and community-based organizations. Finally, the bill would support the work in several state Medicaid programs to expand access to CHW services by issuing guidance from the Centers for Medicare and Medicaid Services (CMS) and providing an enhanced Federal Medical Assistance Percentage (FMAP) for CHW services.
Read our sign-on letter of the CHWA Act here.
The Important Role of CHWs
As an advocate for amplifying the power of primary care, Elation believes CHWs are a complementary and critical extension of primary care physicians, and their ability to affect change at the community level. By sharing information and insights gained from their interactions with patients, CHWs can help PCPs develop more holistic and patient-centered care plans, delivering a collaborative approach that ensures that the unique needs and circumstances of each patient are considered, leading to more effective and personalized care.
Join us is ensuring that CHWs are compensated and supported appropriate to the value they provide in the healthcare system, particularly in addressing the needs of vulnerable populations.
Go to the CHWAA site to find social posts to amplify the importance of this legislation and write your legislators with the help of this resource to make your voice heard. We join our colleagues in urging members of Congress to co-sponsor the CHWAA legislation and ask Congressional leaders to ensure its passage.
Sara J. Pastoor, MD, MHA is Elation's Head of Primary Care Advancement and leader in primary care advocacy. Dr. Pastoor is a board certified and clinically active family medicine physician. Her experience as a primary care innovator spans a career in military medicine, academic medicine, private practice, and employer-sponsored delivery models. She received her MD from Rosalind Franklin University of Health Sciences and MHA from Trinity University.
