Funder: California Health Care Foundation

Author: Jim Lloyd, JD, MPP, Rachel Davis, MPA, and Kathy Moses, MPH, Center for Health Care Strategies

January 2020 | Brief


As health care stakeholders across the nation seek to improve patient outcomes in cost-effective ways, much attention has turned toward the time that patients spend outside of the health care setting and the role that individuals with lived experience can potentially play to support their needs. Community-based organizations, health care systems, and payers are increasingly supporting staff whose most powerful credentials are their own personal knowledge and experiences. These workers have a variety of titles — community health worker, promotora, health navigator, health coach, and community outreach worker, among others — but the common threads that link them are their close ties to the communities where they both live and work, and the experiences that they share with the people they serve. By leveraging their personal experiences and ties to their communities, this workforce is recognized for its unique ability to forge trusting relationships — making them invaluable for engaging a wide range of populations and building critical connections between health care systems and communities.

This brief, made possible through support from the California Health Care Foundation, explores how this workforce — referred to in this brief as “community health workers and promotores” (CHW/Ps) — is currently contributing to the health care system both in California and around the country. It highlights examples demonstrating how CHW/Ps add value to organizations and how their work is financed, as well as emerging opportunities to scale and sustain that work within California. Although the profiles within the brief are of California sites, the insights are applicable to any state seeking to strengthen its health care workforce.