title: Do State Community Health Worker Laws Align with Best Available Evidence?
abstract: Community health workers (CHWs) are expected to improve patient care and population health while reducing health care costs. Law is a tool states are using to build a supportive infrastructure for the CHW workforce. This study assessed the extent existing state law pertaining to the CHW workforce aligned with best available evidence. We used the previously developed Quality and Impact of Component (QuIC) Evidence Assessment method to identify and prioritize those components that could comprise an evidence-informed CHW policy at the state level. We next assessed the extent codified statutes and regulations in effect as of December 31, 2014 for the 50 states and D.C. included the components identified in the evidence assessment. Fourteen components of an evidence-informed CHW policy were identified; eight had best, three had promising, and three had emerging evidence bases. Codified law in 18 states (35.3 % of 51) pertained to the CHW workforce. Fifteen of these 18 states authorized at least one of the 14 components from the evidence assessment (maximum: nine components, median: 2.5). The most frequently authorized component was a defined scope of practice for CHWs (authorized by eight states) followed by a standard core competency curriculum and inclusion of CHWs in multidisciplinary health care teams (each authorized by six states). States could consider the components presented in this article when developing new or strengthening existing law.
authors.affiliation: Centers for Disease Control and Prevention, 4770 Buford Highway, Northeast Mail Stop F-75, Atlanta, GA, 30341, USA. vrm5@cdc.gov.
authors.forename: Colleen
authors.initials: C
authors.lastname: Barbero
authors.affiliation: IHRC, Inc., 2 Ravina Drive Suite 1750, Atlanta, GA, 30346, USA.
authors.forename: Siobhan
authors.initials: S
authors.lastname: Gilchrist
authors.affiliation: University of Illinois at Chicago, 453 Westside Research Office Building, 1747 West Roosevelt Road, Chicago, IL, 60608, USA.
authors.forename: Jamie F
authors.initials: JF
authors.lastname: Chriqui
authors.affiliation: University of Illinois at Chicago, 453 Westside Research Office Building, 1747 West Roosevelt Road, Chicago, IL, 60608, USA.
authors.forename: Molly A
authors.initials: MA
authors.lastname: Martin
authors.affiliation: School of Medicine, Department of Internal Medicine, Tulane University, 1430 Tulane Avenue, SL-16, New Orleans, LA, 70112, USA.
authors.forename: Ashley
authors.initials: A
authors.lastname: Wennerstrom
authors.affiliation: Centers for Disease Control and Prevention, 4770 Buford Highway, Northeast Mail Stop F-75, Atlanta, GA, 30341, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: VanderVeur
authors.affiliation: Brown School of Social Work, Washington University in St. Louis, 700 Rosedale Ave CB 1009, St. Louis, MO, 63112, USA.
authors.forename: Kim
authors.initials: K
authors.lastname: Prewitt
authors.affiliation: Centers for Disease Control and Prevention, 4770 Buford Highway, Northeast Mail Stop F-75, Atlanta, GA, 30341, USA.
authors.forename: J Nell
authors.initials: JN
authors.lastname: Brownstein
mesh_terms: D002983:Clinical Competence; D003150:Community Health Workers; D016208:Databases, Factual; D019317:Evidence-Based Medicine; D006291:Health Policy; D006801:Humans; D014481:United States
keywords: Community health worker; Evidence-informed policy; Health law; Health policy