Center for Health Equity


Strengthening Community Health Worker workforce in Greater Houston  

Published: April 25, 2024

Strengthening Community Health Worker workforce in Greater Houston  

By Wes Gibson

In partnership with the City of Houston Health Department, the Health Equity Collective launched an initiative to strengthen the region’s Community Health Worker (CHW) workforce in 2022. The Health Equity Collective (the Collective) is a systems coalition of over 200 healthcare and community organizations in the Greater Houston region with a singular mission of improving capacity for care coordination for social drivers of health. UTHealth Houston Center for Health Equity (CHE) serves as the backbone organization for the Collective led by Heidi Hagen McPherson, MPH, senior project manager, and Shreela Sharma, PhD, RDN, LD, Center for Health Equity (CHE) director. Additional CHE team members who compose the backbone organization supporting CHW efforts include: Rosalia Guerrero, MBA, CHWI, senior project manager; Maggie Green, MPA, program manager; and Sisan Tennyson, MPH, research coordinator II.  

In fall 2022, the project kicked off with a comprehensive landscape scan of regional organizations hiring and training CHWs. The Collective also facilitated interviews with stakeholders across the state on barriers and facilitators to strengthening the CHW workforce. These data yielded actionable recommendations, including the need for implementing and institutionalizing career development pathways, training, job security, and support for CHWs.  
In spring 2023, the Collective engaged the CHW Network in efforts to strengthen the regional CHW workforce with some of the member organizations taking contracted responsibility for specific aspects of the work and others following the work and collaboratively providing input. The CHW Network is currently comprised of 43 regional organizations who hire and train CHWs to meet monthly sharing updates on their work, resources, and events, along with learning from regional and national experts, discussing advocacy opportunities, and findings from the process of collaborating to strengthen the CHW Workforce.  
In partnership with AlphaChimp LLC, the Collective also conducted a journey-mapping exercise with CHWs that informed the development of a set of comprehensive systems maps—a strategic guide for organizations seeking to strengthen the CHW workforce. The CHW Journey Map and CHW Workforce System Map are freely available for use in print and the CHW Workforce System Map is also available in animated video form. These tools are a visual representation of the barriers that CHWs experience in their own career growth, and actionable solutions needed to successfully support CHW workforce sustainability, including job description clarity, workforce development opportunities, and policies in support of funding and reimbursement for CHW services. These recommendations provide clear steps that employers of CHWs can take to contribute to a stronger CHW workforce within their organizations and across the region.  These tools are intended for use across the CHW Workforce to support policy, practice, and systems changes that contribute to CHW workforce development.  
In response to these recommendations, the Collective has established an CHW Employer Early Adopter Learning Cohort within the CHW Network: a group of organizations who are working towards implementing and institutionalizing various organizational approaches to improve CHW job security, clarifying CHW roles and career opportunities with an ultimate goal of building community-centered care, quality improvement, and accountability. Organizations in this cohort include Harris Health System, Memorial Hermann Health System, The African American Health Coalition, Equity Bridge, Network of Behavioral Health Providers, Community Health Choice, Cigna, Harris County Public Health, and Houston Recovery Center.   
Additionally, the Collective launched a Resource Hub to support the CHW Network and CHW Employer Early Adopters Learning Cohort in early 2024. This dynamic communication platform serves as a centralized repository disseminating crucial information, upcoming events, valuable resources, comprehensive trainings, and exemplary best practices both regionally and nationally. It serves as a centralized repository, ensuring access to resources for CHWs, organizations, researchers, and stakeholders alike.  
In 2023, the HEC collaborated with TX RPC in developing a bill tracker to actively track bills relevant to CHWs in real-time and their progression through the 88th Texas legislative session. The 88th legislative session saw the approval of two seminal bills HB 1575 and HB 113 which created a pathway for CHW SDOH care coordination services to be reimbursable by Medicaid through Medicaid Managed Care Organizations. The CHW Network members are actively participating in discussions and developing recommendations to inform policy implementation and operationalizing these bills across Texas. ? 

Green states that this collaboration “serves as a testament to the profound potency of unity and concerted effort in advancing equity-enhancing strategies for the CHW workforce across our region.”  
The symbiotic relationship between the HEC and the CHW Network has contributed to this success and sets a foundation for the future. Rosalia Guerrero adds, “Supporting effective communication among CHWs and CHW allies as we started recovering from the pandemic was a huge benefit to our work community for sure. There is such a large and diverse population of CHWs in the Houston Region. By leveraging the organizational partnerships already established by the Health Equity Collective, the CHW Network was able to gather and disseminate critical news and information to those who needed it the most during a time of renewal.“  
Using a collective impact approach, the Health Equity Collective continues to support these efforts to strengthen the CHW workforce in the Greater Houston region. To learn more about these efforts and/or to join the Health Equity Collective, visit the Collective’s page here.