Defining the Role
Broad-based programs that focus on helping clients meet both social and medical needs should clearly define the role of the community health worker, their clients, and any partner organization working with the CHWs. All involved should understand how their specific role interacts with others. Clearly and immediately address any role overlap with other professionals. CHWs focusing on social determinants are likely to experience the most overlap with social workers and care coordinators when they are working in the same location or with the same clients.
There are several ways to reduce this potential conflict. Collaborate with program champions and managers to clearly articulate the specific roles and responsibilities of the CHW. Getting input from CHWs and social workers at the beginning of the process may contribute to greater understanding and less territorial conflict.
For example, in a hospital setting, the roles of the CHWs and social workers appear to overlap. While social workers may only need a bachelor’s degree and licensing, they may also need a master’s degree and two years of supervised experience, depending on the state or agency they work for19. Social workers are equipped to handle many situations and can help clients solve and cope with problems. Additionally, clinical social workers can diagnose and treat mental, behavioral, and emotional issues. As such, social work encompasses a far deeper level of assistance than can be provided by CHWs.
HOW TO: SMOOTH INTEGRATION AT CLINICAL SITES
- Make a physical space for the CHW at the clinic.
- Give CHWs access to the electronic health record.
- Ask the CHW to share their caseload list with the clinic to facilitate communication and improve continuity of care for share patients.
- Add the CHW’s schedule to the overall daily clinic schedule so other providers know when the CHW is there.
“Partnerships are successful when both parties respect and buy into the work of one another.”
– Health facility manager
However, CHWs can expand the number of clients who can be assisted. They can also help navigate the labyrinth of administrative or practical problems clients face, freeing up social workers to practice at the top end of their skill sets. While some of the tasks, such as referrals for community resources, might overlap, clearly specifying roles will reduce potential conflict, leading to more and better services for clients. Additionally, CHWs can act as a bridge to the community and sometimes serve directly in the community rather than at a clinical site like a social worker.
