A New Roadmap for Community Health Workers in Rhode Island

by Jon Scaccia November 13, 2024

In this uncertain transition, we don’t know who will help to take the lead on health equity. If it has to come from the bottom up, Rhode Island can be a good example.

Rhode Island has embarked on a transformative journey to support and empower Community Health Workers (CHWs), recognizing their critical role in promoting health equity. Unlike previous, crisis-driven deployments, this initiative has created a sustainable, forward-looking roadmap that integrates CHWs into the state’s health framework. Designed by the Rhode Island Department of Health (RIDOH) and over 140 community leaders, this roadmap addresses not only the health needs of communities but also the structural inequalities that drive these needs.

What’s the Big Deal About Community Health Workers?

Community Health Workers are often the bridge between healthcare systems and underserved communities, trusted messengers who understand the unique challenges their neighbors face. Traditionally, CHWs help connect individuals to vital resources, but in Rhode Island, they are being empowered to drive systemic change as advocates and policy influencers. This expanded role transforms CHWs from helpers into leaders who can identify and address root causes of health inequities.

A Collaborative Roadmap for Change

The roadmap was developed with input from CHWs and leaders from multiple sectors, ensuring that it reflects the voices of those it aims to serve. It rests on five core principles that highlight the importance of agency, relationship-building, holistic care, advocacy, and respect for CHWs’ work.

Four interconnected strategies anchor this roadmap:

1. Empowering CHWs as Leaders and Decision-Makers: By involving CHWs in leadership roles, the roadmap enables them to participate in decisions that affect their work and communities. Education programs and leadership training initiatives support this effort.
2. Developing a Skilled Workforce: To prepare CHWs for supervisory roles, Rhode Island has committed to building a robust workforce development framework. This includes training programs focused on the unique challenges of leading in underserved communities.
3. Sustainable Funding and Policy Support: Long-term support for CHWs depends on stable funding. Rhode Island is exploring a combination of funding streams, including a potential Medicaid waiver, to support CHW programs that tackle upstream determinants of health.
4. Creating Coordinating Infrastructure: The roadmap calls for a place-based approach, positioning CHWs as community leaders who coordinate services across sectors to lower health and social barriers.

Results So Far: Promising Changes on the Horizon

The roadmap, still in its early stages, has already led to increased attendance at CHW Strategy Team meetings and greater involvement from community partners. As Rhode Island works to implement the roadmap, new policies and programs aim to provide consistent support to CHWs. This shift marks a significant change in how healthcare systems view and value community-based health interventions.

Why This Matters: Urgency for Broader Adoption

CHWs play a vital role in reducing health disparities, but their impact is limited without systemic support. Rhode Island’s roadmap represents a model that other states could follow. Investing in CHWs is not just a matter of health outcomes—it’s a step toward correcting deep-seated inequalities that have historically marginalized specific populations.

If we want to create a more equitable healthcare system, other states should look to Rhode Island’s roadmap as a guide for building sustainable, inclusive CHW programs. The sooner we can replicate and expand on these efforts, the closer we will be to achieving true health equity nationwide.

Join the Conversation

• How do you think CHWs can contribute to addressing health inequities in your community?
• What other roles could CHWs take on to further their impact on public health?

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