About the NC Community Health Worker Initiative

North Carolina Community Health Workers currently hold both formal and informal roles within the healthcare system. The skills they exhibit are valuable in reaching individuals and groups who are unfamiliar or distrustful of people outside of a given community; particularly the poor, underserved, and or minorities. Recent changes to healthcare laws encourage the use of CHWs to promote positive and healthy behaviors and outcomes. Section 5313 of the Patient Protection and Affordable Care Act authorizes grants from the Centers for Disease Control and Prevention to promote the community health workforce. This recognition of CHW provides an opportunity to impact population health, reduce disparities and integrate their roles into a new healthcare delivery model.

As a result, North Carolina stakeholders began to explore the opportunity to identify this workforce. Below is a timeline leading to the release of “Community Health Workers in North Carolina: Creating an Infrastructure for Sustainability, Final Report and Stakeholder Recommendations of the North Carolina Community Health Worker Initiative”, May 2018.

October 2014: NC Department of Health and Human Services (DHHS) team began exploring statewide CHW initiative opportunities.

January 2015: DHHS team conducted CHW program inventory.

April 2015: Statewide stakeholder meeting shares results of inventory and gathers input on developing sustainable infrastructure for CHW.

June 2015: Assessment conducted on CHW initiatives in southeastern US states.

December 2015: Second stakeholder meeting held to create plan for moving forward.

February 2016: Workgroups formed to draft recommendations for core competencies and training.

September 2016: Draft recommendations completed.

November 2016: NC Community Health Workers Summit.

April – June 2017: Regional Listening Sessions.

June 2017: NC CHW Survey.

May 2018: Final report and recommendations.

NC CHW Stakeholders’ Recommendation III Core Competencies and Training

Community Health Worker's (CHWs) should possess a set of core skills to effectively meet the demands of their positions.  CHWs in NC should be able to demonstrate each of the nine competencies.  The NC CHW standardized statewide training will cover each of these core skills as part of the certification process.

  • Communication Skills: CHWs will develop communication skills such as being an effective listener to learn about client’s experiences and needs and communicate effectively during conflict or stressful situations. CHWs should be well versed in group communication skills to provide health education and community advocacy to the groups they serve.  
  • Capacity Building Skills: CHWs will support their clients and communities through building new skills and promoting confidence in their own health such as building upon communication skills, reducing of risk behaviors, community organization, and advocation skills.
  • Service Coordination Skills: CHWs will need service coordination skills to coordinate the care of their clients. They may create plans to follow for improving health for their client or community that will require the coordination of services.
  • Interpersonal Skills: CHWs will need interpersonal skills to work with the diverse groups of people and develop relationships with clients, community members, supervisors, nurses, social workers, and policy makers to improve the lives of their communities and meet the needs of others.
  • Advocacy Skills: CHWs must be able to advocate for their clients and communities among agencies, service providers, and to support changes to public policies. They must speak up to create change that would improve the health and well-being of their clients and communities.
  • Personal Skills and Development: CHWs will develop personal skills that will enable them to get a job or volunteer position and to advance in their career. They will allow you to be more effective in promoting and advocating for their clients and communities.
  • Outreach Skills: CHWs will provide outreach to individuals and communities about services that are available and encourage enrollment of those services.
  • Education and Facilitation Skills: CHWs must be able to educate their clients and communities on how to prevent and manage health conditions, provide support in developing healthy behaviors, and advocate for social change.
  • Knowledge Base: CHWs will need to know and recognize social determinants of health and health topics that impact their clients and communities to be able to give support and provide information on these topics.

Graphic of North Carolina Community Health Workers Core Competencies