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For many years, Michigan Community Health Centers have been at the forefront of integrating medical, dental, behavioral care, and patient enabling services; including education, transportation, translation and connection to community support services. In recent years, Community Health Centers expansion and implementation of interdisciplinary team-based approaches has resulted in the addition of Community Health Workers (CHW) to care teams. MPCA is committed to supporting, assisting, and providing technical assistance to Health Centers as they explore and implement team-base models of care, and expand supportive services.

Key Community Health Worker Resources

  • Interact with members of the Community Health Worker Communication Network. Send your request to be added to the network to Brittani Barkley;
  • Stay up-to-date on Enabling Services events, training, resources, and latest news on the Enabling Services webpage.

Community Health Worker Definition

In 2006, the Community Health Worker Special Primary Interest Group (SPIG) of the American Public Heath Association (APHA), working with CHWs and their advocates from across the country, submitted a request for a CHW classification to the Bureau of Labor Statistics for inclusion in the Department of Labor 2010 Standard Occupation Classification revision. The CHW SPIG submitted the following CHW definition:


"Community Health Workers (CHWs) are frontline public health workers who are trusted members of and/or have an unusually close understanding of the community served. This trusting relationship enables CHWs to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery. CHWs also build individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support and advocacy."

MPCA CHW Initiatives and Programs

  • MI Care Team (Health Homes)
    • MPCA and MDHHS are pleased to announce the launch of the MI Care Team, also referred to as Health Homes, on July 1, 2016. Ten Michigan Federally Qualified Health Centers at 44 sites in 23 counties have committed to use an innovative model of care with access to never before available technology and data through Care Connect 360. The participating Health Centers are expected to serve a population of approximately 18,000. In partnership with the Medicaid Services Administration, MPCA is coordinating a comprehensive MI Care Team Learning Community that includes training, technical assistance and peer network supports.
  • Breast and Cervical Cancer Screening Project
    • In March, 2015, Michigan Primary Care Association (MPCA) partnered with Michigan Department of Health and Human Services and the American Cancer Society to incorporate a  Community Health Worker (CHW) in eight Michigan Health Centers. The goal of the Breast and Cervical Cancer Screening Project is to increase the number of cervical and breast cancer screenings in each Health Center site. Each Health Center site has unique geography and community demographics, which creates distinctive challenges when engaging patients into the project. These challenges make it imperative that the CHW identifies and utilizes community partners and resources. 


To see the full list of resources, click on each section heading below.



The Code of Ethics for Community Health Workers is based on and supported by the core values adopted by the American Association of Community Health Workers.

The Promoting Policy and Systems Change to Expand Employment of Community Health Workers (CHWs) course developed by the Center for Disease Control Prevention is designed to provide state programs and other stakeholders with basic knowledge about CHWs, such as official definitions of CHWs, workforce development, and other topic areas. In addition, the course covers how states can become engaged in policy and systems change efforts to establish sustainability for the work of CHWs, including examples of states that have proven success in this arena. The six-session course covers CHWs’ roles and functions, current status of the CHW occupation, areas of public policy affecting CHWs, credentialing CHWs, sustainable funding for CHW positions, examples of states successful in moving policy and systems change forward.


Michigan Community Health Worker Alliance (MiCHWA) mission is to promote and sustain the integration of community health workers (CHWs) into Michigan’s health and human service systems through coordinated changes in policy and workforce development. 

Think Cultural Health (TCH) is dedicated to advancing health equity at every point of contact. With growing concerns about health inequities and the need for health care systems to reach increasingly diverse patient populations, cultural competence has become more and more a matter of national concern. TCH offers an          

E-learning Program for Promotores De Salud (CHWs)


Health and Human Services Health Information Policy Health Insurance Portability and Accountability Act of 1996 (HIPAA) information


Supervisory Support

This MHP Salud Supervision Manual was developed to provide basic guidelines of personnel management to supervisor of Promotor(a) de Salud programs. This manual is intended for a diverse range of supervisors of Promotor(a) programs, ranging from newly-hired to experienced Program Coordinators, Program Directors, or Outreach Coordinators. 


MHP Salud Supervising Community Health Workers |Community Health Workers (CHWs) have
been used to forge a link between health care providers and under-served, vulnerable communities in the United States since the 1950s.


MHP Salud Supervising Community Health Workers |What distinguishes Community Health Workers from other health care providers is their unique ability to understand and navigate the local norms and culture of
under served communities as members of those communities themselves.


Community Health Worker Visit Observation Form |Reducing Ethnic/Racial Asthma Disparities in Youth 2
Adapted with permission from Dr. Jim Krieger, Seattle King County Public Health Department

Community Health Worker Job Descriptions 


Community Health Worker Job Description Example |Michigan Primary Care Association 


Job Description for Community Health Worker | 


Bureau Of Labor Statistics. Community Health Workers assist individuals and communities to adopt healthy behaviors. Conduct outreach for medical personnel or health organizations to implement programs in the community that promote, maintain, and improve individual and community health. May provide information on available resources, provide social support and informal counseling, advocate for individuals and community health needs, and provide services such as first aid and blood pressure screening. May collect data to help identify community health needs. Excludes "Health Educators" (21-1091).


Community Health Worker Roles |Outreach worker, educator, connector, navigator, care coordinator, counselor, organizer, advocate… These are among the key roles that CHWs play, depending on the purpose of their organization, the setting for their work, and the population that they serve.Minnesota Community Health Worker Alliance 


Design Your Workflow

Specific, Measurable, Attainable, Realistic, and Time Certain (SMART) Goals Worksheet

Plan, Do, Study, Act Worksheet for testing change


Plan, Do Study, Act Template Worksheet 


Effective Scheduling Worksheet | Hour by hour planner for a work-week


Prioritized To-Do List | Create a to-do list using priority codes very important or unimportant


Activity Log Template allows tracking for activities, date and time occurred, how a person feels, duration for activity and high, medium, low or no value assignment


Policies and Protocols for Community Health Workers Home Visiting 

The Home Visitor Safety training adapted from the Idaho Department of Health and Welfare Family and Community Service includes education on safety procedures, hazards, principles of communication and crisis intervention, and teaches the “rules of the road” for interaction with individuals in stressful circumstances. Your safety is as important as the work you do. This training is designed to provide you with knowledge to allow you to be safe and effective in your work life.  

City of Minneapolis, MN Police Department Personal Safety for Visiting Professionals 


Abington, MA Police Department Personal Safety for Visiting Professionals In the course of their employment, many professionals make visits to citizens, clients or customers homes to provide services, make sales or check clients welfare. Visiting nurses, police officers, DCF workers, social workers, house cleaners, firemen, EMT's, door to door salesmen, real estate salesmen, are just some examples of such occupations.


Home Visits: Tips and Resources for Making Safe and Effective Home Visits. Vanderbilt Kennedy Center


The purpose of the Oregon's Home Visiting Safety Guide is to establish a basic set of standards that home visiting programs can use to ensure the safety of staff while away from the office. 


Building a Resource Guide 

Code of Ethics for Community Health Workers This Code of Ethics was disseminated during the annual national Unity conference held by The Center for Sustainable Health Outreach June 16-19, 2008 in Albuquerque, New Mexico. 



Protocol for Responding to and Assessing Patient Assets, Risks and Experiences Abstract Tool |Accelerating strategies to address the social determinants of health.


Arizona Self Sufficiency Matrix This is an assessment used to measure need, target services, and evaluate supportive services provisions.  


Development of the Patient Activation Measure (PAM): Conceptualizing and Measuring Activation in Patients and Consumers




The United Way improves lives by mobilizing the caring power of communities around the world to advance the common good.


The Area Agency on Aging of Northwest Michigan (AAANM) is the place to turn when assistance is needed with the complex issues facing older adults and their caregivers. AAANM can connect individuals to a variety of resources that may help those cared for to live as independently as possible in a community setting


The Continuum of Care List brings together extensive and diverse organizations to collaborate and work together as a system rather than as a fragmented set of resources to fund homelessness prevention initiatives, emergency shelters, permanent and supportive housing



Michigan Department of Health and Human Services (MDHHS) offers a number of programs to help with temporary assistance during difficult times such as Assistance Programs, Adult and Children Services, Safety and Injury Prevention, and Keeping Michigan Healthy


The Aging and Adult Services Agency (AASA) coordinates all services for Michigan's aging and adult population so that residents can receive the services they need to maintain their independence, and live a healthier and higher quality life.


The Commission on Services to the Aging works closely with the Aging and Adult Services Agency to shape policy and address the concerns of Michigan's aging and adult population.


Lake Superior Quality Innovation Network brings together Medicare beneficiaries, providers, and communities in Michigan, Minnesota and Wisconsin through data-driven initiatives that increase patient safety, make communities healthier, better coordinate post-hospital care, and improve clinical quality.


The Michigan Cancer Consortium provides a forum for collaboration among its members to improve cancer outcomes for Michigan residents


The Mental Health Association in Michigan (MHAM) is a voluntary membership citizens’ organization representing a broad base of people working together as an advocate for individuals with mental illness. MHAM is affiliated with Mental Health America.


The State of Obesity in Michigan is a collaborative project of the Trust for America's Health and the Robert Wood Johnson Foundation and is supported by a grant from the Foundation.


Association of State and Territorial Health Officials (ASTHO) webpage contains resources for state health agencies on the use of non-licensed providers such as Community Health Workers (CHWs), including resources related to financing, certification and licensure, and examples of work in states to support CHWs.




MHP Salud is a national nonprofit organization that implements and runs Community Health Worker programs. These programs provide peer health education, increase access to health resources and bring community members closer. MHP Salud also has extensive experience offering health organizations training and technical assistance on Community Health Worker programming tailored to their specific needs.

For more than 60 years, the Society for Public Health Education (SOPHE) has served as an independent professional association represented by a diverse membership of nearly 4,000 health education professionals and students throughout the United States and 25 international countries. The organization promotes healthy behaviors, healthy communities, and healthy environments through its membership, its network of local chapters, and its numerous partnerships with other organizations. SOPHE members work in elementary/secondary schools, universities, voluntary organizations, health care settings, worksites, and local/state/federal government agencies.


The State of Obesity |Better Policies for a Healthier America 


Rural Health Information Hub (formerly the Rural Assistance Center) Community Health Worker Toolkit is designed to help CHWs evaluate opportunities for developing a CHW program and provide resources and best practices developed by successful CHW programs.

The toolkit is made up of several modules. Each concentrates on different aspects of CHW programs. The modules also include resources for you to use in developing a program for your area.


By strengthening the skills of the workforce, the Michigan Public Health Training Center (MPHTC) supports public health professionals to promote and protect the health and well-being of Michigan's population. The MPHTC offers competency-based training linked to the Essential Public Health Services and the Core Competencies for Public Health Professionals.


Persons living with multiple chronic conditions experience unique challenges because their healthcare is more complex and costly than that of persons living with one chronic disease. The Health and Human Services Education and Training Curriculum on Multiple Conditions is designed to equip healthcare professionals and paraprofessionals with tools and knowledge on caring for persons living with multiple chronic conditions 


Trust for America's Health works on a variety of issues to help protect the health of every community and make disease prevention a national priority. Major vulnerabilities remain in our preparedness to respond to health emergencies, including bio-terrorism, natural disasters, chronic diseases and emerging infectious diseases. Learn more about our policy work with Congress and the Administration and how you can take action to support public health

Heart Disease and Stroke

The Centers for Disease Control and Prevention Division for Heart Disease and Stroke Prevention has compiled evidence-based research that supports the effectiveness of Community Health Workers (CHWs) in the Community Health Worker Toolkit. The toolkit includes information that state health departments can use to train and further build capacity for CHWs in their communities, as well as helpful resources that CHWs can use within their communities.


The America Heart Association mission is to build healthier lives, free of cardiovascular diseases and stroke. That single purpose drives all we do. The need for our work is beyond question. 




Success with CHWs |Asthma Care for Children


The Merck Childhood Asthma Network, Inc. (MCAN) and the Environment Protection Agency are excited to announce the addition of MCAN’s implementation and evaluation tools, resources, outcomes and best practices from MCAN's programs on the Network. Visit the MCAN page to learn more about MCAN’s groundbreaking work in asthma disparities and then check out the MCAN Library to access content to help your program achieve positive health outcomes in asthma management. 


Mental Health


The Certificate in Integrated Behavioral Health and Primary Care (IBHPC) is designed for direct clinical practitioners -- social workers, nurses, care managers, psychologists, and physicians -- who deliver or plan to deliver integrated health services, and who serve populations often presenting with complex needs in physical health, mental health, and substance use. Participants will gain assessment, intervention, and consultation skills; will learn strategies to apply these skills in the workplace; and will link with a peer distance learning community to practice new skills and discuss ideas.


The Provider Guide to Success with CHWs: Mental Health Services is a helpful web-based resource about the Community Health Worker (CHW) role for providers who address adult mental health and integrated health needs.



Mental Health First Aid is an 8-hour course that teaches how to identify, understand and respond to signs of mental illnesses and substance use disorders. The training gives the skills needed to reach out and provide initial help and support to someone who may be developing and mental health or substance use problem or experiencing a crisis.

Mental Health America (MHA) is the nation's leading community-based nonprofit dedicated to addressing the needs of those living with mental illness and to promoting the overall mental health of all Americans.



The National Diabetes Education Program is a federally-funded program sponsored by the U.S. Department of Health and Human Services’ National Institutes of Health and the Centers for Disease Control and Prevention and includes over 200 partners at the federal, state and local levels, working together to improve the treatment and outcomes for people with diabetes, promote early diagnosis, and prevent or delay the onset of type 2 diabetes.


The Centers for Disease Control and Prevention National Diabetes Prevention Program 


Today, about half of all American adults have one or more chronic diseases, often related to poor diet.Dietary  The Guidelines for Americans 2015-2020 emphasizes the importance of creating a healthy eating pattern to maintain health and reduce the risk of disease. Everything we eat and drink — the food and beverage choices we make day to day and over our lifetime — matters. 



The American Cancer Society works relentlessly to save lives and create a world with less cancer. Together with millions of our supporters worldwide, American Cancer Society helps people stay well and get well, find cures, and fight back against cancer. 


Motivational Interview Resources

Motivational interviewing (MI) is a counseling approach used to help a patient (or client) make or get ready for positive behavior change. MI is defined as “…a collaborative, person-centered form of guiding to elicit and strengthen motivation for change. 

Motivational Interviewing Strategies and Techniques: Rationales and Examples


Motivational Interviewing for Diet, Exercise, and Weight. Here are some examples of the types of questions to ask using a motivational interviewing style when assessing ambivalence and motivation for lifestyle changes in patients who are overweight or obese.


Motivational Interviewing and Tobacco Cessation The principal purpose of motivational interviewing is to help clients resolve their ambivalence (“I know smoking is not good for me, BUT I enjoy it; it calms me down; it helps me keep weight off, etc.”) and move along the continuum of change. 


The Open Ended Questions, Affirmations, Reflections, Summaries (OARS) Model: Essential Communication Skills  OARS is a skills-based model of interactive techniques adapted from a client centered approach, using motivational interviewing principles. These skill-based techniques include verbal and non-verbal responses and behaviors. Both verbal and non-verbal techniques need to be adapted to be culturally sensitive and appropriate.


Visit for information on Motivational Interviewing! 


Acknowledge, Introduce, Duration, Explain and Thank (AIDET) video explains the Five Steps to Achieving Satisfaction.


The "MI Reminder Card (Am I Doing This Right?)" is a quick guide for Motivational Interviewing, the evidence-based treatment. Use the 11 questions on this card to build self-awareness about your attitudes, thoughts, and communication style as you conduct your work. Keep your attention centered on the people you serve. Encourage their motivation to change.


Develop Targeted Materials and Messaging

Develop a long-term outreach plan before you begin to conduct outreach activities. Here are some suggested steps. Steps to Developing Your Outreach Plan from the California WIC Program.


Promote your health center as well as your role as a CHW!  Community health events are great ways to engage, serve and build relationships with the community.  The American Academy of Physician Assistants has developed a resource for assembling Community Health Events.


On Hand Resources

 I Speak Language Identification Guide 

My Medicine Record allows for health education and encourages patients to record and manage their medical needs.

Federal Poverty Level Calculator |The new 2016 federal poverty guidelines have been released. 


Building Relationships with the Community


The Story of Maria and Belen provides an example of the many benefits to having CHWs within health centers. Maria has personal experience and knowledge that allows her to connect with patients and engage with the community by conducting medication administration trainings. 


Community Health Workers bridge community with health care systems.  The Community Guide has provided an evidence based article highlighting the engagement and intervention of CHWs.  The Task Force conducted a study to review the methods, research, practices, and policies in relation to CHWs and cardiovascular disease prevention.


Support groups are a great way to engage the community as they bring together groups of people with similar issues allowing them to bond and encourage one another.  Support groups are also a way to provide health education, community resources, and different view points. The University of Kansas has provided a tool for Creating and Facilitating Peer Support Groups. 


The Affordable Care Act requires new private health insurance plans to cover many recommended preventive services without any patient cost-sharing.The Henry J. Kaiser Family Foundation created the Preventative Services Tracker to help identify these services. 


Beyond Health Care: The Role of Social Determinant in Promoting Health and Health Equity |The Henry J. Kaiser Family Foundation 


Improving the Health of Low-Income and Minority Communities |Trust for America's Health

HealthyPeople 2020 provides science-based, 10-year national objectives for improving the health of all Americans. For three decades, Healthy People has established benchmarks and monitored progress over time in order to encourage collaborations across communities and sectors, empower individuals toward making informed health decisions, and measure the impact of prevention activities.


Video Making the Business Case: Community Health Worker Video Center for Disease Control 


As states transform their health systems many are turning to Community Health Workers to tackle some of the most challenging aspects of health improvement, such as facilitating care coordination, enhancing access to community-based services, and addressing social determinants of health. The National Academy for State Health Policy highlights state activity to integrate Community Health Workers into evolving health care systems. 


More Information?


How to reach us:


Julie Tatko, Health Center Operations and Enabling Services Director 



Brittani Barkley, Outreach Specialist 

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