The Role of Community Health Workers in Emergency Response

The Current State of CHWs in the U.S.

CHWs provide a range of essential services, from chronic disease management and health education to addressing social determinants of health. They are particularly effective in reaching marginalized communities, including low-income, rural, and non-English-speaking populations. They serve as bridges between healthcare institutions and the people who may face barriers to accessing care, offering personalized support that helps individuals navigate complex medical and social service systems.

However, their integration into the healthcare system varies widely by state. Many CHWs work on grant-based funding, limiting their long-term sustainability. Some states have taken steps to formalize CHW roles and ensure they receive fair compensation, but progress is inconsistent. Without a national framework for CHW funding and credentialing, their ability to provide critical services remains precarious, often dependent on short-term funding cycles that create instability in their workforce.

CHWs in Emergency Response

CHWs have the potential to be frontline responders in public health emergencies, including natural disasters, disease outbreaks, and humanitarian crises. Their deep community ties and cultural competence allow them to provide critical services such as:

• Disseminating accurate health information and countering misinformation

• Assisting with emergency preparedness efforts within vulnerable populations

• Coordinating with healthcare providers to ensure continuity of care

• Identifying and addressing unmet health and social needs during and after disasters

• Helping individuals navigate emergency aid programs, including disaster relief funds and temporary medical assistance

During crises like the COVID-19 pandemic, CHWs played a crucial role in supporting vaccine outreach, facilitating access to testing and treatment, and providing culturally competent health education. They have also been instrumental in responding to natural disasters, such as hurricanes and wildfires, where their deep knowledge of local communities allows them to quickly assess needs and direct resources where they are most effective.

Despite their potential, CHWs are often overlooked in emergency preparedness and response planning. Formalizing their role in these efforts could enhance community resilience and improve disaster outcomes. Training CHWs specifically in emergency response tactics—such as mental health first aid, disaster triage, and emergency shelter coordination—would maximize their impact during crises.

Policy Solutions to Strengthen CHW Engagement

One of the most significant policy changes needed to support CHWs is ensuring they are adequately funded. California is leading the way in this area: as of 2022, CHWs in the state can bill Medi-Cal for specific services, making it possible for them to receive sustainable funding. Other states should follow suit, adopting Medicaid reimbursement policies that recognize CHWs as essential healthcare providers.

Additional policies that could enhance the role of CHWs in emergency response include:

• Expanding CHW Training for Emergency Response
  States should develop standardized training programs for CHWs on disaster preparedness and response. CHWs should be certified in emergency protocols and included in disaster drills at the local and state levels.

• Incorporating CHWs into Emergency Response Frameworks
  Public health agencies should formally integrate CHWs into state and local emergency management plans. This would ensure that CHWs are mobilized during crises and recognized as essential personnel.

• Securing Federal Funding for CHW Programs
  The federal government should allocate dedicated emergency response funding to support CHW-led initiatives, ensuring sustainability beyond grant cycles. Federal emergency preparedness funds should be made available to organizations employing CHWs, allowing them to remain active in both preparedness and response phases.

• Expanding Insurance Reimbursement Beyond Medicaid
  While Medicaid billing opportunities for CHWs represent progress, expanding reimbursement to include private insurance and Medicare would further enhance their ability to provide services sustainably. Policymakers should push for CHW services to be recognized as reimbursable by all major payers.

Why This Matters

The healthcare system is only as strong as its ability to reach and serve all communities, particularly in times of crisis. Community Health Workers are a proven, cost-effective solution to improving public health, yet their role remains undervalued and underfunded. By implementing policies that allow CHWs to bill for their services—like in California—and integrating them into emergency preparedness strategies, we can build a more resilient and equitable healthcare system.

Investing in CHWs isn't just about expanding the workforce; it’s about strengthening the foundation of community health and ensuring that, when disaster strikes, no one is left behind. By equipping CHWs with the necessary resources, training, and funding, we can create a system where communities are better prepared for emergencies and able to recover more quickly from disasters.

If the U.S. is serious about improving emergency response and making healthcare more equitable, expanding the role of CHWs must be a top priority. The path forward requires bold policy action, sustainable funding mechanisms, and a recognition that CHWs are not just support staff—they are essential to the health and resilience of our communities.