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Possible Tools for Resolution

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A group of people in a circle with their hands together in the middle.There are several possible tools for resolution of the boundaries that exist between CHWs and other occupations.

These include:

  • Specify roles for CHWs in overlapping areas
  • Define circumstances in which CHWs may perform certain duties
  • Require that CHWs act only under clinical supervision

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Here are some things to keep in mind when addressing scope- of-practice boundary issues:

  • One way to minimize confusion and resistance is to identify areas of overlap and specify CHW duties in more detail in these areas. Another method is to define the circumstances in which CHWs may perform certain duties, as we will see in a later session when we discuss the regulation of CHW certification by the Ohio Board of Nursing.
  • A third strategy is simply to require that CHWs act only with clinical supervision. Minnesota used this strategy in authorizing Medicaid payments for CHW services. We will discuss that experience in Session 6.