Short-Term Funding Keeps CHWs in “Silos”

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Help Wanted sign.The short-term, commonly non-renewable nature of project grants limits employers’ interest in investing in CHW training and development and also:

  • Discourages long-term, holistic, patient-centered approaches
  • Undermines development of CHW skills standards
  • Makes CHWs identify with health issues, not their occupation
  • Discourages CHWs from remaining in the field
  • Leads to high turnover


Currently, most grants that support short-term projects employing CHWs focus on a specific health issue or condition and require a narrowly focused intervention with a specific population. This approach is at odds with the preference of most CHWs to work with families and individuals in a more patient-centered, holistic manner. It also does not help integrate CHWs into their employers’ ongoing operations.

The tailoring of CHW positions to specific interventions and health issues tends to decentralize CHW training and make it specific to individual position requirements. As a result, common standards for core skills have been slow to develop at the state level. In these conditions, some CHWs have come to identify themselves more closely with a specific health issue than with a broader CHW occupation—even though they may have a great deal in common with workers addressing other health issues.

Short-term funding limits employers’ interest in investing in CHW training and development. Why should an employer invest time and resources in staff members who will likely not be around after two or three years?

Furthermore, because CHW positions are treated as temporary and disposable, CHWs have incentive to consider other, more stable occupations rather than remain CHWs, so employers are faced with high turnover.