Question 1 - Is your organization currently employing Community Health Workers or Aides?

The majority of survey respondents (72.5%) indicated that they are not currently employing CHWs, while 27.54% are currently employing CHWs.

27.5% - Yes

72.5% - No 

What other titles are used besides CHW?

  • Community Health Representatives
  • SNAP-Ed or EFNEP Nutrition Educators, SNAP-Ed Program Managers
  • Outreach Workers
  • CAC’s
  • Navigators
  • Resource Advocates
  • Personal Care Attendants

Question 2 - If you do not employ CHWs, how likely are you to employ them in the future?

Approximately 12% of survey respondents stated they would “Likely” employ CHWs in the future, while 27.5% indicated that they were “Not sure” if CHWs would be hired in the future. 36% of survey respondents also specified that they would not hire CHWs in the future. Additionally, survey data included that 25% of respondents already employed CHWs.

In what capacity would you use CHWs?

  • Identify and Register Agricultural Workers, identify health care and social service needs and make appropriate referrals with follow-up, CAC, preventive health education, interpreting, and limited transportation (Migrant workers)
  • Once Medicaid expansion is approved for those over 50 – 65
  • Post-hospital follow up visit to home to review discharge instructions and medications.
  • Peer education for diabetes, support for lifestyle change programs such as the Diabetes Prevention
  • We want to promote the use of CHWs in the healthcare field as a public health model to provide quality patient
  • In rural areas I can see them being utilized as navigators to assist patients throughout the healthcare process especially if referrals are
  • To help provide healthcare services on the Fort Peck reservation where we are short healthcare providers (like through telehealth coordination)
  • Assistance with transitions of care and diabetes self-management education
  • Unsure, but perhaps a hospital/public health partnership for better health outcomes
  • Visiting aid, CNA or Nurse
  • Health education

Questions 3 & 4 - Asked for additional organizations that should be included in the survey and if they were willing to be contacted by phone.

Question 5 – Please explain what your role will be in reimbursing or helping other organizations utilize CHWs?

  • Transportation on reservation - Sheridan and Billings
  • Paid through IHS 638
  • Can fill for services from the state. Need help in paying for coverage in order to continue
  • The Montana State University Extension Nutrition Education Program consists of two federally funded nutrition education programs, SNAP-Ed (Supplemental Nutrition Assistance Program Education) and EFNEP (Expanded Food and Nutrition Education Program). We employ educators across the state to teach nutrition and physical activity low income audiences, and also work in the area of creating policy, systems, and environment change to improve access to and appeal for nutrition and physical
  • We would primarily refer people to navigators. When Medicaid expansion is approved we might consider being more involved with those 50 and
  • Training them to facilitate peer diabetes education
  • I would be happy to assist others in developing CHW programs now that the grant I am currently working on has
  • State public health department, supporting CHWs in finding roles in diabetes public health programs, networking, and
  • Marketing-letting others know the program is
  • We are very interested in payment models that could make this a break-even program.
  • I am working on a CMS Special Innovation Project that would employ CHWs to do patient outreach work with super-utilizer patients. The intent is expand this program to multiple locations.
  • We (MHA/MHREF) will happily help facilitate the management of CHWs at facilities that employ them, and analyze the impact of their
  • We can facilitate the use of CHWs, assess impact statewide, work with facilities and insurers to advocate for reimbursement, and provide other coordination/communication
  • Utilizing revenue cycle setup to fund the
  • I manage the CHW here at this facility and I am an advocate for this program in our
  • MTGEC would be interested in assisting with education of CHW's, particularly in the area of older
  • As a payer we look forward to participating in the discussions and exploring the future of CHW's.
  • May administer funds – community discussion
  • Analysis and conduit for policy

Question 6 – How many Full time and Part time CHWs do you employ?

Of the 25% survey respondents that indicated they currently employ CHWs, the total numbers of Full time positions within their organizations are 92 FTE and number Part time CHW positions within their organizations are 38 PT.

Question 7 – Would you be likely to hire additional CHWs in the future?

Approximately 44% of survey respondents stated that they would “Definitely [hire additional CHWs] within the next 12-18 months.”

28.6% of survey respondents indicated that they were “Unsure”.

The majority of survey respondents (55%) specified “Lacking funding to hire additional CHWs” would be a concern for future employment of community health workers.

Question 8 – How long have you employed CHWs?

50.0% - 10+ years

8.3% - 5-10 years

41.7% - 1-4 years

0.0% - new this year

Additionally survey data indicated that some organizations, such as those within the Tribal Health Department and Expanded Food & Nutrition Education Program (EFNEP), have used CHWs for many years. EFNEP has used nutrition educators for over 45 years while tribal health departments have used Community Health Representatives since 1969.

Question 9 – What is the main method you use for recruiting?

53.2% - Internal recruiting

40.0% - Newspapers

6.7% - Community events

40.0% - Online advertising

6.7% - Employment agencies 

33.3% - Other 

Additionally, survey data indicated that tribal health departments are in the process of hiring new directors and upgrading job descriptions for CHRs.

Question 10 – What are the required qualifications for the CHWs you employ? Is there a difference in qualification for entry level or experienced workers?

  • Driver's license, auto insurance, vehicle registration, own vehicles (GSA) gov. vehicle
  • CHR basic through IHS, Driver's license, background check, CPR/First Aid/HIPAA
  • Job descriptions are so old. High School diploma; CNA if doing diabetes screenings - mostly they transport patients/ (New director is being hired)
  • CNA certification / High School diploma / drug test / background check
  • Many levels - paraprofessional level, entry level professional level, experienced professional level
  • Bilingual
  • Prefer medical or social service background with work in care
  • They had to have a high school diploma or GED, had to have a driver’s license
  • Caregiving experience, Adults, Clear background check
  • Lives in the community & active in the community. Aware of community resources for clients; Communication Skills; Non-clinical Patient-

Question 11 – What are the factors that affect wages and benefits? Please provide minimum/maximum salaries.

Survey respondents indicated a range for salary for FTE as $12 to $14, plus benefits.

Question 12 – What type of training is offered by your organization?

  • CPR training, Supervisor goes to training
  • IHS does training
  • Trainings offered by state, IHS, anything pertaining to health
  • Career development / Certification renewals / IHS CHR conferences and training
  • New hire training, annual training for all employees, webinar training's throughout the year
  • Risk Management, general staff orientation, other trainings offered of organizational memberships to NACHC, MCN, CHAMPS, NCFH
  • All offerings by the federal government
  • We did 2 days of training based off the Minnesota curriculum and had monthly educations
  • We participated in the MHA pilot program so the criteria, qualifications, and training came from
  • CNA and other online and on the job training
  • Direct Agency Training and caregiving training from

Question 13 – Should the state of Montana have a standardized program for CHWs?

77.3% - Agree

22.7% - Disagree

Several respondents expressed an interest in standardized training, but noted that they felt they would still need specialized training for their circumstance. Some expressed an interest in “training in place” rather than going off-site.

NOTE: The Indian Health Service CHR website has an in-depth list of Core Standards and Standards of Practice.

Question 14 – What is the source of funding for financing CHW positions?

75% - Government grants

6.25% - Foundation grants

6.25% - Internal funds

12.5% - Reimbursement cost (insurance/Medicaid) 

18.75% - Other

The majority of survey respondents (75%) indicated government grants as a funding source which include but are not limited to the Federal Farm Bill, IHS, and Medicare.

Other survey participants indicated “Other” (18.75%), “Reimbursable cost (12.5%), “Foundation grants” (6.25%), and “Internal funds” (6.25%) as sources of funding for financing CHW positions.

Question 15 –What services are provided by the CHWs that you employ?

78.6% - Underserved populations

71.4% - Conduit for health care information and services 

64.3% - Health promotion

64.3% - Chronic disease management

57.1% - Education to clients on how to navigate and get access to health care

78.6% - Promote preventive care

35.7% - Conduct health screenings

57.1% - Link uninsured to healthcare coverage

71.4% - Help clients with paperwork

50.0% - Education on nutrition

57.4% - Other services

Other services included Transporting clients/patients.

Question 16 – What populations are served?

16.7% - Non-English speakers 

44.4% - American Indians

55.6% - Rural residents

72.2% - Elderly residents

22.2% - New mothers

50.0% - Low socio-economic households

22.2% - Other

Question 17 – How would you describe your organization?

3.45% - City/County Health Dept. 

27.6% - Non-profit agency

13.8% - Tribal agency

6.9% - State agency

17.2% - Hospital or clinic

31.0% - other