Community-Based Workforce Principles for Pandemic Response and Resilience

To be effective and equitable, COVID-19 contact tracing and broader response, rebuilding and redesign efforts must be embedded in and shaped by disproportionately impacted and minoritized communities.

 

We urge state and local health departments to work with community leaders and adopt these Community-Based Workforce Principles as part of evolving community response and resiliency efforts.

 

HealthBegins helped form and actively supports a national Community-Based Workforce Alliance, a growing group of organizations ready to support cities, counties and states to put these Principles into practice.

 

How to start?Review the Principles listed below, including suggested strategies and resources. Download and use the Guide to help your state, county, or city advance these Principles. Visit the Community-Based Workforce Alliance website to get involved. Contact us to connect with a broader network of allies ready to support your efforts to advance these Principles. Stay connected to share your progress with us and a network of other Bright Spots committed to advancing these Principles.

Download the Guide


Endorsed by

Community-Based Workforce Principles for Contact Tracing

​Principle 1: Recruit & manage with a racial equity framework

A contact tracing workforce should reflect communities disproportionately impacted by COVID-19.

Suggested Strategies

Include an equity, diversity and inclusion policy & adhere to national best practices in recruitment and hiring of workers from low-income, minority, and immigrant populations, including people with disabilities.

Provide a living wage and enabling supports like child care to contact tracers from highly impacted communities.

Include individuals who live and work in impacted communities in contact tracing governance & advisory groups. This includes community health workers & promotors (CHW/Ps), nonprofit staff, community leaders, and residents with disabilities.

Resources:

 

Brightspot:

  • Virginia Department of Health – Health Equity Workgroup
    • Established March 11, 2020. Embedded at the senior-level of the State Agency-wide Coronavirus Unified Command. Meets virtually every week to review policies and determine how vulnerable populations in the Commonwealth are (or are likely to be) impacted).

 


Principle 2. Invest in trusted voices, including Community Health Workers

Expand the roles and ranks of CHWs, promotores, & other trusted community-based workers.

Suggested Strategies

Expand CHW/P authority with Medicaid state plan amendments, and “essential critical worker” recognition.

Include the National Association of Community Health Workers, state networks of CHW/Ps, & other community-based workers as partners in planning, training and support of contact tracing & response efforts.

Apply CDC and other funds (e.g. section 1115 waivers, Dislocated Worker Grants) to pay CHW/Ps & other community-based workers a living wage to support a broad range of activities, including contact tracing.

Provide LHDs & CBOs with advance payments to support CHW/P activities in highly impacted communities

Resources:

 


Principle 3: ​Strengthen connections with psychosocial services & systems

​Integrate response efforts with systems to address psychosocial needs in highly impacted communities.

Suggested Strategies

Use geospatial, social vulnerability, and race/ethnicity data to deploy a community-based workforce to hardest-hit and most vulnerable communities.

Integrate validated, standardized screening items in case investigation systems to identify psychosocial needs* & use interoperable referral platforms to connect contacts to community resources.

Involve residents and adhere to community-based data governance, accountability and privacy standards.

Engage CHW/Ps & other community-based professionals to provide ongoing psychosocial support & care coordination for high & rising risk populations.

Resources:

​*We recommend coordination between vendors of case investigation/management software and community resource & referrral platforms to improve the capacity to assess and address psychosocial needs. With training, Contact Tracers and/or Resource Coordinators can then screen contacts for household acute psychosocial needs using validated screening items. In addition to counseling contacts on quarantine and referring them for COVID-19 testing, refer people with identified psychosocial needs to Resource Coordinators (ideally trained CHW/Ps). They, in turn, use community resource & referral platforms to support households.


Principle 4: ​Launch a community-based jobs program as a force multiplier

Boost response & recovery with a jobs program for unemployed workers from highly impacted communities.

Suggested Strategies

Leverage federal funds and national and state-based service programs to deploy a community-based jobs program.

Develop a state interagency plan (i.e. public health, workforce development, education) to launch a jobs program to support contact tracing, other response efforts, and long-term community recovery activities.

Recruit and pay unemployed, dislocated and other struggling workers from highly impacted communities with living wage jobs that meet contact tracing & other community needs.

Resources

  • Leverage private foundation and corporate giving, as well as national service programs (which Congress is currently considering expanding), National Dislocated Worker Grants from the Department of Labor, and other federal disaster relief funds.
  • National service programs
    • Corporation for National & Community Service (AmeriCorps, Senior Corps)
    • HHS (National Health Service Corps, Medical Reserve Corps)
    • CDC (Funding workers to support state health departments)
  • Congressional proposals
    • Health Force” Bill (U.S. Sens. Gillibrand & Bennett)
    • Pandemic Response and Opportunity Through National Service Act (U.S. Sens. Coons, Reed, Klobuchar, Duckworth, Heinrich, Markey, Van Hollen, Blumenthal, and Durbin​

 


Principle 5: Embed job training & pipelines to local careers

Provide job training to improve opportunities for long-term health and economic recovery.

Suggested Strategies

Use state and federal workforce development funds and programs to provide job and skills training to support contact tracers and other individuals in community-based jobs programs.

Include nonprofit workforce training partners, CBOs and community colleges to address basic skills gaps and prioritize training of individuals from disadvantaged communities and those facing barriers to employment.

Create a pipeline to local careers in local health departments and community-based organizations.

Resources

 

Brightspot:

  • Baltimore Health Corps
    • ​Baltimore will recruit, train, and employ more than 300 residents, including 276 CHWs, including 38 supervisors, for these roles. In addition, there are 10 employment development, 7 managerial, and 10 administrative roles.

 


Principle 6: ​Strengthen community infrastructure & financing

Align incentives and invest in local infrastructure for long-term health and community development.

Suggested Strategies

Support federal and state action to fund and preserve community nonprofits & mission-driven financial institutions that serve highly impacted communities and vulnerable populations.

Pay essential nonprofits in highly impacted communities per contracts even if operations are affected. Preemptively convert funding to unrestricted funds during the response phase.

Braid funds and invest in wellness trusts, outcomes funds & other place-based financing models that are aligned with achieving long-term health outcomes in historically redlined and marginalized communities.

Resources:

Guide to Community-Based Workforce Principles

Download a free copy of the​ Guide to Community-Based Workforce Principles​ to review suggested strategies and resources you can use to advance these Principles in your state, county or city.

The Guide to Community Workforce Principles

How well is your state, county, or city advancing these principles?

What is a “community-based workforce”?

National and international emergency preparedness experts have long recognized a “community-based workforce” as an essential component of response and recovery capabilities.

​As a complement to governmental public health workers, a “community-based workforce” includes community health workers, promotores, local nonprofit staff, & other trusted community-based professionals.

By launching jobs programs, states, counties and cities can also recruit and train lay individuals, including unemployed residents and recent graduates, to support and join a community-based workforce.

While skills and roles vary, members of a “community-based workforce” share common experiences and traits:

  • Live in and share culture, language, and life experiences with the members of the communities they serve
  • Possess strong relational expertise and interpersonal communication skills
  • Have earned a deep level of trust with peers and neighbors
  • Have strong relationships with and knowledge of local community-based resources
  • Demonstrate a long-standing commitment to working in and advancing health equity in their communities.

Where did the Community-Based Workforce Principles come from?

In early May, the HealthAffairs Blog published “Three Workforce Principles to Help COVID-Affected Communities”. Based on themes outlined in the article, HealthBegins published the Community-Based Workforce Principles for Contact Tracing on May 19, 2020. These principles emerged from discussions HealthBegins has been having with allies and leaders across the country since March 2020, when COVID-19 infections began to surge in the US.

On April 23, 2020, HealthBegins convened and co-hosted a National Strategy Call to advance a community-based workforce strategy to pursue urgent health equity and public health priorities amid the COVID-19 pandemic. More than 400 attendees joined to hear from co-hosts and allies, including Last Mile Health, the National Association of Community Health Workers, the Penn Center for Community Health Workers, Health Leads, and Partners in Health. Followup conversations led to the formation of the Community-Based Workforce Alliance, a growing group of allies working to advance equity and community-based workforce members as part of ongoing response and recovery efforts.


  • Initial signatories of the Community-Based Workforce Principles

    Rishi Manchanda, CEO, HealthBegins
    Manisha Sharma, Fellow, CHCF Health Care Leadership Program
    Laura Gottlieb, Director, Social Interventions Research and Evaluation Network (SIREN), UCSF
    Denise Octavia Smith, Executive Director, National Association of Community Health Workers
    Jamie Berberena, Regional Chapter Coordinator, Massachusetts Association of Community Health Workers
    Jeffrey Oxendine, CEO, Health Career Connection & Co-Director, California Health Professions Consortium
    Rebecca Morley, Founder & President, Rebecca Morley Consulting, LLC
    Leana Wen, Visiting Professor of Health Policy & Management, George Washington University
    Claire Qureshi, Senior Director, Community Health Acceleration Partnership
    Sadena Thevarajah, Managing Director, HealthBegins
    Nirav Shah, MD, MPH, Senior Scholar, Stanford University
    Grace Rubenstein, Strategic Communications, HealthBegins
    Dora Barilla, GVP Community Health Investment, Providence St. Joseph Health
    Ellen Lawton, Director, National Center for Medical-Legal Partnership at George Washington University
    Jay Bhatt, DO MPH, Principal, JDB Strategies
    Leigh Kimberg, MD, Professor of Medicine and Program Director, PRIME-UCSF
    Christine Barker, Executive Director, Fresno Interdenominational Refugee Ministries (FIRM)
    Anish Mahajan, MD, MPH, Chief Medical Officer, Harbor-UCLA Medical Center
    Savina McMurry, Community Health Worker, SAHS
    Shoshanah Brown, MS, MBA, CEO, AIRnyc
    Patrick Ma, MBA, Chief Operating Officer, AIRnyc
    Sarah DeSilvey, Lead SDOH Informaticist, The Gravity Project & Rural Family Nurse Practitioner, NMC
    Abner Mason, Founder & CEO, ConsejoSano, Inc.
    Somava Saha, Executive Lead, Well-being and Equity (WE) in the World
    America Bracho, CEO, Latino Health Access
    Hana Arabi RDN, LDN, Nulife Clinics
    Alexandra Quinn, CEO, Health Leads
    Julia Ryan, Vice President – Health, Local Initiatives Support Corporation
    Jill Feldstein, Chief Operating Officer, Penn Center for Community Health Workers
    Maureen Bisognano MS, President Emerita and Senior Fellow, IHI
    Maria Lemus, Executive Director, VISION Y COMPROMISO
    Bonnie Ewald, Program Manager, Rush University Medical Center
    Troy Murrell
    Ali Khan, MD, MPP, FACP, Executive Medical Director, Oak Street Health
    Diana J. Mason, PhD, RN, FAAN, Senior Policy Service Professor, Center for Health Policy and Media Engagement, GWU School of Nursing
    Monica McLemore PhD, MPH, RN, FAAN, Associate Professor and Director, Reproductive Health Equity and Birth Justice CORE – UCSF
    Carl Rush MRP, Principal Consultant, Community Resources, LLC and NACHW
    Brian Rahmer, PhD, MS, Vice President, Health and Housing, Enterprise Community Partners
    Andrew Goldstein, MD, MPH, Assistant Professor, NYU
    Teresa Foster DO, NuVance HQMP
    Amish Desai, MD MSc, Senior Medical Director, Oak Street Health
    Bronwyn Baz, MD, Assistant Professor and Lead Physician, NWP Pediatric Hospital Medicine FAAP, OHSU
    Justin Lowenthal, National Board of Directors, Doctors for America
    Camille Clare MD MPH, Region 1 Trustee, Secretary of Board of Trustees of the National Medical Association
    Paul Davis, Member, Right to Health
    Andrew Broderick, Research Director, Public Health Institute
    Patty James, Nutritionist, Researcher, Author. Culinary Educator, Patty James M.S., N.C.
    Panna Lossy MD, CMO IsoCare & UCSF Clinical Faculty, Santa Rosa Family Medicine Residency
    Drew Halfmann, Associate Professor, UC Davis Sociology
    Adam Schwartz, M.D., Assistant Professor, NYU School of Medicine
    Abraham Young MD, Family Physician, Community Health Center
    Julie Graves, MD, MPH, PhD, Associate Director of Clinical Services, Nurx
    Uma Tadepalli, MD, Assistant Medical Director, Senior Community Care of North Carolina
    Sriram Shamasunder, Co-Founder and Director, UCSF HEAL Initiative
    Leilani Zimmerman, FNP-C, Santa Rosa Community Health
    William Jordan, MD, MPH, Clinical Assistant Professor, Albert Einstein College of Medicine
    Stephanie Burdick, Community Health Policy Analyst
    Amber Hewitt, Director of Health Equity, Families USA
    Mark Humowiecki, Senior Director, National Center for Complex Health and Social Needs, Camden Coalition of Healthcare Providers
    Robert Pezzolesi MPH, Convener, Interfaith Public Health Network
    Keegan Warren-Clem, JD, LLM, Managing Attorney of Medical-Legal Partnerships, Texas Legal Services Center
    Solange Gould, MPH, DrPH, Co-Director, Human Impact Partners
    Lili Farhang, Co-Director, Human Impact Partners
    Elissa Bassler, CEO, Illinois Public Health Institute
    Kathleen Perkins MPA, Director, Kathleen E Perkins, LLC dba Bench Coach Consulting
    Sally Sutton, Program Coordinator, New Mainers Resource Center, Portland Adult Education
    John Shaw, President, Next Wave
    Keandra Wilson PMP CSM, Project Manager, HealthBegins
    Carl M. Toney, P.A., Health Care Planning Consultant, Association of Clinicians for the Underserved
    Sara Bader, MCD, CPHQ, Senior Manager, Upstream Quality Improvement, HealthBegins
    Kedar Mate, Chief Innovation Officer, Institute for Healthcare Improvement
    Dory Escobar, Founder, Director, Coaction Institute
    Tene Franklin, Vice Chair, Nashville, Davidson County Board of Health
    Annie Brack, RN BSNHCP, Care Coordinator, TCHD
    Young-Shin Lee, Associate Professor, San Diego State University
    GerriAnne Huey, MHA, Program Coordinator, DSHS
    Matt Malone, Head Coach, Tstreet Volleyball Club
    Kelly Malone, student, UCSB
    Makini Chisolm-Straker, Assistant Professor of Emergency Medicine, Icahn School of Medicine at Mount Sinai
    Lauri Winter, independent consultant, self employed
    Janelle Sauz, Researcher, New York University
    Sarah Lampe, President and Executive Director, Trailhead Institute, Colorado Public Health Workforce Collaboration
    Dianne Ritchie, Founder, Community Health Innovations of RI
    Holly Scheider, public health advocate and consultant, Holly Scheider consulting
    Pamela Guthman, DNP, RN-BC, Assistant Professor
    Deanna Wathington, MD, MPH, Dean, College of Health Sciences, Bethune-Cookman University
    Denise Cawley, Operations Officer, Healthcare Consulting
    Alma Swisher MA, CHW, Director, GCBC
    Amelia Harju, Population Health Fellow, Wood County Health Department & UW-Madison Population Health Institute
    Tara Immele LISW-S, PCBH Coordinator, GCBHS
    Zinzi Bailey, ScD, MSPH, Founder & CEO, Health Equity Research Solutions, LLC
    Gabrielle Solis, MPH, Nutrition Project Coordinator, The Fund for Public Health NYC
    Mardge Cohen, Physician, Boston Health Care for the Homeless Program
    Kristina Gelardi, PhD, Research Consultant, Harder+Company Community Research
    Michelle Frye-Spray, Concerned Citizen,
    Erica Reaves, Consultant, EquityfortheHealthofIt
    Catherine Cooksley, MPH, DrPH, CPH, retired epidemiologist, part-time educator
    Madison Swanson BHCM, College Graduate, independent
    Kayla Ringelheim MBA/MPH, Manager, Manatt Health
    Jeremy Cantor, MPH, Senior Consultant/Project Director, JSI Research & Training Institute
    Maura Dwyer, Senior Officer, Pew Charitable Trusts