Office of Community Health Workers

The New Mexico Department of Health's OCHW was established in 2008 by former Department of Health Cabinet Secretary Alfredo Vigil. The Office of Community Health Workers has developed a standardized, statewide training program and a certification process for community health workers (CHWs). New Mexico stands out as one of the few states with an Office of Community Health Workers.

The formal recognition and utilization of CHWs as an essential part of a cost-effective health care system received legislative support with the passage of the Senate Bill 58 - Community Health Workers Act during the 2014 legislative session. This Act enables the New Mexico Department of Health to offer voluntary certification for CHWs in the state.

While CHW certification will be a key activity of the OCHW, the overall goal is to support the CHW profession and workforce development. Training, technical assistance, and promotion of career development will be offered to all CHWs, regardless of certification status. Venues for stable funding of CHW services, including but not limited to Medicaid payment, are being explored.

The development of a strong and competent CHW workforce through training, certification, advocacy, and support will increase recognition and utilization of CHWs to their full capacity as integral members of health care and social community service delivery teams in both public and private sectors. The diversity of CHW programs will also provide opportunities for personal and professional growth.

CHWs are frontline public health workers and critical members of health care delivery teams. They focus on the social aspects of care that support and enhance critical clinical activities such as diagnosis, treatment, or clinical procedures that are performed by licensed health professionals like doctors and nurses. These social and routine aspects of chronic care often are not prioritized in busy and resource-low clinical settings which can be managing high patient loads each day. This care is essential to assist families to adopt and maintain behavior change skills needed to manage their health, and to overcome barriers encountered in the health care system.

Because CHWs may face the same barriers as the individuals and families they serve, and because they share the same language, ethnicity, cultural, educational, and class background, they are uniquely positioned to act as bridges between their communities and the health and social service systems. By providing a wide variety of services and health information in a linguistically and culturally appropriate manner CHWs can extend the reach and quality of health care services to improve health outcomes.

CHWs are nationally recognized as health professionals by the US Department of Labor, and as an essential part of cost-effective health care systems. They have a critical role in reducing health disparities, increasing access to care, and coordinating comprehensive care for individuals.

The work of CHWs helps to build individual and community capacity to improve health status by:

• Offering culturally responsive education in easy to understand language to increase health knowledge and self-sufficiency;
• Teaching and supporting families to learn the knowledge and skills needed to manage treatment and prevent disease;
• Linking communities to health and social service systems of care and helping them to navigate the systems to overcome barriers;
• Expanding the health care workforce in underserved communities;
• Informing the clinical care team of social aspects of the family's life that may impact the treatment plan;
• Advocating for services to meet community needs, and empowering individuals and communities to advocate for their health.

Note:Portions of this content were adapted from the Community Health Works, 2006: Community Health Workers/Promotores in Chronic Care: A Discussion Paper.

Promotores(as) de Salud and Tribal Community Health Representatives (CHRs) are terms that are commonly used in our state to refer to an emerging workforce more broadly known as Community Health Workers (CHWs). CHWs, CHRs and Promotores (as) de Salud, have been an important part of health care and social services delivery in New Mexico since the 1960s.

New Mexico CHWs serve all ethnic groups in urban, rural, and frontier settings around the state. Like the communities they serve, New Mexico's CHWs are culturally diverse and have multiple skills that reflect the needs of their communities.

The CHW Scope of Work represents the full range of what CHWs can do, recognizes that CHWs may perform all or some of these roles depending on their job, reflects the input of NM CHWs, employers, and the results of NM & national CHW workforce studies.

Many CHWs in the state work for publicly funded health care provider organizations such as: health clinics, hospitals, local public health departments, tribal health programs, or community-based organizations with an emphasis on social or health services. There are several CHW professional organizations in New Mexico that work to promote a CHW model and provide educational and professional development opportunities for CHWs.

The wide variation of CHW training programs and curricula results in inconsistencies in rigor, content, delivery, and evaluation of CHW training. The Office of Community Health Workers, in collaboration with community partners, has developed a standardized CHW training curriculum based on a defined set of core competencies. Standardized training and voluntary certification have been identified as necessary steps to develop a common, transferable knowledge base among CHWs and gain the recognition of other health-care professionals for the value of CHW services.

New Mexico is defined by several characteristics that act as significant barriers to health and health care access. New Mexico is a frontier state with over 1/3 of our population living in frontier areas. These areas have low population densities and distances to access services require long travel times. New Mexico is one of the most diverse states in the nation with a population that is 82.5% White, 10.5% American Indian/Alaska Native, 2.6% Black or African American, and 1.7% Asian. New Mexico's population is 48% Hispanic or Latino.

There is a critical shortage of primary, oral, and mental health care providers in New Mexico. The overwhelming majority of New Mexico's counties are federally designated by the Health Resources Services Administration (HRSA) as either Medically Underserved Areas (MUA) or Medically Underserved Populations (MUP). New Mexico has levels of poverty and uninsured that are well above the national average.

The combination of these factors results in highly visible health disparities for New Mexico's residents. The combination of these factors results in highly visible health disparities for New Mexico's residents. Please see our Health Equity in New Mexico 2019 report for details.