The US government is awarding more than $266 million from the American Rescue Plan to expand the nation’s community and public health work force, officials will announce Friday.
The plan’s overall investment in community health, outreach and health education workers – totaling more than $1.1 billion – is one of its “crown jewels,” said Gene Sperling, coordinator of the American Rescue Plan and a senior adviser to President Joe Biden.
The funding comes as some public and community health workers have faced intense workloads, backlash and burnout during the Covid-19 pandemic and throughout other overlapping health emergencies, including record-high drug overdose deaths, the monkeypox outbreak and the re-emergence of polio.
Most of the funding to be announced Friday, $225.5 million, will go to 83 recipients as part of a new training program for community health workers, who specialize in local efforts to help people find care and facilitate communication between patients and providers. The multiyear program will support training and apprenticeship for about 13,000 new workers.
“Thirty million people in America get their health care through community health centers that treat people regardless of their ability to pay,” said Carole Johnson, administrator of the US Department of Health and Human Services’ Health Resources and Services Administration, which is facilitating the grants. “Time and time again, we have seen community health workers make the difference when it comes to reaching out in communities and getting people engaged in care and then helping people stay connected to care.”
These health workers are able to build trust to serve as messengers in their communities, she told CNN.
“When you lead a very complicated life and you have to take three buses to get to a doctor’s appointment and you have to take time off work, it can be very, very hard to do what is routine for a lot of other people,” she said. “And so community health workers can be that essential bridge that can help make sure people stay connected to their health care provider,” whether it’s for chronic disease management, mental health and substance use disorders, or maternity care.
Thirty of the 83 recipients will get the largest grants, of $3 million each. One of them is El Sol Neighborhood Education Center in California, where project director Alexander Fajardo says the money will go toward basic and advanced training for more than 250 community health workers.
“As a community-based organization, we have had challenges to really be able to reach this federal funding for years,” he told CNN. “The big entities like universities or these big players, it’s hard for us to compete with them.”
A CNN report earlier this year described how some community health organizations – especially smaller, grassroots groups – struggled to navigate bureaucracy and access funds, even as they provided critical assistance to the US Covid-19 response.
Community health workers, also known as promotores, “are people from the community. They speak the same language; they face the same challenges,” Fajardo said. “Those qualities make them more effective when they are doing the work in the community. Because when they are talking about Covid-19 or diabetes or any situation, they relate with it. They have the same experience. ‘He’s my neighbor. I know them.’ “
Anyone wanting to transform a community “should be looking to these models of community health workers and promotores,” Fajardo said. “It is a super important system.”
Funding for public health training
The rest of the new grants, $40.7 million, will go to 29 schools across the country through the Public Health Scholarship Program, encouraging training and employment in public health.
Hundreds of public health officials have left the field just since the start of the Covid-19 pandemic, partly due to attrition but also because of criticism and other pressures.
“There’s no doubt that there has been significant underfunding at the state and local level for years in the public health work force,” Johnson said. The work her agency is doing, along with funding efforts by the US Centers for Disease Control and Prevention, is aimed at changing that.
“This is a moment when young people are really interested in and engaged in public health, and being able to give them experiences where they can start down a career path and give us an opportunity to then help leverage that and get them on a career ladder in public health is just a huge win for all of us.”
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Sperling told CNN that the new grants alone “may not be a long-term solution” to underfunding in these crucial health areas, “but I think it’s going to provide the enthusiasm and results that will encourage more long-term investments.”
The administration’s aim is to “use these types of funds to build careers, to give people a chance to both serve their country during this pandemic but also build a public health career and to be professional community health workers that could make such a big difference,” he said.