By: Regan Kelso
1.CHWs: A Growing Field
The Community Health Worker field is growing as CHWs are becoming recognized as an essential need in healthcare systems. CHW interventions influence favorable health outcomes for many vulnerable populations who face social barriers. The positive impact of CHW work explains why federal Medicaid programs are ramping up CHW integration across the United States. CHW programs are on the rise.
Building an effective and long-lasting CHW program requires thoughtful consideration of how to implement organizational goals. A quality CHW program will consider assessments, evaluations, and the key team players involved. A successful program will stay true to CHW foundations and models as a whole. Structuring a CHW program will require a program lead or supervisor who can balance the operational needs of CHW work while carefully taking into account the unique needs of the community being served.
2. What is a CHW Supervisor?
A CHW Supervisor provides supervision, coaching, and direct services to a team of CHWs.
The CHW Supervisor has the power to create innovative programs that will advance, retain, and sustain the CHW profession. This role will recruit, hire, and train inclusive talent while fostering mentoring relationships to deepen the capacity of individual CHWs. This empowering position can have a boomerang impact on the community members who are then motivated to become CHWs.
Choosing a supervisor who understands the value of CHWs, barriers within the community, and the CHW profession can make a difference in how to care for those who will deliver services and the ones who receive program services.
I can’t think of a better person qualified to lead a team of CHWs other than a CHW.
3. CHW Supervisor Pathways
The education and work experience of CHW supervisors varies. Until recently, there was no linear pathway to becoming a CHW supervisor.
According to the National Academy of Medicine, “Historically, supervisors of CHWs were often individuals with backgrounds in social work or public health. As CHWs shift into health care, clinicians (e.g., nurses, and doctors) are often asked to supervise. This represents a challenge in some ways because the underlying paradigm of CHW work is different from the biomedical/clinical paradigm.”¹
Current discussions regarding CHW work centers around developing career pathways to promote CHWs to advanced roles and responsibilities. Remuneration is a topic within the discussion on how to distinguish between newly graduated entry-level CHWs and those with experience and expertise in the field.
In my five years of experience, I have never met a CHW who advanced to supervisor from their CHW role. The CHW supervisors I worked with had advanced degrees in public health or social work.
Innovative CHW programs like Baylor Scott and White Health have five CHW job codes to distinguish between CHW positions and compensation. A CHW in-training has the opportunity to become a CHW I, and CHW II can advance to CHW Supervisor.
Learning about Baylor Scott and White Health’s tiering system provides hope for the future of CHW career pathways.
More research and data collection is needed to give insight into how many CHWs hold supervisor titles along with their journeyed pathways.
4. CHW Instructor Training Programs May Lead the Way
One of the most common ways to become a CHW Supervisor is through education. Receiving advanced certification and/or degrees can help CHWs learn the necessary skills to leadership. Vocational Institutes like Community Health Alignment (South Carolina) and Umemba Health (Texas) offer a curriculum that provides skills needed to train and help supervisors lead CHW teams.

Quisha Umemba is the CEO and founder of Umemba Health, LLC, a public health education and consulting firm. Quisha says that Umemba Health “helps public health organizations and healthcare systems to educate their frontline workforce, empower their leadership, and expand their community presence to elevate the lives of the individuals and communities they serve.”
Expanding on their motto to educate, empower, and elevate, Umemba Health is known for their ability to help organizations to integrate, support, and train CHWs. They offer virtual CHW certification, CHW instructor “train-the-trainer” courses, and continuing education. These courses focus on clinical integration of CHWs and the CHW Instructor course focuses on virtual instructor-led training.
Expecting CHWs to know how to manage their peers without formal training may create some challenges,and some soft skills can’t be taught. Umemba nourishes soft skills to strengthen their students’ capacity to train CHWs adding an extra layer of cultural humility to practice.
Quisha emphasizes that “a good training program trains CHWs in the core competencies. According to the C3 Project recommendations, it is suggested that certified instructors with lived experiences as CHWs should provide training.”
These recommendations establish the fundamental aspects of CHW work, including core competencies. Taking the Instructor/Training course will reinforce the CHW certification and assist trainees with the skill set to effectively train CHWs.
Many of Quisha’s students have not only enhanced their CHW skill set, but advanced into leadership positions by staying true to their CHW foundation. Seeking additional education can help solidify a career pathway to train and supervision.
Quisha points out, “A good instructional training program will offer support services like mentorship, resume development, interview prep, and other resources to help CHWs get promoted on the job.”
Quisha suggests finding a program that offers scholarships and payment plans since the affordability of certification programs may present a challenge for CHWs who face financial barriers.
5. The Benefit of CHW-Led Supervision: “Nothing about us without us…”
While I have never experienced having a CHW as a supervisor, the supervisors with whom I worked truly demonstrated an understanding of CHW work. Still, I always felt like a key element in their leadership was missing. None of my supervisors had roots in my community. I once worked in a program with little CHW supervisor support. I always felt misunderstood discussing the challenges my community faced. And, in some ways, I felt misunderstood as I was a representative of the community I served. Sometimes, I felt like the supervisors looked at our program as insignificant compared to other healthcare departments. Feeling undervalued made it difficult to advocate for our patients. CHWs were told we were making too much noise when we brought up problems and possible solutions for addressing the lack of cultural humility towards patients. I soon realized that the healthcare facility could not properly support the needs of the CHWs. And, it was evident by the turnover.
In Chapter 10 of the manual, “Developing and Strengthening Community Health Worker Programs at Scale” (2014), Perry and Crigler mention that “most commonly, (CHW) Supervisors have never tried to function in the work environment of a CHW and thus lack inherent understanding of the CHWs role and challenges CHWs face in performing their work.”²
I was newly integrated into a multidisciplinary team on a hospital unit when a social worker was reluctant about the role I would serve on the team. Although this social worker received an in-service on CHW work, they were frustrated with my ability to build rapport and assist patients with some of their social barriers. This social worker openly questioned my need to be on the team, devaluing my certification over their graduate degree. I constantly had to advocate for my role and provide clarification in the ways our roles seemingly overlapped but did not cross boundaries in scope. I explained how my role on the team supplemented social work and how I could leave the hospital in real-time to accompany appointments at the social security office or the transitional assistance departments to navigate families through social systems. I would explain, “I am holding their hand while jumping through hurdles and helping families avoid unnecessary hurdles.” I spent so much time advocating for my role that I often left my job feeling burned out and not utilized properly. I eventually left that position.
CHW-led supervision can improve collaboration across disciplines and community partnerships. Supervisors can also advocate and problem-solve to find creative solutions to CHW integration to make CHWs feel supported.
CHW-led supervision can bring a unique perspective to work-life balance. CHWs are living experiences that make obtaining basic needs challenging. Getting to work without transportation is a struggle. Buying fresh groceries in a food desert is almost impossible. CHWs face the same obstacles. CHWs may also lack transportation and/or gas money for face-to-face engagements. CHW-led supervisors can meet this challenge with empathy while balancing oversight to ensure compliance with program policies and procedures.
6. Parkland Community Health: When Alignment and Empowerment Collide

Kharmynn Bullock was a long-standing member of Parkland Health’s Patient Family Advisory Council (PFAC) when she discovered her passion for Community Health Worker work during a presentation led by Vidya Ayyr, Director of Community Social Impact.
During the presentation, Vidya shared that she was creating a CHW program to address health disparities resulting from social determinants of health. This inspired Kharmynn to earn a CHW certification while simultaneously finishing a doctorate in public health.
When it was time to hire a supervisor for the program, Vidya who was unaware of Kharmynn’s educational pursuits, was surprised to learn that Kharmynn had received her doctorate. Vidya did not need to search far for a supervisor. Dr. Kharmynn was aligned, empowered and well-suited for the position.
Dr. Kharmynn now supervises a team of twelve CHWs in the program. Vidya shared, “Having Dr. Bullock as the CHW supervisor after she has served as PFAC member and CHW only works to enrich our program and build further trust with our patients, staff, and community.”
Out of the twelve CHWs hired, four are titled Senior CHWs. While Senior CHWs have additional responsibilities, all CHWs are positioned to work alongside each other supporting one another with outreach projects and patient caseloads.

“Senior CHWs provide mentorship, but all CHWs are equally structured under Supervisor Kharmynn.” Vidya also adds, “ It is important for CHWs to know they are leaders in their communities and to also see themselves as leaders within the organization that they serve.”
Parkland Health has an innovative CHW program that builds on Texas’ momentum to utilize CHWs in healthcare settings. Vidya and Dr. Kharmynn are both leading the effort to create health equity within their community while fostering an equitable work environment for CHWs within the organization.
Vidya Ayyr and Dr. Kharmynn Bullock are CHW champions whose dedication to healing their community while progressing the CHW profession can serve as inspiration for others in the field to follow. It should be noted that both Vidya and Dr. Kharmynn are both former students of Umemba Health, LLC.
7. A Word to CHWS: The Empowerment Lives in You
CHWs, this is your time!
Do you want to become a CHW Instructor or Supervisor? Then do it. Sign up for classes. Invest in yourself. Ask your employers about continuing education benefits. Check out programs, payment plans and scholarship information. If you decide that you want to go farther, you can!
Learning about Dr. Kharmynn’s ambition to become a CHW and obtain her Ph.D. truly inspired me. It made me realize how important it is for others to hear stories about other CHWs who are making strides in this work. We do not hear our stories enough. Quisha and Vidya remind me of the importance of showing up in this work. Putting yourself in a position to empower yourself can truly lead others to show up for themselves. Vidya wants CHWs to know that “you’re not just a CHW! Whether you have the CHW title, education, or not, you’re probably exhibiting a drive or passion to do this work…keep going!” Empowerment is not just within you, it’s within us!
*Umemba Health and Community Health Alignment offer both virtual instruction giving access to adult learners throughout the United States. Information about both programs can be found by visiting https://www.umembahealth.com/ and https://communityhealthalignment.org/
References:
- Brown, Orson, et al. “Supervision Strategies and Community Health Worker Effectiveness in Health Care Settings.” National Academy of Medicine, 3 Sept. 2020, nam.edu/supervision-strategies-and-community-health-worker-effectiveness-in-health-care-settings/.
- Perry, Henry, Lauren Crigler, and Steve Hodgins. “Developing and strengthening community health worker programs at scale: a reference guide for program managers and policy makers.” 2014. https://pdf.usaid.gov/pdf_docs/pa00jxwd.pdf