Community Health Worker Institute

The Community Health Worker Institute (CHWI) strives to improve health equity by optimizing community health worker integration within clinical care teams. Community health workers are a bridge between social and clinical care and serve as an invaluable workforce for health systems. Using embedded implementation science, the CHWI aims to demonstrate the value and effectiveness of community health workers as an innovative workforce solution to address adverse social determinants of health, improve access to healthcare for disadvantaged populations, and serve as an entry point to sustainable healthcare careers for local community experts.

The CHWI is embedded within Montefiore’s ambulatory network where it serves as a resource for multiple clinical departments and service lines across Montefiore Health System. The CHWI optimizes the recruitment, training, deployment, continuing professional development and integration of community health workers (CHWs) while designing a cost-effective, value-based model to sustain them. The Institute has four primary objectives to achieve optimization of the CHW workforce at Montefiore and demonstrate a return on investment:

CHWI implementation and research is supported by the Community Health Systems Lab based at Albert Einstein College of Medicine. The Community Health Systems Lab (CHSL) includes an interdisciplinary team of researchers, clinicians, and community partners that supports and enhances CHWI operations through technical assistance and data systems learning. CHSL is embedded within the CHWI as the monitoring, evaluation, and learning unit.

CHSL is led by Kevin Fiori, MD, MPH, MSc, FAAP, Director of Social Determinants of Health, Community & Population Health at Montefiore Health System and Associate Professor of Pediatrics and Family and Social Medicine. Dr. Fiori also serves as the executive director of the CHWI. Renee Whiskey-LaLanne, MPH, MCHES, AE-C, is Associate Director of the CHWI and leads community partnerships and participatory research.

In a county as diverse as the Bronx, effective community partnerships are the key to success. The CHWI works with a broad coalition of community- and faith-based social service providers, government agencies, healthcare providers, public schools, and community colleges to design and deliver social care to families that identify a need.

Patient-centered care that includes social support cannot be developed without patients and their families. For this reason, the CHWI’s Community Advisory Board includes a group of diverse patients at the center of its council, which also relies on membership from local social service providers, healthcare organizations, and academic institutions to drive our interventions and research agenda.

The Montefiore Community Health Workers Institute is supported by multiple foundations, internal funds, and private donations. However, we are committed to the design of value-based payment mechanisms that support transformational change at the system level to improve health equity and provide sustainable employment opportunities for families in the long term.

Since 2018, Einstein faculty involved in designing the system-wide social needs screening program and CHW referral architecture have published presentations, peer-reviewed articles, and research reports sharing results and lessons learned.