Community Health Worker Institute

What We Do

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.

CHWI Core Capabilities

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:

Standardization & Adoption

Standard scopes of practice, training curricula, and supervision

Management & Accountability

Integration of CHWs into care corrdination teams with access to promote social and health serive coordination.
Internal administration and operations with MHS.
CHWs will be Montefiore employees

Embedded Science

Outcomes oriented research using pragmatic clinical trial
designs and real-world evidence will generate data informed
improvement and cost effectiveness research more rapidly

Sustainment & Scale

Adapting best practices system-wide. Demonstrating cost
savings using return of investment analysis. Dissemination
of major findings and lessons learned internally and externally


Social service

Patient & Community Participation: Research questions and implementation guided by community members
with local expertise and shared lived experience.

Who We Are

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.

Bronx Community Partners

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.

Selected Research

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.

Publications by Year:

If you would like to be part of this work, or if you have any questions, please contact us.

Community Health Worker Institute
Albert Einstein College of Medicine
1300 Morris Park Ave
Ste 410
Bronx, New York, 10461
Fax: 718-430-8816