Bill Overview
Title: Building a Sustainable Workforce for Healthy Communities Act
Description: This bill reauthorizes through FY2027 and revises a program carried out by the Centers for Disease Control and Prevention that supports the use of community health workers to improve health outcomes in medically underserved communities. The bill also requires the Government Accountability Office to report on the effectiveness of and other matters concerning the program.
Sponsors: Sen. Casey, Robert P., Jr. [D-PA]
Target Audience
Population: People in Medically Underserved Communities Globally
Estimated Size: 55000000
- The bill focuses on community health workers who are pivotal in providing healthcare services to underserved communities.
- Medically underserved communities are composed of individuals who have limited access to healthcare resources due to a lack of facilities, professionals, and financial means.
- The bill aims to improve health outcomes which directly affect the people within these communities by improving service delivery.
- Globally, many regions face similar healthcare access issues, meaning the program's strategies could potentially inform international efforts.
Reasoning
- I considered 10 different profiles that are likely to exist in the population targeted by the policy. These profiles include a range of impacts from 'none' to 'high'.
- The population covers a diverse range of age, gender, and geographic location to reflect the varied nature of underserved communities.
- The policy budget is limited, so I simulated interviews with people who have different levels of existing access to healthcare resources.
- Some of those interviewed are community health workers themselves, as they are directly involved in the execution of this policy.
Simulated Interviews
Community health worker (New Orleans, Louisiana)
Age: 32 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 12/20
Statement of Opinion:
- I believe this policy could significantly enhance our capacity to reach more women who need maternal health support.
- Additional resources are desperately needed to sustain ongoing efforts in underserved areas.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 9 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 8 | 5 |
Farmer (Rural Wyoming)
Age: 45 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 8/20
Statement of Opinion:
- This policy might finally bring consistent medical attention to our area.
- It would be helpful to have trained professionals who can check in on our well-being regularly.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 4 |
| Year 20 | 5 | 4 |
Retail worker (South Bronx, New York)
Age: 28 | Gender: other
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 15/20
Statement of Opinion:
- The increase in community health workers might help us feel that our health concerns matter.
- It's crucial to have someone who understands local issues and cultural context.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 6 | 4 |
| Year 10 | 7 | 3 |
| Year 20 | 6 | 3 |
Retired coal miner (Appalachia, West Virginia)
Age: 60 | Gender: female
Wellbeing Before Policy: 3
Duration of Impact: 5.0 years
Commonness: 6/20
Statement of Opinion:
- The community health workers can help manage my health better without having to travel long distances.
- My local clinic is too understaffed to provide adequate care.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 3 |
| Year 2 | 5 | 3 |
| Year 3 | 5 | 3 |
| Year 5 | 6 | 3 |
| Year 10 | 5 | 2 |
| Year 20 | 4 | 2 |
Unemployed (Los Angeles, California)
Age: 34 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 7.0 years
Commonness: 10/20
Statement of Opinion:
- Having more community health workers could make mental health services more accessible to me and my neighbors.
- This initiative could provide job opportunities, too, which is greatly needed.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 7 | 4 |
| Year 20 | 6 | 4 |
Student (Chicago, Illinois)
Age: 25 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 3.0 years
Commonness: 14/20
Statement of Opinion:
- I think this new policy can support both my education and community initiatives.
- It'll be great to have better health support for everyone, especially the elderly.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
Fisherman (Remote Alaska)
Age: 52 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 8.0 years
Commonness: 5/20
Statement of Opinion:
- I'm hopeful that the policy will provide us with more reliable health care options.
- Currently, we rely on self-care and infrequent medical visits.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 6 | 3 |
| Year 10 | 5 | 3 |
| Year 20 | 4 | 3 |
Hospital nurse (Houston, Texas)
Age: 38 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 20.0 years
Commonness: 12/20
Statement of Opinion:
- These community health workers can ease the burden on our overstretched hospital staff.
- They are essential for preventative care and education.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 7 | 5 |
Elder (Indian Reservation in South Dakota)
Age: 65 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 4/20
Statement of Opinion:
- The policy can help address the severe lack of healthcare access on the reservation.
- Having trusted health workers from the community will be transformative.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 8 | 3 |
| Year 10 | 7 | 3 |
| Year 20 | 6 | 2 |
Social worker (Detroit, Michigan)
Age: 30 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 7.0 years
Commonness: 13/20
Statement of Opinion:
- Increasing the number of community health workers can really support our educational workshops.
- It's a necessary part of closing the health disparity gap in our area.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
Cost Estimates
Year 1: $250000000 (Low: $200000000, High: $300000000)
Year 2: $250000000 (Low: $200000000, High: $300000000)
Year 3: $250000000 (Low: $200000000, High: $300000000)
Year 5: $250000000 (Low: $200000000, High: $300000000)
Year 10: $250000000 (Low: $200000000, High: $300000000)
Year 100: $250000000 (Low: $200000000, High: $300000000)
Key Considerations
- The effectiveness of community health workers in improving health outcomes.
- Potential challenges in recruiting and retaining qualified community health workers.
- The scalability of the program to effectively cover all medically underserved communities.
- The ability of the GAO to effectively measure and report on the program's impact.