**Forthcoming in Progress in Community Health Partnerships (PCHP) 19.1. All rights reserved.**
ABSTRACT
The Problem: Recognizing the scale of challenges faced by the behavioral healthcare industry, there is a growing call to expand the utilization of community-based health workers (CBHWs). However, neglecting to fully understand the complex realities of working in these roles risks undermining the true costs and sacrifices made by CBHWs as we strive to reshape healthcare policies and systems.
Purpose of Article: Drawing on 21 interviews we conducted with CBHWs in Rhode Island, we describe the evolving role of CBHWs within traditional healthcare settings and identify policy and practice implications.
Key Points: CBHWs have been taking on the burden of a broken healthcare system while experiencing role transformation.
Conclusions: CBHW roles were designed in terms of a desired vision of the healthcare system – rather than the fragmented, overburdened institutional landscape that presently exists. Efforts to support CBHWs, without addressing the scale of role transformation, will continue to push much of the day-to-day labor underground.