Table 2.

Building the COVID-19 Response and Recovery Community Health Infrastructure

Expand the workforceRecruit and train (100,000 to 200,000) a new Community Health Worker Corps comprised of public health workers, primary care practice staff, and members of the communityIntroduce community health workers and primary care-public health extension agents44,45,47,48 to public health settings and primary care practicesTrain community health workers to provide community-engaged behavioral health screening, detection, referral, and educationWhere available, add public health competencies to community health teams (which consist of social workers, behavioral therapists, and community health workers)Create a national program for locally based interpretation consortia for individuals of limited English proficiency
Train the workforceDevelop a core medical school curriculum in primary care-public health collaboration, including a public health rotationSupport inter and trans-disciplinary training“Public health for the local primary care clinician:” Primary care residents and primary care practice staff (nurses, medical assistants, and clinicians) will be trained by local public health staff in testing, contact tracing, and immunity testing.“Primary care for the local public health professional:” Public health professionals and students will be trained by local primary care clinicians in screening, referral, tracking of MEB health, and other primary care essentials“Public health and primary care for all clinicians:” Provide all health profession students with interprofessional education/training in testing, tracking, tracing, MEB screening, and other primary care essentials
Enhance collaborationCreate opportunities for data sharing between public health and primary care that maintain confidentiality but also facilitate rapid identification, contact tracing, and interventionEngage funding agencies and payers to consider how to provide financial support for public health and primary care teamsEstablish a responsible federal agency to inspire, help guide, and sustain communities of solutionEngage professional associations and licensing and certification boards to promote transdisciplinary professionalism, scope of practice, quality, and accountability.Create activities/events for public health and primary care to co-create, co-brand, co-lead, co-operate in local communities. This must include funds to pay primary care clinicians and public health professionals to participate (i.e., replace patient encounter revenue).Develop and/or enhance robust connections with community-led task forces charged to address and mitigate the health care disparities of minority populations
Conduct ongoing evaluationCreate and sustain an analytic workforce to assess progress and drive improvement.Plan, implement, coordinate, and fund clinical research, epidemiological studies, and community-based participatory research to evaluate community of solution functions and interventionsConduct studies that assess the impact of engagement of those most proximal to the problem in co-creating solutions that foster equityConduct studies that assess the impact of models of care that bring together public health and primary careEvaluate the impact of new curricula on professional competencies and behaviorDevelop research training programs that support public health and primary care professionals to develop skills that enable them to become independently funded researchers who prioritize team and systems-based approaches to change
  • Abbreviation: MEB, mental/emotional/behavioral.