Integrated primary and behavioral care for people who are homeless: community health worker contributions

Community health workers (CHWs) are imperative to helping patients navigate integrated primary and behavioral care clinics, yet research is lacking regarding their role. Through participant observation and semi-structured interviews with clinic patients and staff, we describe how CHWs engage and retain people who are homeless in an integrated medical home on the West coast of the USA. CHWs ultimately served as the hub for patient care, enabling the patient to develop a sense of belonging at the clinic. A lack of boundaries and support predisposed CHWs to burnout, which may be addressed by clarifying role, increased training, and ongoing guidance.