A Job Task Analysis for Community Health Workers

Coordinated by the Community Health Works of San Francisco Facilitated by the DACUM 24

The Community Health Works of San Francisco

Department of Health Education

San Francisco State University

1600 Holloway Avenue

San Francisco, CA 94132-4161

Phone: (415) 338-3034

FAX: (415) 338-0561

E-Mail: [email protected] 1996

The Community Health Training and Development Center (formerly The Community Health Worker Training Program) began in 1992 after a series of community conferences pinpointed the need for an educational program for grassroots Community Health Workers (CHWs). At that time, San Francisco State University and City College of San Francisco formed a partnership to establish the first college sponsored training program for CHWs in the United States. In 1992 we published a statewide systematic survey of 1500 CHWs and 200 major employers further specifying training needs, and in 1996 a regional survey of the San Francisco Bay Area. After “an extremely competitive nationwide search” carried out by MPR Associates, we were recognized as one of the “15 most innovative and promising health employment training programs in the country” and featured in a report to the Annie E. Casey Foundation by Seedco.

First-level health professionals work under some 35 titles. These titles as catalogued by the Centers for Disease Control include Social Services Coordinator, Community Health Outreach Worker (CHOW), Public Health Aide, Case Manager and Community Health Specialist, while others have titles based on their topical area of specialty, e.g. Drug and Alcohol Counselor and Nutrition Assistant.

In the spring of 1996, a panel of twelve high-performing Community Health Workers (CHWs) or Community Health Advisors (CHAs) gathered to participate in a two-day workshop at San Francisco State University. The purpose of this workshop was to identify the main competencies that CHWs/CHAs perform on a daily basis. The Spokane Community College DACUM Resource Center facilitated the workshop. DACUM is an acronym for Develop a Curriculum. The Center has carried out job task analyses for over 200 occupations.

Such a job task analysis provides a framework for a training curriculum that is up-to-date and based on the realities of the practice setting. This analysis is a step in developing a competency based training curriculum which will result in a Standards of Practice Manual including job duties and standards indicating when the task is being performed at a mastery level.

Vickie Quijano

Curriculum Specialist


Date: March 29 and 30, 1996

Coordinator: Vickie Quijano, Curriculum Specialist, San Francisco State University

Facilitator: Dr. Robert S. Clark, Spokane Community College

Recorder: Gloria Garner, Spokane Community College

Panel Members:

Eliana Adler, St. Luke’s Women’s Clinic

Sharrie Arcenaux, Bay Area Urban League

Helen Casaclang, Asian Perinatal Advocates

Lisa Clayton, Berkeley Primary Care Access Clinic

Tanzania Edwards, Berkeley Health and Human Services

Diane Gatewood, Family Recovery Project

Rey Macawile, Comprehensive Outreach Project for Asian Substance Abusers

Rachel McLean, Project SAFE

Ana Celia Montenegro, San Francisco, Women, Infants and Children (WIC)

Carla R. Roberts, Homeless Prenatal Program

Jason C. Stanford, Alameda County Health Department

Beverly Thompson, Alameda County Health Department


The Community Health Works of San Franciso is funded in part by the Fund for the Improvement of Post Secondary Education (FIPSE) U.S. Department of Education, Carl D. Perkins Vocational and Applied Technology Education Act, the Bernard Osher Foundation, and the Chancellor’s Office of the California Community College System.


Overview of Competencies

  1. Client Interviewing/Intake

1.Begin the Interview

  1. Discuss Policy and Procedures
  2. Practice Communication Techniques
  3. Assess Client Needs
  1. Client Orientation
  1. Discuss Agency Services
  2. Explain Agency Policy and Procedures
  1. Coordinating Client Care
  1. Keep a Client File
  2. Develop a Plan of Care
  3. Track Clients
  1. Document and Report Client Information
  1. Document Client Information
  2. Report Client Information
  1. Provide Referral Services
  1. Give Referrals
  2. Maintain Referrals
  1. Provide Health Information
  1. Provide Client with Health Information
  2. Assist in Health Service Planning and Development
  1. Community Health Education
  1. Planning, Implementation and Evaluation
  2. Working in Groups
  3. Community Outreach
  4. Community Organizing


  1. Client Interviewing/Intake

A1 Beginning the Interview

Preview client information

Introduce self to the client

Welcome the client/establish rapport

Establish a comfortable and quiet interviewing environment

Identify and address language barriers

Explain the purpose and process of the interview

A2 Discuss Policy and Procedures

Explain confidentiality policy and exceptions

Advise clients of legal rights/immigrant policy

Obtain a signed release/waiver from client

Assist client in filling out forms and paperwork

A3 Practice Communication Techniques

Use appropriate eye contact and body language

Use plain language instead of jargon

Use open-ended questions

Use active listening skills

Verify what you heard to the client

Obtain a translator, if needed

A4 Client Needs Assessment

Determine, evaluate and prioritize needs with the client

Clarify client needs and concerns by paraphrasing

Determine client eligibility for services

Seek consultation from supervisor, if needed

Inform client about what will happen next


  1. Client Orientation

B1 Discuss Agency Services

Explain services the agency offers

Explain agency schedule of services (i.e., specific clinic days)

Inform client about what to expect during agency visits

Give the client agency resources, handouts and pamphlets

Explain managed care and utilization of the system in non technical language

Explain roles of health team members

B2 Explain Agency Policies and Procedures

Take client on a tour of the agency

Explain appointment protocol: cancellation policy, hours, after hours

Explain caregiver team approach

Explain emergency procedures

  1. Coordinating Client Care

C1 Keep a Client File

Set up a client file using agency format

Document client history/information/progress

Give the client agency resources, handouts and pamphlets

Follow established agency legal guidelines

Conduct case presentations in staff meetings

Store client files securely

C2 Develop a Plan of Care

Create a treatment plan with the client

Discharge client upon termination

C3 Track Clients

Make and keep appointments with clients

Make follow up contact with the client based on agency policy

Review treatment to date

Visit client at other sites: home, shelter, hospital, jail

Refer client to other services


  1. Document and Report Client Information


D1 Document Client Information

Explain to the client what you are documenting

Explain how the information will be used

Record client history

Write general notes for self

Follow established charting protocols: date, sign, initial

D2 Report Client Information

Review cases with supervisors

Give case presentations

Write reports

Explain reporting protocols

  1. Provide Referral Services


E1 Give Referrals

Explain the purpose and procedures of referrals

Explain referrals and how they will benefit the client

Explain detailed information about the referral agency

Identify and address possible client barriers to accessing referrals

Call referral agency to advocate for client access and track access

E2 Maintain Referrals

Develop and maintain a community resource/referral book

Establish and maintain contact with referral agencies and key contacts

Assess and evaluate referral information



  1. Provide Health Information


F1 Provide Client with Health Information

Provide health advising: routine/low-risk situations

Perform health presentations and demonstrations

Distribute informational handouts and pamphlets

Identify myths and misconceptions

Discuss effective ways to address myths and misconceptions

Assist client with personal issues: goal setting, empowerment

F2 Assist in Health Service Planning and Development

Develop or obtain literacy-appropriate educational materials

Demonstrate general knowledge about health issues

  1. Community Health Education


G1 Planning, Implementation and Evaluation

Conduct needs assessments

Participate in program planning, implementation and evaluation

Administer pre- and post-test evaluations

Determine target populations

Stay current with health issues and statistics

G2 Working in Groups

Plan and give presentations

Facilitate and participate in group process

G3 Community Outreach

Participate in the outreach process

Plan and participate in health workshops/fairs

Distribute educational materials

Work on crisis hotlines

G4 Community Organizing

Initiate and participate in community events/health fairs

Recruit and work with volunteers

Act as a liaison between community leaders and members

Use the media for community announcements

Build and organize networks

Develop written materials for community

fn: Final DACUM/Standards of Practice disk/vq