Community Health Workers (CHWs) are Utilizing NCCARE360

By September 13, 2021 No Comments

When we think of health care, doctors and hospitals are likely the first thing to come to mind but health is affected by so much more than providers, clinics, or medication. Health is largely determined by our communities and all of the resources available—or unavailable—to us in these environments, as unmet non-medical social needs like food, housing, and transportation can cause negative health effects. For example, people who do not have access to grocery stores with healthy foods are less likely to have good nutrition, which raises their risk of health conditions like heart disease or diabetes. Positive health outcomes start in our communities. Who has the best knowledge of what communities need to achieve these positive outcomes than their own members? Fortunately, grassroot community health workers (CHWs) are leading the way.

CHWs are trained public health workers closing the gap between communities and health care systems. As trusted members of the communities they serve, CHWs provide critical services to those underserved and disproportionately impacted by public health threats, with one of the biggest threats right now being COVID-19. This trusting relationship allows CHWs to serve as a link between health and social services and the community in order to facilitate access to services and to improve the quality and cultural competence of service delivery. CHWs also “build individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support, and advocacy.” CHW activities include helping people complete applications to access health benefits, driving clients to medical appointments, or even providing health screenings. Now, NCCARE360 can support CHWs perform this important community health work.

NCCARE360 is the first statewide coordinated care network that helps providers electronically connect individuals with identified non-medical needs to community resources and allows for feedback and follow up. Now that NCDHHS has expanded the COVID-19 Community Health Worker program, bringing it statewide, CHWs are using NCCARE360 to make electronic referrals, communicate in real time, securely share client information, and track outcomes for our state’s most vulnerable populations.

This critical aid is happening all over North Carolina. At the beginning of August, Kinston, NC, achieved an above-average vaccination rate by making vaccine access a part of larger community-service efforts that utilized CHWs. NC COVID-19 vendors provided CHWs with tablets or laptops and mobile hotspots to leverage NCCARE360 and connect individuals and communities to traditional health care settings and organizations that address non-medical drivers of health.

CHWs are integral to connecting North Carolinians in underserved communities to medical and social supports. Since the CHW program started, more than 134,553 referrals have been made, connecting thousands of community members to needed services! The NCCARE360 implementation team is training and onboarding 350 additional CHWs to the NCCARE360 network this month so they can continue this critical work statewide.

If you have been impacted by COVID-19, or need help with vaccine support, please contact a CHW by reaching out to an organization in your county from this list.


About NCCARE360
NCCARE360 is the first statewide network that unites health care and human services organizations, assesses for and identifies unmet social needs, and enables a coordinated, community-oriented, person-centered approach for delivering care in North Carolina. NCCARE360 is the result of a strong public-private partnership between the NC Department of Health and Human Services (NCDHHS) and the Foundation for Health Leadership & Innovation (FHLI). The NCCARE360 implementation team includes United Way of NC, NC 2-1-1, Expound Decision Systems, and Unite Us.

For more information about NCCARE360, or any of its partner organizations, please send an email to

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