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Board backs feasibility study to build countywide community health worker hub
Summary
After a multi‑hour presentation and broad public support, the Board accepted a feasibility report recommending a county‑backed “hub” to sustain and scale promotor/community health worker programs in East San José and South County, and instructed staff to pursue funding partnerships with Medi‑Cal managed‑care plans and local funders.
The Santa Clara County Board of Supervisors accepted a preliminary feasibility study on April 26 that lays out a countywide approach to expand and sustain promotor and community health worker programs in neighborhoods with the greatest need.
Dr. Sara Redmond, director of the county Health Department, told the board the Latino Health Assessment repeatedly recommended community health workers as a key way to reduce disparities: “When you leverage the wisdom of the very community who needs service, you see the best possible outcomes,” she said.
Health‑department researchers described a blended funding model, a centralized administrative backbone and training pathway. Victoria, the department’s senior health economist, presented the fiscal case: each community health worker position costs roughly $113,000 per year and the model produces an estimated $278,000 in avoided healthcare costs per position — about a 2.5:1 return — though much of those savings accrue to Medi‑Cal plans, hospitals and households rather than the county budget directly.
The study recommends creating a “community resilience hub” to broker billing arrangements, provide shared infrastructure and convene a network of community‑based organizations to expand supervision, training and billing capacity at scale. The hub would not deliver direct services but would support local CBOs that do.
Dozens of promotors, community providers and health‑plan representatives told the board the county should act. “Promotors are trusted community members who provide education and access,” said Amy Goncalves, a promotor who testified in chambers. Community groups urged the board to prioritize pay equity, training gaps and funding stability.
During board discussion Supervisor Arenas urged quick steps to secure partner investments. James Williams, a county administrator, recommended asking the three county Medi‑Cal managed‑care plans to consider proportional investments and pursuing philanthropic fiscal sponsors such as Sobratoto to host backbone funding. The board approved a motion to accept the report, direct administration to pursue funding conversations with the managed‑care plans and to explore a fiscal sponsorship/backbone arrangement and related next steps.
Next steps include outreach to managed‑care plans, issuing requests for proposals for needed services (for example, day‑intensive treatment), developing a hub governance plan and returning to the board with implementation options and an updated budget timeline.
The board vote to accept the report was unanimous.
