NE North Dakota News

Community health workers are playing an increasingly important role in rural North Dakota, acting as a link between patients and essential services. Unlike traditional healthcare positions such as nurses or dentists, the responsibilities of community health workers can differ widely depending on the needs of each community.

At Coal Country Community Health Center (CCCHC) in Beulah, Kylee Schmiesing serves as the organization’s first and only community health worker. Since October 2023, she has worked within the Medicare Chronic Care Management program to support residents across Beulah, Hazen, Center, and Killdeer who face chronic conditions like COPD, heart failure, hypertension, diabetes, and kidney disease. Schmiesing checks in with patients by phone and makes home visits to help those unable to travel for care. She collaborates with a nurse and social worker to assist about 150 patients.

“There’s a lot of patients living on a fixed income who need assistance with different programs, so I help with applications to Medicaid, low-income housing, or the Supplemental Nutrition Assistance Program (SNAP),” Schmiesing said. “If someone needs food or help caring for their home, I can help them contact the local food pantry and get them set up with a homemaker to help with cleaning and care.”

In Grand Forks at Altru Health System, Kaylee Caspers also works as her institution's first community health worker. Caspers helps connect patients flagged during entry surveys with resources related to housing, transportation services, and food assistance programs such as SNAP. She describes her work as focusing on social determinants of health: “Most of the work I do relates to social determinants of health,” said Caspers. “The goal is to find a solution that will work for that person in the long-term.” Caspers balances this role while pursuing her master’s degree.

Melissa Stern fills a similar position at Sanford Hillsboro Medical Center in Hillsboro. Stern addresses issues such as food insecurity by growing vegetables for diabetic or food-insecure patients and works on transportation challenges by launching initiatives like providing rides for medical appointments and lending out equipment that supports independent mobility.

Partnerships play an important part in these efforts. For example, through connections with organizations like Community Action Partnership of North Dakota—which operates statewide—patients have received vital equipment including walk-in showers at no cost.

The state has begun formalizing support for this profession; in 2023 the North Dakota Legislature created a taskforce aimed at developing guidelines for certification and reimbursement related to community health workers’ services.

Rebecca Quinn from the University of North Dakota School of Medicine & Health Sciences participates in this task force. She said: “Community health workers are trusted members of the community who serve as a bridge to healthcare. Often, they provide services outside of our brick and mortar system. For rural communities, this can be vital to extending the reach of healthcare, improving access for individuals.”

Despite their impact on patient lives—including helping navigate government benefits or offering regular check-ins—the title "community health worker" remains unfamiliar among many people outside healthcare circles.

“Oh no, I always have to explain what my job is,” said Caspers when asked if others know what she does by title.

Both Caspers and Schmiesing agree that direct patient interaction is among the most rewarding aspects of their roles.

“I love working with the patients,” said Caspers. “I love building relationships with people and seeing the progress that they make and see how far they’ve come.”

Schmiesing echoed this sentiment: “When I visit with the patients and see the smiles on their faces, that’s the best part of my job. It’s a great feeling to know that I am helping to improve their lives.”

As rural areas often face limited resources or challenging transportation options for accessing care—especially during harsh winters—community health workers continue filling gaps by linking people directly with necessary support systems.