What is a fundamental limit of CHW authority in client care?

• A. CHWs cannot diagnose; they refer to clinicians.
• B. CHWs can prescribe medications.
• C. CHWs can override patient decisions.
• D. CHWs can replace doctors for all care.

Answer: (A)

Understanding the limits of a CHW’s scope of practice is crucial. CHWs are trained to support clients, provide education, help navigate the health system, and connect people with clinicians. They do not perform medical diagnoses; diagnosing requires clinical assessment, interpretation of signs and symptoms, and medical decision-making that comes with appropriate licensure and training. Therefore, the fundamental limit is that CHWs refer clients to licensed clinicians for evaluation and diagnosis rather than making those determinations themselves.

Prescribing medications is another area outside typical CHW authority, as prescribing requires medical licensure and specific credentials. CHWs also do not override a client’s informed decisions or replace physicians for all care; their role is to empower and support clients while coordinating with clinicians to ensure appropriate care.