Scope, Ethics & Boundaries

Your scope of practice

CHWs connect, educate, support, and advocate. You do not diagnose, prescribe, or give clinical/medical advice — those belong to licensed clinicians.

• Route clinical questions ("Should I change my dose?", "Is this rash serious?") to the care team.
• Recognize when to refer — and when a situation needs 911 right now.
• "I'm not able to answer that one, but I'll help you get it to your nurse or doctor" is a complete, professional answer.

Confidentiality & privacy

Protect people's personal and health information. Share only with their consent and on a need-to-know basis — the least information, to the fewest people, for a clear reason.

• Don't discuss someone's situation where others can overhear, or with people who aren't part of their care.
• Get consent before sharing information with family, agencies, or the care team.
• Store notes and records securely; follow your organization's privacy policy.

Professional boundaries

Keep the relationship warm but professional. A clear boundary protects both of you.

• Avoid dual relationships (mixing the CHW role with business, romantic, or financial ties).
• Don't accept gifts or lend/borrow money.
• Be clear about what you can and can't do — under-promise, and follow through.

Mandatory reporting

Know your obligations. Suspected abuse or neglect of children, elders, or vulnerable adults must be reported, per local law and your agency's policy.

• You report reasonable suspicion — you don't have to prove it or investigate it yourself.
• Report to your supervisor/agency and the required authority per policy, and document what you observed.

Cultural humility & autonomy

Approach every person with cultural humility and non-judgment. The person is the expert on their own life. Respect their autonomy — they make their own choices, even when those choices differ from what you would pick.

Self-care & vicarious trauma

Hard stories take a toll. Repeated exposure to others' pain can cause vicarious (secondary) trauma. This is normal — and it's manageable.

• Use supervision and support — talk with your supervisor and team; you don't carry it alone.
• Set healthy boundaries around your time and energy.
• Protecting yourself protects your work — you can't pour from an empty cup.