If we have learned anything from the health care reform initiative, it is evident that change takes time, change takes effort, and change can be difficult. As New Mexico and other states increase efforts in developing CHW curriculums and certification, we can utilize information that has already been developed by other states toward this endeavor. In attending the APHA Annual Meeting in November 2009, I had the opportunity to attend poster sessions regarding CHW curriculum development, where states illustrated some of the work that has already been done around the country. As the current economy poses challenges in keeping CHW programs funded and jobs are lost, the key is to emphasize the cost savings that utilizing CHWs has on health care dollars. CHW programs do this by addressing the underlying causes of poor health and working as part of the health care team. We must prepare for change.

“Who Moved My Cheese,” the simple parable written by Spencer Johnson, MD, suggests ways to deal with unexpected change. He states the following:

• Change Happens — they keep moving the cheese.
• Anticipate Change — get ready for the cheese to move. 
• Monitor Change — smell the cheese often so you know when it is getting old. 
• Adapt to Change Quickly —.the quicker you let go of old cheese, the sooner you can enjoy new cheese. 
• Change — move with the cheese.
• Enjoy Change —savor the adventure and enjoy the taste of new cheese.
• Be Ready to Quickly Change and Enjoy It, Again — they keep moving the cheese.

He writes that we can learn by reading “The Handwriting on the Wall” — one of the characters in the book writes what he has learned on the maze wall so that others can benefit from it and learn from his experience. That is what we can all do regarding CHW curriculum and certification; we can collaborate and learn from each other to continue to develop the emerging CHW work force, linking disadvantaged communities to health care, education and working toward positive health outcomes.