Hundreds of millions of dollars were supposed to go to building a community health workforce after the American Rescue Plan Act was signed into law in March 2021, but much of the money is being quickly spent instead on health departments or national initiatives rather than local, community-based organizations, reported St. Louis Post-Dispatch on Friday.

Community health workers were positioned as key to U.S. President Joe Biden's public health agenda, but the funding situation has been making them difficult to maintain in the United States without consistent ways of payment, according to the report by this major regional newspaper based in St. Louis, Missouri, serving the St. Louis metropolitan area.

A healthcare worker shows a vial of the COVID-19 vaccine at Long Island Jewish Medical Center in New York, the United States, on Dec. 14, 2020. (Xinhua/Wang Ying)

"For bills and a car note, rent or children, that's just not sustainable," Denise Smith, the founding executive director of the National Association of Community Health Workers, was quoted as saying. "We can't do it for free."

Smith is optimistic that the association's current programs will secure money to keep its community health workers on staff and then use the goodwill they've built up in communities to focus on disease prevention.

However, "the fragmented American health care system -- and its systemic inequities -- won't disappear with COVID," while millions of people are poised to lose their insurance coverage as pandemic benefits run out, said the report.