Monthly Archives: April 2015

COMMUNITY HEALTH WORKERS IN CALIFORNIA: Sharpening Our Focus on Strategies to Expand Engagement JANUARY 2015

COMMUNITY HEALTH WORKERS IN CALIFORNIA: Sharpening Our Focus on Strategies to Expand Engagement   JANUARY 2015 – 40 pages

http://www.phi.org/uploads/application/files/2rapr38zarzdgvycgqnizf7o8ftv03ie3mdnioede1ou6s1cv3.pdf

CONTENTS:

Acknowledgements………………………………………………………………………………………………….2 Executive Summary…………………………………………………………………………………………………..3 Introduction ……………………………………………………………………………………………………………….6 Background ………………………………………………………………………………………………………………..8 Discussion Themes Design Considerations in Team-Based Care…………………………………..17 Skills, Recruitment, and Training of CHWs…………………………………………………………………..20 Organizational Capacity for Engagement …………………………………………………………………..23         Building Analytic Capacity ……………………………………………………………………………………….25     Taking the Engagement of CHWs to Scale: Recommendations……………………………………30       Appendix A………………………………………………………………………………………………………………33

TAKING THE ENGAGEMENT OF CHWs TO SCALE: RECOMMENDATIONS

The combined findings from the CHWA statewide assessment and technical consultation meetings provide a credible evidence base to inform the design of strategies that strengthen the engagement of CHWs in comprehensive team-based care in a variety of settings. While CHWs are extensively engaged by safety net providers in the state of California, there is no organized infrastructure to facilitate the rapid dissemination of innovations, develop expanded models of care that include primary prevention activities, build analytic capacity, develop functional links with mainstream providers, and ensure regional access to externally-validated training programs for CHWs and other providers. Common job definitions, recognized standards for core competencies, and a well-defined scope of practice that clarifies working relationships with other members of the care team are needed for both safety net organizations that currently engage CHWs, as well as mainstream organizations that are considering their engagement. These steps will not only provide a clear delineation of their roles and responsibilities, but also a framework for organizations to provide ongoing CHW training, supervision, and support to ensure optimal coordination and efficiency.

There is also a need to evaluate, refine, and replicate new delivery models and better document their impact upon patient experience, cost savings, and population health outcomes. Public policy development and targeted resource allocations are needed to build stable funding mechanisms, facilitate data sharing and service coordination across institutions, and to help organizations scale and formalize their engagement.

To ensure definitive progress in these areas — and to use the invaluable input provided by leaders from safety net organizations who participated in the three regional technical consultation meetings — we offer the following eight recommendations.

Recommendation #1

Establish a statewide clearinghouse to facilitate the rapid sharing of innovations, tools, best practice delivery models, and research support resources. The clearinghouse would engage a statewide network of stakeholders; this network would serve several functions: contribute knowledge, expertise, and resources; serve as a learning collaborative to inform the field on the design and evaluation of practical strategies; support the development of shared resources for the implementation of programs; and advocate for public policies to bring the engagement of community health workers to scale.

Recommendation #2

Develop a landscape analysis that outlines a scope of practice for CHWs that accommodates alternative approaches to team-based care and variations in the roles of other team members, and encompasses the full range of services and activities in clinical and community-based settings. The scope will also identify specific core competencies that will be required to demonstrate that CHWs have acquired or developed the necessary skills to complete the tasks to a satisfactory proficiency level through educational qualifications and/or work experience.

Recommendation #3

Conduct an independent assessment of employer-based, independent, and academic institution-based training programs across the state of California that describes content, scope and intensity, time frame, prerequisites, pedagogical models, geographic focus, and identified competencies. Findings from the assessment will be used to develop a comprehensive strategy to strengthen existing programs and ensure optimal regional access to training resources for both the entry of new CHWs and the additional skill development and advancement of existing CHWs.

Recommendation #4

Implementation of recommendation #3 will provide an evidence-based framework for consideration of competency-based certification standards for both new and existing training programs and for the individuals who complete the appropriate training. Certification of existing CHWs would be enabled through an employer-based examination process. A key consideration in the establishment of certification standards is to be cautious about the establishment of formal education prerequisites that may marginalize current CHWs with advanced knowledge, but lack formal educational training. On a parallel basis with the development of certification standards, the field would benefit from the development and promulgation of employer guidelines for effective recruitment, deployment, and professional development, and formalizing seniority and experience.

Recommendation #5

Identify regional sites to pilot the establishment of centralized data repositories that facilitate the integration of community-level data collection efforts and support the expanded use of collaborative data sharing tools for patient care management. These could start with a focus on Medicaid and uninsured populations among a subset of safety net and mainstream providers, and serve as precursors to regional health information exchanges. These pilot efforts would allow organizations to track and coordinate patient care at a community or regional level and enable the documentation and allocation of cost savings among providers and community based partners. 

Recommendation #6

Provide targeted technical assistance to community health clinics to develop or adapt existing evaluation tools to monitor and disseminate program outcomes. Technical assistance will include analysis and potential care redesign and team member role adjustment to facilitate increased accountability, clarity of function, and attribution of outcomes. Where appropriate, tools developed and/or refined as part of technical assistance will be disseminated as a clearinghouse function (see Recommendation #1).

Recommendation #7

Partner with mobile health technology organizations that are working internationally to adapt existing tools and leverage lessons learned to support mobile data collection, point of care decision support, and case management by CHWs and pilot those interventions with selected communities and organizations.

Recommendation #8

Develop a set of standard metrics that effectively capture outcomes associated with services and activities undertaken by CHWs to address the social determinants of health. The combined use of mobile technology by CHWs (recommendation #7) with standard metrics to document social determinants of health would inform strategies to develop social support systems and contribute to improved health outcomes at the population health level.

Closing Paragraph

Expanding the engagement of CHWs offers an immense opportunity to both enhance quality in our health care delivery system and to significantly expand efforts to address the social determinants of health in our communities, particularly in low-income neighborhoods where health inequities are concentrated.

While California safety net providers have been actively innovating in the use of CHWs, there remains an urgent need to focus attention and resources, rapidly disseminate emerging lessons and existing tools, and strategically build on what has been accomplished so far. The input provided by safety net providers through the CHWA statewide assessment and three regional technical consultations has informed the specific actions recommended in this report.

We look forward to working with colleagues, community stakeholders, and CHWs to realize community health workers’ full potential as critical intermediaries between the health care delivery system and broader efforts to improve health in our communities.

Appendix A: CHWA Technical Consultation Meetings List of Attendees (Note ZERO CHW)

 

 

 

Community Guide’s recent recommendations for CHWs working to prevent cardiovascular disease (CVD)

Community Guide’s recent recommendations for CHWs working to prevent cardiovascular disease (CVD). Here is a brief excerpt from the report:

“There is strong evidence of effectiveness for interventions that engage community health workers in a team-based care model to improve blood pressure and cholesterol in patients at increased risk for CVD. There is sufficient evidence of effectiveness for interventions that engage community health workers for health education, and as outreach, enrollment, and information agents to increase self-reported health behaviors (physical activity, healthful eating habits, smoking cessation) in patients at increased risk for CVD.”

The full report and methods can be found here: http://www.thecommunityguide.org/cvd/CHW.html

Thanks!
Caitlin

Caitlin Allen
Master of Public Health Candidate 2015
Behavioral Science & Health Education
Rollins School of Public Health | Emory University
Tel: 614-554-5298 | https://www.linkedin.com/in/allencg

Minnesota Website – Success with Community Health Workers working in Mental Health

Minnesota Website – Success with Community Health Workers working in Mental Health  

mentalhealth_banner

How to use this website  http://successwithchws.org/mental-health/

Welcome to our helpful web-based resource about the community health worker (CHW) role for providers who who address adult mental health and integrated health needs. Download our Provider Guide to Success with CHWs: Mental Health Services (PDF).
Contact:
Joan Cleary
Executive Director
MN CHW Alliance
joanlcleary@gmail.com
612-250-0902

Our vision: Equitable and optimal health outcomes for all communities

Learn more: www.mnchwalliance.org

Introducing SUCCESS WITH CHWs:

Improving the performance of community health workers: What can be learned from the literature?

By: Maryse Kok
ReachOut diagrams

 

http://chwcentral.org/blog/improving-performance-community-health-workers-what-can-be-learned-literature?utm_source=CHW+Members+1-29-15&utm_campaign=bbbdbb5016-CHWPerformance&utm_medium=email&utm_term=0_1c6055fc8a-bbbdbb5016-99100981

Neighborhood residents serve the community as health educators

USC Health

Neighborhood residents serve the community as health educators

Women lead a call to action as part of a Health Sciences Campus partnership funded by the Good Neighbors Campaign

Ramona Gardens Women's Health Initiative Promotora Graduation
Community organizer Victoria Ortega speaks during the Ramona Gardens Women’s Health Initiative ceremony. (USC Photo/Gus Ruelas)

Over the last few months, the Ramona Gardens housing development in the Boyle Heights neighborhood has been home to a community-wide movement led by local residents-turned-health educators, known in Spanish as promotoras.

As part of an evidence-based health education program on heart disease, diabetes and cancer, aptly named “Ahora es tiempo de cambiar” (Now is the time to change), lessons on a healthy diet and exercise provided more than just tips on lifestyle behaviors — they were a call to action.

As part of a collaboration among Clínica Monseñor Oscar Romero, Ramona Gardens residents and USC Health Sciences Campus Community Partnerships in Civic Engagement, “Ahora Es” is a program of the Ramona Gardens Women’s Health Initiative, funded by the USC Good Neighbors Campaign.

Ramona Gardens Women's Health Initiative Promotora Graduation

The good fight

On March 28, more than 70 promotoras and their families were welcomed by Zul Surani, executive director of HSC Community Partnerships, and his team in a ceremony honoring their achievements as certified community health workers. The event took place outside of the USC Norris’ Comprehensive Cancer Center’s Community Outreach Center and recognized the women as trusted health educators in the fight against top diseases affecting their families and neighbors.

“Leading-edge biomedical, clinical and public health research is being conducted on USC’s Health Sciences Campus to make progress against diseases that affect Ramona Gardens residents such as diabetes, heart disease and cancer,” Surani said. “What good is this progress if it cannot benefit our neighbors just across the street from us?”

Promotora Liliana Martinez, who has lived with diabetes for years, said “Ahora Es” came at a time when she was faced with the possibility of dialysis due to poor disease management. Like all 18 promotoras, who have the capacity to reach 550 residents through their health outreach and workshops, Martinez stressed the importance of education and new scientific discoveries in fighting diseases such as diabetes.

Romana Gardens Program

“Our time is spent taking care of others and in the process we neglect our own health and well-being,” she said. “I am grateful to everyone who has contributed to the program and to the promotoras who are a pleasant group that knows one another. We have shared our learning experiences together and with our families.”

As a result of “Ahora Es,” several participants formed walking groups and began to make healthier food choices. Some even reported weight loss.

Victoria Ortega, one of the original founders of the promotora group, said that her wish for the Ramona Gardens community is “for everyone to unite on a positive note because the Latino community definitely has the ability to do so.”

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APHA CHW Awards Nominations due April 27, 2015

APHA-CHW-Section-Logo

APHA CHW Awards Nominations due April 27, 2015

Calling for Nominations for the APHA CHW Section 2015 Awards:

Outstanding CHW of the Year Award & Outstanding CHW Group Award

Award Applications can be downloaded from www.michwa.org24a50782178998021a88b8cd4c8dcd8/a

Send your nominations by April 27, 2015
Download: Individual CHW Award Application
Download: Group CHW Award Application

American Public Health Association CHW Section is seeking nominations for the 2015 Community Health Worker Section Award. CHWs work, dedication, and efforts go beyond the call of duty and job description and their efforts often go unrecognized. For this reason, the APHA/CHW section would like to award two outstanding CHWs, one in the field of advocacy and one in the field of health promotion.

CHW & CHW Group Attributes:
* Advocates
* Outstanding work in the community
* Dedicated
* Promotes Health
* Compassionate
* Empower
* Education Planning

Send your application by April 27, 2015!!!!

Applications may be mailed, faxed, or emailed to:
Janel Lowman, MHA
University of South Alabama
650 Clinic Dr., Ste. 2500
Mobile, AL 36688
FX: 251-461-1725
Jlowman@southalabama.edu

Or
B.J. Ciesielski
(505) 255-1227
nmchwa@qwestoffice.net