REPORT The 2016 progress report of the CHW Core Consensus (C3) Project
Understanding Scope and Competencies: A Contemporary Look at the United States Community Health Worker Field Progress Report of the Community Health Worker (CHW) Core Consensus (C3) Project: BUILDING NATIONAL CONSENSUS ON CHW CORE ROLES, SKILLS, AND QUALITIES
Project Focus: to help advance consensus in the U.S. Community Health Worker (CHW) field by producing recommendations for consideration and adoption on common elements of CHW Scope of Practice and Core Competencies. It is anticipated these recommendations, building on foundational work in the field, will be useful in various settings including in the design of training curricula and CHW practice guidelines for use at the local, state, and national levels.
C3 Project Timeline:
- Launch: Summer, 2014
- Findings Review Meeting:
at American Public Health Association (APHA) Annual Meeting,
November 15, 2014, 2:30-5:00PM
at American Public Health Association (APHA) Annual Meeting,
November 15, 2014, 2:30-5:00PM
Opportunity for Input: Participants will learn about the C3 project’s mission and methods and will be invited to respond to draft recommendations being made by the project team. Participants will also be invited to provide input regarding strategies for continuing work both to refine recommendations, and to develop strategies to encourage adoption of the recommendations throughout the U.S.
- Recommendations Release: Spring 2015
Project Origins: The C3 Project builds on earlier work (Phase 1) led by the National AHEC Organization (NAO) on CHW curriculum funded by the Amgen Foundation. C3, with continued funding support to NAO from the same source, is collaboratively led by NAO representatives and team members from the University of Texas – Houston Project on CHW Policy and Practice, in collaboration with consultants who are leaders in CHW capacity building. As in Phase 1, the Project looks to the American Public Health Association CHW Section leaders and the Section’s Education y Capacitación Committee for guidance.
For more information on the C3 Project, and to receive regular updates contact: firstname.lastname@example.org
Project on CHW Policy and Practice, University of Texas – Houston:
For NAO’s CHW Working Group contact Leslie Hargrove at: email@example.com
C 3 Project Values and Principles
Developed in Spring 2014 in consultation with Project consultants and administrative team in preparation for the C3 Project launch set for June 2014.
· Come from the communities they serve;
· Be recognized as members of a unique profession with a unique scope of work;
· Be meaningfully involved in efforts to create policy for their field;
· Be trained and supported to play a full range of roles and work across all levels of the socio-ecological model;
· Be recognized and rewarded for their experiential knowledge;
· Participate in initial and on-going training that is informed by and based on popular education and adult learning and that includes relevant and practical content;
· Receive sufficient and appropriate supervision that supports their professional growth;
· Be compensated at a level commensurate with their skills and contribution; and
· As they gain experience, be involved as trainers for new CHWs.
Principles for Working in the CHW Field:
· Integrity: We make decisions transparently, in line with our values and mission, acting with candor and courage.
· Social Justice: We recognize that the work of CHWs is rooted in efforts to create a more just and equitable society. CHW training should also be rooted in this pursuit.
· CHW Leadership: We take steps to achieve our vision of a better world and inspire others to join us.
· Responsiveness: We are responsive to the concerns of members of the workforce.
· Equity: We enable broad and fair access to resources and networks that facilitate inclusion of diverse people and perspectives.
· Effectiveness: We work to achieve impact by using efficient and creative processes in our work to accomplish short and long-term goals.
· Progress/Innovation: We believe in the potential of ideas to transform the lives of people and build stronger social relationships.
C3 initial Project values reviewed and adopted by C3 core team members to-date including: Wiggins N, Matos S, Proulx D, Hargrove L, Trachtenberg R, Rush C, Rosenthal L. April, 2014
Values statement principal sources:
Wiggins, N., Kaan, S., Rios-Campos, T., Gaonkar, R., Rees-Morgan, E., Robinson, J. (2013). Preparing community health workers for their role as agents of social change: experience of the Community Capacitation Center. Journal of Community Practice, 21 (3).
Catalani C, Findley S, Matos S, Rodriguez R (2009). Community Health Worker Insights on Their Training and Certification. Progress in Community Health Partnerships: Research, Education, and Action. Fall 3.3: 227-235
The Project on Community Health Worker (CHW) Policy and Practice was created in late 2011 as a special statewide and national initiative of the Institute for Health Policy.
The Project’s purpose is to serve as a statewide and national leadership resource for advancement of the CHW workforce through the provision of research, policy analysis and stakeholder education. The Project Core Team includes national leaders in CHW policy development and research who are active in the American Public Health Association (APHA). The Core Team also has access to a broad network of other experts in specific aspects of the CHW field, and will seek public and private grants and contracts to support its work.
The Project is committed to the promotion of CHW leadership and self-determination through CHW involvement in these activities and support for CHW networks and associations at the state and national levels. The Center will support CHW roles in both provision of health care and community-based public health.
Community Health Workers
APHA Policy Statement 2009-1 defines CHWs as
“…a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. This trusting relationship enables the CHW to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery. A CHW also builds individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support and advocacy.”
CHWs, also known as Promotores de Salud, outreach workers, lay health advisors and other titles, have been contributing to public health for decades, but have come to greater prominence in recent years through a growing body of research attesting to their contributions, recognition as an occupation by the U.S. Department of Labor and prominent mention in the Patient Protection and Affordable Care Act. State and federal policy, however, have not kept pace with the growing interest in this workforce. At least a dozen states are seeing significant movement toward more supportive policies around CHWs.
Key aims of the Project are to:
- support development of CHW policy and financing strategies for CHW employment;
- promote awareness and recognition of CHW roles and contributions; and
- build CHW leadership capacity and offering technical assistance to CHWs, their networks/associations and their employers.
The Project and its core team have been engaged in the following initiatives since its inception:
- Research under contract from the Texas Department of State Health Services for a report to the Legislature on the “desirability and feasibility” of increased CHW employment in Texas (the report was submitted in December 2012)
- A CHW workforce survey for the Indiana State Department of Health
- A policy study for Public Health Seattle/King County on development of internal policies on CHW employment and linkages between public health and provision of safety net health care services
- A contract with a national CDC REACH project for evaluation and technical assistance services to 15 project sites in eight states
- Technical assistance to CHW state-level policy initiatives in Arizona, California, the District of Columbia, Florida, Michigan, Mississippi, Nebraska , New York, New Mexico, Nevada, Virginia and Wisconsin, and to multiple states through the National Governors Association and the National Conference of State Legislatures
- CHW and supervisor training services in Maryland, Nevada, Texas and Wisconsin
- A national study of CHW scope of practice and training curriculum content from leading programs in 6 states, for the National AHEC Organization
- Revision and upgrading of an e-learning series for the CDC, “Promoting Policy and Systems Change to Expand Employment of CHWs”
- Renewal of the annual Unity Conference, the largest national conference of and for CHWs
- Support for the Grantee CHW Learning Collaborative of the Center for Medicare and Medicaid Innovation
- A forthcoming white paper by the National Council for Behavioral Health on CHWs and the integration of behavioral health in primary care, for HRSA and SAMHSA
- A convening of national public sector interest groups and federal officials to track state implementation of new Medicaid rules allowing payment for provision of preventive services by non-licensed individuals
- Advisor panels for the National Peer Support Collaborative Learning Network, the Transition Clinics Network and an AHRQ-funded Johns Hopkins project on IT support for CHWs
- Conference planning for the Northwest Regional Primary Care Association, the DC Primary Care Association and Communities Joined in Action
CHWs as Leaders
The Project is committed to the long-term development of participation by CHWs in leadership roles in research and policy development. To that end, the Project is seeking to develop advisory bodies and internship opportunities for experienced CHWs in all of its future activities. Since the CHW discipline is not based in conventional academic preparation, special efforts will be needed to orient CHWs to the expectations of research and policy development. We believe, however, that such efforts are necessary for the long-term growth and stability of the CHW profession.
For more information
Please contact Dr. Héctor Balcázar, lead faculty for the Project, at Hector.G.Balcazar@uth.tmc.edu or 915-747-8507