Foundations For Community Health Workers (2nd Edition) (2016) Berthold, T., Editor San Francisco, C.A.: Jossey-Bass Chapter Two Copyright © 2000-2017 by John Wiley & Sons, Inc., or related companies. All rights reserved. The Evolution of the Community Health Worker Field in the United States

Reflection of Last Session What did you learn? Share what you discovered when googling Community Health Worker Characteristics of CHWs Time management Have students review what they learned from the last session on these key topics. There will be mini homework assignments along the way. If students have nothing to share from the previous week, encourage them to understand

What You Will Learn Describe the contributions of CHWs in promoting the health of individuals and communities in the United States and around the world Identify and discuss major trends and debates that have impacted the development of the CHW field in the Untied States Discuss the role that CHWs have played in advocating for greater recognition and respect in their field Consider what place you want to have in the CHW field

Words to know Natural Helping System Self-Determination Capacity Building

CHW KC CARE Style

What’s in a Name? CHW Occupation not well defined The National Community Health Advisor Study identified more than 60 titles such as: Health advocate Health navigator Outreach educator Peer health promoter CHWs (used by World Health Organization)

CHWs’ Roles and Qualities Connected to the community Develop geographic, social, and cultural relationships Reach out to natural networks to address health issues Work in public health departments, hospitals, other healthcare institutions Organize to ensure their skills are valued and integrated into healthcare systems

CHWs’ Formal History 1950s: programs started in Native American communities 1960s: health issues in urban settings Community health centers Advocated for free health care 1980s: Healthy Start Chronic disease prevention AIDS civil rights 1990s: welfare-to-work programs 2000s: Patient navigators and advocates

Research and the CHW Field National Community Health Advisor Study Increased access to CHW educational programs and identified CHW work settings CHW National Workforce Study defined roles and functions of CHWs Additional research needed: CHW cost-effectiveness CHW impact on health status CHW funding options CHW as capacity builder CHW promoting access to quality healthcare

Capacity Building and Education On the job training is most often used. Formal CHWs curricula: no single national curriculum exists instead there is training materials for specific health issues (HIV, diabetes, infant mortality). CHWs Credentialing is controversial because it would disqualify many qualified CHWs. CHWs National Education Collaborative advises college-based CHWs programs on best practices. Very important to include history and policy related issues during the past years since Affordable Care Act in 2010 and other federal and state legislation related to access to health care and Medicaid/Medicare expansion topics. Core competencies and scope of practice are important issues in the future of the CHW.

CHWs’ Initiatives and Sustainability CHWs are funded by grants and state funds. 2003 Federally-funded Community Health Centers employ CHWs 2007 Minnesota reimburses CHWs under Medicaid Program - more states follow with reimbursements 2009 The Standard Occupation Classification lists Community Health Worker as a distinct occupation (SOC 21-1094) 2014 Medicaid rule change allows payment for preventative services by “nonlicensed” individuals

Networks and Conferences Provide CHWs with peer support, mentoring, and leadership Five national groups: APHA (American Public Health Association) CHWs Special Primary Interest Group Created living wages and sustainable jobs Developed policy that for roles and importance Developed a Committee on Education and Capacity

Networks and Conferences (cont.) The National Association of Community Health Representatives Honors leadership and programs 3. The National Association of Hispanic CHWs Focus is on Hispanic promoters 4. The Center for Sustainable Health Outreach (CSHO) CHWs nationally exchange information at the annual CSHO Unity Conference 5. The American Association of CHWs Creates national standards for CHWs

Practice Contact a public health official in your area Ask what priorities are currently the focus of their work Document the Name of the person, his/her Title and Date of phone conversation. Add to your contacts Complete Chapter 2 HW & DB in Blackboard Read Chapter 3 and the lead contamination article in Blackboard

Resources: Image on slide 2 digital-drugs-binaural-beats by digitalbob8 is licensed under CC BY 2.0 Image on slide 3 Bring Light Bulb is available in the public domain under CC0 Public Domain Video on slide 5 Community Health Workers – Kansas City Style by the Center for Health Policy, University of Missouri is licensed under a Standard YouTube License Image on slides 7 Social Media is available in the public domain under CC0 Public Domain Image on slide 14 Cat at a blue door by Heidi Bauer is licensed under CC BY SA 2.5

Acknowledgements: MoSTEMWINs Adapted from the Foundations for Community Health Workers, 2nd Edition (Berthold) with permission from Wiley Publishing by the Institute of Workforce Innovation of the Metropolitan Community College Kansas City and the Workforce Solutions Group of St. Louis Community College. Unless otherwise noted this material by St. Louis Community College is licensed under a Creative Commons Attribution 4.0 International License. This product is partially funded by the MoSTEMWINs $19.7 million grant from the U.S. Department of Labor Employment and Training Administration. The product was created by the grantee and does not necessarily reflect the official position of the U.S. Department of Labor. The Department of Labor makes no guarantees, warranties, or assurances of any kind, express or implied, with respect to such information, including any information on linked sites and including, but not limited to, accuracy of the information or its completeness, timeliness, usefulness, adequacy, continued availability, or ownership MoSTEMWINs