CHW Montana CHW Fundamentals September 12, 2017

CHW Fundamentals Introductions CHW Fundamentals Updated - Program Themes, Core Competencies, and Skills Training Program Delivery (on-ground, blended, online, instructor/preceptor-guided) Site Selection, Oversight, Requirements, and Assessment of the Supervised Experience Training/ “Certification" of Instructors/Preceptors Instructor/Preceptor Manual Program Implementation Program Sustainability CHW Advanced

CHW Fundamentals Overview CHW Fundamentals – Montana is a standardized Program designed for individuals interested in becoming a Community Health Worker (CHW) or for those already in CHW positions. It is an instructor/preceptor-guided Program; 80 hours in length. The Program consists of 4-15 hour Training Modules and 1- 20 hour supervised agency/facility experience Module taken at the completion of the 4 Training Modules. CHW Fundamentals students are expected to achieve a PASS in each Module attempted. Additionally they are to successfully perform all expected CHW skills, complete a Reflective Practice Journal, and present a CHW Case Study.

CHW Fundamentals Learning Outcomes At the end of CHW Fundamentals, students will: Display positive behaviors and attitudes needed to effectively succeed in the role and fulfill the responsibilities of a CHW, engage in self-care, and maintain personal and client safety. Apply a basic knowledge of anatomy and physiology, human development, aging, and acute and chronic illness and disease to plan, monitor, and determine client needs and resources for care. Incorporate legal requirements and ethical guidelines into all responsibilities particularly when observing, reporting, and documenting. Exhibit effective communication and coaching skills and the ability to collaborate with a multi- disciplinary healthcare team. Identify how healthcare and public/community health structure, design, issues, and technology influence the coordination and management of care and services, and effect quality and safety.

CHW Fundamentals Learning Outcomes, Cont. Use appropriate decision making, organization, coordination, and navigation skills to ensure appropriate and timely delivery of resources, services, and care. Integrate into the provision of resources and services, the values and needs of the cultures and practices of the populations and communities represented. Provide outreach, advocacy, and social support to promote health needs. Implement community/individual education programs to build capacity, promote health and wellness, and bring about change to improve health outcomes. Demonstrate expected CHW skills.

CHW Fundamentals 6 Training Program Themes Population Dynamics Cultural Humility Client Safety Wellness Population Health Health Promotion

CHW Fundamentals 9 Core Competencies Professional Skills and Conduct Communication Self-Care Interpersonal Relationships Organization Service Coordination and Navigation Skills Capacity Building Advocacy and Outreach Teaching

CHW Fundamentals Delivery Options On-ground Blended Online – web based or LMS* Instructor/Preceptor-Guided * Natalie Petersee to discuss RISE…

CHW Fundamentals 5 Modules 1. Community Health Worker: Role and Responsibilities 2. Communicating and Collaborating with Individuals, Groups, and Communities 3. Delivering Safe Quality Healthcare: Resources, Services, and Care 4. Outreach, Advocacy, and Promoting Healthy Communities 5. Supervised Agency/Facility Experience

CHW Fundamentals Module Activities CHW Application (Activities) and Power Points Self-Assessments and Checklists Video Introduction, CHW Video Interviews, Video Roleplay Vignettes CHW Case Scenario and Questions– Mrs. J. (Modules 1-4) CHW Reflective Learning Journal CHW Module Evaluation

CHW Fundamentals Videos Introduction Video Focused interviews of 4 working CHWs  embedded in the summary of each module. Emphasis on their role at the agencies in which they work and best practice/handy tips on the content of that module.  Module Vignettes – 3-5 minutes   Module 1 -  Compassionate Communication. Student views the video and responds by critiquing the communication...what was good, what was not good, and what could be done to improve.   Module 2 - Interviewing a client on a first home visit. Student views the video and responds by critiquing the interviewing skills...what was good, what was not good, and what could be done to improve.   Module 3 - Priority Setting and Work Planning - role play between a supervisor and CHW regarding a client referral...client  background, needs, and the goals for the care are provided.  Student views and then identifies priorities and develops a work plan.   Module 4 - Motivational Interviewing - Student views the video and responds by critiquing the motivational interview...what was good, what was not good, and what could be done to improve.

Module 1. Community Health Worker: Role and Responsibilities 15 Hours Module 1 Description In this Module, students learn the roles and responsibilities of CHWs which includes positive workplace behaviors and attitudes and personal and professional boundaries. In addition, the Module focuses on legal requirements and ethical guidelines and how to effectively observe, report, and document in a technological environment. Also emphasized is compassionate care, cultural humility, and the importance of self-care and personal safety.

Module 1. Community Health Worker: Role and Responsibilities, Cont.  Module 1 Objectives At the end of this Module, students will: Effectively integrate the CHW role and responsibilities into daily work activities. Exhibit positive workplace behaviors and attitudes and self-care and personal safety strategies. Recognize professional, personal, and community boundaries. Display compassionate communication and cultural humility. Explain key legal requirements and ethical guidelines and how they impact the role and responsibilities of the CHW. Demonstrate skill in observing, reporting, and documenting using technology.

Module 1. Community Health Worker: Role and Responsibilities, Cont. Module 1 Units The following are the three Units found in this Module. A. CHW Role, Responsibilities, and Boundaries, Positive Behaviors and Attitudes; Self- Care and Safety B. Compassionate Care and Cultural Humility C. Legal Requirements and Ethical Guidelines: Observation, Reporting, and Documentation

Module 2. Communicating and Collaborating with Individuals, Groups, and Communities 15 Hours Module 2 Description In this Module, students learn verbal and nonverbal communication skills and how to develop and maintain positive, respectful, and trusting interpersonal relationships with individuals, groups, populations, and communities. They will also learn active listening, interviewing, coaching and support to promote change. Also emphasized are strategies to collaborate with a multi-disciplinary healthcare team, and sensitivity and competence to effectively work with a variety of individuals, groups, and communities.

Module 2. Communicating and Collaborating with Individuals, Groups, and Communities Module 2 Objectives At the end of this Module, students will: Demonstrate appropriate verbal and nonverbal communication in a variety of CHW situations. Build interpersonal, interviewing, and conflict management skills. Recognize values when working with individuals, groups, and communities. Develop skills in coaching and support to help promote change. Apply strategies to ensure effective teamwork and collaboration with a multi- disciplinary healthcare team.

Module 2. Communicating and Collaborating with Individuals, Groups, and Communities Module 2 Units The following are the three Units found in this Module. A. Verbal and Nonverbal Communication, Active Listening, Interviewing, and Conflict Management B. Values and Needs, Interpersonal Skills, and Coaching C. Teamwork and Collaboration with Multi-disciplinary Healthcare Teams

Module 3. Delivering Safe Quality Care: Resources, Services, and Care 15 Hours Module 3 Description In this Module, students learn about the structure, function, delivery, and current issues and the technology used in healthcare, public, and community health systems. They also learn about the importance of promoting quality and ensuring safety. Focus is also on problem solving as a framework for making effective decisions and evaluating a variety of CHW situations. Also emphasized are community assets; networking; navigation skills, making referrals; and organizing and coordinating and resources, services, and care.

Module 3. Delivering Safe Quality Care: Resources, Services, and Care  Module 3 Objectives At the end of this Module, students will: Explain the structure, function, and delivery of healthcare, public, and community health systems. Explore current political, financial, and environmental issues in healthcare, public, and community health. Describe the role and responsibilities CHWs have in promoting quality and ensuring safety. Use problems solving to make effective decisions. Identify community assets and resources through the use of navigation skills, networking, and referrals. Display knowledge and skills in organizing (priority setting, time management, and work planning), coordinating, and tracking resources, services, and care.

Module 3. Delivering Safe Quality Care: Resources, Services, and Care Module 3 Units   The following are the three Units found in this Module. A. Healthcare Systems: Structure, Function, Delivery, and Current Political, Financial, and Environmental Issues. Quality and Safety for CHWs B. Problem Solving and Decision Making, Community Assets, Networking, and Referrals C. Organizing, Coordinating, and Tracking Resources, Services, and Care

Module 4. Outreach, Advocacy, and Promoting Healthy Communities 15 Hours Module 4 Description In this Module, students explore the importance of outreach and case finding, their role as an advocate, and strategies to develop social support. They also learn teaching/learning/change principles to create individual/community education programs that recognizes assets, builds capacity, and promotes health and wellness.

Module 4. Outreach, Advocacy, and Promoting Healthy Communities Module 4 Objectives At the end of this Module, students will Develop outreach skills. Identify strategies to advocate and bring about social support. Recognize change as a concept and as an important process. Use teaching/learning principles. Create individual/community education programs that recognize assets, build capacity, and promote health and wellness.

Module 4. Outreach, Advocacy, and Promoting Healthy Communities Module 4 Units   The following are the three Units found in this Module. A. Outreach and Advocacy B. Recognizing Strengths, Capacity Building, and Facilitating Change C. Teaching and Learning to Promote Health and Wellness

Module 5. Supervised Agency/Facility Experience 20 Hours Module 5 Description In this Module, students are supervised by an instructor or preceptor to complete a 20 hour supervised agency/facility experience which culminates in successful demonstration of CHW skills, completion of a reflective practice journal, and presentation of the case study.

Module 5. Supervised Agency/Facility Experience Module 5 Objectives At the end of this Module, students will Satisfactorily complete the 20 hour supervised experience. Demonstrate the expected CHW skills. Complete the CHW Reflective Practice Journal. Present the selected CHW Case Study.

Module 5. Supervised Agency/Facility Experience Module 5 Units   The following are the three Units found in this Module. A. Introduction, Expectations, and Reflective Practice Journal B. Skills Performance – Assessment C. CHW Case Study – Selection, Analysis, and 5 Minute Presentation

CHW Fundamentals Supervised Experience Site Selection Requirements Agency/Facility Expectations Instructor/Preceptor Requirements and Expectations Student Requirements and Expectations

CHW Fundamentals Supervised Experience – Skills Performance CHW core Competency Expected skill Critical skill Assessment   Y N N/O Professional Skills and Conduct Professional Appearance Maintain Legal and Ethical Responsibilities Communication Compassionate Communication Cultural Humility Observation and Reporting Written Skills Documentation Self-Care Self-Care Management Personal Safety Interpersonal Relationships Building Respectful, Trusting Relationships Active Listening Interviewing Teamwork Coaching and Support Conflict Management Organization Priority Setting and Time Management Problem Solving Developing Weekly Work Plans Service Coordination and Navigation Skills Community Asset Mapping Networking for Resources Making Referrals and Tracking Care Capacity Building Community Scanning Motivational Interviewing Advocacy and Outreach Advocacy for Needed Care Outreach/Case-Finding and Follow-Up Teaching Strengths Based Identification Teaching Strategies Behavioral Change Facilitation

CHW Fundamentals Supervised Experience – Reflective Practice Journal 1. Reflect on your supervised experience. What 3 specific areas of knowledge or skills did you learn and were able to apply? 2. Think about one experience you had…maybe a home visit or providing a resource. What did you learn about CHW practice from this experience. The learnings can be knowledge, skills, or a feeling. 3. In what 3 ways did the supervised experience prepare you for your role and responsibilities as a CHW? 4. Describe any areas of knowledge or skills you are still unclear or unsure about. Identify how you will obtain or develop these areas of knowledge or skills. 5. As you are completing the CHW Fundamentals Training Program, describe how you feel about practicing as a CHW.

CHW Fundamentals Supervised Experience – CHW Case Study (3 Hours) Select One Case from Three Case Studies: Elder – Mr. and Mrs. R.; son Peter, and Nan, the nurse practitioner Behavioral Health – Teresa M. Family – Misty S, Ben, and Lotus Use the answers to the Case Study questions as the foundation for a 5 minute presentation. Presentation Rubric Provided.

CHW Fundamentals Supervised Experience – Elder Case Study Analysis 1. List and prioritize 3 issues you uncovered during this first visit. 2. Describe how the 6 themes of this Training Program relate to Mr. and Mrs. F.’s issues and needs. Include how this understanding will assist you in making decisions about what actions need to be taken to assist them. Population Dynamics Client Safety Cultural Humility Wellness Population Health Health Promotion 3. Explain what will be important for Peter to know and how should it be communicated. 4. Discuss how you will work with Nan and what information will be useful to both of you. 5. Identify 2 resources that might be helpful to Peter and Mr. and Mrs. F. 6. Develop your goals and action plan for your next visit.

CHW Fundamentals Instructors/Preceptors What type, depth, and amount of training should be provided for instructors and preceptors Should instructors and preceptors have to be “certified”, that is, successfully complete training to be able to “teach” in the Training Program? How should instructors/preceptors be monitored once the Training Program is implemented? What should be included in an Instructor/Preceptor Manual?

CHW Fundamentals Program Implementation Completion of Training Program Final Peer Review Prep for Implementation – LMS, et al. Announcement Ready to Go!

CHW Fundamentals Program Sustainability - Strategies

CHW Advanced Modules In: Fundamentals of Behavioral Health – Available Late September Geriatrics Chronic Disease Dental Maternal-Child Health