Employer Engagement and community health worker In collaboration with the CHW Statewide Planning Committee -Developed by the Employer Engagement Sub-Committee

Chws: what do they do? CHWs are trusted members of the community who promote good health and nutrition among community residents. Their training and focus is on education and health system navigation rather than direct provision of health care services. CHWs may be known by a variety of titles, including community health advisor, lay health worker, community health representative, promotora or promotores de salud, or health coaches. Slide revised to align with brochure.

WHY CHW’s Market evolution from fee-for-service to a risk-based, fee-for-value, payment model is requiring a redesign of the tradition health care labor model. CHWs can improve health care access and quality, while reducing cost and community disparities. Such roles can amplify the value of clinical roles, by allowing clinicians to each perform toward the top of their own skill ranges, while ensuring efficient relationship building and care coordination. Improved health outcomes and increased patient engagement/satisfaction should also result. While lower cost than typical clinical roles, the roles pay a living wage and, if effectively embedded in health systems, can provide rewarding career paths that produce long-term, fully engaged employees.

Roles of the CHW Creating connections between vulnerable populations and healthcare systems Managing care and care transitions for vulnerable populations Determining eligibility and enrolling individuals into health insurance plans Ensuring cultural competence among healthcare professionals serving vulnerable populations Providing culturally appropriate health education on topics related to chronic disease prevention, physical activity and nutrition Advocating for underserved individuals to receive appropriate services Providing informal counseling Building capacity to address health issues Let me know if we want to add the potential roles suggested by Beth or keep the what’s listed (didn’t receive any feedback concerning this slide).

Services Provided by CHW’s Advocacy Outreach education

WHO HIRES CHW’S Community Health Workers work in a wide variety of organizational settings. CHW’s are employed by many non-profits and community based organizations, including healthcare facilities, e.g.: acute care, physicians practices, Federally Qualified Health Centers, government agencies, schools and community agencies. There are many types of CHW positions; they may work in an office or call center environment, but often carry out their roles where people live, work, worship and go to school. The principle reasons employers have CHWs are: To reduce hospital admissions To help patients manage chronic conditions Many responsibilities reported by employers for CHWs: Patient Navigation Health Education Connecting patients to health and social services

Community Health Worker Community Population Ethnicity African American Latinos Immigrant Communities Geographic Rural Urban Disease population Maternal & Child Health Injury Prevention Mental Health Chronic Disease Management Diabetes Cancer HIV/AIDS

CHW core competencies CHW training programs teach a range of skills to prepare individuals Engage and work with patients and clients Understand, engage and work within healthcare environments and systems. In PA competencies include the following: Communication and interpersonal skills Motivational interviewing. Knowledge of community specific health issues and social service systems Teamwork: working in a healthcare team Cultural competency Community resources and Asset Mapping Advocacy & Teaching skills Medical terminology and healthcare systems *Note: Data Collection & Documentation are integral components as well. Should we keep the Items listed in RED or take them out?

Core Competencies for Teaching & Advocacy https://youtu.be/b8vj8sSyVC0

Meeting the needs of Community Teaching & advocacy Meeting the needs of Community

Employing a Community Health Worker https://youtu.be/4TL8r3Ft7So

Engaging the HR Process For initial CHW hires, employers must establish a criteria for hiring that serves the employers’ identified needs and results in an optimal match. The following should be given careful consideration: Job Descriptions: Duties with Minimal requirements i.e., education level, training, community experience, experience, experience as a medical assistant The role of the CHW On-Boarding – Main Responsibilities Patient navigation Health Education Connect to Health and Social Services Supervision – OJT, Continuing Education Payment/Reimbursement – Grant opportunities Develop hiring process/selection guidelines Recommend appropriate reporting relationships and management guidelines Develop career ladders/pathways to ensure long-term CHW engagement In RED is not on the brochure….do we want to keep? In Yellow are the additions.

Return on investment The return on investment or ROI is promising. Areas of focus include reduced rates of hospital admission, ameliorating compound problems, and facilitating patient compliance; however there is data that needs to be gathered formally. A recent article in the Journal of the American Medical Association 2014, indicated that “ Patient-centered CHW intervention improves access to primary care and quality of discharge while controlling recurrent readmissions in a high-risk population. Health systems may leverage the CHW workforce to improve post hospital outcomes by addressing behavioral and socioeconomic drivers of disease. The study showed CHWs: Increased access to primary care Improved HCAHPA scores for quality of communication between patients and providers Reduced likelihood of recurrent 30 day hospital readmissions among readmitted patients Improved patients’ mental health and level of engagement with their health care providers http:chw.upenn.edu

OTHER Job titles FOR CHWs EMPLOYED in the USA Abuse Counselor Access Worker Adult Case Manager Addiction Treatment Specialist Assistor Case Coordinator Asthma Outreach Worker Asthma Educator Asthma Family Support Worker Asthma Peer Educator Bilingual Family Outreach Specialist Bilingual Family Advocate Birth Assistant (Doula) Birth Attendant Birthing Family Support Worker Case Management Technician Care Coordinator Care Transitions Coordinator Career Coach Case Worker Case Managers SNAP Certified Application Assistant (CAA) Certified Recovery Specialist Community Activist Community Advocate Community Aide Community Care Worker (CCW) Community Coordinator Community Connector Community Dental Health Coordinators Community Health Associate Volunteers Volunteer Health Worker Wellness Ambassadors Women’s Health Specialist Youth Development Specialist Youth Worker-Program Assistant

OTHER Job titles FOR CHWs EMPLOYED in the USA Community Follow-Up Worker Community Health Adviser Community Health Advocate Community Health Aide Community Health Coach Community Health Educator Community Health Navigators Community Health Outreach Worker Community Health Outreach Worker Community Health Promotion Community Health Representative Community Health Specialist Community Liaison Community-Clinical Linkage Specialist Community Navigator Community Organizer Community Outreach Manager Community Outreach Worker Community Social Worker Cooperative Extension Professionals Counselor Cultural Case Manager Cultural Counselor Cultural Interpreter Diabetes Educator Diabetes Family Support Worker Diabetes Navigator Direct Care Worker Discharge Planner Educator Eligibility Worker Youth Peer Counselor Youth Worker

OTHER Job titles FOR CHWs EMPLOYED in the USA Enrollment Worker Family Advocate Family Education Coordinator Family Planning Counselor Family Support Worker Family Health Advocate Family Health Promoter Family Leadership Specialist Family Outreach Worker Family Support Specialist Financial Counselor Frontline Health Worker Head Start Teacher Assistant Health Advisor Health Advocate Health Agent Health Assistant Health Broker Health Communicator Health Educator Health Extension Workers Health Facilitator Health/Nutrition Support Worker Health Information Specialist Health Insurance Counselor Health Promoter Health Liaison Health Specialist Health Workers HIV/AIDS Educator

OTHER Job titles FOR CHWs EMPLOYED in the USA HIV/AIDS Family Support Worker HIV Peer Advocate HIV Prevention Coordinator HIV Risk Assessment/Disclosure Counselor HIV Service Coordinator HIV/STD Prevention Counselor Home Care Worker Home Visitor Home-Based Clinician Intake Specialist Homeless Advocate Independent Living Services Manager Informal Counselor Intake Coordinator Intake Assistant Interpreter La Leche Peer Counselor (Breastfeeding support) Lay Health Advisor Lady Health Worker Lay Health Advocate Maternal and Child Health Case Manager Medical Concierge Medical Interpreter Medical Representative Mental Health First Aid Responder Mental Health Worker Men’s Health Specialist Men’s Health Worker Multicultural Health Brokers Natural Researcher Navigator

OTHER Job titles FOR CHWs EMPLOYED in the USA Neighborhood Health Advocate New Professionals Non Clinicians Nutrition Adviser Nutrition Assistant Nutrition Educator Nutrition Support Worker Mental Health Aide Outreach Advocate Outreach Case Manager Outreach Coordinator Outreach Educator Outreach Specialist Outreach Worker Parent Aide Parent Liaison Part Time Project Associates Patient Experts Patient Navigator Peer Advocate Peer Counselor Peer Educator Peer Health Advisor Peer Health Educator Peer Leader Physical Activity Specialist Preconception Peer Educator  Pre-Perinatal Health Specialists Public Health Advisor Public Health Aide Public Service Aide Roving Listener Social Determinants of Health Specialists Social Worker Assistant Street Outreach Worker Team Advocate, Level I Trained Health Extension Workers Prevention Specialist Program Coordinator Promotor

Community health worker funding http://www.nhchc.org/wp-content/uploads/2011/10/CHW-Policy-Brief.pdf http://www.healthreform.ct.gov/ohri/lib/ohri/sim/care_delivery_work_grou p/funding_chw_best_practices.pdf http://www.astho.org/Community-Health-Workers/Medicaid- Reimbursement-for-Community-Based-Prevention/

Stephen Klein Wellness Center We love having community health workers at the Stephen Klein Wellness Center (SKWC) and are fortunate to have two--one full-time and one part-time employee.   Our community health workers are a bridge between the clinic and our patients and wider community, at large.  They each have their own panels of patients and are tasked to reach out to them-- to help engage and promote patients'  health and wellness.  Sometimes, this is a simple weekly "check-in" phone call.  Other times, it's a home visit with food from our emergency pantry.  Or, it's help to make follow-up clinical appointments and then transportation to that specialist's office with communication back to the referring SKWC medical provider and nurses.  Our CHWs can be found comforting anxious patients during SKWC dental appointments, engaging with individuals who simply walk in to our building and want to learn about our services, making reminder phone calls about our wellness programs or even helping vulnerable patients in our hospitality program with a shower and a sandwich.  No two days are ever the same!

PA CHW Resources PA Department of Health www.nashp.org/wp-contentuploads/2015/05/pa_CHW_information_2_pages.pdf Stater Reforum www.staterereforum.org/state-community-health worker-models PENN Center for Community Health Workers chw.upenn.edu Temple University – CSPCD https://cspcd.temple.edu/community-health-workers PA AHEC http://www.ecpaahec.org/CHWTrainingOverview.htm Rural Health Information HUB https://ruralhealthinfo.org/community-health/community-health-workers/3/certification District 1199C Training & Upgrading Fund www.1199ctraining.org

Community health workers are members of a community who are chosen by community members or organizations to provide basic health and medical care to their community