CHW Scope of Practice & Statewide Curriculum

 Overview of CHW core role and scope of practice  Review of MN CHW certificate curriculum  Overview of how CHWs reduce health inequities  Review the Triple Aim and CHWs

 Questions?  Who is in the audience? What would you like to know today?

Community Health Workers (CHWs) come from the communities they serve, building trust and vital relationships. This trusting relationship enables the CHWs to be effective links between their own communities and systems of care. This crucial relationship significantly lowers health disparities in Minnesota because CHWs: provide access to services, improve the quality and cultural competence of care, create an effective system of chronic disease management, and increase the health knowledge and self sufficiency of underserved populations.

 Critical Links: Community Health Workers Critical Links: Community Health Workers  DVD produced by the Blue Cross and Blue Shield of Minnesota Foundation  Available to be viewed on YouTube

 Role 1: Bridge the gap between communities and the health and social service systems.  Role 2: Navigate the health and human services system  Role 3: Advocate for individual and community needs  Role 4: Provide direct services.  Role 5: Build individual and community capacity.

 In 2009, the U.S. Department of Labor announced a Standard Occupational Classification for CHWs.  The umbrella term "community health worker" refers to individuals alternately known as outreach worker, Community Health Representative, promotor (a) de salud, and patient navigator.

 Pilot of CHW curriculum began in 2005 with an 11 credit certificate program  Curriculum was updated in 2010 to a 14 credits  Curriculum is a model program in U.S.  Curriculum is offered free to higher education institutions in MN  Credits provide educational pathway

 Core Competencies  Role, Advocacy, and Outreach (2 cr)  Organization and Resources (2 cr)  Legal and Ethical Responsibilities (1 cr)  Coordination, Documentation and Reporting (1 cr)  Teaching and Building Capacity (2 cr)  Communication and Cultural Competence (2 cr)  Health Promotion Competencies (3 cr)  Student Field Internship (2 cr)

 Role, Advocacy, and Outreach This course focuses on the CHW’s personal safety, self care and personal wellness and on the promotion of health and disease prevention for clients.

 Organization and Resources: Community and Personal Strategies This course focuses on the CHW’s knowledge of the community and the ability to prioritize and organize work. Emphasis is on the use of and critical analysis of resources and on problem solving.

 Teaching and Capacity Building This course focuses on the CHW’s role in teaching and increasing the capacity of the community and of the client to access the health care system. Emphasis is on establishing healthy lifestyles and clients developing agreements to take responsibility for achieving health goals. Students learn about and practice methods for planning, developing and implementing plans with clients to promote wellness.

 Legal and Ethical Responsibilities This course focuses on the legal and ethical dimensions of the CHWs’ role. Included are boundaries of the CHW position, agency policies, confidentiality, liability, mandatory reporting and cultural issues that can influence legal and ethical responsibilities.

 Coordination, Documentation and Reporting This course focuses on the importance and ability of the CHW to gather, document and report on client visits and other activities. The emphasis is on appropriate, accurate and clear documentation with consideration of legal and agency requirements.

 Communication and Cultural Competence This course focuses on the context and skills in communication to assist the CHW in effectively interacting with clients of diverse backgrounds, their families and a range of healthcare providers. Students learn about communicating verbally and non-verbally, listening and interviewing, networking, building trust and working in teams. Students practice communication skills in the context of a community’s culture and the cultural implications that can affect client communication.

Healthy Lifestyles This course focuses on the knowledge and skills a CHW needs to assist clients in realizing healthy eating patterns, controlling their weight, integrating exercise into their lives, taking their medications, talking with their doctors, controlling substances such as tobacco, managing stress, achieving life balance, and attaining personal and family wellness.

 Health Promotion Competencies ◦ Healthy Lifestyles ◦ Heart Disease and Stroke ◦ Maternal/Child/Teen ◦ Diabetes ◦ Cancer ◦ Oral Health ◦ Mental Health

 Internship Students work in selected agencies to fully apply and integrate what they have learned to ensure an effective transition into the CHW role.

 Mapping of community NEIGHBORHOOD FEATURESPOTENTIAL HEALTH IMPACTS Example: Living near a freeway or road with lots of truck traffic Asthma from diesel pollution; noise disturbs sleep Plenty of parks Lots of fast food restaurants

 Minneapolis Community and Technical College: F2F  Normandale Community College: F2F (new 2014)  Northwest Technical College: online hybrid  Rochester Community and Technical College: F2F  St. Catherine University: hybrid  South Central College: completely online  Summit Academy OIC: F2F

 Better Care  Better Health  Lower Cost Economic analysis published by Wilder Research Center in June 2012 found that every dollar invested in CHW cancer outreach and prevention saves society $2.30. (Cleary, 2012)

 African American – diabetes, hypertension  Latina – prenatal  Native American – diabetes  Native American –colorectal screening  WISEWOMAN Program (CDC, 2014)

 Questions?

 Centers for Disease Control and Prevention. (2014). How the Centers for Disease Control and Prevention (CDC) supports community health workers in chronic disease prevention and health promotion. Retrieved from  Cleary, J. (2012). Community health workers: Bridging barriers to care. Minnesota Health Care News. 10(11). Retrieved from  Sabo, S., Ingram, M., Reinschmidt, K. M., Schachter, K., Jacobs, L., de Zapien, J. G.,... Carvajal, S. (2013). Predictors and a Framework for Fostering Community Advocacy as a Community Health Worker Core Function to Eliminate Health Disparities. American Journal of Public Health, 103(7), e67-e73.