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

2. 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

3. 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

4. Words to know Natural Helping System Self-Determination
Capacity Building

5. CHW KC CARE Style

6. 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)

7. 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

8. 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

9. 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

10. 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.

11. CHWs’ Initiatives and Sustainability
CHWs are funded by grants and state funds 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 ) 2014 Medicaid rule change allows payment for preventative services by “nonlicensed” individuals

12. 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

13. 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

14. 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

15. 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

16. 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