1. Promoting Community Health: Certification for Community Health Workers State of Asian Women’s Health MA May 14, 2015 Terry Mason, Consultant, DPH Office of Community Health Workers Niem Naykret, CHW, Lowell Community Health Center 1

2.  Answer the following questions: 1.Who are community health workers (CHWs)? 2.How do they build connections among communities and health care & public health organizations? 3.What will certification for community health workers look like in Massachusetts? 4.Why should and how can CHWs become certified by the state? Objectives of Presentation 2

3.  American Public Health Association definition:  frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served,  trusting relationship enables the CHW to serve as a liaison/link/intermediary between health/social services and the community,  to facilitate access to services and improve the quality and cultural competence of service delivery. Who are community health workers? 3

4.  CHW also builds individual and community capacity by increasing health knowledge and self- sufficiency through  activities such as outreach, community education, informal counseling, social support and advocacy.” Definition of CHW cont’d... 4

5.  Massachusetts Department of Public Health definition CHWs are distinguished from other health professionals because they:  Are hired primarily for their understanding of the populations and communities they serve;  Conduct outreach a significant portion of the time in one or more of the categories above;  Have experience providing services in community settings. CHW definition cont’d... 5

6. How do community health workers connect communities to health organizations? 6

7. Education and outreach  By bringing education, information, and support to people’s homes. 7

8. Connecting with people in community settings 8

9. Bringing help and support beyond the walls of health organizations 9

10. CHWs often work as part of teams in clinical settings today  Culturally aware, responsive support for improving self- management of chronic diseases  Helping get needed social support and services from community organizations  Diversifying the workforce 10

11. CHW Umbrella: outreach worker, family advocate, promotore, patient navigator, community educator, etc. 11

12. Challenges: unreliable low wage positions, lack of recognition, respect  Massachusetts Association of Community Health Workers (MACHW)  MA Dept of Public Health  CHWs and allies 1.Organized forums to discuss state certification possibilities 2.MACHW and DPH wrote legislation for a Board 3.CHWs and allies worked to pass it –it passed in 2010! 12

13.  Located in DPH Division of Professions and Licensure (though is NOT a license)  Chaired by DPH Commissioner or designee—4 of 11 members required to be CHWs  additional members, appointed by governor MACHW nominates 4 members (eligible for certification) Mass. Public Health Association Mass. League of Community Health Centers Mass. Association of Health Plans Single reps from: CHW training program, community based employer, public  Statewide geographic representation required CHW Board of Certification established – began work 2012 13

14. Establishment of standards and requirements for: Certification of individual CHWs, including a grandparenting option Approval of CHW training programs Certification of a CHW tier for CHW trainers Renewal for all three Individual certification is VOLUNTARY (title act, not practice act) CHW Board of Certification Authority 14

15. Objectives & Concerns of CHWs and Allies Influenced Draft Regulations Created  OBJECTIVES:  Be inclusive, not exclusive: voluntary certification  Create core competencies that help define the field  Set standards for training of CHWs around the state  Provide a credential (state certification) which is respected across employers  CONCERNS (AVOID):  Barriers for dedicated community members with strong CHW abilities, including non-English speaking  Overly academic training and eligibility 15

16. Core competencies defined by board, based on statute: #1: Outreach Methods and Strategies #2: Individual and Community Assessment #3: Effective Communication #4: Cultural Responsiveness and Mediation #5: Education to Promote Healthy Behavior Change #6: Care Coordination and System Navigation # 7: Use of Public Health Concepts and Approaches #8: Advocacy and Community Capacity Building #9: Documentation #10: Professional Skills and Conduct REGULATIONS DRAFTED : 16

17. Two pathways (one temporary): –Successful completion of 80 hr core training + 2,000 hours work experience as CHW –“Grandparenting” (experience only pathway, 4,000 hours work experience, available for first 3 years only) Good moral character Documentation of mastery of competencies –3 professional references REGULATIONS DRAFTED: 17

18. Current range for core training in MA: 45- 55 hours State certification will require 80 hours of core training: 80% core competencies (64 hours) 20% special health topics (16 hours) Flexibility in curriculum design and delivery Based on interactive learning methods CHW trainers will be required in training teams Training Program Draft Regulations 18

19.  Draft regulations completed (Jan 2015) √  Administrative review followed by 35-day public comment period (2015)  DPH staff developing applications, standards of conduct exam, flyers, publicity  MACHW to conduct regional meetings to get CHW input & prepare CHWs for how to apply  Certification becomes operational in 2015 CERTIFICATION TIMELINE 19

20. Mass. DPH Office of CHWs: –shttp://www.mass.gov/eohhs/gov/departm ents/dph/programs/community- health/primarycare- healthaccess/healthcare-workforce- center/comm-health-wkrs/shttp://www.mass.gov/eohhs/gov/departm ents/dph/programs/community- health/primarycare- healthaccess/healthcare-workforce- center/comm-health-wkrs/ Mass. Board of Certification of CHWs: –http://www.mass.gov/eohhs/gov/departme nts/dph/programs/hcq/dhpl/community- health-workers/about/http://www.mass.gov/eohhs/gov/departme nts/dph/programs/hcq/dhpl/community- health-workers/about/ FOR FURTHER INFORMATION 20

21. Caitlin Allen MDPH Office of Community Health Workers caitlin.allen@state.ma.ua (617) 624-5486 Jackie Toledo Massachusetts Association of Community Health Workers (MAHCW) jtoledo@cmahec.org 508 756-6676 (ext. 25) CONTACT INFORMATION 21