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Community Health Workers and Oral Health: Creating an Integrated Curriculum in Kansas
/in Community Health Workers Kansas Featured News Home, Reports Community Health Workers, Oral Health /by Allie Atkeson and Ella RothState Community Health Worker Models
/in Community Health Workers Featured News Home, Maps Behavioral/Mental Health and SUD, Care Coordination, Chronic and Complex Populations, Chronic Disease Prevention and Management, Community Health Workers, Cost, Payment, and Delivery Reform, Health System Costs, Long-Term Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health, Primary Care/Patient-Centered/Health Home Community Health Workers /by NASHP StaffStates Engage Community Health Workers to Combat COVID-19 and Health Inequities
/in COVID-19 State Action Center Blogs, Featured News Home Community Health Workers, COVID-19, Health Equity, Population Health, Social Determinants of Health /by Elinor HigginsAs recent data shows, COVID-19’s infection and death rates illustrate the profound racial and ethnic disparities in the nation’s health care system and the social and economic inequalities that affect health outcomes. To curb COVID-19 and improve the quality of care delivered to communities that have faced decades of discrimination, a few states are bolstering their community health workforces.
Community health workers (CHWs), are culturally competent, frontline public health workers who are trusted by the communities they serve. Evidence suggests individuals benefit from relationships with people who have similar lived experiences and are members of their community. CHWs are uniquely positioned to build trust and address barriers that traditionally underserved communities face when seeking medical care and services. CHWs can also provide collaborative, patient-centered approaches to care and generate cost savings for state programs.
History of State CHW Initiatives
Before the pandemic, many state programs enlisted CHWs to address challenging aspects of their health improvement initiatives, such as facilitating care coordination, enhancing access to community-based services, and addressing social determinants of health. Payment strategies for CHWs vary; a majority of services are grant-funded with some states reimbursing for CHW services through their Medicaid programs or hiring CHWs as part of managed care organizations.
As states work to address COVID-19, they are bolstering their health care workforces, ramping up contact tracing programs, and finding new ways to fill the gaps in the public health infrastructure created by chronic underfunding. With increased recognition of the adverse health impacts of structural racism, CHWs — who were deemed essential critical infrastructure workers” by the Department of Homeland Security — may strengthen the emergency response and facilitate recovery across demographics.
State Examples of CHW Engagement to Address COVID-19
- Delaware: In May, Gov. John Carney announced a partnership with Healthy Communities Delaware — a collaboration between the Delaware Division of Public Health, the Delaware Community Foundation, and the University of Delaware. The partnership’s goal is to provide linkages between those who test positive for COVID-19 and CHWs, who can help coordinate basic needs like grocery delivery and housing during a period of quarantine. Healthy Communities Delaware is coordinating the effort in partnership with community-based organizations.
- Hawaii: The University of Hawaii is partnering with the Hawaii Department of Health to expand the CHW curriculum at community colleges so that graduating CHWs are equipped to assist with COVID-19 contact tracing efforts. CHWs will specifically help with contact tracing efforts in Native Hawaiian/Pacific Islander communities, which are disproportionately affected by COVID-19, and among individuals facing homelessness and unemployment.. The funding for this initiative was appropriated from Hawaii’s federal CARES Act relief funds.
- Massachusetts: The Office of Community Health Workers recently issued guidance for CHW employers detailing how they can engage CHWs in the state’s COVID-19 pandemic response. The suggestions include cultural competence training and outreach about the virus and its impacts, connecting individuals with community services and supports, and assisting people with the new technologies needed for telehealth appointments. The guidance also acknowledges the increased need for resources, technology, and employer support as CHWs take on a growing and varied number of challenges presented by the pandemic.
Some cities also present promising examples of how CHWs can factor into response and recovery plans. The City of Baltimore is responding to COVID-19’s dual economic and public health crises by creating the Baltimore Health Corps. The pilot program, funded by the CARES Act, the Baltimore City Health Department, the Mayor’s Office of Employment Development, and The Rockefeller Foundation, will hire and train individuals who have recently lost their jobs due to the pandemic to be contact tracers and CHWs. The Health Corps will primarily serve communities that have been disproportionately impacted by COVID-19.
The examples above spotlight how partnerships between different sectors allow cities and states to address the needs of specific populations, to create jobs, and to ramp up their contact tracing workforces. Each addresses the need for equitable care that is delivered by people who understand the lives and challenges of the community they are serving in order to make sure interventions are appropriate and effective. States may want to consider adopting similar strategies along with training their existing CHW workforces for the new challenges of COVID-19 response and recovery.
State Policy Levers for Advancing Quality Improvements in Primary Care
/in Policy Reports Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement /by Johanna Butler, Christina Cousart and Jennifer ReckStates, as major purchasers of health care, have a compelling interest to spur primary care providers to adopt the latest research to improve the quality and cost-effectiveness of care. This new report, the third in the EvidenceNOW: Insights for State Health Policymakers Series, highlights policy levers states can use to support the adoption of evidence-based care.
Read/download: State Policy Levers for Advancing Quality Improvements in Primary Care, April 2019
Read/download NASHP’s other two EvidenceNOW: Insights for State Health Series reports:
Community Health Worker Resources for States
/in Policy Minnesota, New York, Utah Reports Chronic and Complex Populations, Chronic Disease Prevention and Management, Community Health Workers, Cost, Payment, and Delivery Reform, Essential Health Benefits, Health Coverage and Access, Health Equity, Health System Costs, Long-Term Care, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement, Safety Net Providers and Rural Health, Social Determinants of Health, Value-Based Purchasing /by Tina KartikaAs states transform their health systems, many are turning to community health workers (CHWs) to improve health outcomes and access to care, address social determinants of health, and help control costs of care. While state definitions vary, CHWs are typically frontline workers who are trusted members of and/or have a unique and intimate understanding of the communities they serve. NASHP has produced a number of resources, below, to support state efforts to incorporate CHWs into their health and health equity improvement work. If you would like to suggest a resource or share your state’s efforts, please contact Elinor Higgins.
Resources
- Innovative Community Health Worker Strategies: Medicaid Payment Models for Community Health Worker Home Visits, December 2017. This case study examines Medicaid payment models from Minnesota, New York, Utah, and Washington for CHWs providing in-home services that address healthy home environments.
- Innovative Community Health Worker Strategies: My Health GPS in Washington, DC, Seeks to Achieve Sustainable Funding and Whole-Person Care, November 2017. This case study explores the financing and roles of CHWs in My Health GPS, the District of Columbia’s health home program.
- Community Health Workers: Policy Opportunities for Population Health and Patient-Centered Health Care, October 2017. This NASHP conference session highlighted state strategies and experiences in CHW financing, training, and oversight. Speakers from Oregon, Texas, and Wisconsin discussed the national CHW landscape and policy opportunities that could be explored to advance the CHW workforce in states. Please click on the speakers’ names to access their conference slides.
- State Community Health Worker Models Map, last updated August 2017. This map highlights state-level activities and policies to integrate CHWs into evolving health care systems in key areas such as financing, education and training, certification, and state definitions, roles and scope of practice. The map includes enacted state CHW legislation and provides links to state CHW associations, state agencies, and other leading organizations working on CHW policy in states. An instructional video, designed with support from the National Center for Healthy Housing (NCHH) and the W.K. Kellogg Foundation, is available to facilitate use of the map.
- Community Health Workers in the Wake of Health Care Reform: Considerations for State and Federal Policymakers, December 2015. This brief captures key themes that emerged during an October 2015 meeting of state and federal leaders to identify areas in which state and federal policy can align around the use of CHWs in transforming health systems to achieve better care, lower costs, and improved population health.
These resources were produced and updated with support from the Robert Wood Johnson Foundation, The W.K. Kellogg Foundation, the National Center for Healthy Housing, and The Commonwealth Fund.
Community Health Workers in the Wake of Health Care Reform: Considerations for State and Federal Policymakers
/in Policy Reports Care Coordination, Chronic and Complex Populations, Chronic Disease Prevention and Management, Community Health Workers, Long-Term Care, Population Health /by Lesa RairAs states and the nation transform their health systems, many policymakers are turning to community health workers (CHWs) to tackle some of the most challenging aspects of health improvement, such as facilitating care coordination, enhancing access to community-based services, mitigating the impacts of the social determinants of health, reducing health disparities, and containing costs. In light of the many emerging CHW models nationwide, state and federal policymakers need information and evidence to guide their decisions on CHW engagement, recruitment and retention, training, credentialing, and financing.
Integrating Community Health Worker Models into Evolving State Health Care Systems
/in Policy Massachusetts, New Mexico, South Carolina Webinars Chronic Disease Prevention and Management, Community Health Workers, Population Health /by NASHP StaffMonday, February 23, 2015
1:30 pm – 3:00 pm EST
View Webinar Here
As states transform their health systems, many are turning to CHWs to tackle some of the most challenging aspects of health improvement, such as facilitating care coordination, enhancing access to community-based services, and addressing social determinants of health. As interest in CHWs continues to rise, so do challenges related to defining roles and scope of practice, training and certification, financing, and integrating CHWs into evolving health care systems. This webinar describes the federal government’s investment in CHWs to set the context and features speakers from state agencies in Massachusetts, New Mexico, and South Carolina who shed light on how each state is addressing these important issues.
MODERATOR
- CDR Thomas Pryor, United States Public Health Service, Center for Medicare and Medicaid Innovation
PRESENTERS
- Gail Hirsch, Office of Community Health Workers, Division of Prevention and Wellness, Massachusetts Department of Public Health
- Kari Armijo, Health Care Reform Manager, Medical Assistance Division, New Mexico Human Services Department
- Allie Gayheart, Manager of Health Initiatives, South Carolina Department of Health and Human Services
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For individuals living with complex, often chronic conditions, and their families, palliative care can provide relief from symptoms, improve satisfaction and outcomes, and help address critical mental and spiritual needs during difficult times. Now more than ever, there is growing recognition of the importance of palliative care services for individuals with serious illness, such as advance care planning, pain and symptom management, care coordination, and team-based, multi-disciplinary support. These services can help patients and families cope with the symptoms and stressors of disease, better anticipate and avoid crises, and reduce unnecessary and/or unwanted care. While this model is grounded in evidence that demonstrates improved quality of life, better outcomes, and reduced cost for patients, only a fraction of individuals who could benefit from palliative care receive it. 
