The understand the context of patients’ lives—where they

The Case forCommunity Health WorkersCommunity Health Workers (CHWs) arepublic health workers who are members of the communities they serve. (London,Carey, Russell, 2015) “CHWs typically share ethnicity, culture, language, and socioeconomicstatus with community members. Because they understand the context of patients’lives—where they come from, how they do things, what their families and friendsexpect, what foods they cook— CHWs can coach a patient to implement carerecommendations, such as diet, exercise, medications, and asthma-sensitivecleaning strategies, that are manageable and also fit their lifestyles”.(London, Carey, Russell, 2015). Since more states have begun toparticipate in employing Community Health Workers, data has shown a reductionof long term health care costs. This is due to the improvement of health careaccessibility and navigation in these communities.

In response to this success,Connecticut is currently working on legislation for certification and paymentmodels for CHWs. Many insurance companies and healthcare delivery systems areunwilling to support payment models for Community Health workers, despite thefact that there is significant data showing the benefits of CHWs working withincommunities. The issues of certification and education are also a cause forconcern among payers.  Despite the factthat there are still questions in need of answers, and issues that must beworked out, this is a conversation that must continue. Through the examinationof the purpose and the benefits of community health workers, this paper willattempt to begin to answer these questions and bring to light the importance ofsupporting community health workers.            What areCommunity Health Workers and why are they an important part of the health caredelivery process?  “Many now recognizethat providing good health care has to go beyond the doctor’s office —especially for minorities and low-income communities.” “Limited access tohealthy food, environmental perils, crime, insecure housing, insufficientrecreational opportunities and the absence of affordable transportation all canhave a huge effect on a person’s health. These factors, often called the socialdeterminants of health, are hard for clinicians to address during medicalappointments.

We Will Write a Custom Essay Specifically
For You For Only $13.90/page!


order now

To contend with them, hospitals, community health clinics, publichealth agencies and some health plans are increasingly turning to communityhealth workers.” “A lot of us have struggled with food and housing andtransportation just like our patients have,” said Amy Smith, a community healthworker at HCMC. “We understand their struggles and know what it takes to comeout the other side.” “These shared experiences are one of the most valuableassets a community health worker can have”, said Carl Rush of the Project onCommunity Health Policy and Practice at the University of Texas-Houston’sInstitute for Health Policy. “For a low-income population, there is a power differentialbetween patient and provider that the provider is not in a good position to tryto resolve,” Rush said. Often, patients will confide important healthinformation to community health workers that they’d feel intimidated or ashamedto reveal to their doctor or nurse. “Because we can spend more time with themand don’t wear white coats and can talk to them about more than medical things,they confide in us,” said Shawn McKinney, a community health worker at HCMC’sWhittier Clinic.

(Ollove, 2016). There is a sense of understanding and apotential for a special type of connection between CHWs and community membersthat brings to the table a variety of benefits the health care industry did notpreviously have.”Some key issues of debate are thequestions of what functions individual CHW’s can effectively perform,considering level of education, type and duration of training, health needs ofthe community, size and geographical spread of the population to be covered”.(Rep.,2007) Why should we investin community health worker services? Research shows that community healthworkers enhance patient experience, strengthen care coordination, improveclinical outcomes, and can help to control rising health care costs. “Theybring an understanding of patients’ culture, language, and community to thehealth care team. They can be the team’s eyes and ears on the ground byidentifying obstacles patients face and tailoring health management strategiesto meet each patient’s needs”.

“The health care system’s movement towardvalue-based payment methods – which reward quality health care with incentivepayments – encourages providers and payers to meet ambitious quality standardsfor all patients, including those who face significant barriers to achieving betterhealth”. (London, Love, Tikkanen,,2017). “Return on Investment Researchconfirms that intervention models involving CHWs create cost savings andrevenue enhancements across a wide range of health issues. For example: ?       CHWsprovided home visit services, appointment support, health literacy andeducation, advocacy, and facilitated access to equipment and supplies to 691high-risk patients enrolled in the New Mexico Medicaid managed care plan. Anevaluation of claims data for a sample of patients and a non-CHW comparisongroup showed significant reductions in Emergency Department use,hospitalization, and prescription medication producing an annual cost offset of$3,003 per patient relative to the non-CHW comparison group.

Total programcosts were estimated at $559 per patient per year (or $46.58 per month).?       CHWsin Seattle-King County provided a home environmental assessment, individualconsultations related to patient-specific action plans, educational and socialsupport, and facilitation to home environmental mitigation resources to 214low-income, high-intensity children suffering from persistent asthma. Childrenin the CHW group produced a cost off-set of $342 to $480 annual from reduceduse of emergent or urgent care.?       CHWsworking with behavioral health care patients in Denver increased patientutilization for primary care and specialty care and decreased utilization ofurgent, inpatient, and outpatient care. The model produced a cost savings of$2.28 for every dollar.

?       CHWsin Baltimore helped Medicaid diabetic patients reduce their emergency roomvisits by 38% and hospitalizations by 30% translating to a cost savings of$80,000 annually per CHW.?       InConnecticut CHW’s working as part of cross-cultural teams with pharmacistsprovided Medication Therapy Management to 100 Limited English speaking personswho had experienced extreme trauma. The average person had 6.1 medicationproblems and the teams were able to solve 93% of the problems at a cost savingsof $3,032 per person per year”.  (Rep.,2014) “Certification without over-professionalizingincreases the likelihood that CHWs will get hired and that their services willget paid”.

In many states private nonprofit organizations focusing on thepromotion of CHWs play a key role in training and certifying CHWs.Certification generally includes classroom training on core competencies, apracticum or internship experience as well as an evaluation of skills and/orknowledge. “It is important to note that in most states that have establishedCHW certification processes, certification is voluntary”. A starting point forConnecticut is to study the approaches of other states that have establishedCHW certification systems.

(London, Carey, Russell, 2015). “While the CHW model has been usedsuccessfully for many years, reliance on time-limited grant funding has createdsustainability challenges. Health reform and changes to federal rules haveopened new opportunities to integrate CHWs into Connecticut’s health caredelivery and payment systems.

In order to maximize these opportunities, the CHWpolicy agenda for Connecticut should include:•                    Enacting legislation to establish a process forcertifying CHWs, along with training and experience requirements, to documentCHWs’ skills for potential employers and insurers.•                    Implementing Connecticut’s State Innovation Model(“SIM”) plan to establish training programs for CHWs and CHW supervisors toimprove and standardize knowledge and skills.•                    Adding CHW services to the set of Medicaid-coveredservices and establishing a Medicaid payment rate to provide sustainablefunding for these cost-effective services.

•                    Providing training for health care providers on how touse CHWs to help achieve practice transformation goals.•                    Establishing a CHW task force to promote and coordinatethis agenda”. Credentialingand certification requirements for CHWs vary from state to state. “QualifiedCHWs hold competencies such as: communication skills; interpersonal skills;service coordination skills; capacity building skills; advocacy skills;teaching skills; organization skills; and knowledge base on specific healthissues.

National and statewide initiatives exist to expand the CHW workforce.For example, the Community Health Worker National Education Collaborative offersa national community of practice website to support the development of collegeresponsive programs and to facilitate development of CHW educational resources,services, curricula, and promising practice delivery strategies. Connecticutcan take advantage of CHW workforce efforts championed by other statesincluding Massachusetts, New York, and Texas. These states have developedlegislation, competency-based frameworks, curricula, certifications andcredentials, career pathways from CHWs to health care occupations, trainingdelivery systems, and professional organizations for CHWs”. (Rep.,2014)Health care providers are underpressure to meet higher quality of care standards, such as providingrecommended preventive screenings while reducing the need for expensiveemergency department visits.

(London, Love, Tikkanen, 2017). “Studies show thatcommunity health workers help underserved and high-need patients access theright care at the right time by removing barriers to care. These servicesenhance patient experience, improve population health outcomes, and reducecosts”. (California Health Workforce Alliance, 2013).Connecticutcan utilize current statistical data available from states that havesuccessfully created certification and education standards and provensustainable payment models to develop a sustainable model for CHWs inConnecticut.

CHWs have a proven track record of reducing barriers faced byminority and impoverished communities face when attempting to navigate thehealthcare system. There is data to show the cost reduction in long term healthoutcomes in these communities that CHWs work in.                      References London, K., Carey, M., , K. (2015). Tomorrow’s Health Care System Needs Community HealthWorkers: A Policy Agenda for Connecticut (Rep.

). Connecticut Health Foundation.Ollove, M. (2016). Under AffordableCare Act, Growing Use of ‘Community Health Workers’.

Retrieved December 03,2017, from http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2016/07/08/under-affordable-care-act-growing-use-of-community-health-workersCommunity health workers: What dowe know about them? (Rep.). (2007). Evidence and Information for Policy,Department of Human Resources for Health Geneva.Community Health WorkerCertification in 15 States.

(n.d.). Retrieved November 18, 2017, from https://www.

cthealth.org/publication/state-chw-certification/London, K., Love, K., &Tikkanen, R. (2017). Community Health Workers: A Positive Return on Investmentfor Connecticut (Rep.

). Connecticut Health Foundation.The Business Case for CommunityHealth Workers in Connecticut (Rep.). (2014).

The Connecticut Department ofPublic Health. http://www.healthreform.ct.gov/ohri/lib/ohri/CHW_Business_Case_2014_with_Task_Force_Final.pdf 

x

Hi!
I'm Mary!

Would you like to get a custom essay? How about receiving a customized one?

Check it out