Community Health Worker Initiatives on Long Island: Enhancing Public Health Engagement

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Community Health
Worker Planning on
Long Island
 
HEALI MEETING
WEDNESDAY, OCTOBER 19
 
What is a CHW?
 
 
According to the National Association for Community Health Workers:
 
 
Community Health Worker is an umbrella term and includes community health representatives,
promotores, peers and
 other workforce members
 who are 
frontline public health
professionals
 that share life experience, trust, compassion, cultural and value alignment with the
communities where they live and serve.
 
CHW Program Models
 
Promotora de Salud/Lay Health Worker Model
: 
CHWs are members of a target population with specialized training to
provide health education
Member of Care Delivery Team Model
: 
CHWs work alongside medical professionals to address health issues
Care Coordinator/Manager Model
: 
CHWs help patients with complex health conditions navigate healthcare systems
Screening and Health Educator Model
: 
CHWs deliver screenings and health education to a target population
Outreach and Enrollment Agent Model
: 
CHWs are responsible for providing outreach and enrollment to a target
population
Community Organizer and Capacity Builder Model
: 
CHWs promote community action and build community support
for new activities
 
Community Health Worker Assessment
 
 
Initial Survey
42 respondents began survey or completed portions of the survey
23 out of 42 (55%) have employed CHWs
All respondent programs still active
22 out of 23 participants responded to the second question. The majorities were split
between all full-time or, mostly FT, and some PT, or all part-time.
Reason for not employing CHWs were mostly the lack of funding (50%) and 6.25%
said they did not see the need
Shared lived experience (23%) and Diploma/ GED (26%) were the highest responses
for minimum eligibility requirements for hiring CHWs and none selected for Graduate
degree
Peer educator and community outreach worker were the commonly used titles
among the organizations for their CHWs and none had Maternal/ Infant Health
outreach specialist
 
CHW Job Titles
 
 CRPA
 Case manager
 Peer specialist
 Community Educator
 Health Liaison
 
 
 Foster Parent Advocate
 Peer Recovery Coach
 Family Peer Advocate
 Youth Peer Advocate
 
Key Informant Interviews
 
 
Completed 8 key informant interviews:
1.
EPIC
2.
LIQFHC
3.
Suffolk County Health Services
4.
Hands Across Long Island (HALI)
5.
The Retreat
6.
SEPA Mujer
7.
Tempo Group
8.
Family and Children’s Association
 
Questions focused on 4 key areas:
 
1.
Hiring and Recruitment Process, and Ongoing
Professional Development
2.
Funding Streams
3.
Populations served by CHWs
4.
Vision and Goals for program
 
Key Findings:
 
Hiring and Recruitment Process, and Ongoing Professional Development
Most have NOT recruited from a CHW training program
Prioritize hiring within the community, shared lived experience
Frequently mentioned motivational interviewing, active listening, and empathy
Barriers include low salary and lack of advancement opportunities
Many different CHW models and no standard definition blurs roles and expectations
 
Key Findings:
 
Funding
 
Mostly not currently Medicaid billing for CHWs
One expressed concern for undocumented population
 
Majority privately/govt funded
 
Salary ranges - $30k – 60k
 
Key Findings:
 
Populations Served
 Varied – and loose parameters
 
Vision and Goals
 Better integration of CHWs into existing structures
 Long term funding
 Strengthening skills such as outreach and engagement, written and communication
skills, additional trainings for career advancement
 
CHW Ongoing Work:
 
 
 
CHW CORE FUNCTIONS
1.
Identify common core functions of CHWs, including those that are potentially reimbursable
2.
Identifying other functions, including those that are potentially reimbursable
3.
Standardization of CHW job titles and/or roles
TRAINING
1.
Recruitment of CHWs into training programs and training incentives
2.
Training that is reflective of core functions for reimbursement
3.
Training of additional functions (may or may not be reimbursed, but are critical for appropriate care of
clients)
CHW PLACEMENT WITHIN SDHN NETWORK
1.
Education of network on CHWs
2.
Pipeline from training to positions within SDHN orgs
3.
Technical support for CHW supervision, management, administration, and reimbursement process
 
Next Phase…
 
CHW PAYMENT/REIMBURSEMENT
 CHW payment goals:
Medicaid
In lieu of service
Non-Medicaid clients
 How to CHWs track their work for potential billing purposes
 CHW certification goals (incl. work experience in lieu of credits)
 Administration of CHW programs and sustainable funding (supervision, etc.)
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Explore the role of Community Health Workers (CHWs) as frontline public health professionals on Long Island. Learn about CHW program models, job titles, assessment findings, and key informant interviews highlighting the importance of shared lived experiences and minimum eligibility requirements for hiring CHWs.


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  1. Community Health Worker Planning on Long Island HEALI MEETING WEDNESDAY, OCTOBER 19

  2. What is a CHW? According to the National Association for Community Health Workers: Community Health Worker is an umbrella term and includes community health representatives, promotores, peers and other workforce members who are frontline public health professionals that share life experience, trust, compassion, cultural and value alignment with the communities where they live and serve.

  3. CHW Program Models Promotora de Salud/Lay Health Worker Model: CHWs are members of a target population with specialized training to provide health education Member of Care Delivery Team Model: CHWs work alongside medical professionals to address health issues Care Coordinator/Manager Model: CHWs help patients with complex health conditions navigate healthcare systems Screening and Health Educator Model: CHWs deliver screenings and health education to a target population Outreach and Enrollment Agent Model: CHWs are responsible for providing outreach and enrollment to a target population Community Organizer and Capacity Builder Model: CHWs promote community action and build community support for new activities

  4. Community Health Worker Assessment Initial Survey 42 respondents began survey or completed portions of the survey 23 out of 42 (55%) have employed CHWs All respondent programs still active 22 out of 23 participants responded to the second question. The majorities were split between all full-time or, mostly FT, and some PT, or all part-time. Reason for not employing CHWs were mostly the lack of funding (50%) and 6.25% said they did not see the need Shared lived experience (23%) and Diploma/ GED (26%) were the highest responses for minimum eligibility requirements for hiring CHWs and none selected for Graduate degree Peer educator and community outreach worker were the commonly used titles among the organizations for their CHWs and none had Maternal/ Infant Health outreach specialist

  5. CHW Job Titles CRPA Case manager Peer specialist Community Educator Health Liaison Foster Parent Advocate Peer Recovery Coach Family Peer Advocate Youth Peer Advocate

  6. Key Informant Interviews Completed 8 key informant interviews: 1. EPIC 2. LIQFHC 3. Suffolk County Health Services 4. Hands Across Long Island (HALI) 5. The Retreat 6. SEPA Mujer 7. Tempo Group 8. Family and Children s Association

  7. Questions focused on 4 key areas: 1. Hiring and Recruitment Process, and Ongoing Professional Development 2. Funding Streams 3. Populations served by CHWs 4. Vision and Goals for program

  8. Key Findings: Hiring and Recruitment Process, and Ongoing Professional Development Most have NOT recruited from a CHW training program Prioritize hiring within the community, shared lived experience Frequently mentioned motivational interviewing, active listening, and empathy Barriers include low salary and lack of advancement opportunities Many different CHW models and no standard definition blurs roles and expectations

  9. Key Findings: Funding Mostly not currently Medicaid billing for CHWs One expressed concern for undocumented population Majority privately/govt funded Salary ranges - $30k 60k

  10. Key Findings: Populations Served Varied and loose parameters Vision and Goals Better integration of CHWs into existing structures Long term funding Strengthening skills such as outreach and engagement, written and communication skills, additional trainings for career advancement

  11. CHW Ongoing Work: CHW CORE FUNCTIONS 1. Identify common core functions of CHWs, including those that are potentially reimbursable 2. Identifying other functions, including those that are potentially reimbursable 3. Standardization of CHW job titles and/or roles TRAINING 1. Recruitment of CHWs into training programs and training incentives 2. Training that is reflective of core functions for reimbursement 3. Training of additional functions (may or may not be reimbursed, but are critical for appropriate care of clients) CHW PLACEMENT WITHIN SDHN NETWORK 1. Education of network on CHWs 2. Pipeline from training to positions within SDHN orgs 3. Technical support for CHW supervision, management, administration, and reimbursement process

  12. Next Phase CHW PAYMENT/REIMBURSEMENT CHW payment goals: Medicaid In lieu of service Non-Medicaid clients How to CHWs track their work for potential billing purposes CHW certification goals (incl. work experience in lieu of credits) Administration of CHW programs and sustainable funding (supervision, etc.)

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