Community Health Worker CT

About

About

The Community Health Worker (CHW) movement began as a grassroots effort of community leaders working as intermediaries to help their families and neighbors access a healthcare system that sometimes fails to recognize cultural barriers to care. Recognition of the importance of CHWs is growing as more and more studies demonstrate the value of CHWs in improving health outcomes and reducing the cost of care for chronic disease management. As this recognition increases, groups like the American Public Health Association, the U.S. Department of Labor, the U. S. Department of Health and Human Services, the Health Resources and Service Administration, and individual states who wish to employ the services of Community Health Workers have begun to refine and explore the role of the Community Health Worker.

Substantial evidence confirms that intervention models involving CHWs produce improved health outcomes. Rooted in the communities they serve, CHWs possess a unique understanding of how their communities function and how local resources, environment, and culture affect health. This enables them to complement the work of clinical healthcare teams by providing a broad range of services that facilitate access to healthcare, improve care quality, and address social determinants of health.

The CT AHEC Program has been involved with CHWs since 2000, when it conducted the first statewide survey of Connecticut’s CHWs and their employers. Since then, CT AHEC, with Southwestern AHEC as the lead, has worked with numerous partners to promote, train, and develop the CHW workforce. These efforts at development received a significant boost when CT AHEC was selected in 2014 to lead the CHW component of Connecticut’s State Innovation Model (SIM) Test Grant.

In 2016, the SIM-CHW Advisory Committee was created and charged with developing policies to promote the CHW workforce. Over the course of SIM, the committee adapted a definition for CHWs in CT, defined roles and skills, and ultimately developed recommendations for certification. In 2019, a bill incorporating these recommendations (Public Act 19-117) was signed into law declaring that, starting on January 1, 2020, there will a certification program for CHWs to be administered by the Department of Public Health (DPH).

Roles of Community Health Workers

Cultural Mediation Among Individuals, Communities, and Health and Social Service Systems
  1. Educating individuals and communities about how to use health and social service systems (including understanding how systems operate)
  2. Educating systems about community perspectives and cultural norms (including supporting implementation of Culturally and Linguistically Appropriate Services [CLAS] standards)
  3. Building health literacy and cross-cultural communication
Providing Culturally Appropriate Health Education and Information
  1. Conducting health promotion and disease prevention education in a manner that matches linguistic, cultural, and developmental needs of participants or communities
  2. Providing necessary information to understand and prevent diseases and to help people manage health conditions (including chronic disease)
Care Coordination, Case Management, and System Navigation
  1. Participating in care coordination and/or case management
  2. Making referrals and providing follow-up
  3. Facilitating transportation to services and helping to address other barriers to services
  4. Documenting and tracking individual and population level data
  5. Informing people and systems about community assets and challenges
  6. Facilitating the participant-provider relationship and effective communication
Providing Coaching and Social Support
  • Providing individual support and coaching
  • Motivating and encouraging people to obtain care and other services
  • Supporting self-management of disease prevention and management of health conditions (including chronic disease)
  • Planning and/or leading support groups
Advocating for Individuals and Communities
  1. Advocating for the needs and perspectives of communities
  2. Connecting to resources and advocating for basic needs (e.g. food and housing)
  3. Conducting policy advocacy
Building Individual and Community Capacity
  1. Building individual capacity
  2. Building community capacity
  3. Training and building individual capacity with CHW peers and among groups of CHWs
  4. Identifying gaps in available resources and recommending improvements
Providing Direct Service
  1. Providing basic screening (e.g., heights & weights, blood pressure)
  2. Providing basic services (e.g., first aid, diabetic foot checks)
  3. Meeting basic needs (e.g., direct provision of food and other resources)
  4. Conducting psychosocial screening
Implementing Individual and Community Assessments
  1. Participating in design, implementation, and interpretation of individual-level assessments (e.g. home environmental assessment)
  2. Participating in design, implementation, and interpretation of community-level assessments (e.g. windshield survey of community assets and challenges, community asset mapping)
Conducting Outreach
  1. Case-finding/recruitment of individuals, families, and community groups to services and systems
  2. Follow-up on health and social service encounters with individuals, families, and community groups
  3. Home visiting to provide education, assessment, and social support
  4. Presenting at local agencies and community events
Participating in Evaluation and Research
  1. Engaging in evaluating CHW services and programs
  2. Identifying and engaging community members as research partners, including community consent processes
  3. Participating in evaluation and research:
    1. Identification of priority issues and evaluation/research questions
    2. Development of evaluation/research design and methods
    3. Data collection and interpretation
    4. Sharing results and findings
    5. Engaging stakeholders to take action on findings

C-3 project

Skills

Communication Skills
  •  Ability to use language confidently
  •  Ability to use language in ways that engage and motivate
  •  Ability to communicate using plain and clear language.
  • Ability to communicate with empathy
  • Ability to listen actively
  • Ability to prepare written communication including electronic communication (e.g., email, telecommunication device for the deaf)
  • Ability to document work
  • Ability to communicate with the community served (may not be fluent in language of all communities served)
  • Ability to negotiate and advocate on behalf of participants
Interpersonal and Relationship- Building Skills
  • Ability to provide coaching and social support
  • Ability to conduct self-management coaching
  •  Ability to use interviewing techniques (e.g. motivational interviewing)
  •  Ability to work as a team member
  • Ability to manage conflict
  •  Ability to practice cultural humility
Service Coordination and Navigation Skills
  • Ability to coordinate care in a way that is person- centered
  • Ability to identify and access resources and overcome barriers
  • Ability to make appropriate referrals
  • Ability to facilitate development of an individual and/or group action plan and goal attainment
  • Ability to coordinate CHW activities with clinical and other community services
  • Ability to follow-up and track care and referral outcomes
Capacity Building Skills
  • Ability to help others identify goals and develop to their fullest potential
  •  Ability to work in ways that increase individual and community empowerment
  • Ability to network, build community connections, and build coalitions
  • Ability to teach self-advocacy skills
  • Ability to conduct community organizing
Advocacy Skills
  •  Ability to contribute to policy development
  •  Ability to advocate for policy change
  • Ability to speak up for individuals and communities
Education and Facilitation Skills
  • Ability to use empowering and learner-centered teaching strategies
  • Ability to use a range of appropriate and effective educational techniques
  • Ability to facilitate group discussions and decision-making
  • Ability to plan and conduct classes and presentations for a variety of groups
  • Ability to seek out appropriate information and respond to questions about pertinent topics
  • Ability to find and share requested information
  • Ability to collaborate with other educators
  • Ability to collect and use information from and with community members
Individual and Community Assessment Skills
  • Ability to participate in individual assessment through observation and active inquiry
  •  Ability to participate in community assessment through observation and active inquiry
Outreach Skills
  • Ability to conduct case-finding, recruitment and follow-up
  • Ability to prepare and disseminate materials
  •  Ability to build and maintain a current resources inventory
Personal Skills and Conduct

 

  •  Ability to set goals and to develop and follow a work plan
  • Ability to balance priorities and to manage time
  • Ability to apply critical thinking techniques and problem solving
  • Ability to use pertinent technology
  • Ability to pursue continuing education and life-long learning opportunities
  • Ability to maximize personal safety while working in community and/or clinical settings
  • Ability to observe ethical and legal standards (e.g. CHW Code of Ethics, Americans with Disabilities Act [ADA], Health Insurance Portability and Accountability Act [HIPAA])
  • Ability to identify situations calling for mandatory reporting and  follow mandatory reporting protocols
  • Ability to participate in professional development of peer CHWs and in networking among CHW groups
  • Ability to set boundaries and practice self-care
  • Ability to work in teams
Evaluation and Research Skills
  • Ability to identify important concerns and conduct evaluation and research to better understand root causes
  •  Ability to apply the evidence-based practices of Community Based Participatory Research (CBPR) and Participatory Action Research (PAR)
  •  Ability to participate in evaluation and research processes including:
    • Identifying priority issues and evaluation/research questions ii) Developing evaluation/research design and methods
    • Data collection and interpretation
    • Sharing results and findings
    • Engaging stakeholders to take action on findings
Knowledge Base
  •  Knowledge about social determinants of health and related disparities
  • Knowledge about pertinent health issues
  • Knowledge about healthy lifestyles and self-care
  • Knowledge about mental/behavioral health issues and their connection to physical health
  • Knowledge about health behavior theories
  • Knowledge of basic public health principles
  • Knowledge about the community served
  • Knowledge about United States health and social service systems

C-3 project

Qualities

The personal characteristics or traits that can be enhanced but not taught.

These qualities include:

  1. Connected to Community
  2. Mature (e.g., courageous, prudent, temperate)
  3. Friendly, Outgoing, Sociable
  4. Patient
  5. Open-Minded/Non-Judgmental
  6. Honest, Respectful
  7. Open to Change and Learning
  8. Dependable, Responsible, Reliable
  9. Caring, Compassionate
  10. Persistent, Creative, Resourceful, Adaptable