Maine Community Health Worker Initiative: Maine CHW Inventory
December 2, 2013
Agency Name/ Entity & Contact Info. / Name /Definition of CHW/ Shared or Paired Trait / Defin-ition Source / AP
H
A / Population Served / Recruitment
Methodology / Training/
Supervision / Salary/
Stipend
($$$) / Base of Operation
MEPCA Patient Navigation Approach/
Kim Humphries
207.621.0677 / No paired trait but cultural competency is part of training. Also, integrates patient perspective to better understand the community, as well as the sub-populations. Responsibilities are shared across team, can divide it to work for them. “…defining patient navigation as a “process” rather than a “person” …the navigation team is a critical component. The purpose of the project is to improve patient care across the continuum of care. Achieved by improving referrals, early detection and streamlining system within CHCs / MA-PNav
Prog. / N / Individual participating FQHCs define the population they would target (i.e. for breast, cervical and colorectal health and other chronic conditions). / N/A Varies based on capacity of individual FQHC and make-up of team. No pre-requisites / 48 hour course- based on MA curriculum. On-line plus two on-site training sessions (14 weeks). Supervision varies by FQHC. / Navigation team members are all employees of FQHCs. / Most of work goes on in the practice/FQHCs but also building relationships to community resources/entities (i.e. AAA and Healthy ME Partnerships). It is the HC staff who make these connections.
Portland Public Health- Bankole Kolawle
207.874.8773 / Community Health Outreach Worker: emphasize the outreach component of their work. CHOWs are indigenous to their community- addressing, structural, culture & language barriers. Shared language, country of origin and culture. / MA-CHWA / Y / Thirteen racial/language/ ethnic communities.
i.e. Cambodia, Vietnamese, Serbia, Swahili, Chinese, Sudanese (Acholi/Nur), Russian, Spanish, etc. / For FTEs because hired under PPH follow city HR expectations. Each FTE CHOW has an advisory committee, from these CHOWs are recruited, also Faith Based & Community Leaders. Previous involvement w/PPH. / CHOW Training- 35 hour mixture of MA, AZ & NY curriculums- core competencies (10 hrs.), health specific topics (9 hrs.).
Supervised by PPH Staff and Clinical Partners (assigned coordinators at each site- MMC, Mercy, PCHC, etc.) / 4 FTE CHOWs (Somali, Spanish, French, Arabic)
Contracted & Per Diem CHOWs-
Maximum 39 CHOWs (13 communities)
Per diem are actually employees of City / 4 FTE CHOWs are housed at City Hall & at clinical sites (Riverton, Mercy, India, Fore River). Clinical Sites provide space. Also working in So Portland, Westbrook- i.e. Cumberland County.
Maine Migrant Health Program / Promotora/Camp Health Aide Traits shared: ag work, language, and race/ethnicity. CHWs are community members who promote health in their own communities. They provide leadership, peer education, support, and resources to support community empowerment. As members of minority and underserved populations they are in a unique position to build on strengths and to address unmet health needs in their communities…. / MHP / Y / Farmworkers / Outreach based- camp visits, recommendations of previous CHAs or other peers, postings in camps / 10 hour- basic training on core competencies followed by 2-3 hours on specific health issues/initiatives. Face to face supervision 2x/month / $100/week (expectation of 10 1 on 1 contacts or group education / MMHP- CHA Project Coordinator spends 70+% of time during season in harvest areas. In 2013 MMHP will have 12-14 CHAs all live and work in a labor camp.
United Somali Women- Fatuma Hussein, Executive Director
207.753.0061 / Same cultural background, language, system they work in, lot of commonalities with the people they serve. Same community- i.e. Acholi speakers for Sudanese members. 10-15 different language groups spoken by staff. / Y / Refugee & Immigrant Populations-African & Middle Eastern Ethnic Groups, Somali, Sudanese, Rwanda, Burundi, Somali Bantu, Angola, Chad, Egyptian / Cultural and language (written & spoken) skills are most important to assess. Language proficiency and background checks are part of screening. Going to take a lot of effort to get cultural knowledge base increased. Trauma/needs high important to important we recruit from within our communities / Training- interpretation basic training. Orientation for new staff, training-40 hour advocacy (DV/SA), health systems training, role of CHOWs, 2006 training from folks in MA- chronic disease, system of CHOW, partnerships w/providers & community agencies, and job shadowing. Grass roots outreach & then skills needed to do this work in community. Also act as a trainer / Mostly employees (.80 FTE) and a few contract positions to CMMC / Lewiston, Auburn and there is an office in Portland (Riverton)
Frannie Peabody Center- Jennifer Putnam, Director of Programs
207.774.6877 / “Outreach Worker” tend to try to match them to the community that they serve, esp. with MSM prevention work. / Y / MSM, IDU, Asylees (falling under category of women at high risk). / Typically put word out in community that they would be serving. / Training- FP orientation- CDC HIV CTR training, rapid testing training, outreach and safety training. Cultural competency training. Do some shadowing of the work. Lots of continuity amongst staff. Supervised by director of programs and some clinical supervision (not required). / I FTE 2 PT- serving MSM/ 1 FTE female serving IDU community as well as asylee community Also do some stipended outreach / Based out of (Store front) Portland and Ogunquit offices.
Area Agency on Aging- Jess Mauer, Executive Director 207.592.9972 / Enhanced options counseling thru “ADRC Counselors” AAAs is also aging and disability resource centers (ADRCs). ARDC grant collaboration with CCTs and PCMH sites to do options counseling & go into the home to do assessment (2.5 hours) on home risk, barriers to managing health, nutrition needs, medication mgmt. issues. SES & physical needs & potential harms- work in PSP with medical provider. Traits shared- people who have been around for a long time, most are social workers. Grounding in understanding the population. / US Agency on Aging / M / Disabled adults and adults 60 years and older. CCT enhanced project it is 50 years and older (top 3% of medical users).
Agency is serving about 130K individuals per year (not necessarily by ARDC). / Need to get back to me on this / All ARDCs are trained in Coleman model. One universal assessment tool and documentation data collection tool so training is done to match these instruments. Depending on where ARDCs are housed will define the scope of their work and what background is required of them. MaineHealth is using LCSWs as part of their CCTs. / Full-time. Employees, 5 ADRCs under CCT project. Working collaboratively with healthcare to improve care and decrease costs. / Based out of the 5 regional AAAs employed as an ARDC.
EMHS (AAA)
Lanie Abbott
/ “Patient Advisors”- service line or practice define their involvement. No common definition developed yet, Evolved from PCMH expectation for patient/family advisory role. / PCMH / N / Patients- Scope of Involvement is how to inform work of practice to be better- i.e. processing patient complaints
Looking for mixed demographics- age, family status / Patients who can get out of the way of their story-recommendations of frontline staff will know who is available, and then using the provider or nurse care coordinator to do actual ask. Beginning to use social media. / Developing a toolbox/resource for individual practices with tools- how do you make it worth time of staff & patients / Provide a healthy meal. / Because of staff time is intensive- there is some consolidation of patient advisory groups (i.e. Inland and Sebasticook Family Health).
Amistad Peer Coaching Pilot
Chris Monahan
207.773.1956 (no call back) / “Peer Coach” refers to a person who has been diagnosed with a mental illness and has reached a level of stability in his or her recovery process that he or she can work with and relate to their peers who may be experiencing feelings of anxiety, fear, apprehension, etc.
Somali Cultural and Development Association- DD Swan non-profit coach
207.773.3430 / Community Health Outreach Worker/CHW is used interchangeably. “CHOWs” are matched on shared language and culture / MA CHWA / Y / Refugees/ Immigrants / Mohammud does most of the recruiting through his connections amongst other medical interpreters, community contacts, & shelters. / DD/PCHC provide supervision. All CHOWs need to be certified medical interpreters. They have completed the CHOW training available under the CHANNELS/PPH/ UNE project. Also trained in content of MEHAF /ACA collaborative and thru PCHC. / To date 9 have been trained and are receiving stipends for specific activities. / Based out of office on Elm Street, many of the community events are done at Franklin Twrs.
Portland Community Health Center
Laura Gottfried
207.874.2141 / “Community Health Outreach Workers” of PPH placed at HC for a couple of hours per week. Two volunteers at HC are trained as CHOWs. One of whom completed the Stanford Chronic Care Model. / MA CHWA / Y / Kiera Moss, logistical point person for PPH Staff & is Outreach Manager. Once chronic care piece is up and running clinical SW will act as supervisor. / The volunteers approached us to get involved, one of whom is a BOD member, the other is a family member. / Both completed CHOW training with City of Portland/ CHANNELS project. / May have received stipend for training & travel- no ongoing financial support / 180 Park Ave. site only
Catholic Charities/ Refugee Resettlement-
Karen Balicki
523-2711 / Cultural life Skills Trainer- Doing group-level orientation (Portland & Lewiston) one is focused on community the other on culture. Also a group bus tour, car seat trainings. Donation distribution of winter clothing. One on one w/families (i.e. EBT/grocery shopping /laundry/household/trash disposal. Parenting skills, more rarely. / Ref Rstlmt Def. / N / Refugees from Somalia and Iraq coming directly from home country. Lewiston more secondary wave. / Recruited based on skill development/ training experience. / Life Skills training from BU. Over 100 hours of training in psych rehab and skill development (i.e. training people). Part of refugee and resettlement team. Under contract with US State Dept. services include CM, Employee CM, and Cultural Orientation- Reception & Placement Services. / Employee / Portland only in Lewiston (2 days/month)
Tribal Health Departments (Maliseet, Penobscot, Passamaquoddy)
Community Health Resource Worker
CC Transformation Grant- Alex London/Houlton Band of Maliseets
Cell: 207- 538-1916 / Understanding and good relations with tribal member. Responsibilities include home/safety assessments, BP screenings, post-hospitalization home visits, health education and community activities. They are either unusually close or a member of the tribal community. They understand the community, share practices, common interests. IHS definition guides this role/individual at each of the tribes, but depending on who is in it, their role might be different. In this liaison role the CHR is often the face of the health center, the trusted individual who advocates on behalf of the patients. / IHS / Y / Relationship w/ IHS HC means that a service (i.e. post hospital visits) are tied to individual being a patient of HC. Community activities are more broadly available. There seems to have significant focus on elders / Varied depending on how Tribe funds/defines scope of work (i.e. everything from GED to nursing degree All CHR positions are first posted to the tribal community which is customary hiring procedure; if it is not filled it is shared with the greater/broader community.) / Dependent on role- i.e. if CHR is a nurse there will be clinical supervision, but inevitably leads up to HC Director. / Income from health center/IHS support. Two of tribes have vacancies due to lack of funding. All are employ-ees of Tribal Health Center. / Depends on how the job is structured within the Tribal Health Center.
MDI Hospital/ HRSA Diabetes Community Outreach Project- Deb Turner (207) 460-2581 / Adjunct to supplement to professional doing care management. Community Health Volunteers mostly doing diabetes prevention groups. Have longest programming in Swan’s Island. Shared trait was used but not exclusively bc/of grant pressures. Focused on MDI Hospital service area. / Commun-ity health coach definition from NDPP. / N / High risk of type 2 diabetes or already diagnosed with type 2 diabetes. Promoting screenings & getting care. Engage community members to increase awareness or risk & then getting folks into NDPP. / High interest in community service, passion about health education & prevention. In our opinion would participate well & engage well in community. / Basic hospital orientation, half-day project introduction, instruction in diabetes prevention program. Pairing/ shadowing with trained facilitator who is also supervisor (nurse & SW). / Volunteer- currently have 5, new group in 2014. / All services are provided in community. Since most of the work is doing the prevention group- health center on Swans in Bar Harbor using YMCA, SW Harbor- primary care clinic. Convenient locations.
A Community Health Worker (CHW) :
is a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. This 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.
A CHW also builds individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support and advocacy. (American Public Health Association, 2009)
Assist individuals and communities to adopt healthy behaviors. Conduct outreach for medical personnel or health organizations to implement programs in the community that promote, maintain, and improve individual and community health. May provide information on available resources, provide social support and informal counseling, advocate for individuals and community health needs, and provide services such as first aid and blood pressure screening. May collect data to help identify community health needs (Bureau of Labor Standards, 2010)
Conclusions
· The inventory is not exhaustive in including all programs that might have one or two characteristics shared with CHWs, it is a convenience sample and looks to represent the different approaches folks in Maine are taking to engage patients in a new way, outside of the traditional medical model.