NC CHW Standardized Core Competency Training Pilots Underway

Beginning Spring 2020, six community colleges will pilot the NC CHW Standardized Core Competency curriculum.  The curriculum has been specifically designed to cover the nine core competencies recommended by the NC CHW Initiative stakeholders. All six colleges designated staff to participate in a mandatory train-the-trainer event October 23rd – 24th at the Friday Center in Chapel Hill with support from NC AHEC. Students recruited for the pilot course offering will be required to participate in a longitudinal study designed to assess workforce and client outcomes. The pilot training sites are Catawba, Durham, Edgecombe, Gaston, Haywood and Robeson counties.    

Evidence-Based CHW Program Addresses Unmet Social Need and Generates Positive Return on Investment

Researchers from the University of Pennsylvania have found positive returns of investment when using evidence-based CHW programming. A recent article in the Health Affairs, explains their methodology. Click here to access the full article.

Community Health Workers and Rural Communities

A recent article featured in HealthPayer Intelligence under the Value-Based Care News section focuses on CHWs and particularly the value they add to rural healthcare. The most significant role is that of CHWs as upstream professionals who understand the context of the communities served. For more information about how Community Health Workers Fill Gaps in Rural Health care click here.

Community Health Workers and Population Health Management

The Association of State and Territorial Health Officials (ASTHO) Center for Population Health Strategies released the Top 10 promising approaches that state and territorial health officials should explore with partners to address health outcomes.

Making the Case for an Evidence Based Approach to Coordinated CHW Efforts in NC

The Centers for Disease Control and Prevention released a Policy Evidence Assessment Report: Community Health Worker Policy Components to provide stakeholders with a summary of the current evidence to support chronic disease policies. Evidence categories include best, promising quality and emerging. The components were gathered through key informant interviews with subject matter experts and state laws. Best evidence components are listed below. For promising quality and emerging evidence read more here. North Carolina CHW Initiative Stakeholders have included each of these elements below in the recommendations to create a sustainable infrastructure for CHW in this state.

1. CHW provide chronic disease care services (Chronic Care).
2. Inclusion of CHW in team-based care models (Team-based Care).
3. Core competency CHW certification (Core Certification).
4. CHW supervised by health care professionals (Supervision).
5. Standardized core CHW curriculum (Standard Core Curriculum).
6. Medicaid payment for CHW services (Medicaid).
7. Specialty area CHW certification (Specialty Certification).
8. Inclusion of CHW in development of their certification requirements (Certification Development).

Community Health Workers and Whole Person Care

The health care system is being asked to address the needs of their patient population beyond physical and mental issues. To that end, some systems and their providers are thinking about assisting their patients through expanded care teams. This team-based care approach will rely on every member contributing to the well-being of the patient, which includes identifying issues in the context of the whole person.

To achieve that level of care, community health workers are being identified as one profession that can assist health systems and providers in gaining the knowledge to assist patients beyond physical or mental manifestation of illness. CHW have been shown to reduce hospital readmissions, divert emergency room visits to the appropriate health care provider and provide culturally appropriate education and linkages to resources.

Understanding the Roles of Community Health Workers

In 2014, the national Community Health Worker Core Consensus (C3) Project was initiated to determine the common CHW Scope of Practice and Competencies to establish CHW training curricula and practice guidelines for use at the local, regional, state and national levels. The researchers determined there were approximately 30 roles with accompanying sub-roles specific to CHW. The full report can be accessed at C3 Project Final Report. The North Carolina Community Health Worker Initiative Stakeholders used the preliminary findings as a benchmark for creating state specific recommendations.

Community Health Workers and Diabetes

The Community Guide, also known as The Guide to Community Preventive Services, recommends that CHW services be used to assist in the control of diabetes through prevention and management. In addition, the American Diabetes Association added CHW to their 2017 Standards of Care. Addressing diabetes will require a multi-pronged approach with team-based care as a standard. To learn more about the resources and services available throughout the state visit DiabetesNC.

Learn how one system in NC used CHW (Peer Supporters) to address diabetes in a disparate community.

Community Health Workers and Asthma

The Community Guide has published findings that support using CHW as part of the intervention strategies to address asthma in pediatric patients. Most interventions include a home visit with an assessment for asthma triggers. CHW can conduct assessments, note mitigating circumstances and provide education related to asthma triggers. In addition, the National Center for Environmental Health, Division of Environmental Hazards and Health Effects supports using CHW with asthma education and home assessment training as part of home visits.

Community Health Workers and the Social Determinants of Health

Community Health Workers are known for their strong connection with the communities they serve. Most often that is where you will find them as they assist their clients in identifying resources, navigating systems and building capacity. According to the NC CHW Workforce Survey conducted in 2017, CHW reported working for community and religious organizations, community health centers, hospitals, local health departments and physician’s offices as well as other settings.

Community Health Workers and Cardiovascular Disease (CVD)

The latest news from the Community Guide supports the cost-effectiveness of CHW services in the management and prevention of cardiovascular disease as well as diabetes.  According to researchers conducting systemic reviews the economic impact of CHWs and chronic disease; particularly CVD and diabetes, “the estimated costs per quality adjusted life year (QALY) gained for these intervention approaches were below $50,000—a benchmark for cost-effectiveness.” For more information on the study published in the American Journal of Preventive Medicine click here.

Community Health Workers as Partners in Health

During a recent New England Journal of Medicine (NEJM) Catalyst event of the Essentials of High Performing Organizations, representatives from the Detroit Department of Public Health and the University of Michigan Health Policy and Innovation discussed the importance of CHWs.   The partnership includes creating an environment to sustain CHWs in the changing health care landscape.