COVID 19 Response

 MHP Salud’s COVID-19 Directory includes resources in both English and Spanish. These resources focus on CHW and COVID-19 interventions for Latino and farmworker communities to include vaccine information, tips and best practices for CHWs. 

To access the Guides and Educational tools click here. 

 Advancing CHW Engagement in COVID 19 Response Strategies  ( pdf 19 pages) 

" The Playbook" 

The COVID-19 Pandemic has highlighted the persistent inequities in healthcare access,

quality and cost throughout American society. Local Health Departments (LHDs) must

advance health equity in all facets of their response and rebuilt efforts. Community Health

Workers (CHWs), as trusted members of the community and experts in community health,

are critical for this advancement. CHWs should be engaged as necessary partners throughout

several key activities of the local COVID-19 response strategy, including but not limited to

contact tracing and healthcare coordination, community-based testing, vaccine readiness

education, and the navigation of social resources.

 9 key areas of engagement: 

1.  Role Definition
2.  Recruitment
3.  Training and Professional Development 
4.  Safety and Supplies 
5.  Supervision
6.  Compensation 
7.  Multisector Integration 
8.  Career Investment 
9.  Program Evaluation 

Four levels of an engagement continuum: 

1. Limited or Harmful Engagement 
2. Moderate Engagement
3. Mature Engagement
4. Robust Engagement

READ MORE

 ADVISORY MEMORANDUM ON ENSURING ESSENTIAL CRITICAL INFRASTRUCTURE WORKERS' ABILITY TO WORK DURING THE COVID-19 RESPONSE FROM: 

Author: Brandon Wales Acting Director Cybersecurity and Infrastructure Security Agency (CISA)  

Pages: 24

Date:  December 16, 2020  

Contact: CISA at CENTRAL@CISA.GOV. 

U.S. Department of Homeland Security Cybersecurity & Infrastructure Security Agency Office of the Director Washington, DC 20528 

 IDENTIFYING ESSENTIAL CRITICAL INFRASTRUCTURE WORKERS

• Includes Community Health Workers

 The following list of identified essential critical infrastructure workers is intended to be overly inclusive reflecting the diversity of industries across the United States.  

 From the Factory to the Frontlines The Operation Warp Speed Strategy for Distributing a COVID-19 Vaccine  ( 11pages) 

 National Covid 19 Resiliency Network

Morehouse School of Medicine (MSM) has been at the forefront of anticipating and responding to the needs of communities who have been disproportionately impacted during and after pandemics and other disasters.

To mitigate the impact of COVID-19 on racial and ethnic minority, rural, and other disproportionately impacted populations, MSM announced the National COVID-19 Resiliency Network (NCRN) as part of the  National Infrastructure for Mitigating the Impact of COVID-19 within Racial and Ethnic Minority Communities (NIMIC) Initiative, a three-year cooperative agreement between Human and Health Services Office of Minority Health and the Morehouse School of Medicine. 

•  Identify and engage disproportionately impacted communities 
•  Nurture existing and develop new partnerships
•  Disseminate culturally and linguistically appropriate information 
• Leverage technology to connect communities to resources
•  Monitor and evaluate 
•  Apply broad and comprehensive dissemination methods 

PARTNERS

Contact: 

Morehouse School of Medicine

email:     ncrn@msm.edu

Address: 720 Westview Drive, Atlanta, GA 30310 

Phone:   1-877-904-5097

 An Environmental Scan to Inform Community Health Worker Strategies within the Morehouse National COVID-19 Resiliency Network (NCRN ) was developed by the National Association of Community Health Workers (NACHW) and a consultant from the Community Health Acceleration Partnership (CHAP) to examine key factors within the United States landscape that create challenges or opportunities to integrate the CHW workforce into COVID-19 responses. The methods, participants and geographic locations engaged in the development of the report are filtered by the Morehouse NCRN Five Priority Communities impacted by COVID-19.

Read the full report HERE

Date: December 2020

Pages: 82 

Authors: 

• Jane Berry
• Aurora Grant Wingate
• Denise Octavia Smith

Contributors

• Bernadine Mavhungu

https://nachw.org/ncrn/

Table of Contents

Executive Summary................................................................................................................................1

Background............................................................................................................................................13

The Morehouse School of Medicine’s National COVID-19 Resiliency.

Network (NCRN).................................................................................................................................... 14

Environmental Scan..............................................................................................................................16

State Specific  Descriptions..................................................................................................................28

Listening Sessions................................................................................................................................ 42

Key Informant Perspectives on Challenges and Strategies to Partner &

Engage Populations of Focus ..............................................................................................................48

Appendix................................................................................................................................................55

Strengthen public health emergency response with Community Health Workers. 

Articles, Blogs and Research 

• NACHW Health Affairs Blog in May 2020 articulating the ways CHWs can help Strengthen Public Health Response during the pandemic 
• Published research on the insights from CHW State Leaders on the impact of COVID-19
• Joint Statement with Health Leads and partners on Ensuring Racial Equity in the Development and Distribution of a COVID-19 Vaccine 
• A Blog COVID-19 Sparked a Health Equity Movement – and Vaccines are Just the Beginning 
• Kaiser Health News Article: Community Health Workers, Often Overlooked, Bring Trust to the Pandemic Fight 

COVID-19 Coalitions and Partnerships 

• The Community-Based Workforce Alliance co-founded with Health Begins, Health Leads, the WHO Community Health Acceleration Project, Partners in Health, Last Mile Health and others intended to strengthen advocacy, communications, technical assistance, and monitoring 

Handouts, Reports and Playbooks 

• NACHW handout on Ways for Public and Private Institutions to Amplify CHWs during COVID-19 

1. Classify CHWs as “essential, critical infrastructure workers” and pay them to respond to COVID-19.
2. Mobilize funding to scale CHW networks and association capacity for contact tracing  and care coordination training and services.
3.  Recognize CHWs as leaders in COVID-19 community recovery & health system transformation efforts. 

• NACHW handout on ways to partner with CHWs during COVID unify national messaging on CHW roles during COVID-19 developed through engagement with over 30 CHW from 27 states 
• NACHW Environmental Scan to Inform Community Health Worker Strategies within the Morehouse National COVID-19 Resiliency Network 
• A Playbook for Local Health Departments to Advance CHW Engagement in COVID-19 Response Strategies developed by the Community-Based Workforce Alliance 

Webinars and Websites

• NACHW webpage with curated and original COVID-19 resources for CHWs.
• NACHW webinar and webcast with the CDC and ADA on the roles of CHWs during
• COVID-19
• NACHW web page with CHW Networks, Associations, Coalitions and CHW training sites to promote local CHW Network membership, training, career advancement and partnerships
• NACHW webinar for the 2020 HHS OMH Virtual Symposium on Community Centered Solutions for Addressing COVID-19 among Racial and Ethnic Populations - Meeting Community Members Where They Are
• Webinar: Overcoming Barriers To Equitable And Effective COVID-19 Vaccine Distribution
• A Vaccine Equity Resources website developed by Health Leads, NACHW, Native Ways, CONVINCE, CHAP and partners to center racial equity in vaccine distribution
• A CDC web page with Resources for Community Health Workers, Community Health Representatives, and Promotores de la Salud

Date: Updated Dec. 14, 2020

Author: CDC

• Personal Protection and Safety  :Information to keep CHWs safe—including avoidance and protection strategies and steps when someone is diagnosed with COVID-19
•  Adapting Practices for COVID-19:Telehealth and in-person risk assessment tools for CHWs and client engagement
•  Stress and Coping   : Self-care and mental health resources for CHWs during challenging times
•  Training and Support: Webinars, modules, and training resources focused for CHWs
•  Communication Tools: Posters, handouts, and graphics for CHWs to share with clients
•  Information for Employers: Policies, safety procedures, and the role of CHWs during the pandemic—including the latest information on contact tracing—for employers

Link to Webpage

 A Playbook for Local Health Department Strategies in the United States

(The National Community-Based Workforce)  

Date: January 2021

Authors: Community Based Health Alliance, Health Begins ( Dr Rishi Manchandra)

Pages:  19

Areas of Engagement

1. Role Definition
2. Recruitment
3. Training and Professional Development
4. Safety and supplies
5. Supervision
6. Compensation
7. Healthcare Integration
8. Community Partnerships
9. Career Investment
10. Program evaluation

Community Wisdom: CHWs are positioned to deliver the wisdom of the communities being served to the health system, not only health services to unreached communities.

Community-Based Workforce Principles for Contact Tracing

​Principle 1: Recruit & manage with a racial equity framework 

Principle 2. Invest in trusted voices, including Community Health Workers

Principle 3: ​Strengthen connections with psychosocial services & systems

Principle 4: ​Launch a community-based jobs program as a force multiplier

Principle 5: Embed job training & pipelines to local careers

Principle 6: ​Strengthen community infrastructure & financing

 ORIGINAL ARTICLE 

Author:  By Michele Cohen Marill

Date: February 8, 2021

For 11 months, Cheryl Garfield, a community health worker in West Philadelphia, has been a navigator of pandemic loss and hardship. She makes calls to people who are isolated in their homes, people who are sick and afraid and people who can’t afford their rent or can’t get an appointment with a doctor. 

The conversations always start with a basic question: “Tell me about yourself.” She wants to know her clients before she figures out how she can help.

“Sometimes a patient just needs somebody to listen to them, so you just listen,” said Garfield, 52.

Public health authorities are relying on Garfield and her peers to be a bridge to communities that have been hardest hit by covid-19 and who are most skeptical about the new vaccines. African Americans and Hispanics have been hospitalized with covid at rates more than three times higher than for non-Hispanic white Americans, but they are among the most hesitant to get the vaccine. As the pandemic brings long-standing health disparities into sharper view, community health workers are coming to the forefront in the public health response. 

 It is an about-face after their efforts were largely curtailed early in the pandemic, when “nonessential” health services came to a halt. Community health workers “were sidelined but the needs of the community weren’t sidelined,” said Lisa Hamilton Jones, co-president of the Florida Community Health Worker Coalition. “Now we’re seeing more hiring of community health workers than ever. If you look at the virus and the timeline, why did it take so long?” 

President Joe Biden has endorsed a bigger role for these workers as part of his $1.9 trillion “American Rescue Plan.” The proposal includes the hiring of 100,000 people to help with “vaccine outreach and contact tracing in the near term, and to transition into community health roles” after the covid crisis is over.

With their deep roots in the community, many of these workers were disappointed when they were not called on to help initially in the pandemic. Community health workers often work on grant-funded projects with a specific goal, such as improving blood sugar control among people with diabetes. When the pandemic shutdown suspended those programs, many found themselves without a job.

They became marginalized workers within marginalized communities.

“We were hearing from our members across the country, ‘I’m trying to get in touch with my local health department to say I want to help,’” said Denise Octavia Smith, executive director of the National Association of Community Health Workers. “They couldn’t even get through to the [local covid] task force.”

‘Shared Life Experiences’

Garfield works for Penn Medicine, the health system of the University of Pennsylvania, but she isn’t a medical professional. She and other members of this fast-growing workforce help fill the gaps between health care providers and low-income communities by offering education, advocacy and outreach.

Before the pandemic, Garfield met with at-risk patients as they were discharged from the hospital and eased their path to care in the community. Her work often isn’t directly related to health care. In one case, she took a formerly homeless man bowling. The outing, which triggered joy and memories from his youth, helped him decide to turn his life around. He got a job, kept the doctors’ appointments he had been avoiding and took better care of himself.

Since the pandemic, her caseload has varied — and her encounters occur by phone. She helped a young woman with a high-risk pregnancy — and a positive test for covid — find a doctor. She assisted a homeless man in getting federal stimulus funds and care in a nursing home.

Garfield is a grandmother who raised six children as a single mom, and she’s a survivor of domestic violence. She lost a nephew to gun violence, has friends who died of covid and has her own serious health problems — sickle cell disease and the inflammatory disorder sarcoidosis. She doesn’t hesitate to share those personal details. They help her relate to patients.

“You look at them like they’re a family member,” said Garfield. “We connect with our patients more because we’re from the community, and we have the shared life experiences that they have.”

Health care has always been most personal when it extends beyond the clinic or hospital. Community health workers often are employed in traditional health settings, but in recent years they also have served in community centers and churches or gone door to door, providing health education and connections to resources. They promote, among other health issues, HIV/AIDS prevention, prenatal care, immunizations and cancer screening.

Dr. Shreya Kangovi, founding executive director of the Penn Center for Community Health Workers at the University of Pennsylvania, helped demonstrate these workers’ effectiveness in a study published last year that followed 302 patients who were on Medicaid or were uninsured, lived in poor neighborhoods and had at least two chronic health conditions. Community health workers met one-on-one with half those people in 2013 and 2014 and helped them create plans to address their health and social needs. The patients who received help from community health workers had fewer and less costly hospital admissions than the rest of the group. Kangovi and her colleagues calculated an annual return on investment of $2.47 for every dollar spent.

Other studies similarly showed lower health costs.

Investing in Community Engagement

Covid’s unequal burden became obvious by May and June as demographic data emerged, documenting higher infection rates among African Americans and Hispanics.

The Trump administration awarded $40 million to Morehouse School of Medicine in Atlanta to lead a broad initiative to mitigate the impact of covid on minorities. Morehouse created the National COVID-19 Resiliency Network, which is hiring and training community health workers and building partnerships with organizations that represent a wide scope of vulnerable populations, including Native Americans, African Americans, Latinos, people with disabilities and those who are incarcerated.

In September, the National Institutes of Health launched the Community Engagement Alliance Against COVID-19 Disparities, or CEAL, in 11 states as an effort to improve outreach to high-risk communities and to combat misinformation about covid and the vaccines. The program offers community health workers an opportunity to express concerns they have heard from the people they serve.

For example, in a recent online “listening session” sponsored by the Georgia CEAL, a community health worker noted local fears about vaccine safety. “My folks are concerned if [electronic] chips are going to be in the vaccine,” she said.

No chips and no live virus, responded Dr. Lilly Immergluck, a Morehouse infectious disease physician. She explained how the vaccines work — information community health workers can share to counter misinformation.

“As a community health worker, I’m an advocate for vaccinations,” Adrianne Proeller, community engagement coordinator at Morehouse, later said. But she added, “I think we need to be very careful about not coming on too strong, and listening and taking people’s concerns seriously, and not just brushing them away.”

‘Support My Patients’

In Philadelphia on a December morning, Garfield reviewed her caseload and picked up her phone. “I’m just giving them a call to check on them in these stressful times of  covid,” she said.

One patient rents a room in a house with five other people. She wanted to move out because she was worried about the risk of covid with so many housemates. Garfield told her she would help with the search, but they would need to wait until it was safer to visit potential apartments. Another client had run out of food. Garfield arranged three months of deliveries from a food bank.

Vaccines promise to end the isolation caused by covid. Garfield offers information and answers questions, and if people feel uncertain, she encourages them to talk to their doctor. Ultimately, they will make the decision about when or if to get a covid vaccine.

But if they tell her they want a vaccine, she said, “we’ll find a way to make it happen.”

ORIGINAL ARTICLE 

EDITORS' PICK

Date: Nov 9, 2020

Authors: 

• Raj PanjabiContributor Coronavirus Frontlines Contributor GroupHealthcareI’m the CEO of Last Mile Health and Assistant Professor at Harvard Medical School.
• Niranjan Bose Contributor Coronavirus Frontlines Contributor GroupHealthcare Niranjan Bose is Managing Director of Exemplars in Global Health. 

" ...In the United States, 64,900 community health workers are actively working in their communities to treat diseases like diabetes, HIV/AIDS, tuberculosis, or cancer, and provide prevention services ranging from sexual and reproductive health, behavioral health, cardiovascular health, and chronic disease. During the pandemic, they have also played an important role. In major cities like Boston, Philadelphia, and San Francisco, contact tracing, testing and education efforts have happened partly because of the tireless efforts of community health workers on the ground. But because community health workers can have over 100 different job titles, they are not always properly identified or recognized as a key part of the health workforce. "

READ MORE

Author: Rob Waters

Date: July  2020 

Abstract:  Systems are investing in workers who come from the communities they serve to meet patient needs that extend well beyond clinic walls.

Before COVID-19: Philadelphia’s IMPaCT community health workers, such as Orson Brown (right), visited patients, including Walter Briggs (left), in their homes. Most visits take place virtually now, but workers continue to help patients navigate the same challenges... Today, at age fifty, he is one of thirty people deployed by the University of Pennsylvania’s Penn Center for Community Health Workers as part of the Individualized Management for Patient-Centered Targets program, also known as IMPaCT.... 

Clements sees his role as helping patients meet basic needs, gain access to services, and solve problems, using his own experiences and insights to gain patients’ trust. “We open the door, using health care to get in, but once we do, we try to assist the patient holistically with any issues they may be having,” he says. “You name it, we do it.”

Now, as people across the United States and the world grapple to survive and eventually emerge from the novel coronavirus disease (COVID-19) pandemic, a growing number of health planners and advocates propose hiring tens of thousands of additional community health workers to help. An expanded community health workforce could respond to the enormous need for social, material and psychological support, helping people who have lost their incomes get food, strategize ways to pay their rent or mortgage, fill prescriptions, and figure out how to live more safely in crowded apartments. These needs are especially dire in low-income African American and Latino communities, which have been disproportionately afflicted by the virus..."

READ MORE

Community Health Worker Outreach Initiative Extended

Author: LA Public Health Department News

Date:  November 09, 2020 

Extension will provide an estimated $3 million in unspent funds for partner agencies.

LOS ANGELES – The Los Angeles County Department of Public Health’s Community Health Worker (CHW) Outreach Initiative has been extended after the federal government extended the CARES Act funding into 2021. Originally slated to end December 30th, this extension will provide an estimated $3 million in unspent funds for partner agencies to conduct outreach by deploying CHWs through end of January and possibly into February.

The extension comes at a time when the county is experiencing a dangerous surge in COVID-19 cases, hospitalizations and deaths. Having trusted community members as ambassadors will ensure that hardest hit communities are getting accurate information to help slow the spread.

The CHW Outreach initiative began mid-October with a budget of $18.5 million and mobilized a Public Health Team of about 60 CHWs, and in partnership with California Community Foundation, contracted with 16 community-based organizations with existing peer outreach networks to conduct outreach countywide to those most impacted by the virus.

Together, these 16 agencies mobilized more than 900 part-time and full-time CHWs who conducted more than 200,000 outreach activities virtually and in the community across LA County, reaching an estimated 369,000 individuals, and distributing 232,000 face coverings and 60,000 hand sanitizer bottles.

The multidisciplinary initiative engaged different peer workers, including promotores, indigenous and people of color advocates, health outreach workers, essential worker advocates, parent advocates, and gang intervention workers and peace ambassadors; all were credible messengers who provided “virus interruption” by amplifying accurate and up-to-date information regarding COVID-19 within their communities and networks. The initiative is building infrastructure for a community-based system of care and supported workforce development by training CHWs in field safety, trauma informed practice, and supervision skills.

“These Community Health Workers and promotores are trusted community members who not only share the ethnicity and language of the people they serve, they are often from those very same neighborhoods,” said Hilda L. Solis, Chair, Los Angeles County Board of Supervisors, and Supervisor to the First District. “With this current surge, we are seeing huge disparities in communities of color that have the fewest resources. It is more important now than ever that these respected communicators continue providing those hardest hit by the pandemic with the information and resources that will allow them to protect themselves and their families.”

“The Community Health Worker Outreach Initiative has been one of the most effective communication programs through Los Angeles County’s response to COVID-19 and this extension, will allow critical efforts to continue across the hardest hit communities,” said Barbara Ferrer, PhD, MPH, MEd, Director of Public Health. “Public Health is committed to closing the gaps experienced among communities of color, where there are higher case, hospitalization, and death rates. This extension provides communities across the county with critical information about COVID-19 vaccinations, dispels myths and rumors, and informs residents on steps they can take to slow the spread of the virus, including following safety protocols, getting tested, and reporting workplace outbreaks.”

CHW Outreach Partner Agencies – California Community Foundation (Fiscal Agency)

• Alma Family Services
• Asian Pacific Policy and Planning Council (A3PCON)
• Clinica Msr. Oscar A. Romero
• Community Build
• East LA Women's Center
• East Valley Community Health Center, Inc.
• Pilipino Workers Center of Southern California
• Providence Little Company of Mary Foundation   Soledad Enrichment Action, Inc (SEA)
• Southern California Crossroads
• St. John's Well Child & Family Center
• The Children's Center of the Antelope Valley
• The Wellness Center
• United American Indian Involvement, Inc. (UAII)
• Urban Peace Institute
• Vision y Compromiso

CHW Outreach Training & Communications Partners

• Urban Peace Institute
• Lumos Transforms
• Worker Education Resource Center
• Team Friday (Communications)