CHW Common Indictor Project

The purpose of the Community Health Worker Common Indicators (CI) Project is to contribute to the integrity, sustainability and viability of CHW programs.

The Problem

Despite progress in documenting the outcomes of Community Health Worker (CHW) interventions, the lack of standardized measures to assess CHW practice has made it impossible to aggregate data across programs and regions, impeding commitment to sustainable, long-term financing of CHW programs. Lack of easy-to-use indicators hampers the ability of many community-based programs to reliably report outcomes to funders. Lack of attention to the processes by which CHWs achieve outcomes has made it difficult to conclusively demonstrate the importance of particular CHW roles, skills, and qualities. Finally, while CHWs have sometimes been involved as data collectors, they have seldom been engaged as full partners in all stages of research.

History of the National CHW Common Indicators Project

Responding to this set of problems, in 2013, members of the Michigan CHW Alliance (MiCHWA) began the process of creating a common set of evaluation indicators and measures to understand the unique contributions of CHWs to successful program outcomes and their added value to health care and human services systems. In 2015, CHWs and researchers in Oregon brought MiCHWA colleagues together with partners from three additional states and founded the national CHW Common Indicators (CI) Project.

CHW Common Indicators Project Leadership Team and CHW Council, 2020-2021

Contact: Noelle Wiggins EdD, MSPH ninanoelia@msn.com

Using popular education in an online environment: lessons learned from the Community Health Worker Common Indicators Summit

Community Health Workers and the Power of Measurement

Wiggins, N., Maes, K., Palmisano, G., Rodela, K., Rodriguez Avila, L., Kieffer, E. (2021). A Community Participatory Approach to Identify Common Evaluation Indicators for Community Health Worker Practice. Progress in Community Health Partnerships, 15(2): 217-224.

This paper covers the early phase of the project, including its origins as a regional project in Michigan, the founding of the national project, and work conducted up to the point that funding was first received in August of 2019.

Rodela, K.R., Wiggins, N., Maes, K., Campos Dominguez, T., Adewumi, V., Jewell, P., Mayfield-Johnson, S. (2021). The Community Health Worker (CHW) Common Indicators Project: Engaging CHWs in measurement to sustain the profession. Frontiers in Public Health, 9:1-12. doi: 10.3389/fpubh.2021.674858

This paper describes work conducted in 2019-2020, including the collaborative selection of 10 priority constructs and development of associated indicators.

Links to Documents & Recordings (NWRPCA)

California Health Care Foundation (CHCF)

Healthforce Center at UCSF

Understanding California’s Community Health Worker/Promotor Workforce
A new series of reports aims to paint a more complete picture of the community health worker/ promoter workforce in California, as well as challenges and opportunities related to training and employment. Reports will be released during the fall of 2022 and winter of 2023.

Understanding California’s Community Health Worker/Promotor Workforce: A Survey of CHW/Ps

NOVEMBER 16, 2022

Download: Understanding California’s Community Health Worker/Promotor Workforce: A Survey of CHW/Ps (PDF)

Understanding California’s Community Health Worker/Promotor Workforce: CHW/P Training Programs

FEBRUARY 6, 2023

Download: Understanding California’s Community Health Worker/Promotor Workforce

NACHW Document Center

Who should use it?

The NACHW Document Center is the nation’s largest searchable collection of documents on policies around CHWs (mainly on the state level).

Documents found in this resource center are most useful for: state government officials; CHW leaders; current and potential employers and payers for CHWs; other individuals and stakeholder organizations involved in considering policies on CHWs This database is not a resource for individual CHWs looking for tools to inform or improve their practice.

The current document collection focuses on four main topic areas:

CHW Certification
Sustainable financing of CHW services
The process of implementing state policies
CHW workforce development (including training)

How can you use it?

The main use of this resource center is to find information on the process other states have gone through in advancing policies around CHWs.

This can help you understand policy options available to your state, or to learn about experiences in other states who have pursued policies or investments similar to ones you are considering for your state.

Find out more

The National Health Advisor Study

Summary 1998

Community Health Advisors (CHA) help people take greater control over their health and their lives. They promote healthy living by educating about how to prevent disease and injury as well as how to access health and human service systems. The National Community Health Advisory Study identified steps to strengthen outreach services of CHAs across the country. The study was funded by the Annie E. Casey Foundation.

Download full report PDF

Table of Contents

1. Overview (pp. 1-7)

2. Methodology & Study Participants (pp. 8-10)

3. Core Roles and Competencies of Community Health Advisors (pp. 11-17)
Study Chapter written by Noel Wiggins, MSPH (Assisted by Angelina Borbon, PHN)

4. Evaluating CHA Services (pp. 18-24)
Study Chapter written by J. Nell Brownstein, PhD (Assisted by E. Lee Rosenthal, MPH)

5. Community Health Advisors - A Career in Development (pp. 25-33)
Study Chapter written by E. Lee Rosenthal, MPH
Study Youth Supplement written by Roberta Rael, et al.

6. Community Health Advisors in the Changing Health System (pp. 34-41)
Study Chapter written by Sarah Johnson, MSW, MPH

7. Conclusion (pp. 42-44)
Study Chapter written by E. Lee Rosenthal, MPH

Summary of Core Recommendations - Reference Page (pp. 45-46)

2021

NACHW National CHW Survey 2021

Assessing the Community Health Worker (CHW) Workforce at the State and Local Level

Data for Action: NACHW National CHW Survey to Advance CHW Professional Identity, Leadership and Capacity

As part of the Johnson & Johnson Our Race to Health Equity initiative to eradicate racial and social injustice, the National survey launched in 2021 with a snapshot of 867 CHWs represented across each CHW title, region, sector, race/ethnicity identities, and values. Call to action to unify, gain and build recognition of the CHW professional identity, and advance our leadership. From the largest number of CHWs represented in a survey created by CHWs for CHWs, CHW facilitators will take you on the journey of the data findings, meaning and story behind the data, and examples in applying key takeaways in practice, advocacy, state and local policy, research, and CHW community well-being.

Handouts

For more information on the National CHW Survey, consult these handouts!

Assessing the Community Health Worker (CHW) Workforce at the State and Local Level

Assessing the Community Health Worker (CHW) Workforce at the State and Local Level

The National Association of Community Health Workers (NACHW) unifies the voices of Community Health Workers to support communities in achieving health equity and social justice.

Author Meredith Sugarman, MPH

Contributors Carl Rush, MRP and Theresa Mason, MA, PhD and Bernadine Mavhungu

May 2021 ( 5 pages)

VISIT The NACHW CHW Document Resource Center

AMERICAN PUBLIC HEALTH ASSOCIATION CHW SECTION • https://www.apha.org/apha-communities/member-sections/community-health-workers/

ASTHO CHW RESOURCES: • https://www.astho.org/Community-Health-Workers/

NATIONAL ASSOCIATION OF STATE HEALTH POLICY: STATE CHW MODELS • https://www.nashp.org/state-community-health-worker-models/

COMMUNITY HEALTH WORKER NATIONAL WORKFORCE STUDY • https://bhw.hrsa.gov/sites/default/files/bhw/nchwa/projections/communityhealthworkforce.p df

CENTERS FOR DISEASE CONTROL CHW RESOURCES • https://www.cdc.gov/publichealthgateway/chw/index.html

PENN CENTER FOR CHWS: PUBLISHED RESEARCH • https://chw.upenn.edu/research/ BUREAU OF

LABOR STATISTICS • https://www.bls.gov/oes/current/oes211094.htm • https://www.bls.gov/ooh/community-and-social-service/health-educators.htm

How California’s Community-Based Organizations Filled the Gaps for Underserved Communities

SEPTEMBER 9, 2021
51 pages

Meeting the needs of racially & ethnically diverse communities during the pandemic

Across California, community-based organizations (CBOs) have stepped up to address community needs during the COVID-19 pandemic. While the ongoing crisis continues to affect most Californians, BIPOC communities (Black, Indigenous, and people of color) continue to experience disproportionately negative economic impacts and the highest COVID-19 case rates.

This report — created by the California Pan-Ethnic Health Network, ChangeLab Solutions, and Prevention Institute, with contributions from 21 California CBOs — shows policymakers and community leaders how they can improve California’s efforts toward an equitable recovery from the social, economic, and health effects of the pandemic.

An equitable recovery is one that prioritizes racially just, community-led solutions to reverse the underlying inequities that have generated disparities in COVID-19 case and death rates. An equitable recovery must give decision-making power to BIPOC communities, to ensure that their needs are adequately addressed. Informed by interviews with CBOs throughout the state about how they pivoted to deliver crucial supports and services to community members, this report offers recommendations for changes in policies and practices that can help governments partner with community organizations to better meet community needs.

Besides documenting efforts toward equitable recovery and providing recommendations, the report reveals that the success of equitable recovery efforts — and efforts to promote health equity more broadly — depend on improved relationship building between government entities, CBOs, and community members. Local governments must make structural changes to ensure that equity considerations are incorporated properly and effectively in all of their policies and services. CBOs are indispensable within the wider public infrastructure and should be empowered and funded in accordance with the vital services and supports that they provide.

Effect of CHWs on 30-Day Hospital Readmissions

How California’s Community-Based Organizations Filled the Gaps for Underserved Communities

Effect of Community Health Workers on 30-Day Hospital Readmissions in an Accountable Care Organization Population: A Randomized Clinical Trial

Jocelyn Carter, MD, MPH1; Susan Hassan, BA1; Anne Walton, RN1; et al
JAMA Network Open. 2021;4(5):e2110936. doi:10.1001/jamanetworkopen.2021.10936
May 20, 2021

Key Points

Question: Does community health worker care reduce 30-day hospital readmissions in inpatient adults participating in accountable care organization plans?

Findings: In this randomized clinical trial including 550 adults, intervention patients were significantly less likely to experience 30-day hospital readmissions than control participants. In post hoc subgroup analysis, the effect remained significant for participants discharged to short-term rehabilitation but not for those discharged home.

Meaning: In this study, community health workercare improved postdischarge outcomes in clinically complex patients insured by accountable care organizations, particularly for those discharged to short-term rehabilitation.

Importance: Value-based care within accountable care organizations (ACOs) has magnified the importance of reducing preventable hospital readmissions. Community health worker (CHW) interventions may address patients’ unmet psychosocial and clinical care needs but have been underused in inpatient and postdischarge care.

Conclusions
This randomized clinical trial found that integration of CHWs into clinical care improved preventive care and reduced 30-day readmissions for patients discharged to rehabilitation. Reducing preventable readmissions is a central priority for the Centers for Medicare & Medicaid Services and principal health care stakeholders. As US health care organizations continue to adopt ACO models with the goal of achieving higher quality care at lower costs, policies supporting insurance-based reimbursement for CHW care and investment in comprehensive training and integration of CHWs as valued members of patient care teams will continue to be critical.46 Future research is needed to identify which patients benefit most from certain CHW intervention activities.

2019-2020

CHW COMMON INDICATORS PROJECT

The California CHW Certification Debate

The purpose of the Community Health Worker Common Indicators (CI) Project is to contribute to the integrity, sustainability and viability of CHW programs.

The Problem

History of the National CHW Common Indicators Project

CHW Common Indicators Project Leadership Team and CHW Council, 2020-2021

Contact: Noelle Wiggins EdD, MSPH ninanoelia@msn.com

Wiggins, N., Maes, K., Palmisano, G., Rodela, K., Rodriguez Avila, L., Kieffer, E. (2021). A Community Participatory Approach to Identify Common Evaluation Indicators for Community Health Worker Practice. Progress in Community Health Partnerships, 15(2): 217-224.

Rodela, K.R., Wiggins, N., Maes, K., Campos Dominguez, T., Adewumi, V., Jewell, P., Mayfield-Johnson, S. (2021). The Community Health Worker (CHW) Common Indicators Project: Engaging CHWs in measurement to sustain the profession. Frontiers in Public Health, 9:1-12. doi: 10.3389/fpubh.2021.674858

This paper describes work conducted in 2019-2020, including the collaborative selection of 10 priority constructs and development of associated indicators.

The California CHW Certification Debate

It's important for us to get recognized and be somebody: Community health worker attributes, attitudes towards certification, and certification options in California

By Ashley Kissinger MPH, PhD

A dissertation submitted in partial satisfaction of the requirements for the degree of Doctor of Public Health in the Graduate Division of the University of California, Berkeley

PDF ( 82 pages)

Summer 2020

Community health workers (CHWs) are trusted members of the community who have an intimate understanding of the populations and communities they serve. They deliver culturally informed interventions to their communities and leverage their shared experiences and linguistic and cultural relationships to bridge their community to health care and social services. Historically successful in developing countries, CHWs promote chronic disease management, improve health outcomes, and reduce health care costs.

Despite the evidence, CHWs are not widely utilized within the health care system. The National Academy of Medicine declares barriers to working with CHWs, such as inconsistent scope of practice, variable training and qualifications, and lack of professional recognition by other health care providers. States are investigating ways to standardize the CHW workforce, such as certification, to set workforce entry standards and integrate CHWs into health care systems.

Currently, the CHW workforce faces a crossroads. One path leads to a standardized CHW workforce integrated into health care systems via formalized training and qualifications. The other path holds CHWs as part of the communities where they live and work, valuing their relationships and embodied knowledge. While both paths are options for the CHW workforce, CHWs and CHW stakeholders must determine if or how these two paths can coexist. California is the perfect case study because there is continued debate across CHW stakeholders about the stakes of certifying CHWs. California’s diverse CHW workforce represents varying CHW types with contrasting ideologies of care, such as clinical and community-based CHWs and promotores de salud, a subset of CHWs who primarily serve Latinx communities and are grounded in a social, rather than medical, model of care. California’s size and social characteristics pose implementation factors that are relevant for the diverse issues other states will have to address for their own CHW workforce.

This dissertation identifies the unique contributions offered by CHWs to fill health system gaps and challenges differently than other health care providers. The research then describes feelings of opportunity and exclusion related to CHW certification in California. Finally, this dissertation presents strategic options for California stakeholders to develop an appropriate CHW certification model.

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The California CHW Certification Debate

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PAVING A PATH TO ADVANCE THE CHW WORKFORCE

Summary Report and Recommendations

CONTENTS

Executive Summary 1
Introduction 3
Background 3
CHW Business Case 4
The New York State CHW Initiative 5
RECOMMENDATIONS 6
CHW Scope of Practice 6
Work Group 6
CHW Scope of Practice Roles and Related Tasks 8 Recommendations 9
CHW Training and Credentialing 10
Work Group 10
Recommendations 11
CHW Financing 12
Work Group 12
Considerations 13
Recommendations 14
Appendix A 16
REFERENCES 17

Details

Date: October 2011

Pages: 28

Report Summary and Recommendations

Authors:

Sergio Matos, BS
Sally Findley, PhD
April Hicks, MSW
Yasmine Legendre, MPA
Licy Do Canto, BA

Partners:

The New York State Community Health Worker Initiative
Columbia University Mailman School of Public Health
NYS Health Foundation

REPORT PDF

2021

HRSA: CHWS 2016-2030

Processes for Implementing Community Health Worker Workforce Development Initiatives

CHW Common Indicators Project: 22 June 2021

Allied Health Workforce Projections, 2016-2030: Community Health Workers

Authors: National Center for Health Workforce Analysis

Pages 3

Using HRSA’s Health Workforce Simulation Model (HWSM)

"Current data on CHWs is limited due, in part, to the diverse role of CHWs, the lack of standardized training, highly varied certification and licensure requirements, the low barriers to entry to and exit from the workforce, and the high proportion of volunteers.

Therefore, this factsheet does not include future supply projections for CHWs. Improvements in data sources and modeling ethodologies may support CHW supply projections in the future. However, it has been argued that the flexible roles, educational pathways, credentialing standards, and scopes of practice for CHWs that limit availability of reliable data sources for health workforce projection work may also be a key strength for

this occupation.

Visit the website: https://bhw.hrsa.gov/national-centerhealth-workforce-analysis

CHW Common Indicators Project: 22 June 2021

Processes for Implementing Community Health Worker Workforce Development Initiatives

CHW Common Indicators Project: 22 June 2021

The Community Health Worker (CHW) Common Indicators Project: Engaging CHWs in Measurement to Sustain the Profession

Front. Public Health, 22 June 2021

Abstract

Despite progress in documenting the outcomes of Community Health Worker interventions, the lack of standardized measures to assess CHW practice has made it difficult for programs to conduct reliable evaluations, and impossible to aggregate data across programs and regions, impeding commitment to sustainable, long-term financing of CHW programs. In addition, while CHWs have sometimes been involved as data collectors, they have seldom been engaged as full partners in all stages of evaluation and research. This manuscript details the current work being done by the CI Project, demonstrating how CHWs are able to contribute to the integrity, sustainability, and viability of CHW programs through the collaborative development and adoption of a set of common process and outcome constructs and indicators for CHW practice and CHW program implementation.

[ Full Text ]

Citation:
Rodela, K., Wiggins, N., Maes, K., Campos-Dominguez, T., Adewumi, V., Jewell, P., & Mayfield-Johnson, S. (2021). The Community Health Worker (CHW) Common Indicators Project: Engaging CHWs in Measurement to Sustain the Profession. Frontiers in public health, 9, 674858. https://doi.org/10.3389/fpubh.2021.674858

Ful text

Processes for Implementing Community Health Worker Workforce Development Initiatives

Processes for Implementing Community Health Worker Workforce Development Initiatives

Abstract

Introduction: The objective of this observational, cross-sectional study was to identify, document, and assess the progress made to date in implementing various processes involved in statewide community health worker (CHW) workforce development initiatives.
Methods: From September 2017 to December 2020, we developed and applied a conceptual model of processes involved in implementing statewide CHW initiatives. One or more outputs were identified for each model process and assessed across the 50 states, D.C., and Puerto Rico using peer-reviewed and gray literature available as of September 2020.
Results: Twelve statewide CHW workforce development processes were identified, and 21 outputs were assessed. We found an average of eight processes implemented per state, with seven states implementing all 12 processes. As of September 2020, 45 states had a multi-stakeholder CHW coalition and 31 states had a statewide CHW organization. In 20 states CHWs were included in Medicaid Managed Care Organizations or Health Plans. We found routine monitoring of statewide CHW employment in six states.
Discussion: Stakeholders have advanced statewide CHW workforce development initiatives using the processes reflected in our conceptual model. Our results could help to inform future CHW initiative design, measurement, monitoring, and evaluation efforts, especially at the state level.

[ Full Text ]

Citation:
Barbero, C., Mason, T., Rush, C., Sugarman, M., Bhuiya, A. R., Fulmer, E. B., Feldstein, J., Cottoms, N., & Wennerstrom, A. (2021). Processes for Implementing Community Health Worker Workforce Development Initiatives. Frontiers in public health, 9, 659017. https://doi.org/10.3389/fpubh.2021.659017

Full Text

Statewide Training Approaches for Community Health Workers

Community Health Workers and Promotores: Investing in Change Agents for a Healthy California

Processes for Implementing Community Health Worker Workforce Development Initiatives

NACHW presents a new report on statewide training approaches for CHWs. This report provides an example of the use of the CHW Document Resource Center to investigate the topic of setting standards for statewide core training for community health workers. Brief case examples from six states illustrate different features of and approaches to statewide training standards for the workforce and related infrastructure.

Authors: Theresa H. Mason, Carl H. Rush, Meredith K. Sugarman

Community Health Workers and Promotores: Investing in Change Agents for a Healthy California

Latino Coalition for a Healthy California (LCHC):
"CHW/P Investing in change agents for a healthy California"
By: Abhinaya Narayana and Oscar G Echevrria
Harvard Kennedy School of Public Health
April 6, 2021 ( 89 pages)

Presentation to the community

June 30 2021

4pm

Contact:

Abhinaya Narayanan, MPP anarayanan@hks.harvard.edu
Oscar G. Echeverria, MPP oecheverria@hks.harvard.edu

Dr. Seciah Aquino, Deputy Director of LCHC, and Mar Velez, State Policy Senior Manager of LCHC, will be carrying forward the efforts at LCHC to advance CHW/P policy.

Community Health Workers: Evidence of Their Effectiveness

Community Health Workers and Promotores: Investing in Change Agents for a Healthy California

ASTHO: Community Health Workers: Evidence of Their Effectiveness

Number of CHW Studies:

1964–1973 (14)
1994–2003 (252)
2014–2016 (574 )
2017- 2022 (?)

SYSTEMATIC REVIEWS ON CHW INTERVENTIONS
RANDOMIZED CONTROL TRIALS (RCTs):
RETURN ON INVESTMENT (ROI) STUDIES ON CHW INTERVENTIONS
INTERVENTIONS FOR CHRONIC DISEASE MANAGEMENT
CHW PROGRAM SUCCCESES IN RURAL SETTINGS

Financing Strategies to Support the Community Health Worker

Preserving A Transformative Community Health Worker/ Promotor Workforce

Financing Strategies to Support the Community Health Worker

Financing Strategies to Support the Community Health Worker (CHW) Workforce: November 12, 2019 (PPT 18 slides)

Hourly Wages and Turnover of Community Health Workers

Preserving A Transformative Community Health Worker/ Promotor Workforce

Financing Strategies to Support the Community Health Worker

AJPH

Hourly Wages and Turnover of Community Health Workers According to US State Certification Policy and Medicaid Reimbursement, 2010–2021

Tammie M. Jones, PhD, MHA, Chanup Jeung, PhD, Alex Schulte, Charlotte M. Lewis, DrPH, MPH, andPeggy J. Maddox, RN, EdD, MSN

States that adopted CHW certification programs saw an increase in wages for CHWs.

Increases in wages in response to certification have been found to reduce turnover among low-wage workers in previous studies.

Medicaid reimbursement was not found to have an effect on wages or turnover

Preserving A Transformative Community Health Worker/ Promotor Workforce

Supporting Community Health Workers to Enhance Effectiveness of Behavioral Health-Primary Care Integ

Preserving A Transformative Community Health Worker/ Promotor Workforce:

El Sol’s CHW/P Training Center Approach

Click on the link below to view the full report

View PDF Version

View Web Version

As more organizations are integrating CHWs/Ps into their operations, we hope that this case study can help stimulate reflection, dialogue, and action among CHW/P organizations on how to incorporate these long-standing guiding principles into their operations. In doing so, we can continue to build examples of CHW/P-centered interventions that reflect values and paradigms such as health care for all, health equity, and health as a right. Key topics include:

CHW/P Training Application of Underlying Principles
CHW/P Contributions to Health Equity
Application of Popular Education
El Sol Training Center Components
Recommendations for Building Organizational Readiness to Integrate CHWs/Ps and Much More

Supporting Community Health Workers to Enhance Effectiveness of Behavioral Health-Primary Care Integ

June 2021

Supporting Community Health Workers to Enhance Effectiveness of Behavioral Health-Primary Care Integration

More and more, community and migrant health centers (C/MHCs) are seeing the positive health benefits of integrating behavioral health care into their patients' primary care. As C/MCHs work to develop models of team-based care to provide integrated behavioral health services, attention is turning to the roles that Community Health Workers/Promotores/as (CHW/Ps) can play in the promotion of emotional wellness and the provision of mental health services to the community.

Click here for the Full Report with Appendices

Click here for the Full Report without Appendices

Click here for the Executive Summary

California Brief Multicultural Competence Scale (CBMCS)

Supporting Community Health Workers to Enhance Effectiveness of Behavioral Health-Primary Care Integ

Effect of CHWs on 30-Day Hospital Readmissions in an ACO Population: A Randomized Clinical Trial

CBMCS Multicultural Reader

Glenn C. Gamst – University of La Verne, USA
Aghop Der-Karabetian – University of La Verne, USA
Richard H. Dana – Regional Research Institute for Human Services, Portland State University

Features a wellspring of seminal research studies critical to understanding the complex issues surrounding mental health care and diversity. Providing a wealth of in-depth research into delivering culturally competent care, this rich anthology examines general issues in multicultural counseling competence training; ethnic minority intervention and treatment research; and sociocultural diversities.

Key Features and Benefits Features carefully selected research articles that are accessible to and practical for mental health practitioners and students. Provides critical background research that sprang from rigorous research methods and multivariate statistical processes

Opens with the key article that details the development of the ground-breaking 21-item California Brief Multicultural Competence Scale

Reviews: Instructor trained in the model and module by California Mental Health Institute. Best model I have been exposed to. Trainers from CIMH are good.

Dr Juan Garcia Counseling Special Ed Dept, California State University – Fresno

Effect of CHWs on 30-Day Hospital Readmissions in an ACO Population: A Randomized Clinical Trial

Supporting Community Health Workers to Enhance Effectiveness of Behavioral Health-Primary Care Integ

Effect of CHWs on 30-Day Hospital Readmissions in an ACO Population: A Randomized Clinical Trial

Jocelyn Carter, MD, MPH1; Susan Hassan, BA1; Anne Walton, RN1; et al
JAMA Network Open. 2021;4(5):e2110936. doi:10.1001/jamanetworkopen.2021.10936
May 20, 2021

Key Points

Question: Does community health worker care reduce 30-day hospital readmissions in inpatient adults participating in accountable care organization plans?

Meaning: In this study, community health worker care improved post discharge outcomes in clinically complex patients insured by accountable care organizations, particularly for those discharged to short-term rehabilitation.

Importance: Value-based care within accountable care organizations (ACOs) has magnified the importance of reducing preventable hospital readmissions. Community health worker (CHW) interventions may address patients’ unmet psychosocial and clinical care needs but have been underused in inpatient and post discharge care.
Conclusions
This randomized clinical trial found that integration of CHWs into clinical care improved preventive care and reduced 30-day readmissions for patients discharged to rehabilitation. Reducing preventable readmissions is a central priority for the Centers for Medicare & Medicaid Services and principal health care stakeholders. As US health care organizations continue to adopt ACO models with the goal of achieving higher quality care at lower costs, policies supporting insurance-based reimbursement for CHW care and investment in comprehensive training and integration of CHWs as valued members of patient care teams will continue to be critical.46 Future research is needed to identify which patients benefit most from certain CHW intervention activities.

Article

vision y compromiso

Key Workforce Priorities for the Community Transformation Model 2017

Key Workforce Priorities for the Community Transformation ...

visionycompromiso.org › workforce_report_web PDF

Key Workforce Priorities for the Community Transformation Model

January 2017

Pages: 32

Authors: Visión y Compromiso

Funders: This work was made possible by the generous support of

The California Endowment, Kaiser Permanente Northern California Community Benefit

Program, Y&H Soda Foundation, and The Women’s Foundation of California.

TABLE OF CONTENTS

From the Executive Director 2

Executive Summary 3

The Community Transformation Model 7

Findings 13

1. The Promotor Model is a Model for Community Transformation

2. Training and Professional Development

3. Core Competencies and Curricula

4. Credentialing 19 5. Supervision

6. Funding and Program Sustainability 2

Next Steps 24

Endnotes 27

Acknowledgements 28

ADVISORY GROUP (pg 28)

Alma Avila, City College San Francisco

Gerry Balcazar, Visión y Compromiso

Mayra Barcenas, El Sol Neighborhood Educational Center

Norma Benitez, Esperanza Community Housing Corporation

America Bracho, Latino Health Access

Melinda Cordero-Bárzaga, Visión y Compromiso

Alma Esquivel, Visión y Compromiso

Alex Fajardo, El Sol Neighborhood Educational Center

Gloria Giraldo, Latino Health Access

Lupe Gonzalez, Promotora

Nancy Halpern Ibrahim, Esperanza Community Housing Corporation

Miriam Hernandez, Providence Holy Cross Medical Center

Ruben Imperial, Stanislaus County Behavioral Health And Recovery Services

Maria Lemus, Visión y Compromiso

Carlos Londoño, Tiburcio Vasquez Health Center

Magaly Marques, Planned Parenthood Los Angeles

Marie Mayen-Cho, Providence Holy Cross Medical Center

Patricia Veliz-Macal, Planned Parenthood Los Angeles

Contact: Visión y Compromiso

1000 N. Alameda Street Los Angeles, CA 90012

(213) 613-0630

info@visionycompromiso.org

READ REPORT

Public Health Institute

CALIFORNIA HEALTH WORKFORCE ALLIANCE

COMMUNITY HEALTH WORKERS IN CALIFORNIA: Sharpening Our Focus on Strategies to Expand Engagement

Date: January 2015

Pages: 33

http://www.phi.org/uploads/application/files/2rapr38zarzdgvycgqnizf7o8ftv03ie3mdnioede1ou6s1cv3.pdf

CONTENTS Acknowledgements..............................................................................................................................2

Executive Summary..............................................................................................................................3 Introduction ..........................................................................................................................................6 Background ...........................................................................................................................................8 Discussion Themes Design Considerations in Team-Based Care..................................................17

Skills, Recruitment, and Training of CHWs.......................................................................................20

Organizational Capacity for Engagement .......................................................................................23

Building Analytic Capacity .................................................................................................................25

Taking the Engagement of CHWs to Scale: Recommendations....................................................30

Appendix A..........................................................................................................................................33

RECOMMENDATIONS (Page 5)

R1: Establish a statewide clearinghouse to facilitate the rapid sharing of innovations, tools, best practice delivery models, and research support resources.

R2: Develop a landscape analysis that outlines a scope of practice for CHWs that accommodates alternative team-based models and other team members and the full range of services and activities in clinical and community-based settings.

R3: Conduct an independent assessment of employer-based, independent, and academic institution-based training programs that describes content scope and intensity, time frame, prerequisites, pedagogical models, geographic focus, and competencies.

R4: Develop competency-based certification standards for new and existing training programs and for individuals who complete the appropriate training.

R5: Identify regional sites to pilot the establishment of centralized data repositories that facilitate the integration of community-level data collection efforts and support the expanded use of collaborative data sharing tools for patient care management.

R6: Provide targeted technical assistance to community health clinics to develop or adapt existing evaluation tools to monitor and disseminate program outcomes.

R7: Partner with mobile health technology organizations to support mobile data collection, point of care decision support, and case management by CHWs and pilot those interventions with selected communities and organizations.

R8: Develop standard metrics that effectively capture outcomes associated with services and activities undertaken by CHWs to address the social determinants of health.

Public Health INstitute

CALIFORNIA HEALTH WORKFORCE ALLIANCE

Taking Innovation to Scale: Community Health Workers, Promotores, and the Triple Aim A Statewide Assessment of the Roles and Contributions of California’s Community Health Workers Preliminary Findings, Observations, and Recommendations

Date August 2013

Pages 24

Contact: For more information, please contact: Kevin Barnett, Dr.P.H., M.C.P., Senior Investigator, Public Health Institute, and Co-Director, California Health Workforce Alliance (www.calhealthworkforce.org), at kevinpb@pacbell.net

PROJECT LEADERSHIP TEAM (pg 22)

Steve Barrow CEO and President AHEAD

Juan Carlos Belliard, Ph.D. Assistant Vice President for Community Partnerships and Diversity Loma Linda University

America Bracho, MD Executive Director Latino Health Access

Xochitl Castaneda Director Health Initiative of the Americas,

UC Berkeley, School of Public Health

Cecilia Echeverría, MPP, MPH Director of Safety Net Partnerships Kaiser Permanente

Catherine Dower, JD Associate Director Center for the Health Professions, University of California, San Francisco

Pamela Ford-Keach, MS California Department of Public Health

Nancy Halpern Ibrahim, MPH Executive Director Esperanza Community Housing Corporation

Maria Lemus Executive Director Vision y Compromiso

Laura Long, MBA Director of National Workforce Planning and Development, Kaiser Permanente

Jean Nudelman, MPH, Director of Community Benefit Programs, Kaiser Permanente

David Quackenbush, Vice President of Member Services, California Primary Care Association

Rea Pañares, MHS ;Senior Advisor, Prevention Institute

Beatriz Solis, Ph.D., MPH, Director of Healthy Communities, Strategies South Region, The California Endowment

Perfecto Munoz, Senior Policy Advisor on Consumer Health and the Workforce, UC Berkeley, School of Public Health

Tivo Rojas-Cheatham, MPH, Chief of the Community Participation and Education Section, CDPH

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