INCREASING ACCESS TO HEALTH CARE FOR THE UNINSURED AND UNDERSERVED

Community Health Workers

Community Health Workers (CHWs) are known around the world as lay health advisors, community health advisors, community health representatives, or promotoras. Due to the international success of this health profession, CHWs are becoming increasing popular in the United States with training programs springing up across the country.

WHAT’S A COMMUNITY HEALTH WORKER?

CHWs are members of the community who work almost exclusively to connect fellow community members in need of healthcare care to information or to healthcare providers. This profession targets groups that have traditionally lacked access to adequate care. CHWs link people to care and address the health outcomes of a community by helping to build trust and relationships with individuals in that community. CHWs can connect people to healthcare and other services they need by: 1) empowering them with information about what services are available; 2) helping them get to those services and navigate an often cumbersome system; and 3) connecting them to a medical home so that necessary referrals, coordination of services and primary care and prevention can be the focus of treatment.

Community Voices Miami is aware that the success of the CHW model comes from the very nature of it being an indigenous effort help people access care. Standardized trainings that are built upon the knowledge of indigenous CHWs will help to streamline and bolster their existing work in the community. This approach not only benefits the community by improving access to care, but also by giving the CHWs the opportunity to be recognized and to continue on a professional career track. By certifying the work CHWs already are doing we believe we are encouraging efforts that keep our community healthy.

The Community Health Worker Project:

Through our Community Dialogues we have learned just how important the work of CHWs is and how necessary it is to recognize their work. We also learned that the healthcare system is very fragmented and that although Community Workers can help link people with services they need, there's very little collaboration and coordination between health care providers. Therefore, CVM partnered with United Way of Miami-Dade, to develop the Community Health Workers Project with the goal of integrating CHW practice and training with existing primary and preventive healthcare services and community resources and ultimately develop a professional career track for CHWs. The project has been designed in five consecutive phases: preliminary, research, planning, pilot and implementation phases.

The Planning Phase involved developing a local collaborative to create a training curriculum and manual based on the expertise of the community members and the research of the previous phase. Out of this collaborative process a comprehensive three level training manual geared for Miami-Dade County was developed. CVM piloted the basic Level I course in the Summer of 2005 at Miami Dade College and evaluated the curriculum with the support of project stakeholders and five funders: The Health Foundation of South Florida, Annie E. Casey Foundation, Dade Community Foundation, the Women’s Fund of Miami Dade County, and Alleghany Franciscan Ministries, Inc. The results from the Training Program Evaluation for Community Health Workers: Final Report indicated that the training participants and their supervisors were satisfied with the course, the curriculum was appropriate for Miami Dade County, and there was a statistical increase in trainee knowledge from pre to post training. Recommendations from the evaluation report, which included feedback from the trainee participants, provided the basis for editing the curriculum. The curriculum is now in its final form and a public Level I CHW course will be implemented through Miami Dade College in the Fall of 2006.

As community support for the project spread, we were able to begin the Research and Planning Phases of Levels II and III of the curriculum through the support of the Annie E. Casey Foundation and Dade Community Foundation. Levels II and III target CHWs who are already working in the field but are looking to expand their knowledge and build their networks. We are working to have the curriculum certified so that participants will receive academic credit and completing the training will result in an Associates of Science degree. The Level one training is perfect for community members who want to begin their Community Health Worker careers.

By conducting a comprehensive review of various CHW training curriculums used nationally, we plan to submit recommendations to the stakeholders for the development of Levels II and III. Once the recommendations are complete, CVM will work with Miami Dade College to build the curriculum using existing Miami Dade College classes and create additional classes focused on the specifics of Community Health Work. The Children’s Trust has agreed to support the building of these levels over a 3-year period. We hope to pilot the Levels II and III training curriculum in 2007.



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Community Voices