Post on 20-Jul-2020
transcript
INTEGRATING A COMMUNITY HEALTH
WORKER CERTIFICATE INTO AN
ASSOCIATES DEGREE
Janet Lavin Grant, MSPH and Becky Lewis MSW, MPH
Holyoke Community College
Foundations of Health Department
League of Innovations Conference
Baltimore, MD
Brief Participant Survey
Presentation Objectives
• Describe the competencies needed by CHWs in Massachusetts
• Discuss how the CHW certificate fits into the emerging field of community health at community colleges across the U.S.
• Identify potential strategies, challenges and opportunities in certificate development, curriculum development, implementation, and assessment.
• Explain how proactive advising and community outreach to both employers and potential students have been integral to the success of the program.
• Examine the benefit and challenges of a stack-able certificate that straddles multiple disciplines (e.g. Human Services and Health Sciences) to their constituency and if they would be able to use this model at their institution or organization.
OVERVIEW OF HOLYOKE
COMMUNITY COLLEGE
OUR STUDENTS
“Who” Goes to Holyoke Community
College • HSI status – Awarded Fall 2016- at least 25% of student
population is Hispanic
• Approx 50% of students come from the small-to-medium
cities of Springfield, Holyoke, Chicopee, and Westfield
• Holyoke Public Schools registered 200 students by
January 16 post Hurricane Maria
• HCC enrolled approx 50 students post hurricane Maria
from Puerto Rico
• City of Holyoke has 2nd largest number of residents from
Puerto Rico in State of Massachusetts
• Gap between health interest and entrance into selective
programs
Our student body reflects many of the same populations
that CHWs often serve:
• Low-Income
• People of Color
• First-Generation College Student
• Bi-lingual
• Bi-Cultural
• Veterans
• Students with Disabilities (including behavioral health
issues)
• Receive financial aid/Pell-eligible
Social Determinants of Health
• Food Insecurity
• Homelessness
• Housing Quality
• Access to Healthcare
• Intergenerational trauma
• Education & Employment
• Health disparities
WHAT IS A COMMUNITY
HEALTH WORKER?
Community Health Worker
• Through applying their unique understanding of the community they serve:
• Provides culturally appropriate outreach and health education
• Navigates health and human service systems
• Assures full and equal access to health and social services
• Advocates for individual and community health needs
• Builds the capacity of individuals to improve their own health and the health of others
http://www.machw.org/index.php?option=com_content&view=article&id=25&Itemid=131
Access 3/16/17
Massachusetts Department of
Public Health
American Public Health
Association
Department of Labor
Affordable Care Act
MassHealth Pilot 2018
EFFECTIVENESS OF
CHWS
Children’s
Hospital of
Boston
Community
Asthma Initiative
Study
https://docs.google.com/viewer?a=v&pid=sites&srcid=bnBhLXJoZWMub3JnfHJlZ2lvbjF8Z3g6NzhmYmNkO
WYyZTlhZGE5MQ Accessed 4/17/2017
Denver/Molina Study Measuring Return on Investment of
Outreach by Community Health Workers (M2006)
• Tracked spending on primary and specialty care, urgent care,
inpatient and outpatient behavioral health care.
• ROI estimate of $2.28 saved per dollar spent.
• Costs included in the investment were limited to direct personnel
costs. Not included were program development, management,
or evaluation.
• Used in state of Massachusetts to lobby for CHW
certification and inclusion in Medicaid-reimbursable
activities
HISTORY &
CERTIFICATION OF CHWS & (ACO) Certification Program in Massachusetts
History of CHWs
Prior to 1970:
China
Mexico
USA
’80’s and ‘90’s:
HIV/AIDS Epidemic
Maternal/child Health
Early 2000’s
South Africa 2006
Health Care Reform in MA
2018
2009
DPH Office
CHWs
2010
Chapter 322
“An Act to
establish a
Board of
Certification for
Community
Health
Workers”
Massachusetts 10 Core Competencies
Outreach Methods &
Strategies
Care Coordination & System
Navigation
Individual & Community
Assessment
Use of Public Health
Concepts & Approaches
Effective Communication Advocacy & Community
Capacity Building
Cultural Responsiveness &
Mediation
Documentation
Education to Promote
Healthy Behavior Change
Professional Skills &
Conduct
Education/Training for CHWs
80 hours training
• 64 Core Competency training
• 16 special health topics
• Can be partially online
CHW Trainers as part of team
• Required minimum 40% of the time
Interactive Learning Methods
• Role play
• Simulation
Flexibility in curriculum design and
delivery
Components
of Required
Training
Massachusetts Health Policy Commission:
Accountable Care Organization (ACO) Certification
Program
• A program designed to accelerate care delivery transformation in Massachusetts and promote a high quality, efficient health system.
• Pursuant to G.L., c. 6D, §15, the HPC is required to "establish a process for certain registered provider organizations to be certified as accountable care organizations."
• The purpose is to complement existing local and national care transformation and payment reform efforts, validate value-based care, and promote investments by payers in efficient, high-quality, and cost-effective care.
• Approved: April 27, 2016
• CHWs can now be reimbursed under Mass Health as part of healthcare team
EVOLUTION OF CHW
CERTIFICATE AT HCC
Foundations of Health Program
FOH Transfer Degree (A.A.)
Community Health Worker Certificate
Direct Care Worker Certificate
Medical Billing & Coding Certificate
Medical Assisting Certificate
FOH Career
Degree (A.S.)
History of CHW Certificate Funding at HCC
2013
2015
2017
Next? • ACO, Medicaid, Dual Enrollment
“Stacking” CHW Certificate
• Had existing FOH Career Degree
• Most logical place to embed CHW certificate
• Students can just enroll in certificate and complete, or can
enroll in degree first then choose certificate
• CHW/Public health classes also count towards human
services degree
• We are working on stacking CHW certificate into our
human services degree (adding Children’s behavioral
health classes)
• Also considering public health degree in future
“Stacking” CHW Certificate
Why
Allows students to integrate workforce skills into academic degree for career advancement
Provides flexibility for students who may otherwise not choose to complete a degree
Students can just enroll in certificate and complete, or can enroll in degree first then choose certificate
How
Spoke to employers on advisory board about what courses/content to include
Used Existing FOH Degree- created CHW Certificate as one of four certificate options
We are working on stacking CHW certificate into our human services degree (adding Children’s Behavioral Health classes)
How can this certificate be “stacked”?
Future Directions for CHW Certificate
Stack into Human Services Degree
2019
Multiple Tracks:
Addiction
Post-Incarceration
General
2020
Stacks into Interdisciplinary Public Health
Degree
2021
Case study: (José)
• Some college completed in Puerto Rico
• Worked 25+ years as a cook
• Cannot do that work anymore due to chronic back problems.
Background
Education/Career Interest
• Interested in studying Nutrition
• Discussed education needed to become RD; interested in diabetes education
• Eligible for Training Opportunities Program
• Explored CHW as a career pathway by taking HTH 104 SP2017
Barriers
• Income
• Lost eligibility for Training Opportunities Program
• Family
Success
• Completed two full semesters of Community Health
Worker Certificate Program.
• Will complete full certificate Spring 2018
• Interested in continuing for a degree in Nutrition
Tenets of Proactive Advising
• Regular outreach to students (phone, email,
social media)
• Advising embedded in core classes (HTH 101)
• Emphasis on relationship building from Day One
• Every student in CHW Certificate is assigned an
individual advisor
HRSA- BHWET FUNDING: TO
TRAIN COMMUNITY HEALTH
WORKERS
About Our HRSA Funding
• HCC awarded 4-year, $431,000 grant from HRSA- BHWET
• Grant pays up to $3,000.00 per student in a 12 month
period
• Develop paraprofessional workforce of underrepresented
students in community health worker role, integrating
behavioral health into primary care
• Students take 3 credit- bearing classes
• 1 course per term/semester
• Enrolled in college
• Certificate of completion
About the Classes/Training
HTH 104-Core Competencies for CHW (4cr)
HTH 201-Essential Health Topics (2cr) OR
HSV 140-Children’s Behavioral Health (3cr)
HTH 209-Practicum for CHWs (3cr)
*Classes offered 2
evenings (6-9) a week
or on Saturdays (10-4) *Classes completed in
12 months; 1 per
semester
Criteria for Eligibility
HCC HRSA Funded CHW
Classes
Incumbent Worker (ideally)
College English eligible
Cori/Sori, Drug testing/Immunizations (practicum)
Commit to completion of
3 classes [sans
absences]
Important Courses
Core Competencies for CHW (4 credits)
Essential Health Topics ( 2 credits)
Practicum for CHWs(3 credits)
Intro to Public Health (3 credits
Required for
DPH
Certification
Counts as social science
elective and fulfills course
requirement at UMass
CHW CERTIFICATION: A
NATIONAL MOVEMENT
Massachusetts Association of Community
Health Workers
CHW Education at Community Colleges
in Massachusetts
2+ colleges offer:
• Specific courses for college credit
• Not part of an academic certificate
3 colleges offer:
• Public health associates degree
• CHW/Community Health Certificate embedded
5+ colleges offer:
• CHW specific academic certificate for college credit
• Not necessarily part of an associates degree
Overview of CHW Wages/Hours/Education
Opportunities for Advancement
$15/hour
None to some training in core competencies or experience
$20/hour
Some formal training in core competencies
Some experience and/or associates degree
$40/hour
Formal training in core competencies
Plus other education, certificates, degrees (Bachelors or higher) and years of experience
Examples of Where Our Students are
Working…..
• Holyoke YMCA facilitating a Diabetes Prevention Program/Healthy Weight and Your Child...
• Behavioral Health Network as a Care Coordinator based at Holyoke Health Center
• AIC Grad who completed course working in Elder Human Services Agency
• Immigrant Resettlement Specialists-Staff at Jewish Family Services have completed Core Competencies course
• Holyoke Health Center
CHALLENGES & LESSONS
LEARNED
Lessons Learned: Internal
• Low enrollment
• Educating colleagues/administration, etc. about
what a CHW is
• Internal Recruitment-within college continues to be
a challenge
• Location & Timing of classes for incumbent workers
Lessons Learned: External
• How to effectively partner with employers/community
partners
• Marketing/communication- who is our audience?
• Selling value of taking for college credit when offered as
workforce training (stuck on academic calendar)
• Recruitment of incumbent workers given lack of steady
employment
• Lack reimbursement, jobs
ACTIVITY: APPLICATION OF THIS INFORMATION TO
YOUR PROGRAMS/SCHOOLS
This project is supported by the Health
Resources & Services Administration (HRSA)
of the US Department of Health & Human
Services (HHS) under M01HP31268 Behavioral
Health Workforce Education & Training
(BHWET) Program. This information or content
and conclusions are those of the author and
should not be construed as the official position
or policy of, nor should any endorsements be
inferred by HRSA, HHS, or the US Government.
Questions?
Thank You!
Janet Lavin Grant: Jgrant@hcc.edu
(413) 552-2445
Rebecca Lewis: rlewis@hcc.edu
(413) 552-2426