CHW Advocacy and Initiatives: National and Regional PerspectivesVenoncia M. Baté-Ambrus, MS, PhD candidate

Director of Workforce Development & Diversity

Interim Coordinator WI CHW Alliance

Milwaukee Area Health Education Center

Definition of CHWs:

A Community Health Worker (CHW) is a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. This trusting relationship enables the CHW to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery.

A CHW also builds individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support and advocacy.

APHA’s CHW Section

The Patient Protection and Affordable Care Act (ACA) lists CHWs as members of health care teams.

Increasing Support for Community Health Worker Self-Determination in Training and Credentialing

APHA CHW Section is the national leadership for the CHW workforce

Proposed “Policy Statement”: Guidelines for Credentialing CHWs characterized by trusted status among

the communities they serve, vital part of the public health workforce.

Demand for CHWs is expected to increase with implementation of the ACA

Policy is needed to support CHW leadership in determining professional standards, with collaboration from other public health colleagues.

Relationship to existing American Public Health Association (APHA) Policy

In 2009, the American Public Health Association (APHA) adopted Policy Statement on CHWs

Description was developed within the APHA CHW Section, with national representation of CHWs and their advocates.

Policy addressed numerous issues related to the community health worker (CHW) workforce. Vital element being a statement that included a definition of CHWs.

Proposed Policy Statement: APHA’s CHW Section Certification and Credentialing Guidelines Encourages local, state, and national CHW professional associations

to organize CHWs to develop consensus about the desirability of training and credentialing.

Calls on CHW professional groups to pursue legislation regarding CHW training and credentialing, if appropriate for local conditions, in collaboration with CHW advocates and other stakeholders.

Urges all entities considering creating policies regarding CHW training or credentialing to defer to the desires of local CHWs and/or CHW professional groups. If CHWs and other entities partner in order to pursue policy development, a working group comprised of at least 50% self-identified CHWs should be established.

Encourages any entity drafting new legislation regarding CHW credentialing and training to include in the policy the creation of a governing board comprised of at least 50% CHWs.

American Psychological Association (APA) Div. 27: Society for Community Research & Action (SCRA) Mission: SCRA is an international organization devoted to

advancing theory, research, and social action. Its members are committed to promoting health and empowerment and to preventing problems in communities, groups, and individuals. SCRA serves many different disciplines that focus on community research and action.

Vision: SCRA will have a strong, global impact on enhancing well-being and promoting social justice for all people by fostering collaboration where there is division and empowerment where there is oppression.

SCRA Guiding Principles

Community research and action requires explicit attention to and respect for diversity among peoples and settings;

Human competencies and problems are best understood by viewing people within their social, cultural, economic, geographic, and historical contexts;

Community research and action is an active collaboration among researchers, practitioners, and community members that uses multiple methodologies. Such research and action must be undertaken to serve those community members directly concerned, and should be guided by their needs and preferences, as well as by their active participation;

Change strategies are needed at multiple levels in order to foster settings that promote competence and well-being.

SCRA Public Policy Rapid Response Procedures

The purpose of this process is to provide a mechanism for SCRA to provide a quick response, as an organization, to evaluate and potentially adopt public stances or action plans on public policy issues of a time sensitive nature.

On April 18, 2014 a CHW rapid response proposal was approved and forwarded by a 5 person ad hoc policy committee to the SCRA Executive Committee for formal division level approval. If approved it will be shared with the APA for their approval.

The CHW submission of rapid response CHW proposal was supported by SCRA’s Community Health Interest Group (CHIG).

Other National & International Associations Supporting CHWs American Academy of Family Physicians Foundation supports the

Peers for Progress program which accelerates and promotes best practices in peer support as a regular part of health care and prevention around the world. http://peersforprogress.org/

National Association of Social Workers offers associate memberships to CHWs which entail free chapter membership and access to free or discounted educational products and programs. http://www.socialworkers.org/joinBenefits/associate.asp

Association of Black Cardiologists, Inc. offers free memberships to CHWs which include newsletters, health education materials and annual access to 3 health screening and monitoring events. http://abcardio.org/CHA_advocates.php

State Legislation on CHW Certification and Credentialing

Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA 30333 Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348 National Center for Chronic Disease Prevention and Health Promotion Division for Heart Disease and Stroke Prevention E-mail: cdcinfo@cdc.gov Web: www.cdc.gov Publication date: 07/2013

Region V (IL, IN, MI, MN, OH, WI): Legislation, Policies and Initiatives Region V: CHW coalition leaders planning a 2015 regional CHW

conference

IL: HB 5412 & Basic/Advanced Certificates+Associate degree programs

IN: ISDH Division of Maternal and Child Health developed IN’s first certification for CHWs in care coordination. INCHWA formed Jul 2013

MI: MiCHWA celebrates CHW Month in August and hopes the rest of the state will, too, as it seeks a proclamation from the governor’s office.

MN: Minnesota CHW Payment Statute (MS 256B.0625, Subd. 49) re: care coordination. First state to have a Deaf CHW Project.

OH: CHW Law 4723-26, CHWs overseen by OHIO Board of Nursing

WI: Conducts CHW, CHW Supervisor & Best Practices in CHW Integration trainings, assists low income CHWs via HPOG & discusses CHW legislation

National or Governmental: References and Resources

http://www.apha.org/membergroups/sections/aphasections/chw/

http://www.scra27.org/about

http://peersforprogress.org/

http://www.socialworkers.org/joinBenefits/associate.asp

http://abcardio.org/CHA_advocates.php

http://www.abcardio.org/articles/cms_rule.html

http://www.bls.gov/soc/2010/soc211094.htm

http://nationalahec.org/

http://legiscan.com/IL/text/HB5412/2013

Local and Regional CHW Coalition: References and Resources IL: http://chwnetwork.wordpress.com/

IN: http://www.chwisc.org/Indiana.html http://inchw.betterme.info/

MI: http://www.michwa.org/

MN: http://mnchwalliance.org/ http://www.deafchw.org/

OH: http://www.med.wright.edu/chc/programs/ochwa

WI: http://www.milahec.org/

WI HPOG: http://www.wfdc.org/documents/HPOGRandomAssignmentBrochure-7.24.13.pdf

Thank you for your interest

Contact information:

Venoncia M. Baté-Ambrus, MS, PhD candidate

Outreach Consultant

Suburban Primary Healthcare Council

Access to Care Program

708.531.0680 ext. 236

venonciab@sphcc.org

http://www.accesstocare.org/