Larry Fricks, Joan Kenerson King and Nick Szubiak The National Council for Behavioral Health

Transcription

1 Larry Fricks, Joan Kenerson King and Nick Szubiak The National Council for Behavioral Health Community Health Workers and Peer Support Staff: Friend, Foe or Partners

2 Objectives: Describe the role of peer support staff and community health workers Identify potential ways to use each, their commonalities and differences

3 What is a Community Health Worker? CHW Definition Community health workers are lay members of communities who work either for pay or as volunteers in association with the local health care system in both urban and rural environments and usually share ethnicity, language, socioeconomic status and life experiences with the community members they serve. They have been identified by many titles such as community health advisors, lay health advocates, promotores(as), 1 outreach educators, community health representatives, peer health promoters, and peer health educators. CHWs offer interpretation and translation services, provide culturally appropriate health education and information, assist people in receiving the care they need, give informal counseling and guidance on health behaviors, advocate for individual and community health needs, and provide some direct services such as first aid and blood pressure screening. (HRSA)

4 What is a Community Health Worker? Community health workers should be members of the communities where they work, should be selected by the communities, should be answerable to the communities for their activities, should be supported by the health system but not necessarily a part of its organization, and have shorter training than professional workers. (World Health Organization, January 2007)

5 The Status of CHWs As of December 13, 2012, 15 states and DC had enacted laws addressing CHW infrastructure, professional identity, workforce development, or financing. The U.S. Bureau of Labor Statistics says employment growth for social and human service assistants will be 28% from In 2012, these professionals earned a median of $28,850 per year.

6 Minnesota and CHW Minnesota CHW Building Blocks (Recognized by federal Agency for Health Care Research and Quality) CHW Scope of Practice Standardized statewide competency-based CHW training in higher education Medicaid coverage for diagnostic-related patient education services delivered by CHW certificate holder with clinical supervision, including mental health professionals CHW workshops through the MN CHW Peer Network Role of MN CHW Alliance as health equity catalyst, convenor, partner and expert including interest groups such as the CHW Supervisor Roundtable

7 Wisconsin Three week training program in MI and collaborative care Used CHW s in SBIRT, assessment of depression, behavioral activation Demonstrated effectiveness and cost savings (American Journal of Managed Care, Vol. 20, No. 4, 2014)

8 What is a Peer Provider? The SAMHSA-HRSA Center for Integrated Health Solutions defines a peer provider (e.g., certified peer specialist, peer support specialist, recovery coach) as a person who uses his or her lived experience of recovery from mental illness and/or addiction, plus skills learned in formal training, to deliver services in behavioral health settings to promote mind-body recovery and resiliency.

9 First Medicaid Approval of Billable Peer Support Services in 1999 Georgia State Plan Amendment Primary role to provide direct services designated to assist consumers in regaining control over their own lives and control over their recovery process Model competence and possibility of recovery Assist consumers in developing the perspective and skills that facilitate recovery

10 CMS 2007 Peer Support Services Guidelines Letter for States Requiring Training, Continuing Education, Supervision, and Care Coordination Peer support services are an evidence-based mental health model of care which consists of a qualified peer support provider who assists individuals with their recovery from mental illness and substance abuse disorders.

11 Roles of Peer Providers The impact of lived experience Lived experience of recovery that inspires hope and promotes trust Enhanced ability to connect with those they serve and role model recovery and resiliency Strengthening their own recovery by service to others Insight into impact of stigma and discrimination and supports to overcome

12 Roles of Peer Providers Compassionate listening Using stories of recovery for motivation Teaching skills to combat negative self-talk Person-centered goal setting Promotion of whole health and resiliency factors Navigation of community resources and supports Catalyze a strengths-based recovery culture Building social support networks

13 Roles of Peer Providers The Evidence Significant research shows that peer support is effective in: engaging and retaining people in mental health and addiction services, supporting individuals in playing active roles in their treatment through empowerment, lowering re-hospitalization rates, reducing utilization of crisis and emergency room services, significant reduction in inpatient days, significant increase in use of outpatient services.

14 Roles of Peer Providers The Evidence, continued increasing overall satisfaction with services providing knowledge about psychiatric disorder and addictions, and their management assisting in connecting to communities reducing symptoms and or substance use improvements in practical outcomes e.g. employment, housing, and finances increasing quality of life increasing ability to communicate with mainstream providers positive outcomes in chronic illness reducing relapse and initiating recovery engagement when relapse occurs

15 Workforce Complementarity CHW Lived experience, community knowledge, skills and abilities CPS RS

16 Common Strengths Common Challenges Community based lived experience= real life knowledge of community resources and challenges Cultural knowledge: ethnicity, culture of other Mind/Body impacts Engagement Funding drives practice Not always accepted as part of the team Career ladder Role confusion: not being respected for special expertise Salaries Patient Activation Resilience Hope

17 What might the future hold? Questions, answers and discussion

18 Trainings to help Behavioral Health for Community Health Workers Whole Health Action Management Training (WHAM) Mastering Supervision Case Management to Care Management Adult Child/Adolescent Supervisor

19 Contact information