Beginning the Story of Community Health Workers in Wisconsin Ana Paula Soares Lynch MS, LPC. CORE/El Centro United Voices Joelisa Castillo CHW Lead of United Voices WI March 24, 2016 BEGINNING THE STORY OF COMMUNITY HEALTH WORKERS IN WISCONSIN United Voices CHWs Collaborative of WI - http://www.unitedvoices-wi.org/ 1
Presenters: Ana Paula Soares Lynch MS, LPC. Staff Director United Voices CORE/El Centro Sherri Ohly, BSW. Health Promotion Consultant WI Department of Health Services, Division of Public Health, Chronic Disease Prevention Program Joelisa Castillo, CHW. United Voices WI Lead Coordinator WI CHWs are Changing Public Health in WI Jarvis West is a CHW and a certified Navigator for the Affordable Care Act. He works for Independent Care Health Plan, where he helps mentally and/or physically disabled people as well as low-income people and families receive affordable health care services. Jarvis is an energetic volunteer at Community Health Improvement for Milwaukee's Children, Men's Wellness Initiative; Life Course Initiative for Healthy Families. As an enrolled member of the Oneida Nation of Wisconsin and Mexican- American, Keetah Smith is privileged to have an understanding of the challenges her people face. Keetah decided to become a Community Health Worker after training to be a Leader for the Wisconsin Institute for Healthy Aging s Living Well with Chronic Conditions workshops. Christiana Atterre is originally from Cameroon and moved to the United States in 2005. She is passionate about Community Health and the empowerment of women. As a CHW she was one of the visionaries of the Annual Milwaukee International Women's Day Celebration, and cofounder of the Milwaukee African Women s Association. 2
Presentation Objectives: Understand the role of the CHWs and how they can improve access and quality of health, in addition to increasing access to health care. Learn about the findings of a recent annual CHW statewide census survey administered by United Voices Community Health Worker Collaborative. 3
1940 s and 1950 s http://proyectosalud.shutterfly.com/ History of CHW Programs Worldwide World Health Organization Barefoot Doctors China Village Health Volunteers Thailand Hundreds of thousands trained 1960 s CHW programs are recognized worldwide 1970 s CHWs start to be involved in social change and civic and human rights especially in African countries. 1980 s The world economic crisis destroyed many CHW s programs. 1990 s Countries like Brazil and China started to institutionalize CHWs practices and create policies, training and certification. 2000-2011 There is an estimated 1.3 million CHWs in more than 50 countries. 4
Socio-Economic Determinants of Health -WI Segregation Unemployment Access Racism Immigration Education Poverty Transportation 5
Doctor, where did my social determinants go? Social determinants have not been integrated into clinical practice or health care systems Leads to lower value, substandard care Public Health SDOH research & intervention Health Care Individual Level Disease Research & Intervention IOM. 2013. U.S. Health in International Perspective: Shorter Lives, poorer health. Washington DC: The National Academies Press. The medical model is limited to symptoms Money Housing Work Family Violence Children 6
CHWs Can Change the Current Health Scenario in WI! Increase Culturally and Linguisticly Appropriate Services (CLAS). Increase Quality of Care patient-centered approach. More effectively Reach the Most Vulnerable Populations. Increase Preventive Health. Increase Diversity in the Public Health Workforce. Reduce Health Disparities. Inform Policy Development. Effectively Implement Public Policies. http://www.michwa.org/resources/research-evidence/ CHWs: A Public Health Strategy 7
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES ~ Agency for Healthcare Research and Quality AHRQ Publication No. 15-0007 April 2015 www.ahrq.gov/research/findings/nhqrdr/index.html Health Disparities in WI Disparities in quality and outcomes by income race and ethnicity are large and persistent, and were not, through 2012, improving substantially. Disparities related to chronic disease management grew larger 8
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WI Department of Health Services, Division of Public Health, Chronic Disease Prevention Program. Strategy: Support CHWs Profession Increase of Access, Quality and Preventive Care Healthier Communities and Health Equity 10
Michigan CHW s Statewide Census Data 2015 Developed and Implemented by United Voices CHW s Collaborative. Conducted in April/May of 2015 by a team of CHWs trained by United Voices. Funded and supported by DHS Chronic Disease Prevention Program. 152 completed the survey statewide. Technical Assistance provided by MetaStar 11
CHWs Titles in WI Employment: 90 80 70 60 50 40 30 20 10 0 Volunteer Full Time Part Time Paid by Stipends Access to Health Insurance: 83 CHWs states not having insurance through employment. 12
Racial Ethnicity Age 70 65 60 Identified Race/Ethnicity Grouping Age 55 50 45 40 35 30 25 20 Number of Records 15 10 5 0 Hispanic Black or or Latino African- American White African American Multiple Asian Ancestral Indian or Alaska Native CHWs Affected by Poverty Languages 13
CHWs who works with Diabetes How do CHW s help people manage their chronic disease? Medication adherence 40.00% Self-monitoring of blood pressure/glucose levels 29.57% Increased consumption of nutritious food and beverages 40.87% Increased physical activity 47.83% Maintaining medical appointments 55.65% Increased community members/client's skills and confidence in managing health problems 59.13% Regularly assessing progress and problems with community members/clients 40.87% Setting goals 60.00% Access to healthier food 39.13% Problem-solving support 59.13% 14
CHW s affected by Social Determinants: United Voices - WI A MULTI-CULTURAL COLLABORATIVE OF COMMUNITY HEALTH WORKERS Personal connections build healthier communities. CHWs Working together for collective impact. Vision: Through a Strong and United Body of CHWs, we Envision a Healthier Community with Equal Voices and Equal Opportunities. Mission: Stand as One True Collective Voice of Multicultural Community Health Workers to Support Each Other, Alleviate Health Disparities & Influence Policy Making. 15
Our Goals: Increase Visibility and Value of CHWs. Serve as the Headquarters for the CHWs in WI. Create Financial Sustainability so CHWs can Serve the Community. Alleviate Health Disparities through System Change. Break Segregation in the State of Wisconsin. Exchange Languages, Cultures and Resources. Develop and Influence Policies that Affect Public Health and the growth of the CHW s Profession Locally and Nationally. Communication Strategies and Awareness: Outreach and Presentations Website/Social Media Digital Media and Story Telling 16
CHW Leadership Local, Regional & National Influence Participatory Research Internship: CHWs received training and conducted research, evaluation, and data analysis. Wisconsin Public Health Association United Voices has been leading the formation of the CHW s section for policy making and public health diversity. Representation in the American Public Health Association- CHW Section. Representation in the Region V Health Equity Council for the Office of Minority Health Representation in the CHW Core Consensus C3 Advisory Board Continuing Education and Professional Growth: Networking & Self-Care Opportunities $ 6,500.00 in scholarships that provided support for CHWs to network, learn, and engage in important projects locally and nationally. WI CHWs Apprenticeship Program Susan G Komen: Conversations for the Cure Commom Ground: Community Organizing Training American Cancer Society CHW Breast Cancer Conference WIHA Chronic Disease Self Management Trainings 17
Working Together for Health: Given what you have learned today can you identify people who work in the CHW s role? We need you to be a champion engaging CHWs in your organization. Identify CHWs to participate in the 2016 CHW. Join and Support United Voices By being a CHW s Mentor. By providing continuing education training. By helping us to identify CHWs to take the 2016 CHW Census survey. 18
For more Information: Joelisa Castillo, CHW United Voices (414) 225 4228 Ana Paula Soares Lynch (414) 530 4620 Sherri Ohly (414) 687 1223 e mail at: info@unitedvoices wi.org Questions? Mary Funseth Project Specialist MetaStar, Inc. mfunseth@metastar.com 608-274-1940 or 800-362-2320, ext. 8229 www.lsqin.org www.metastar.com MetaStar represents Wisconsin in Lake Superior Quality Innovation Network. 38 19
This material was prepared by the Lake Superior Quality Innovation Network, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The materials do not necessarily reflect CMS policy. 11SOW-WI-B2-16-09 031616 20