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Indiana State Department of Health

Chronic Disease > Rural Health > Community Health Workers Community Health Workers (CHWs)

Primary Care Symposium: Enhancing Care with Community Health Workers 2013

View the presentations from the Symposium below

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.

- American Public Health Association

CHW Code of Ethics               

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CHWs enable patients to adhere to provider recommendations by connecting patients to community-based resources. The literature points to CHWs as having a significant impact on:

  • reducing unnecessary hospital readmissions 
  • strengthening patients self efficacy
  • increasing patient satisfaction
  • supporting adherence to medication and other provider recommendations
  • improving access and quality of care
  • enhancing social support

Social support is an indicator of health outcomes. Community health workers provide social support and greatly enhance personal and community health.

Common titles used to describe CHWs include but are not limited to - Abuse Counselor, Access Worker, Adult Case Manager, Assistor, Case Coordinator, Certified Recovery Specialist, Community Coordinator, Community Counselor, Community Health Advisor, Community Health Coach, Community Health Educator, Care Transition Coordinator, Community Health Representative, Community Liaison, Community Organizer, Community Outreach Manager, Community Outreach Worker, Community Social Worker, Discharge Planner, Educator, Family Advocate, Family Education Coordinator, Family Support Worker, Financial Counselor, Health Advisor, Health Advocate, Health Agent, Health Assistant, Health Broker, Health Communicator, Health Educator, Health Insurance Counselor, HIV Peer Advocate, HIV Prevention Coordinator, Home Care Worker, Home Visitor, Home-Based Clinician, Intake Specialist, Interpreter, Lay Health Worker/Advisor, Maternal and Child Health Case Manager, Medical Representative, Mental Health Worker, Navigator, Nutrition Educator, Outreach Advocate, Outreach Case Manager, Outreach Coordinator, Outreach Educator, Outreach Worker, Parent Aide, Parent Liaison, Patient Navigator, Peer Advocate, Peer Leader, Promotoro, Promotor(a) de Salud, Roving Listener, Street Outreach Worker, Youth Development Specialist, Youth Worker.

Models of Care Include:

  • Navigation
  • Care Coordination
  • Organizing/Peer Support
  • Outreach/Informing/Enrollment Agent
  • Member of the Care Delivery Team



Why CHWs?

US Bureau of Labor Statistics
Standard Occupational Classification

  • 21-1094 Community Health Workers
Assist individuals and communities to adopt healthy behaviors. Conduct outreach for medical personnel or health organizations to implement programs in the community that promote, maintain, and improve individual and community health. May provide information on available resources, provide social support and informal counseling, advocate for individuals and community health needs, and provide services such as first aid and blood pressure screening. May collect data to help identify community health needs. Excludes "Health Educators" (21-1091)

Leveraging CHWs is one of many evidence-based practices known to improve population health. Indeed, the National Prevention Strategy, Institute of Medicine, U.S. Health and Human Services and others recommend integrating CHWs into the health care delivery system.

Evidence

Evidence to support the role of CHWs continues to grow. Our annotated bibliographies (below) help to understand the nature and impact of their work.

The Indiana State Department of Health's Role in Supporting CHWs

ISDH is deeply committed to supporting the role of CHWs as a means of advancing care, reducing costs, and improving community health.

  • Establishing a scope of practice,
  • Hosting an annual symposium; and
  • Advancing system level integration.

Success in developing a sustainable system with CHWs is a direct result of our partners from all sectors of the community including CHWs and public and private entities.

Our current partners include:

American Health Network, Inc., Area Five Agency on Aging, ASPIN, Community Resources, LLC, Dia de la Mujer Latina, Inc., Esperanza Ministries, Goodwill Industries, Health Care Excel, Head Start, HealthLinc, Inc., HealthVisions Midwest, Indiana Academy of Family Physicians, Indiana Cancer Consortium, Indiana Health Care Association, Indiana Minority Health Coalition, Indiana Primary Health Care Association,  Indiana State Medical Association, Indiana University Department of Public Health, Indiana University Health La Porte Hospital, Indiana University Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, IU Health, IU Health - Bloomington, Ivy Tech State College, Little Red Door Cancer Agency, Marion County Health Department, Memorial Hospital of South Bend, Mental Health America of Indiana, Northwest Indiana Area Health Education Center - Purdue University Calumet - Academic Learning Center, Office of the Center of Wellness for Urban Women, Partnership for a Healthier Johnson County, Purdue University - Affecting Cancer Together, Purdue University -Department of Consumer Sciences and Retailing - College of Health and Human Sciences, St. Vincent Hospital, Susan B. Komen, United HealthCare of Texas, University of Notre Dame - Institute for Latino Studies, Weiss Communications, Windrose Health Center, Wishard Hospital,

Indiana State Department of Health

Cardiovascular Health and Diabetes Section, Children's Special Health Care Services, Chronic Respiratory Disease Section, Comprehensive Cancer and Control, Division of HIV and STDs, Maternal and Child Health, Office of Minority Health, Office of Primary Care, Office of Women's Health, Office of Refugee Health

Join the Movement

Are you a CHW interested in meeting other CHWs? Would you like to get involved with the CHW movement in Indiana? If so, email INcommunityhealth@gmail.com or contact your regional representative. Regional Representative Contact Map

To join the Indiana Community Health Worker Association, email INcommunityhealth@gmail.com or download the brochure.

Also, "Like" the INCHWA at www.facebook.com/IndianaCHW

Community Health Worker's Symposium

2013 Primary Care Symposium: Enhancing Care with Community Health Workers

On Thursday, Sept. 5, 2013 the ISDH and the Indiana Community Health Worker Association hosted a state-wide CHW Symposium. The below presentations were given during the symposium. We hope they are as informative to you as they were for those able to attend in person.

Bernard J. Emkes, MD, is the Medical Director of Managed Care Services at St. Vincent Health in Indianapolis where he is focused on improving hospital efficiency, assuring payments for appropriately provided services, and reducing payment denials.  Dr. Emkes provided an overview of the current state of health care and emerging innovations to enhance value. View Dr. Emkes’ presentation.

Wayne H. Giles, MD, MS, is the Director of the Division of Population Health for the National Center for Chronic Disease Prevention and Health Promotion at the Centers for Disease Control and Prevention (CDC). Dr. Giles presented on the national landscape related to the prevention and control of chronic conditions with CHWs. He also touched on how the Chronic Care Model can be used to advance integration of the workforce into primary care to improve population health. View Dr. Giles’ presentation.

Tammy Geltmaker, RN, BSN, MHA is the Business Development Manager at Health Care Excel, the Medicare Quality Improvement Organization (QIO) for Indiana and Kentucky. Ms. Geltmaker and her colleague, Kristin Celesnik, BS, CHTS-PW, Health Care Excel’s Health Information Technologist shared how CHWs enhance the Triple Aim.  Please view Ms. Geltmaker and Ms. Celesnik’s presentation.

Cora Butler, Outreach Specialist for Anthem Blue Cross and Blue Shield and State Representative, Robin Shackleford presented on how their CHW model complements Indiana’s public health infrastructure from an advocacy and applied perspective. View Ms. Butler and Ms. Shackleford’s presentation.

Odilia Garcia, Program Coordinator for Migrant Health Promotion presented on the multifaceted opportunities that exist to address health inequality with CHWs.  View Ms. Garcia’s presentation.

Malaz A. Boustani, MD, MPH, Associate Director and Cathy Alder, MSW, JL, Chief Administrator at Indiana University Center for Aging Research presented on their research findings from the Centers for Medicaid and Medicare Innovations award to address equitable brain care with CHWs.  View Dr. Boustani and Ms. Alder’s presentation.

Teasa Thompson, MPH Program Manager and Assistant Director of Outreach Purdue University and James E. Garrett, Jr. Executive Director, Indiana Commission on the Social Status of Black Males with the State of Indiana’s Civil Rights Commission offered a session entitled, “Affecting Cancer Together™ Novel Approaches to Men’s Health Utilizing Evidence- Based Methodologies: The Unconventional CHW.” This innovative model builds community capacity to change the trajectory of early disability and death among men of color in Indiana. View their presentation.

Robin Costley, CRT, AE-C, Certified Asthma Educator & Coalition Manager, Marion County Health Department, shared her experience providing in-home asthma education and services to Marion County residents. View Ms. Costley’s presentation.

Lucina Kessler, ACNS, BC, CDE, Program Coordinator and Amparo Caudell, CHW/Promotora de Salud with Columbus Regional Hospital shared a health coaching model that their team developed and is proving to be successful in supporting self-management skills. View “Diabetes Educators Designing Programs Using Health Coach Extenders in the PCMH.”

Jane Clawson, CHW/Health Access Worker and Nicole Kowalski, Health Access Manager, St. Vincent Health provided an in-depth review of the Pathways model.  Pathways is a model that the U.S. Agency for Healthcare Research and Quality (AHRQ) has noted as best practice.  View the presentation.

Raquel Castro, RN, BSN, CCM, Nurse Manager and Rosa Montemayor LPN, CC/CHW for Health Visions Midwest presented on how CHWs are reducing hospital readmission in Lake County.  View the “Bridges to Wellness” model.

Waldo A. Mikels-Carrasco, Community Health Research Program Manager at University of Notre Dame and Indiana Clinical Translational Sciences Institute (CTSI) presented, “CHWs: Creating Large Scale Social Change.”

Kim Rayford-Townsend, CHW with the Madison County Community Health Center offered a session on the transformation occurring in Madison County as a result of integrating the CHW role within the clinic setting. View “A Safety Net Story.”

Nazareth Savanero, CHW and Chuck Sallee, CHW with South Bend Memorial Hospital offered a session entitled, “Healthy Diabetics Program.” View their presentation and learn how they are reducing diabetes related hospital readmissions.

2012 CHW'S Symposium Presentations

On Monday, Oct. 15th, ISDH and the Indiana Community Health Worker Coalition hosted a state-wide CHW Symposium. The attached presentations were given during the symposium. We hope they are as informative to you as they were for those able to attend in person.

Carl Rush, M.R.P. is one of the leading academics in CHW policies and initiatives throughout the nation. Mr. Rush presented on the national landscape related to current policies that encourage CHWs. He also touched on several studies that have shown a return on investment for creating CHW initiatives. View Carl Rush presentation.

Lee Rosenthal, Ph.D. has worked on CHW policy and legislation for more than 20 years. Dr. Rosenthal has worked with many states to help assess their CHW populations as a first step to integrating CHWs into their health care systems. Her presentation includes the results of Indiana's state-wide assessment. View Dr. Rosenthal's presentation.

Sherry Gray and Jane Clawson of St. Vincent run a highly successful CHW driven program to address pre-natal and infant care in the Pathways model. This presentation outlines the program and successes they have seen as a result. View presentation

Bruce VanDusen of the Division of Mental Health and Addictions and Martha Levey of ASPIN have created a billable peer-support program for those struggling with mental illness and substance abuse issues. To learn more about this program and how these organizations have bridged the gap between primary and behavioral health care, view their presentation.

Windrose Health Network, Partnership for a Healthier Johnson County, and Esperanza Ministries have formed a unique model working together to address the health disparities in Johnson County. View the presentation to learn more about each organization's contribution and the use of CHWs to address their need.

The Marion County Health Department has a well-developed and long-standing asthma education program that uses CHWs. View MCHD presentation.

Health Visions Midwest has been working in the East Chicago region for years and has used CHWs in many initiatives to great effect. View HVMW presentation.

 

Resources and Trainings

** Please post trainings and/or events on the CHW Facebook Page **

Sample Position Description

Sample 1

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National CHW Resources

  • CDC "Promoting Policy and Systems to Expand Employment of CHWs" - 6 session e-learning flyer
  • Diabetes Training and Technical Assistance Center (DTTAC) "CHWs: Policy and Systems Strategies for Improving the Prevention and Management of Chronic Diseases Among Disparate Populations" - 6 webinar modules & handouts
  • American Association of Community Health Worker (contact: Durrell Fox, dfoxnehec@aol.com or Pam Chapman, pam.chapman@spectrum-health.org, Co-chairs
  • CHW National Education Collaborative
  • American Public Health Association, CHW Section
  •