Transcript Community Health Workers

“Community Health Workers (CHWs) work in association with the local
health care system (hospitals, doctors, clinics) in both urban and rural
environments to bridge the gap between providers and underserved
populations in need of care. They are members of the community who
share ethnicity, language, socioeconomic status and life experiences with
those they serve.
CHWs provide culturally appropriate health education and information in
order to assist people in receiving the care they need. They can give
informal counseling and guidance on health behaviors; advocate for
individual and community health needs; and provide some direct health
services, like first aid and blood pressure screening.”
http://www.abcardio.org/articles/cms_rule.html
45 CFR Parts 155 and 156 [CMS–2334–F] RIN 0938–AR04
Medicaid and Children’s Health Insurance Programs: Essential Health Benefits
in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal
Processes, and Premiums and Cost Sharing; Exchanges: Eligibility and
Enrollment
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Final rule.
SUMMARY: This final rule implements provisions of the Patient Protection and
Affordable Care Act and the Health Care and Education Reconciliation Act of
2010 (collectively referred to as the Affordable Care Act).
Comment: One commenter urged HHS to clarify that § 440.130 of
the proposed regulation does not dictate who can provide
preventive services; it merely dictates what providers can
recommend them, consistent with the totality of the statute.
Response: The proposed regulation does not dictate who can
provide preventive services; it defines who can recommend such
services. States will have discretion to determine which providers
will provide the service using the state plan amendment process.
PART 440—SERVICES: GENERAL PROVISIONS
■ 35. Section 440.130 is amended by revising paragraph (c) to read as
follows:
§ 440.130 Diagnostic, screening, preventive, and rehabilitative
services.
*****
(c) Preventive services means services recommended by a physician or
other licensed practitioner of the healing arts acting within the scope of
authorized practice under State law to—
(1) Prevent disease, disability, and other health conditions or
their progression;
(2) Prolong life; and
(3) Promote physical and mental health and efficiency.
160 Hours of Training
• Communication Skills
– Listening
– Use language confidently and
appropriately
– Ability to read and write well
enough to document activities
• Service Coordination Skills
– Ability to identify and access
resources
– Ability to network and build
coalitions
– Ability to provide follow-up
• Interpersonal Skills
– Counseling
– Relationship-building
– Ability to work as a team
member
– Ability to work appropriately
with diverse groups of people
• Capacity-Building Skills
– “Empowerment” - Ability to
identify problems and resources
to help clients solve problems
themselves
– Leadership
– Ability to strategize
– Ability to motivate
• Advocacy Skills
– Ability to speak up for
individuals or communities
and withstand intimidation
– Ability to use language
appropriately
– Ability to overcome barriers
• Teaching Skills
– Ability to share information
one-on-one
– Ability to master information,
plan and lead classes, and
collect and use information
from community people
• Organizational Skills
– Ability to set goals and plan
– Ability to juggle priorities and
manage time
• Knowledge Base on Specific
Health Issues
– Broad knowledge about the
community
– Knowledge about specific
health issues
– Knowledge of health and
social service systems
– Ability to find information
From a Local University Medical School:
“I am the PI on the RWJF grant to pilot the clinical curriculum that she and I and our
Patient Care Team developed for the grant application.
Our clinical curriculum we designed is intended to elevate the typical CHW to serve as
a CMS-reimbursable Patient Health Advisor in a clinic setting rather than only in the
home/community setting.
This is an additional 40-hour clinical module (in addition to the general 160-hour
CHW course) that would train students to measure vital signs conduct urine and
saliva tests to detect a variety of disorders and/or diseases.
Biomarkers such as proteins, glucose, ketones, hemoglobin, bilirubin, urobilinogen,
acetone, nitrite and leucocytes as well as testing of pH and specific gravity as well as
illicit drugs, pregnancy, and strep A will be taught as well as obtaining blood samples
to check for cholesterol, A1C and some medications. This is just a snippet of the
additional clinical education they will receive.”
EMS MIH-CP Implications
• Certify EMT’s as CHW?
– Already a reimbursable service under some state
essential benefit plans
• Will CHW’s be a better alternative to EMS
personnel
– The ‘value’ questions
• What “space” does EMS ‘own’
– …….