UCHWA Resource Library

COVID COMMUNITY PARTNERSHIP PROJECT PHASE 4

sara@uchwa.org (Sara Palomino) — Fri, 10 Nov 2023 20:20:00 GMT

1 Background

4 Covid-19 Utah

6 Strategy #1 Partnerships

8 Strategy #2 Building CHW Capacity

11 Strategy #3 Access to Testing

12 Access to Vaccines

13 Strategy #4 Addressing Social Needs

16 Strategy #5 Outreach and Education

18 Strategy #6 Understanding Community Experience

20 CCP Moving Forward

Background

The COVID Community Partnership (CCP) project was established in May 2020 by the Utah Department of Health and Human Services (DHHS) Office of Health Equity (OHE) in response to the spread of the COVID-19 pandemic in Utah, and the disproportionate burden it placed on racial and ethnic minority communities. The CCP project focused addressing health disparities exacerbated by the pandemic by mitigating the spread of COVID-19 among under-resourced communities in Utah. The CCP project is a part of the DHHS effort to achieve health equity by responding to health disparities and inequities created and exacerbated by the COVID-19 pandemic. Health equity is a priority and focus within the department, showcased through the DHHS vision:

"The Utah Department of Health and Human Services will advocate for, support, and serve all individuals and communities in Utah. We will ensure all Utahns have fair and equitable opportunities to live safe and healthy lives. We will achieve this through effective policy and a seamless system of services and programs".

Community health workers (CHWs) were identified as a necessary component in this public health response to reduce the spread and effects of COVID-19 on communities who were at a higher risk of poor health outcomes. The CCP project partners with community-based organizations (CBOs) and local health departments (LHDs) to employ CHWs from diverse communities and incorporate them into the COVID-19 emergency response. The CCP project has been operationalized in 5 phases and continues to evolve and adapt to the changing state of the COVID-19 pandemic. As detailed in this report, Phase 4 of the project aimed to build CHW capacity, facilitate networking, and increase collaborative capabilities of partners. The strategies with significant outcomes are listed below, along with a timeline to see the progress and development of the CCP project.

COVID COMMUNITY PARTNERSHIP PROJECT

sara@uchwa.org (Sara Palomino) — Thu, 09 Nov 2023 16:02:07 GMT

1 Executive Summary

2 Introduction

5 CCP Project Strategies

6 Strategy #1: Partnerships to Reach Diverse Communities

7 Strategy #2: Building CHW Capacity

10 Strategy #3: Community Access to Testing & the Vaccine

12 Strategy #4: Addressing Social Needs

16 Strategy #5: Community Outreach & Education

17 Strategy #6: Understanding Community Experiences & Health Disparities

23 CCP Project Moving Forward

24 Appendix

Executive Summary

The COVID Community Partnership (CCP) project aims to address disparities in COVID-19 related health outcomes among under-resourced communities in Utah. The CCP project employs community health workers (CHWs) from diverse communities by partnering with community-based organizations (CBOs) and local health departments (LHDs) to incorporate CHWs into the COVID-19 emergency response.

CHWs are involved in many different activities for the CCP project. Individuals who indicate they need help with basic needs during the contract tracing process are provided with education. CHWs also conduct a comprehensive social determinants of health (SDOH) screening to identify specific areas of need. CHWs then connect individuals to resources for basic needs, assist with adherence to public health protocols, and ultimately reduce the spread of COVID-19 among disproportionately affected groups.

"The CCP project employs community health workers (CHWs) from diverse communities by partnering with community-based organizations (CBOs) and local health departments (LHDs) to incorporate CHWs into the COVID-19 emergency response".

The CCP project was created in 2020 and to date has been operationalized in three phases. In 2020 with Phases 1 and 2, the CCP project partnered with COVID-19 testing sites to increase accessibility in communities experiencing health disparities. Through July 2021 with Phase 3, the project transitioned to focus on supporting equitable vaccine distribution efforts and combating misinformation.

INVESTING IN COMMUNITY HEALTH WORKERS

sara@uchwa.org (Sara Palomino) — Sat, 04 Jun 2022 22:29:02 GMT

1. Key Terms and Acronyms

2. Utah's History of Promotoras and Community Health Workers

4. Executive Summary

5. State of Utah Health

8. The Role of Community Health Workers

13. Moving Forward with Community Health Workers: Policy Recommendations

21. Investing in Community Health Workers is Investing in a Stronger Utah
22. Conclusion
23. References

Executive Summary

As the Covid-19 pandemic erupted in 2020, interest in an existing but underfunded community-centered workforce emerged. Federal and state policymakers, public health agencies, health system leaders, and social service providers increasingly recognized what neighborhood organizations and community clinics knew all along—community health workers are critical to improving health outcomes. The purpose of this policy report is to provide a brief snapshot of Utah’s health disparities; dive into the role of community health workers; and discuss opportunities for long-term sustainability of this workforce. We hope this policy report will provide policymakers, public health and healthcare leaders with an understanding of this unique workforce and how they fit into a vision of health equity in Utah.

Through the pandemic, case rates, death rates, hospitalization rates, and economic hardship have not been evenly distributed revealing inequalities in health outcomes across our state. Health disparities are unjust and preventable are not unique to the coronavirus. They exist in diabetes, cancer, infant mortality and many more health indicators. These gaps in health cannot be explained by biology or geographical boundaries. Instead, the causes are due to the conditions in communities that influence our health, otherwise known as the social determinants of health. Generating healthier outcomes will require policymakers and public health objectives to focus on addressing these social and environmental determinants of health.

"The purpose of this policy report is to provide a brief snapshot of Utah’s health disparities; dive into the role of community health workers; and discuss opportunities for long-term sustainability of this workforce."

Community health workers are frontline public health ambassadors and health educators, with a trusted and close understanding with the community being served. Health workers can assist community members in addressing unmet social needs, promoting health, and building the capacity of the community. Recommendations to support community health workers include partnering for health equity programming; formalizing certification; and development of a sustainable Medicaid payment model. Utah will benefit from these policies through improved health outcomes, increased empowerment in historically under-resourced communities, and a stronger health workforce.

This report is the result of a lengthy and highly collaborative process and reflects the local and national landscape for community health workers. The sum of this report was put together through a combination of CHW meetings and small group interviews, survey collection, and observations from public health practitioners. Moving toward health equity will not happen with one policy; however, collaborating with community health workers as co-equal partners will be an essential step forward.

DRIVING IMPROVEMENTS IN UTAH'S HEALTH OUTCOMES

Thu, 02 Jun 2022 22:05:30 GMT

Introduction

Utah has been a leader in health care for many years. The state is known for its healthy populations, low cost of health care, and innovative practices. 1 The state, payers, and providers have a common goal to keep its citizens, members, and patients healthy and to provide high quality care. In alignment with this goal, the state has an initiative to increase engagement of community health workers (CHWs) by developing standardized training and a supportive professional development network.

Community health workers are frontline public health workers who serve as a bridge between patients, health care providers, and social service providers. They provide support and implement strategies to improve individuals’ health. Organizations within Utah refer to CHWs by a variety of terms, including care guides, care transitionists, community connectors, family service specialists, case managers, advocates, promotoras, and peer support specialists, among others.

As the number of CHWs within the industry grows, their contributions to healthy populations are being increasingly recognized. According to the U.S. Department of Labor, the number of CHWs in the United States has grown by 36 percent since 2012 and is predicted to increase an additional 18 percent by 2026.

Where are Utah’s community health workers found?

A recent environmental scan conducted by the Utah Department of Health indicated that many organizations in Utah are seeking to improve health outcomes by employing CHWs. Survey results showed that CHWs are engaged or employed in every county in the state—with Salt Lake, Utah, and Davis counties having the highest concentration—and are found in a variety of setting, including hospitals, medical clinics, health plans, schools, government agencies, and other community-based organizations.

The U.S. Department of Labor estimated that in May 2016 there were 550 CHWs in Salt Lake City and Ogden. 3 However, the number of CHWs is often underreported because of the nature and variability of the position. The lack of standardized training and certification programs, core competencies, and scope of work throughout the state and nation contributes to the difficulty in tracking how many CHWs are employed within their communities.

"In Utah, CHWs help the state reach its health care goals and the Triple Aim (improved health, improved care, and reduced costs) by focusing on the needs of individuals. Community health workers provide education about disease prevention and lifestyle modification, informal counseling and coaching, and extended support to targeted individuals. They have the potential to increase self-sufficiency and build community capacity by acting as a link between patients and their providers and other community resources".

How do community health workers benefit Utah’s communities?

The role of a CHW is unique within each health care community. In Utah, CHWs help the state reach its health care goals and the Triple Aim (improved health, improved care, and reduced costs) by focusing on the needs of individuals. Community health workers provide education about disease prevention and lifestyle modification, informal counseling and coaching, and extended support to targeted individuals. They have the potential to increase self-sufficiency and build community capacity by acting as a link between patients and their providers and other community resources. Common CHW roles within Utah, as expressed in the recent environmental scan, include promoting health literacy, hosting health education activities, facilitating goal setting and action planning, providing one-on-one and group education and counseling, addressing individual basic needs, supporting care coordination and case management, scheduling health care and community appointments, mentoring, and connecting individuals to community resources.

Community health workers are able to build a relationship of trust that improves interactions and garners successful outcomes because they are often members of the populations and communities with which they are working; they speak a common language, come from a similar culture, and have a deeper understanding of the populations’ needs. Duties of CHWs have been implemented across many organizations in Utah. In some cases, the job functions are split up among several staff, such as nurses, social workers, doctors, or other clinical workers. However, many organizations are increasingly engaging specific individuals (CHWs) to carry out the full scope of services.

The individuals best served by CHWs often have diverse and complex needs, requiring a greater degree of care management and support. These needs may be in the form of multiple chronic conditions, non- English-speaking immigrants, functional limitations, behavioral health challenges, or complex social needs, such as lack of housing, food, or supportive personal relationships. 4 CHWs are uniquely trained and positioned to address these social and care management needs of the patients, while allowing nurses, physicians, social workers, and other licensed workers to practice at the top of their license by focusing on diagnosis, treatment, and administration of care.

MEDICAID REIMBURSEMENT FOR COMMUNITY HEALTH WORKERS

sara@uchwa.org (Sara Palomino) — Wed, 01 Jun 2022 22:18:25 GMT

We respectfully request that the Medical Care Advisory Committee support the efforts of the Community Health Workers in Utah and the Community Health Worker Coalition by:

"Supporting formal recognition of Community Health Workers by the Utah State Legislature as vital members of the workforce in the State of Utah".

Supporting Medicaid reimbursement for services provided by CHWs through a State Plan Amendment, 1115 Waiver Amendment, ACO contract modifications, administrative agreement with community health organizations, targeted programmatic application, and/or another mechanism deemed most appropriate by Medicaid.

According to the American Public Health Association (APHA), and as adopted in the State of Utah by the Community Health Worker Coalition, “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 worker to serve as a connector between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery. A community health worker is not necessarily a clinical professional but receives training to build 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.” 1

UCHWA Resource Library

COVID COMMUNITY PARTNERSHIP PROJECT PHASE 4

Table of Contents

Background

COVID COMMUNITY PARTNERSHIP PROJECT

Table of contents

Executive Summary

"The CCP project employs community health workers (CHWs) from diverse communities by partnering with community-based organizations (CBOs) and local health departments (LHDs) to incorporate CHWs into the COVID-19 emergency response".

INVESTING IN COMMUNITY HEALTH WORKERS

Table of Contents

Executive Summary

"The purpose of this policy report is to provide a brief snapshot of Utah’s health disparities; dive into the role of community health workers; and discuss opportunities for long-term sustainability of this workforce."

DRIVING IMPROVEMENTS IN UTAH'S HEALTH OUTCOMES

Introduction

Where are Utah’s community health workers found?

How do community health workers benefit Utah’s communities?

MEDICAID REIMBURSEMENT FOR COMMUNITY HEALTH WORKERS

"Supporting formal recognition of Community Health Workers by the Utah State Legislature as vital members of the workforce in the State of Utah".

UCHWA Resource Library

COVID COMMUNITY PARTNERSHIP PROJECT PHASE 4

Table of Contents

﻿

Background

﻿

COVID COMMUNITY PARTNERSHIP PROJECT

Table of contents

﻿

Executive Summary

"The CCP project employs community health workers (CHWs) from diverse communities by partnering with community-based organizations (CBOs) and local health departments (LHDs) to incorporate CHWs into the COVID-19 emergency response".

INVESTING IN COMMUNITY HEALTH WORKERS

Table of Contents

Executive Summary

"The purpose of this policy report is to provide a brief snapshot of Utah’s health disparities; dive into the role of community health workers; and discuss opportunities for long-term sustainability of this workforce."

DRIVING IMPROVEMENTS IN UTAH'S HEALTH OUTCOMES

Introduction

Where are Utah’s community health workers found?

How do community health workers benefit Utah’s communities?

MEDICAID REIMBURSEMENT FOR COMMUNITY HEALTH WORKERS

"Supporting formal recognition of Community Health Workers by the Utah State Legislature as vital members of the workforce in the State of Utah".