Pub. 4 2020 Issue 2

By Alan Pruhs have one thing in common: the trust of the communities they serve. They are trained laypeople who share life cir- cumstances with the clients they serve and are “natural helpers.” CHWs work in a variety of settings throughout Utah in both paid and volunteer positions such as Community Health Centers and Homeless Health Centers. CHWs have been part of Utah’s com- munities. The trusted relationships they have with community members are the primary reason they have been called on in response to the pandemic, not just in Utah but across the world. The UPHA CHW Section Leadership, AUCH and the Broad- Based CHW Coalition all continue to work together with Cares Act funding through the Office of Health Dis - parities. They hire and train CHWs in mobilizing efforts in communities with a high prevalence of COVID-19 to ensure correct information, access and resource connection. CHWs are working on the front line at testing centers, health facilities, and community-based organizations (CBO), providing outreach, educa- tion, and resources to address social determinants of health. Cares Act Funding was also granted to the UPHA CHW Section who hired a COVID-19 program coordinator, outreach coor- dinator, and membership coordinator to assist with the development and implementation of training programs for local, state and county CHWs as well as professional development and support for the CBOs who provide wrap-around services for community members impacted by COVID-19. CHWs have also been working with the state to develop and distribute multicultural materials for various eth- nic communities in different languages and deliver presentations through traditional media, social media and the news. The power of these collaborative efforts has demonstrated the effec - tiveness of CHW work. Their ability to reach diverse, underserved com- munity members, provide culturally appropriate services, and connect them to resources that improve their quality of life is nothing short of a miracle. There are so many barriers and inequities that serve as obsta- cles to ensuring health equality and equity to all community members. Community Health Workers help con- nect these community members to resources that may have previously seemed completely inaccessible. Through services such as language in- terpretation, translation of marketing materials, community outreach and education, systems navigation and care team representation, CHWs are a service extension to many profession- als. They provide holistic care and fol- low up to patients — especially those who need extra care and assistance. Only through collaborative efforts can we better serve our communi- ties. Utah has been a great example of these efforts bringing together community and government sectors in addressing the health care of ALL community members. We are all in this together! Together, We Can! CHWs in Primary Care — Extending Reach Beyond the Clinic Walls C ommunity Health Workers have been a valu- able addition to primary care clinicians and care teams. Their unique perspective and ability to connect with patients have contributed sig- nificantly to improving quality outcomes and lowering health care costs. CHWs have a keen ability to com- municate with patients, who may otherwise feel judged or unwilling to share social determinants with clinicians. In the calendar year 2019, 557 clients received a CHW intervention. The CHWs met with patients, established rapport, conducted Social Determinants of Health (SDoH) screenings, made home visits, and provided 2,133 refer- rals to community services to address identified needs. SDoH data showed that 15% of clients identified six or more socioeconomic needs, increasing to 61% of clients with three or more socioeconomic needs. Dental care (54%), transportation (48%), food (43%), housing (29%) and mental health care (29%) were the highest areas of need. CHW referrals lead to access to needed resources, most of which included connections to food (15%), medical services (12%), transportation (10%), housing (9%), clothing (9%) and mental health services (7%). CHWs also use the Patient Activation Measure (PAM) questionnaire, developed by Insignia Health, to measure systemwide cost savings based on client changes within four different levels of engagement: disengaged, becoming aware, taking action and maintaining behaviors. Accord- ing to Insignia Health, “Each point increase in a PAM score correlates to a 2% decrease in hospitalizations and 2% in- crease in medication adherence.” During the intervention, referrals to community resources improved client relation- ships, goal setting, empowerment and health engagement. Fifty-six percent of clients increased their engagement level, as measured through the PAM — improving on aver - age 10.4 points, and resulting in a systemwide cost savings of $6,264 per patient per year. 21 |