Online Program

Study of the community health worker workforce: A report to the Texas legislature

Monday, November 4, 2013

Hector Balcazar, MS, PhD, El Paso, Regional Campus, UT Health Science Center-School of Public Health, El Paso, TX
Beverly MacCarty, M.A., Community Health Worker Training and Certification Program, Office of Title V and Family Health, Texas Department of State Health Services, Austin, TX
E. Lee Rosenthal, MPH, PhD, Project on Community Health Worker Policy and Practice, UT School of Public Health, Institute for Health Policy, El Paso Regional Campus, El Paso, TX
Carl H. Rush, MRP, UT School of Public Health, Institute for Health Policy, San Antonio, TX
The presentation highlights several methodological strategies developed as part of a legislatively required study to assess the desirability and feasibility of employing community health workers (CHWs) within health care systems in Texas and to explore methods of funding and reimbursement. This work informed the Texas Department of State Health Services and Health and Human Services Commission in developing recommendations to maximize CHW employment opportunities and to expand funding and reimbursement for services provided by CHWs. The Institute of Health Policy of the UT School of Public Health in collaboration with the Department of State Health Services and Health and Human Services Commission utilized multiple methods and engaged a wide range of stakeholders. Methods included a targeted literature assessment, case examples of successfully sustained CHW services, state and national key informant interviews, eight focus workshops with CHWs and employers, an online survey of CHW employers and potential employers, and consultation with the CHW Training and Certification Advisory Committee. Survey data showed that 84% of current CHW employers and 72% of those currently not employing CHWs indicated interest in expanding the CHW workforce in their organization. Results indicated that CHW are viewed as a desirable workforce for their contribution to the organization's functions. Several study methods included evidence demonstrating the positive impact CHWs have made in increasing health care efficiency, quality and access. Examples recognized that CHW services can increase access to services and improved outcomes, including decreasing cardiovascular disease risk and increasing breast cancer screening rates. Results showed that there are financial benefits, in both the public and private sectors, to employing CHWs. Several examples of these benefits are discussed. An overview of study recommendations related to CHW professional development, workforce recognition, reimbursement, and CHW roles in health plans, Patient Centered Medical Homes, and public health is presented.

Learning Areas:

Advocacy for health and health education
Diversity and culture
Other professions or practice related to public health
Public health or related public policy
Public health or related research

Learning Objectives:
List the different methods used to assess desirability and feasibility of employing community health workers in Texas Assess empirical evidence associated with impact of community health workers services on access, quality and efficiency Identify measures of community health worker effectiveness including return on investment.

Keyword(s): Cost-Effectiveness, Community Health Promoters

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been working with the community health worker model for more then 25 years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.