Online Program

Strategies for policy and systems change supporting the integration of community health workers

Tuesday, November 5, 2013 : 2:30 p.m. - 2:50 p.m.

Pamela Ford-Keach, MS, California Heart Disease and Stroke Prevention Program, California Department of Public Health, Sacramento, CA
Lily A. Chaput, MD, MPH, California Heart Disease and Stroke Prevention Program, California Department of Public Health, Sacramento, CA
Kate Cheyne, MPH, CA4Health, Public Health Institute, Oakland, CA
Background/Purpose: Community Health Workers (CHW) are uniquely positioned to promote, maintain, and improve individual and community health. The Task Force on Community Preventive Service recommends Team Based Care to support medication adherence and promote healthy behaviors. California's Community Transformation Grant, CA4Health, is designed to increase the number of physician-led teams that link with community-based resources by engaging CHWs.

Methods: Local health departments (LHDs) are playing a key role in 12 small counties to facilitate the integration of CHWs in the health care delivery team. Initial efforts focused on building capacity within communities, including evidence-based, chronic disease self-management programs led by CHWs. As access to workshops becomes more robust, LHDs are engaging communities in Wellness Summits, designed to facilitate organizational change within the health care system. Since California lacks a formal CHW certification process, counties are implementing comprehensive strategies in workforce development, occupational regulation, and financing to fully support the integration of CHWs in health care teams.

Results/Outcomes: All 12 CA4Health counties now have the capacity to offer chronic disease self-management programs, and more than 50 percent have conducted Wellness Summits. Six counties are currently working on CHW workforce development strategies, two on occupational regulations, and four on financing strategies. One small urban county has adopted a written systems change protocol within a health care setting.

Discussion: Integrating CHWs as a part of the health care team is a feasible approach to delivering high quality chronic disease care in states that lack a formal CHW certification process.

Learning Areas:

Chronic disease management and prevention
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe the role of local health departments integrating CHWs in the health care delivery team. Identify emerging policy opportunities to support Community Health Workers. Name three strategies of a comprehensive Community Health Worker policy approach.

Keyword(s): Chronic Diseases, Community Health Promoters

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Ms. Keach is a nationally recognized arthritis and chronic disease expert, and a program manager within California Department of Public Health's Chronic Disease Control Branch. Ms. Keach is responsible for directing, implementing, and evaluating cardiovascular and other chronic disease program activities, and is directly involved in the implementation of CA4Health.
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.