Online Program

A Community Health Governance Model with Community Health Workers at the Center: A Model to Improve Community Health and the Health Care System

Wednesday, November 4, 2015 : 8:30 a.m. - 8:50 a.m.

Dannie Ritchie, MD, MPH, Center for Primary Care and Prevention, Brown University, Providence, RI
Background: The Triple Aim of the health care reform requires the improvement in population health along with reducing costs of health care and improved quality of care. Reform discussion is often limited to the health care system. However, a significant shift has occurred that recognizes the need for a health-in-all-policies approach. This requires engagement of nonmedical sectors of the community that can be in partnership with health care to better ensure communities can support good health and increase health equity.

Objective: The Culturally and Linguistically Appropriate Services (CLAS) standards asks health care organizations to develop participatory, collaborative partnerships with communities and utilize a variety of formal and informal mechanisms to facilitate community involvement in designing and implementing CLAS related activities. A community approach with a CHG and CHW team model will provide the formal infrastructure.

Methods: A CHG community based CHW program builds and strengthens existing networks to produce an iterative process that is responsive to community priorities to improve community health and could be sustained through advanced payment models in the Affordable Care Act (ACA).

Results: A multicultural community based frontline public health workforce that attends to community priorities and provides a connection to the health care system and because from the contextual view point of the community better able to assist in improving healthcare quality as part of an integrated health care team.

Conclusions: A CHG with a community-based CHW team provides a macro system integration and financial model that can redesign primary care and population health management.

Learning Areas:

Advocacy for health and health education
Other professions or practice related to public health
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Describe A model of community health governance (CHG) being developed in Rhode Island that centers on community health worker (CHW) teams, which can be integrated into the community health teams of health care systems as a means to address the Triple Aim of improving population health. Assess how the shift from a fee-for-service to a capitated model for health care and prevention as recommended in the ACA requirements could sustain funding for these community-based CHWs teams. Compare concepts of community capacity building and social capital for prevention and to improve community health that will be promoted by a CHW team centered CHG. Evaluate the evidence the state and national dialogue shift to focus on the improvement of community health and implementing population-level approaches to health across the spectrum of medical, social, and environmental determinants of health, which would be answered by a CHG and CHW team approach. Identify advanced payment models for the sustainability of community-based CHWs teams that can be integrated with health care organizations. Discuss future action steps to implement advanced payment models to engage nonmedical sectors of the community in new partnerships with health care to achieve health equity and improvement of the Triple Aim within population health.

Keyword(s): Community Health Workers and Promoters, Community Health Programs

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: My background is in community health, policy analysis, and research in race, ethnicity, health care systems and community engaged research and development. I have actively worked on the promotion of the community health worker (CHW) workforce through course development, policy papers, initiation of a CHW association, labor department survey on the CHW workforce and the lead in Rhode Island to join national efforts for Federal recognition of the CHW workforce as a profession.
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.