Session
Models for CHW Sustainability & Workforce Development
APHA 2022 Annual Meeting and Expo
Abstract
Project CHAMPP: Advancing and Sustaining a Community Health Worker-Centered Political Platform
APHA 2022 Annual Meeting and Expo
Community Health Workers (CHWs) are an effective, powerful workforce. They are experts in mitigating the impact of social and structural determinants of health, a unique set of skills developed through their own lived experiences and their roles as trusted members of, and leaders in, their communities. While CHWs have existed for hundreds of years in various forms, they remain overlooked, underappreciated and, consequently, underpaid, even as states grapple with developing and implementing sustainable financing arrangements for their services. Building CHWs’ capacity to generate and galvanize support for CHW-related legislation, at both the state and federal levels, is critical to protecting the integrity of their professional identities, ensuring fair compensation for their work, and advancing equity across the spectrum of organizations they are employed in. From 2020 to present, Project CHAMPP (Community Health Workers Advocating for Movement in Policy and Practice), an 8-person group composed of community health workers, researchers, policy analysts, and representatives from philanthropic organizations, has convened to 1) inform, and advocate for, the development of federal legislation to create sustainable financing for the CHW workforce; 2) gain skills in identifying, and effectively communicating with, healthcare payors, policymakers, philanthropic organizations, leaders of community-based organizations, and other key stakeholders; 3) create guardrails to hold employers accountable for creating environments that are conducive to CHWs’ personal and professional success; and 4) increase our knowledge about the processes underpinning legislation development procedures. Half of the members of Project CHAMPP are CHWs. Under their leadership and guidance, we propose a 90-minute oral presentation that describes facets of our multistakeholder coalition that serves as a model for cultivating meaningful collaborations between CHWs and their partners across academia, philanthropy, and policy. A CHW team member will provide a brief summary of the work undertaken by the Project CHAMPP partners. This will be followed by a moderated panel discussion featuring perspectives from the CHWs, health equity researchers, and government relations experts comprising Project CHAMPP. Members of the panel will share the evolution of our partnership, lessons learned, accomplishments, and aspirations for promoting the dissemination and uptake of policies and practices that will support the CHW workforce at the state and national levels. Through this presentation – whose goals and objectives were created by our CHW colleagues – we will showcase the ways in which we leveraged our individual strengths to optimize our collective impact.
Abstract
Creating Sustainability in CHW Workforce Development through Braided Funding
APHA 2022 Annual Meeting and Expo
The CHW workforce continues to stand on “soft funding, usually supported by grants and alternative funds. As the field works towards establishing itself into the operational budget of organizations, an alternative method is possible. Braided funding allows organizations to leverage multiple sources of funding in support of shared goals and activities. While organizations can seek and secure braided funding to implement a single project, one can also look at look at how different projects combined to form a distinct program or initiative. Organizations should identify their core programming and goals and look at funding opportunities as vehicles for advancing organizational strategies. By blending funding streams and intentionally designing projects that are complementary in nature, organizations will be better positioned to develop defined programs. This in turn will establish parallels and promote synergy across their grant and funding portfolio. This strategy allows for continuation of initiatives in the early development and anchors the ability of an organization to further explore and determine a long-term sustainability plan.
Abstract
Apprenticeships: An underutilized training model for the CHW profession
APHA 2022 Annual Meeting and Expo
Apprenticeships are an underutilized training model that can support the development and growth of the CHW profession. They also serve as a middle ground within the debate on formal training and/or regulation versus leveraging organic skills within the CHW profession. The argument behind formalized training and regulation is that if the CHW profession is regulated it will become a more recognized and accepted profession encouraging Medicaid and insurance reimbursement. In contrast, those against formal training and regulation argue that doing so creates barriers of entry for prospective CHWs. Specifically, CHWs who are coming from the communities they serve and impacted by social determinants, such as poverty, which prevents access to higher education or fee-based training.
Apprenticeships can be structured in a way that attracts and retains CHWs from the communities they serve. Apprenticeships can also work in tandem with state certifications (in states where it is applicable) by acknowledging the documented training and the recognized credential received upon completion of the apprenticeship. Apprenticeship can be state registered (ex. California Department of Apprenticeship Standards), federally registered (Department of Labor), or recognized through certification such as a certification of completion or diploma from an accredited training program.
CHW apprenticeships come in a variety of packages. Some are established through academic centers, some through employers while others are hybrids that often include a third-party entity. A review of 45 registered apprenticeship programs, including outreach to directors and organization representatives, found that the apprenticeships that were the most successful in terms of attracting CHWs from communities served, completion rate, and continuation into the CHW profession were programs that were fully funded, provided a stipend/salary through all aspects of training, and provided assistance to address social determinants of health.
Abstract
Strengthening the Community Health Worker Ecosystem
APHA 2022 Annual Meeting and Expo
The Health Equity Collective is a community coalition of over 175 organizations (primarily healthcare, social services, academic institutions, and insurance companies) across the Greater Houston region with the mission of establishing an impactful, collective, sustainable, data-driven system to improve social determinants of health (SDOH) needs and promote health equity. The Collective is focused on developing human, data, technology, and financial capacity for organizational alignment to multi-sector collaboration. Across the Greater Houston region, many SDOH efforts are operating in siloes of excellence falling short of their desired impact, and this includes efforts supporting community health workers (CHWs). Community health workers have long played an important role in care coordination efforts. And more recently, there has been an influx of millions of dollars in the Greater Houston region to improve CHW capacity, reach and impact. The Health Equity Collective is tasked with understanding and improving the infrastructure of CHWs in our region to advance equity, by supporting existing efforts, and creating new opportunities for expansion of a CHW Network. The purpose of our presentation is to present results of the landscape analysis of CHW capacity in the Greater Houston region to mitigate SDOH needs, and the framework to achieving improving CHW capacity in our region. This includes, the CHW role in elevating the role of CHWs in the community, high quality training and in-service opportunities, consistency in core training, training in specialty areas, promoting and showcasing work of CHWs as a valued member of the team, promoting parity in living wages, providing a career pipeline for further advancement, recruiting from the ethnically and racially diverse communities, full-time employment opportunities with benefits, valuing the CHW and community voice and promoting advocacy among network members The landscape analysis and framework development are currently underway with anticipated completion in August 2022.
The shared opportunity to support CHWs in their roles, educate employers of community health worker capacities/opportunities, develop community health worker sustainability strategies, and align investments across the region for more impactful efforts.