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Empowering Communities through Lay Health Advisor Certification Programs

Empowering Communities through Lay Health Advisor Certification Programs Elizabeth M. Whitley, Ph.D., R.N. 911 Medical Response. Denver Health Medical Center. Rocky Mountain Poison and Drug Center. Correctional Care. Denver Public Health. Family Health Centers. Denver CARES.

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Empowering Communities through Lay Health Advisor Certification Programs

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  1. Empowering Communities through Lay Health Advisor Certification Programs Elizabeth M. Whitley, Ph.D., R.N.

  2. 911 Medical Response Denver Health Medical Center Rocky Mountain Poison and Drug Center Correctional Care Denver Public Health Family Health Centers Denver CARES Denver Health Foundation Denver Health Medical Plan Rocky Mountain Regional Trauma Center Rocky Mountain Center for Medical Response to Terrorism School-based Health Centers

  3. Lay Health Advisors, aka Community Health Workers Outreach to underserved communities to • Improve access to health and other services • Promote client knowledge and behavior change through health education

  4. Denver Health (DH)CHW Requirements • Indigenous to community • HS diploma/GED • Desire to serve • Interest in Health • Bilingual preferred

  5. DH Community Outreach target populations • Geographic (i.e., 5 West neighborhoods) • Racial/Ethnic (i.e., Latinos) • Special Populations (i.e., Men)

  6. DH, prior to 2000 • On the job training conducted by DH resource intensive and inconsistent • CHWs lacked basic work readiness skills

  7. DH/CCD partnership • Create, implement and evaluate a standardized academic education certificate program • Provide CHWs with basic transferable skills necessary to succeed in health care workforce and communities • Entry for individuals into health careers and higher education

  8. CHW certificate program • Workplace, academic and vocational skills • 17 credit hours • 1 semester or over 1 year • Clinical internship/field experience

  9. CHW Certificate Program Curriculum • COM 126 Communication for Healthcare • CIS 118 Intro to PC Applications • AAA 109 Advanced Academic Achievement • CHW 120 Community Health Issues • CHW 130 Community Health Resources • CHW 297 Field Experience

  10. The partnership • CCD coordinates and administers program and delivers workplace core • DH obtains grant funding for tuition and fees, helps recruit students, delivers vocational core, arranges field experiences and evaluates the program • Community partners offer field experiences, faculty to teach vocational core and employment

  11. Program Outcome Measures Students must • Complete curriculum with at least a C average • Pass competency based testing

  12. Program Results • Majority female, low income and minority • 30% of those who start drop out before mid-term • 100% of those who have passed courses passed competency based testing

  13. Program Results • Of 20 graduates from first 2 programs, 19 still employed in health work 2 years after earning certificate. • 10 students completed 3rd program and all still employed in health work after 1 year. • 8 students completed 4th program in August 2007. • 5th program began Fall 2007.

  14. Program Results • Program now offered Statewide through Community Colleges • Program being replicated in other states

  15. Financial Effectiveness of CHWs • What is the financial impact of a CHW intervention with a particular population on the health system?

  16. Prerequisites to determining financial effectiveness • Robust evaluation • Database to track CHW activities • CHW participation • Integrated information system

  17. Free Pregnancy Testing (FPT) Return on Investment: • New patients who deliver at DH following free test in 2004 • ROI of 6.9:1.0 • DH increased revenue of $251,680

  18. FPT Conclusions • Increased access to DH services for underserved pregnant women. • Concurrent increase in overall DH deliveries. • New Medicaid insured patients to DH. • Improved prenatal care. • New system revenue of $251,680 annually.

  19. Men’s Health Initiative (MHI) January 1, 2003 – June 30, 2004 • Subset of 590 men • Utilization increased and improved and uncompensated care reduced • ROI of 2.28:1.0 • DH savings of $95,941 annually

  20. MHI Conclusions • Increased access to health care services for underserved men. • Fostered more appropriate use of system. • Decreased total patient charges and uncompensated care. • Saved DH system $95,942 annually.

  21. Acknowledgements • Community Voices is funded by the W.K. Kellogg Foundation and administered by the Morehouse School of Medicine Center for Primary Care • Thanks to Community Health Works of San Francisco for breaking the ground and paving the way.

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