CHW Advocacy and Initiatives: National and Regional Perspectives

1. CHW Advocacy and Initiatives: National and Regional Perspectives Venoncia M. Baté-Ambrus, MS, PhD candidate Director of Workforce Development & Diversity Interim Coordinator WI CHW Alliance Milwaukee Area Health Education Center

2. Definition of CHWs: • A Community Health Worker (CHW) is a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. This trusting relationship enables the CHW to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery. • A CHW also builds individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support and advocacy.

3. APHA’s CHW Section • The Patient Protection and Affordable Care Act (ACA) lists CHWs as members of health care teams. • Increasing Support for Community Health Worker Self-Determination in Training and Credentialing • APHA CHW Section is the national leadership for the CHW workforce

4. Proposed “Policy Statement”: Guidelines for Credentialing • CHWs characterized by trusted status among the communities they serve, vital part of the public health workforce. • Demand for CHWs is expected to increase with implementation of the ACA • Policy is needed to support CHW leadership in determining professional standards, with collaboration from other public health colleagues.

5. Relationship to existing American Public Health Association (APHA) Policy • In 2009, the American Public Health Association (APHA) adopted Policy Statement on CHWs • Description was developed within the APHA CHW Section, with national representation of CHWs and their advocates. • Policy addressed numerous issues related to the community health worker (CHW) workforce. Vital element being a statement that included a definition of CHWs.

6. Proposed Policy Statement: APHA’s CHW Section Certification and Credentialing Guidelines • Encourages local, state, and national CHW professional associations to organize CHWs to develop consensus about the desirability of training and credentialing. • Calls on CHW professional groups to pursue legislation regarding CHW training and credentialing, if appropriate for local conditions, in collaboration with CHW advocates and other stakeholders. • Urges all entities considering creating policies regarding CHW training or credentialing to defer to the desires of local CHWs and/or CHW professional groups. If CHWs and other entities partner in order to pursue policy development, a working group comprised of at least 50% self-identified CHWs should be established. • Encourages any entity drafting new legislation regarding CHW credentialing and training to include in the policy the creation of a governing board comprised of at least 50% CHWs.

7. American Psychological Association (APA) Div. 27: Society for Community Research & Action (SCRA) • Mission: SCRA is an international organization devoted to advancing theory, research, and social action. Its members are committed to promoting health and empowerment and to preventing problems in communities, groups, and individuals. SCRA serves many different disciplines that focus on community research and action. • Vision: SCRA will have a strong, global impact on enhancing well-being and promoting social justice for all people by fostering collaboration where there is division and empowerment where there is oppression.

8. SCRA Guiding Principles • Community research and action requires explicit attention to and respect for diversity among peoples and settings; • Human competencies and problems are best understood by viewing people within their social, cultural, economic, geographic, and historical contexts; • Community research and action is an active collaboration among researchers, practitioners, and community members that uses multiple methodologies. Such research and action must be undertaken to serve those community members directly concerned, and should be guided by their needs and preferences, as well as by their active participation; • Change strategies are needed at multiple levels in order to foster settings that promote competence and well-being.

9. SCRA Public Policy Rapid Response Procedures • The purpose of this process is to provide a mechanism for SCRA to provide a quick response, as an organization, to evaluate and potentially adopt public stances or action plans on public policy issues of a time sensitive nature. • On April 18, 2014 a CHW rapid response proposal was approved and forwarded by a 5 person ad hoc policy committee to the SCRA Executive Committee for formal division level approval. If approved it will be shared with the APA for their approval. • The CHW submission of rapid response CHW proposal was supported by SCRA’s Community Health Interest Group (CHIG).

10. Other National & International Associations Supporting CHWs • American Academy of Family Physicians Foundation supports the Peers for Progress program which accelerates and promotes best practices in peer support as a regular part of health care and prevention around the world. http://peersforprogress.org/ • National Association of Social Workers offers associate memberships to CHWs which entail free chapter membership and access to free or discounted educational products and programs. http://www.socialworkers.org/joinBenefits/associate.asp • Association of Black Cardiologists, Inc. offers free memberships to CHWs which include newsletters, health education materials and annual access to 3 health screening and monitoring events. http://abcardio.org/CHA_advocates.php

11. State Legislation on CHW Certification and Credentialing

12. Region V (IL, IN, MI, MN, OH, WI): Legislation, Policies and Initiatives • Region V: CHW coalition leaders planning a 2015 regional CHW conference • IL: HB 5412 & Basic/Advanced Certificates+Associate degree programs • IN: ISDH Division of Maternal and Child Health developed IN’s first certification for CHWs in care coordination. INCHWA formed Jul 2013 • MI: MiCHWA celebrates CHW Month in August and hopes the rest of the state will, too, as it seeks a proclamation from the governor’s office. • MN: Minnesota CHW Payment Statute (MS 256B.0625, Subd. 49) re: care coordination. First state to have a Deaf CHW Project. • OH: CHW Law 4723-26, CHWs overseen by OHIO Board of Nursing • WI: Conducts CHW, CHW Supervisor & Best Practices in CHW Integration trainings, assists low income CHWs via HPOG & discusses CHW legislation

13. National or Governmental: References and Resources • http://www.apha.org/membergroups/sections/aphasections/chw/ • http://www.scra27.org/about • http://peersforprogress.org/ • http://www.socialworkers.org/joinBenefits/associate.asp • http://abcardio.org/CHA_advocates.php • http://www.abcardio.org/articles/cms_rule.html • http://www.bls.gov/soc/2010/soc211094.htm • http://nationalahec.org/ • http://legiscan.com/IL/text/HB5412/2013

14. Local and Regional CHW Coalition: References and Resources • IL: http://chwnetwork.wordpress.com/ • IN: http://www.chwisc.org/Indiana.htmlhttp://inchw.betterme.info/ • MI: http://www.michwa.org/ • MN: http://mnchwalliance.org/http://www.deafchw.org/ • OH: http://www.med.wright.edu/chc/programs/ochwa • WI: http://www.milahec.org/ • WI HPOG: http://www.wfdc.org/documents/HPOGRandomAssignmentBrochure-7.24.13.pdf

15. Thank you for your interest • Contact information: Venoncia M. Baté-Ambrus, MS, PhD candidate Outreach Consultant Suburban Primary Healthcare Council Access to Care Program 708.531.0680 ext. 236 venonciab@sphcc.org http://www.accesstocare.org/