1

Promoting Community Health:

Certification for Community Health Workers

State of Asian Women’s Health MA May 14, 2015

Terry Mason, Consultant, DPH Office of Community Health Workers

Niem Naykret , CHW, Lowell Community Health Center

2

Answer the following questions:1. Who are community health workers (CHWs)?

2. How do they build connections among communities and health care & public health organizations?

3. What will certification for community health workers look like in Massachusetts?

4. Why should and how can CHWs become certified by the state?

Objectives of Presentation

3

American Public Health Association definition:frontline public health worker who is a

trusted member of and/or has an unusually close understanding of the community served,

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.

Who are community health workers?

4

CHW also builds individual and community capacity by increasing health knowledge and self-sufficiency through

activities such as outreach, community education, informal counseling, social support and advocacy.”

Definition of CHW cont’d. . .

5

Massachusetts Department of Public Health definition

CHWs are distinguished from other health professionals because they:

Are hired primarily for their understanding of the populations and communities they serve;

Conduct outreach a significant portion of the time in one or more of the categories above;

Have experience providing services in community settings.

CHW definition cont’d. . .

6

How do community health workers connect communities to health organizations?

7

Education and outreach

By bringing education, information, and support

to people’s homes.

8

Connecting with people in community settings

9

Bringing help and support beyond the walls of health organizations

10

CHWs often work as part of teams in clinical settings today

Culturally aware, responsive support for improving self-management of chronic diseases

Helping get needed social support and services from community organizations

Diversifying the workforce

11

CHW Umbrella: outreach worker, family advocate, promotore, patient navigator, community educator, etc.

12

Challenges: unreliable low wage positions, lack of recognition, respect

Massachusetts Association of Community Health Workers (MACHW)

MA Dept of Public HealthCHWs and allies1. Organized forums to

discuss state certification possibilities

2. MACHW and DPH wrote legislation for a Board

3. CHWs and allies worked to pass it –it passed in 2010!

13

Located in DPH Division of Professions and Licensure (though is NOT a license)

Chaired by DPH Commissioner or designee—4 of 11 members required to be CHWs

additional members, appointed by governor MACHW nominates 4 members (eligible for

certification) Mass. Public Health Association Mass. League of Community Health Centers Mass. Association of Health Plans Single reps from: CHW training program,

community based employer, public

Statewide geographic representation required

CHW Board of Certification established –began work 2012

14

Establishment of standards and requirements for:• Certification of individual CHWs, including

a grandparenting option• Approval of CHW training programs• Certification of a CHW tier for CHW

trainers• Renewal for all three • Individual certification is VOLUNTARY (title

act, not practice act)

CHW Board of Certification Authority

15

Objectives & Concerns of CHWs and Allies Influenced Draft Regulations Created

OBJECTIVES: Be inclusive, not exclusive:

voluntary certification

Create core competencies that help define the field

Set standards for training of CHWs around the state

Provide a credential (state certification) which is respected across employers

CONCERNS (AVOID): Barriers for dedicated

community members with strong CHW abilities, including non-English speaking

Overly academic training and eligibility

16

• Core competencies defined by board, based on statute:

#1: Outreach Methods and Strategies#2: Individual and Community Assessment#3: Effective Communication#4: Cultural Responsiveness and Mediation#5: Education to Promote Healthy Behavior Change#6: Care Coordination and System Navigation# 7: Use of Public Health Concepts and Approaches#8: Advocacy and Community Capacity Building#9: Documentation#10: Professional Skills and Conduct

REGULATIONS DRAFTED:

17

• Two pathways (one temporary):– Successful completion of 80 hr core

training + 2,000 hours work experience as CHW

– “Grandparenting” (experience only pathway, 4,000 hours work experience, available for first 3 years only)

• Good moral character• Documentation of mastery of

competencies– 3 professional references

REGULATIONS DRAFTED:

18

• Current range for core training in MA: 45-55 hours

• State certification will require 80 hours of core training: • 80% core competencies (64 hours) • 20% special health topics (16

hours)• Flexibility in curriculum design and

delivery• Based on interactive learning

methods• CHW trainers will be required in

training teams

Training Program Draft Regulations

19

Draft regulations completed (Jan 2015) √

Administrative review followed by 35-day public comment period (2015)

DPH staff developing applications, standards of conduct exam, flyers, publicity

MACHW to conduct regional meetings to get CHW input & prepare CHWs for how to apply

Certification becomes operational in 2015

CERTIFICATION TIMELINE

20

• Mass. DPH Office of CHWs:– shttp://www.mass.gov/eohhs/gov/de

partments/dph/programs/community-health/primarycare-healthaccess/healthcare-workforce-center/comm-health-wkrs/

• Mass. Board of Certification of CHWs:– http://www.mass.gov/eohhs/gov/dep

artments/dph/programs/hcq/dhpl/community-health-workers/about/

FOR FURTHER INFORMATION

21

Caitlin Allen MDPH Office of Community Health Workers

caitlin.allen@state.ma.ua(617) 624-5486

Jackie ToledoMassachusetts Association of

Community Health Workers (MAHCW)jtoledo@cmahec.org

508 756-6676 (ext. 25)

CONTACT INFORMATION