Clarence and Stan chat with Angela Fields, Kristin Godfrey Walters, and Nasadir Mohamed about the scope and importance of Community Health Workers. Angela Fields - Associate Executive Director of Minnesota Community Health Worker Alliance - has a career in working throughout the community to expand community health relations. Similarly, Kristin Godfrey Walters - Community Health Worker Training Program and Community Engagement Director for the Health Promotion and Chronic Disease Division of the Minnesota Department of Health - plans, implements, evaluates, disseminates information, and recommends policies and practices to support the enhancement of the Community Health Worker workforce in Minnesota. Lastly, Nasadir Mohamed - Community Health Worker Training Program Data Coordinator - directs data coordination and program management by developing, implementing, analyzing, interpreting, and reporting on assessment and evaluation activities for the training program.These three folks bring an array of knowledge and experiences to community health work. More about the Minnesota Community Health Worker Alliance can be found here: https://mnchwalliance.org/More about the Community Health Worker Training Program can be found here: https://mnchwalliance.org/community-health-worker-training-program/Join the conversation at healthchatterpodcast.comBrought to you in support of Hue-MAN, who is Creating Healthy Communities through Innovative Partnerships. More about their work can be found at http://huemanpartnership.org/
Hello, everybody. Welcome to Health Chatter. Today's episode is on community health workers. And boy, we have a great group of guests today. Actually, this is the first show where we've had multiple guests. So this is going to be a first, but it will be really good. So stay tuned. We'll introduce everybody in a second.
We have a great group that helps us make these health chatter productions successful. And without them, Clarence and I would be lost for sure. Maddie Levine-Wolf, Aaron Collins, Deandra Howard are our researchers, put together excellent information for us that guides our thinking today. and our questions and comments for all our shows. So a true thank you to them. They're second to none.
Our production manager is Matthew Campbell. He makes sure that the shows are put out for you, the public, the listening audience. And he makes sure that everything is edited properly and sounds really, really good. So thank you to Matthew. Sheridan Nygaard is our... a marketing guru that helps us get the shows out to more and more people. So thank you to her as well. My co-host is Clarence Jones.
He and I are having a lot of fun doing this. We chat a lot, whether it be on the show or off the show. You guys have no clue how many times we might talk to each other, at least during the week, about various things. So he's a Really one of my dearest of dears as far as colleagues. And he's a great friend as well. So thank you, Clarence, as always. It's great, great, great, great.
And then there's Human Partnership, who's our community sponsor for this engagement, for Health Chatter, for all our engagements. Wonderful group. in the Twin City metropolitan area that provide useful community-oriented health information for the public. They're a great organization. We encourage you to look them up on our website that has a link to their website.
By the way, you can look up our website at healthchatterpodcast.org. So thank you to everybody. So today we're doing a show on community health workers. For our listening audience, many of you might not even know what a community health worker is or how to utilize their talents. And believe it or not, the United States has kind of slow on the uptake.
Community health workers are very, very common in other parts of the world, which we'll talk about for sure. So what I'd like to do is have each of our guests, we have one, two, three, four guests with us, five guests with us today. So I'd like to have each of them introduce themselves. So Rachel, you go first.
Hi there, my name is Rachel Stahl and I am a community health worker. I currently work as the program manager for the HRSA program, the community health worker training program funded by HRSA for the Minnesota Community Health Worker Alliance. I also work for the Minnesota community, the Winona Community Hub in Winona, Minnesota, which is also a program that utilizes community health workers.
Wonderful having you. Kristen.
Hi, everyone. I'm Kristen Godfrey Walters, and I'm the Community Health Worker Training Program Director at the Minnesota Department of Health, where I work with this fabulous team of community health workers.
And I've also had the opportunity to work with community health workers for many years, where I previously worked at a safety net hospital and clinic system, implementing community health worker programs and services. So happy to be here with this wonderful team.
Thank you. Thank you. Thank you. Angela.
Hello everyone, my name is Angela Fields and I'm a community health worker, but I'm also the Associate Executive Director for the Minnesota Community Health Worker Alliance, where I oversee daily operations of the organization and also serve as a community engagement manager. leading and coordinating community engagement efforts and communication with stakeholders and partners of the Alliance.
I have extensive experience working alongside communities and families, helping them find solutions to address health and social inequities.
Thank you. Thank you. And thank you for doing it again.
Hello everyone, my name is Vani Howard and I'm a community health worker as well. Right now I am self-employed working on several contracts, one of which is the Minnesota CHW Alliance HRSA grant coverage. I'm the field experience apprenticeship coordinator and I have been a CHW since 2008. Some of the roles that I have held are
As far as the healthcare field, I have worked with people with mental health conditions, chronic health diagnoses. I came to the profession with a rich background in healthcare. I am also a doula, and so I'm learning and growing in that area as well. And it's great to be here to be part of this discussion today.
Thank you. Thank you. A doula as well. Wow. We could do a show on that. We should think about that, Clarence. We could do it.
You know what I'm saying? By the way, Stan, I am a doula as well. You're a doula as well. Okay.
Hold on. We're going to get to you in a second. Just so you know.
Just so you know. Okay. So whenever you're ready, Von D, we will be ready. Okay.
All right. Okay. Got it. Got it. All right. Nazadeer.
Hi everyone, my name is Nassadeer Mohammed and I am the data coordinator for the CHWTP at the Minnesota Department of Health and
I have worked as a CHW for about six to seven years. And with majority of my CHW career has been with WellShare, which is a nonprofit organization. And during that time, I have partaken and worked in numerous programs and projects throughout.
And I'm honored to be on this discussion this morning. Thank you.
Thanks. Thanks to everybody. So Clarence. All right. So I'm going to push it over to you, Clarence, because lo and behold, Clarence is, you know, besides a great colleague, he's also a community health worker. He's also now a doula, which I didn't know. Okay.
For a couple of years. I'm a fatherhood doula, which means that I don't do the birthing stuff. I just help the men get through the process and understanding the process.
Wonderful.
All right.
But it never, I'm always amazed because every time I talk to Clarence, he always gives me another surprise. So today the surprise is doula, but we're talking about CHWs. So Clarence, I'm going to let you kick it off, okay?
So I think you kind of talked about this, Stan. A lot of people do not understand what a CHW or community health worker is. And so I'd just like some of our guests to just explain to our audience what exactly is a community health worker. And- and tell me some of the other names that CHWs use.
Who could do that? How about Angela? How about you Doris?
I can do that one. Well, a community health worker is a frontline public health professional. We serve as liaisons between medical and social services and systems and the community. So we advocate for change and cultural competency of services delivered to those communities, as well as help improve access to care and the quality of care.
And being that frontline health care professional, we build trust, lines of trust between those communities that are usually underserved. And so these trusting relationships helps us establish a streamlined system of care for those in those individual populations. Community health workers is an umbrella term for community health workers.
We're commonly called CHWs, prematuras, community health representatives, outreach workers, and the list just goes on and on. It's about 50 names listed for us. Some health systems have exclusive names for the community health worker, such as system navigators, patient liaisons, and there's a caveat of names.
So, you know, interesting enough, I think, Stan, you mentioned this, is that other countries have been utilizing CHWs a long, long time. I spent some time in Africa and I spent some time with some oral health CHWs. So there's a variety of ways in which CHWs are engaged in the community. And so what I wanted to do was to just talk about how do you bridge the gap?
You know, you talk about you are a bridge. How do you bridge the gap between the community and the medical professions?
I would say that community health workers are often from the communities that they're serving and they're real experts at being able to sort of speak the language of the medical and social service communities and also speak the languages of their communities, whether that be a language besides English or just a way of speaking, way of understanding the world. And so
they kind of help people in the community understand the systems. And I think at our best, we also help those systems understand those communities and how to best serve them. So we can sort of advocate for both and help those places understand each other so that those providers can really do work at the top of their licenses and can serve the communities more effectively.
Because I think a lot of times... professionals who work in health or social services really, really, really want to do right by their patients and by their clients and by participants in their programs, and they may just not be able to understand how to do that.
So community health workers can sort of translate between different ways of seeing the world, different ways of speaking, different ways of understanding.
Here's a kind of getting down to the basics of it all. And, you know, and maybe Kristen, you can respond to this one. It's like, okay. I, frankly, I remember distinctly asking my mother who is now passed away, but she was 93 years old at the time. And she was actually kind of spunky in the, in the all nine yards, but you know, she needed help. assistance of sorts.
And I asked her at that time, I said, Mom, how about a community health worker? And she looked at me like, you know, excuse me, what the hell is a community health worker? Okay. She had absolutely no clue. So it's obvious that all of you on this show know what it is. Okay. But does everybody else know what it is?
And to the point of even, you know, even for myself, I could ask myself, okay, I know, I know what you guys do, but How is it that a patient or just an individual knows to even ask for assistance from a community health worker? That's of course, if they know what a community health worker is. So maybe Kristen, you can reflect on that a little bit.
Sure. Sure.
And I'll welcome others to chime in as well, but I would say right now, at least the current state in Minnesota, in the structure of, uh, of, of community health workers, for example, in a healthcare system, it's usually the provider or the community health worker themselves doing identifying the patient and kind of doing the outreach or introducing themselves, um, you know, community organizations, um,
do a similar things or insurance companies where they may be identifying patients either based on that individual relationship, understanding what barriers or challenges that a patient or our member or community member may be having. So it could be kind of from the provider perspective
or looking at systems information to see, oh, that all of these, this group of patients has diabetes and could benefit from a community health worker. So in kind of current state, it's usually the, again, the clinic, the provider,
the insurance company, the nonprofit community agency kind of identifying either individuals or groups of individuals and connecting the community health workers or having the community health workers make connection through outreach and relationships. And so I don't know that we're in a place yet in Minnesota where an individual, a patient, your mom may know to ask
or say, hey, I could utilize the assistance of a community health worker. And that's something that we're hoping that we're working on in this grant work that we're doing together between MDH and the Community Health Worker Alliance and other partners.
and just the alliances doing in the state in general is to really try to build the community health worker workforce so that there's a larger workforce and to build the awareness of who community health workers are and how to connect with them. But I would welcome anyone else if there's other perspectives here as kind of the current state in Minnesota.
But right now, I think that's the landscape that I'm familiar with.
So Vanya, what do you think about that?
I think that Kristen is exactly right as far as the approach and how accessing community health workers. The one thing that I want to add is even in my work as a doula, I have asked folks if they have heard of a community health worker.
And when Angela gave some of the titles earlier, they may not specifically know community health workers by that specific title, but they may know a community health worker who's working in
a role where they're the patient navigator or they're the resource connector or some other title other than a community health worker because a lot of times after getting to know both in and outside of the doula world, it becomes apparent that they have in fact connected with someone who helped them through a role that is a community health worker type of role.
I said, dear, what do you think? Anything you want to add to that?
Um, I mean, uh, majority of the points, uh, Kristen, um, have basically touched based on it, but yeah, but I mean, uh, when I was starting off as a CHW, um, it was like a very new field and, um, and, you know, and position, um, in the community itself, but being in it for, for, for quite some time, I feel like that itself has basically, um,
came up in the works and has gotten a lot of recognition and is still getting a recognition in the midst of all this. And even within today, just this current time that we're in, that's the whole thing that we're working towards at is basically to get that recognition out for CHWs more in the community for individuals to kind of know that CHWs do exist.
I mean, like how Angela and Vanya has stated that people might have worked and been assisted by a CHW, but under a different title. So technically that, you know, they may have been assisted or they might have, you know, collaborated with other individuals, but not under maybe the CHW title.
But I mean, that's the whole purpose that we're on here today is to get that word out, to get that recognition out to let the community know that CHWs do exist and that we're basically here to help.
So Clarence, you're one. You're a CHW. What do you think about all this?
I think, you know, quite honestly, my honest opinion, and I've said this before, I even had, it was on this show. I think CHWs are some of the most underutilized health professionals in our community. That's what I honestly believe. But I think that there are, you know, I want to get, I want to get, more clearer or dig deeper in this whole thing around barriers to the CHWs.
I mean, because I think a lot of times we are very political in terms of how we describe some things, but what are the real barriers for community health workers in terms of being recognized and being utilized more in our communities? So you've got to be politically correct. We just, this is health chatter. let's just talk because this is important. This is important.
Yeah. So, you know, there are a lot of political realities around this. One, one question that public might have is centered around kind of the politics of it all. If you want to call it, that is like, okay, are, for instance, CHWs licensed, you know, like a medical doctor or a nurse or whatever, or are they registered or are they, and how, How are they trained?
And to the point whereby a patient or an individual needs to have, or at least would think that they need to have that kind of information in their head in order to bring their trust level up a notch in order to be able to work with a community health worker. So Angela, what do you think about that?
Stan, let me add something to this real quick. Are you perceived as competitors? The scope of practice issues, yeah. Yeah, let's talk about that as well.
Okay, so let's talk first thing about training and licensing and all that kind of stuff, and then how your scope of practice as a field differs enough so that people can help, you can help people make that distinction. So training and education, all that stuff, let's start with that first. Angela?
Yes, CHWs follow a core competency that supports our activities that can be applied throughout our continuum of care. So we help individuals navigate social and health systems by linking them to appropriate services. So we are, it's a certification, it's a certificate program offered at various health institute, I mean various colleges throughout the state of Minnesota.
And so it's a 16 credit, oftentimes program. And so we follow a scope of practice. And so we have a very distinct practice that we follow under our certificate. And so we help workers train, we are healthcare workers that are layman people. to be honest. And so it's those shared life experiences that we share with the community that helped build out our scope of practice.
And so we work with a multidisciplinary team of licensed healthcare professionals. So we're not a competitor. And so we provide a mixture of basic health care to patient services in the settings such as the hospitals, clinics, schools, physician offices, nursing care facilities, and even patients' homes. And so we're also in behavioral health settings, and so we're our support workers.
So we're not a license holder. So we work with licensed professionals, such as various clinicians, licensed practitioner doctors, nurses, social workers, case managers, and such. So we are that support workforce. And so we work also include peer support counselors, mentors, outreach workers, social service aides, and even substance use disorder and recovery.
So we work in those capacities and we align ourselves up with these clinicians, as Rachel was saying, to allow them to work at the highest of their licensure. So they are the delegating professionals that delegates a task and it's all organizations specific. And so we work within the scope of practice to make sure that we are in compliance of our training.
So we bridge the gaps between communities and health and social systems. We navigate health and human services and social services. We advocate. So we're that advocating piece for our clients to provide a two-way system of communication from the community to the providers, as well as the providers to the community. Because most oftentimes in clinics and organizations,
The clinical practice stops at the front door. Community health workers go beyond the clinical and organizational walls. So we're those grassroots professionals, the boots on the ground. We're out there in the community and we meet the community where they are.
Got it. So, yeah, Rachel, chime in on this one.
Yeah, I really think that often people, when they go to their doctor or even the therapist or any other licensed professional, they get recommendations from those professionals. And it's often very difficult for any of us to understand how to take those recommendations and apply those to our lives. And there really isn't enough time in the clinic for a provider to to really go there with someone.
And so, you know, your doctor will tell you you need to get exercise. And one of our clients or patients or participants in our programs might think, well, I don't have tennis shoes. I don't have a membership to the gym. I don't understand what you're talking about. I have all these things going on in my life. I don't have time for this, whatever.
And the community health worker can sit down with them and say, hey, what are you already doing? You're already taking your dog for a walk. That's awesome. What if you just went a little bit further? Sort of saying you don't need to join a fancy gym. You don't need to buy any new equipment. Let's talk about how you can get more active in your life in a way that actually works for you.
And so the community health worker isn't recommending exercise, the community health worker is taking the recommendation from the provider and really translating it to the real life of the participant.
So it's that deep knowledge of where a client patient participant is coming from and sort of that empathy and listening and time to say like, hey, everybody can get a little bit more activity in their day. Let's talk about it. Let's make a plan that can really work for you. And then I can provide support and accountability
And then tell your doctor what you're doing, because often a lot of times people don't know how to tell their doctor like, hey, I'm actually I made these changes and it's going really well or I made these changes. And here's a question I have. So also helping the person, you know, plan for their appointments with their doctors and say, like, here's what I've done since our last appointment.
Here are the questions I have. And so it's really that translating recommendations from from licensed providers.
Let me ask you something. Are community health workers ever hospital-based or are they more at the clinic community level? Let me give you a for instance. Okay. So I see orthopedic patients and You know, from time to time, some of these patients need help instead of going home, going to a transitional care facility. Is that an intervention point for a community health worker or not?
So maybe Vanya, you can answer that or help us with that one.
Community health workers really are everywhere. The hospital and clinic setting is very common for community health workers to be at. Me personally, I started my community health worker career out at a community agency that did home visits.
So everything that Angela talked about, everything that Rachel talked about, kind of being those boots on the grounds, the eyes and ears for the patient to be able to communicate some of those concerns. Why isn't the patient making it to their doctor's appointments? Well, because... Have the funds. Why didn't the patient pick up their prescriptions? Well, because they don't have the funds.
Rent is more important. So we're at many different levels, but I feel like when you go into the patient's home and like Rachel was saying, spend that necessary time to get
deep down into what the real issues are and the barriers are for access to healthcare and access to services is where we can really help people the most and kind of take away, as Clarence mentioned earlier, that competitive piece. And so I've been fortunate as a CHW to not have felt that in any of the workplaces that I've worked in, but I've definitely heard about it.
And I feel like accessing a community health worker, wherever there's a need, even if it's at the local government assistance office, wherever that need is, we need to be meeting people in the community where they are, where we can spend that time to get acquainted with them, spend that time to build the trusting relationships, because that's where the real work is done once that trust is built.
Yeah. So it seems to me, hold on one sec, Clarence. So it seems to me the point of contact for a particular patient, at least right now, and you hope that it morphs broader, but at least right now is through a healthcare professional themselves. Am I right or not? In other words, like a physician or a nurse says, you know, Stan, you know, let's say I'm a patient, Stan, you could really
be helped by utilizing a community health worker as opposed to me, Stan, knowing that I want a community health worker because I might not know what they are yet. Is that fair or are we morphing more towards everybody kind of knowing? Go ahead, Angela. I see the hand up on that one.
That's the common avenue that CHWs were utilized initially as the profession was emerging. But as Vanyi and Rachel were saying, we're everywhere. And so the question is, where do you find community health workers? You find us in state and local governments. You find us in clinics and hospitals that are common.
You find us in outpatient care centers, nursing insurance companies, nursing care facilities, nonprofit and community-based groups and organizations, faith-based groups. So we're all over the place. We're in barbershops, we're in beauty shops, we're in oral health, we're in senior health. And so it's just those role titles that we work up under.
So you may not know that you've encountered a community health worker. MNsure uses community health workers as MNsure navigators. So it's various areas that CHWs can be utilized in. And so it's not commonly through clinical. If I can speak on that, prior to becoming a doula, she worked in a governmental setting. And she can tell you a little bit about her work as a community health worker,
an adult guardian.
Yeah. Okay. Go ahead, Vanya. Yeah.
Yeah, as Angela mentioned, that was a very different role that I had never heard of, a community health worker holding a title as a public guardian. My role was to support folks who are developmentally disabled and they also happen to be seniors. So they had developmental disabilities as well as some of those chronic health conditions, the high blood pressure.
And as you can imagine, they needed a lot of support. They had supports that were set through group homes and my role was to collaborate with the group homes, with the work readiness programs, with the transportation, and make just huge life decisions on behalf of these people as far as what was best for them. So yeah, we're everywhere and doing a lot of different things.
And it just depends on where that person is. For instance, I also used to work for another agency that did support for seniors coming out of the hospital. Now they had to be coming out of the hospital, being discharged to home. And my role was to go out and support them to prevent a rehospitalization.
So they would not have otherwise been able to access a community health worker for those specific services had they not been hospitalized and then returning home. So if they were going to a nursing home, then they would not have access to me. They would have just gone into the nursing home. But since they were returning
to their home, then now they need, we need to go in and do a false risk assessments. We need to find out if they have food for proper nutrition. Again, all of these things that would help to prevent a rehospitalization.
Yeah. Okay. So Ms. Muhammad, I want to ask you this question. What do you really, really enjoy about being a community health worker? I remember I said, what do you really, really enjoy about being a human health worker?
What I really enjoyed when I was working as a CHW with that nonprofit organization was the fact that I was an advocate for the community that I represent, which is basically the Somali community. So working as an advocate for such a large community and knowing that Minnesota basically holds one of the largest Somali population in the United States.
So coming across different individuals of different ages needing assistance, whether it was in the clinics, in the hospitals, whether it was inpatient, outpatient care, whatever it was, whether it was Just, you know, health prevention overall, whether it was just just advocating for them and and and other ways of like assisting them, whether it was with housing with food with.
There was just like the the assistance that I was doing as a CHW within the Somali community was very, very large and it was very like a broadened aspect of a lot of things and. And just knowing that I was able to kind of assist them with every need that they basically have was one of my biggest and my most enjoyable thing that I worked as a CHW.
Because even within the communities that we were serving as a CHWs, and even with my previous colleagues that I was working with, and they were from the Oromo community, they were from the Hmong community, they were from the Hispanic community. So, so many CHWs come from different ethnics and backgrounds.
And knowing that a lot of people are being assisted and a lot of CHWs from different backgrounds are being utilized, knowing that we're able to give back to the communities that we represent and that we're from is one of the most enjoyable thing that a CHW could really attest to.
You know, for our listening audience, Minnesota is kind of historically pretty much on the cutting edge of community health worker engagement. Although it took a while. I remember back in 2008 when I was at the health department and we got a grant from CDC on how it is that we can use community health workers in a clinic setting in order to engage those that need help with blood pressure control.
So I remember that distinctly. And then it got to the point, it was really interesting. It got to the point where everybody kind of understood what a community health worker was and how they can help.
But then, you know, the grant was done and then all of a sudden it says, well, wait a minute now, if we have a choice, this is the clinic talking now, if we have a choice of hiring a nurse that can maybe cover that kind of stuff or a community health worker, now keep in mind, this was 2008, we've got to choose a nurse.
And then linked to that, which is the question I'm getting to, is the idea of reimbursement, which was not in the queue at that time. Fortunately, in the state of Minnesota, you can get Medicaid, if I'm not mistaken, Medicaid reimbursement. But let's talk about how it is that, frankly, you guys get paid. Is it through insurance? Is it through...
a person just paying you individually, how is it that you guys are paid? Is it through a referral system from a doc or a nurse who refers you? And then consequently, they can put it into the billing, et cetera, et cetera. How is this all kind of work? Who can tackle that one? Kristen, take a stab at it.
All right. Well, I'll take a start and then pass it on to Vani or others. So I think in general, um, community health workers in Minnesota are employed by organizations. Um, like you mentioned, like the healthcare clinic, the, uh, you know, the community organization that, uh, NASA deer worked for.
The county that or the the government organization that money worked for so in general those organizations have to have a funding mechanism to hire a Community health worker and that may be. You know it's usually a mix of grant funding some healthcare reimbursement dollars, which again can only be accessed for. organizations that can bill for healthcare services. And then operational funding.
So usually there's a mix of different funding sources for community health workers. And of course, there's also community health workers in the community that volunteer their time and probably don't get paid for their time or are independent contractors.
So there's a number of other models, but I'd say in general, employers or organizations have to have funding or come up with funding or commit funding to, you know, hire community health workers to, you know, to reach their goals and their mission and their work with patients and individuals.
And as you mentioned, one of the funding sources in Minnesota is reimbursement for patients that are on Minnesota health care programs, clinics or providers that are set up to bill for services. So fee for service can can bill for community health worker services.
However, one thing that we're working on and can talk more about, or the Alliance is working on and can also talk more about, is right now it's a narrow scope of services that are billable. So community health workers complete their academic certificate program, as Angela talked about. So they complete their, they get a community health worker certificate.
They can then apply to the Minnesota Department of Human Services to get what's called an UMPI number, which is a billing number that's similar to an NPI number that a provider would get And then for the organization that they're working for, they need to have general supervision by usually a licensed provider or healthcare professional, which there's a long list of what that includes.
And then the services that are diagnosis-based health education type of services are reimbursable. through the billing and claims system. So it's great that there's reimbursement and it's also a fairly limited scope of the services. You heard all of the services that community health workers provide.
It's kind of a subset of services that are reimbursed and it needs to be in a setting that can be billed to insurance. And right now it's primarily for those that are on Minnesota healthcare programs, which is great, but that may also not be everyone.
So there is, so I guess to kind of sum that up a little bit, as you talked about the organizations that are looking to support, you know, should I hire a nurse or should I hire a community health worker? And, you know, how is the organization going to sustain or maintain that position?
Yeah.
Really, the financing model for the billing isn't going to, you know, right now, likely isn't going to fund the full, a full position if that's what, you know, organization is looking for. And so usually it's, it's a commitment of different sources of funding, and hopefully eventually expanding reimbursement options in Minnesota.
So, so, Rachel, maybe you could give us or somebody that let me point to Rachel, can you give us a perspective for our listening audience of, you know, we've been kind of Minnesota centric on the show so far. What, what's going on nationally? I mean, is this, you know, because we have listeners all over the place. What's going on in other states?
Or are we so far ahead of the game that, you know, we just hope that other states catch up? What's going on for the United States as far as community health workers are concerned?
Well, I would actually kick this to Angela. Angela has been doing work with the National Association of Community Health Workers over the last several months. And so she's a lot more in tune with what's going on on the national level. I hate to put you on the spot, Angela, but do you want to answer that one?
Okay, you said what models has the US used compared to other countries or other what we're doing across the state? Well, CHW is an emerging profession, but we're still on the rise. We are still increasing in numbers across the United States.
I've been fortunate to work on the project with the National Association of Community Health Workers as a representative for, we're considered region nine, the Minnesota region.
um here in Minnesota there's roughly um certified those that have the certificate um there's roughly I would say about seven to eight hundred um community health workers here um but uh there are is a caveat I would estimate of close to maybe 1600 total in the state of Minnesota that our CHWs are working as a CHW but don't hold the certificate
I've had the privilege to work on this project with community health workers from Michigan, Kansas City, Chicago, Illinois, New York, New Jersey, and Puerto Rico and Hawaii. So in Hawaii, community health workers are called aunties or uncles. So that really, that deep rooted community connection. I mean, you know how you feel about your aunt or your uncle.
if you've grown up and you've had in those public figures in your neighborhood that took those leadership roles such as your grandma or your uncle in the neighborhood. So that's how community health workers are utilized in Hawaii. So I'm learning how this scope of practice is pretty similar to our model, but they add those cultural pieces or their geographical specific components.
that are appropriate for the care in those regions. So I'm learning quite a bit of the utilization and the large spectrum of CHWs and how we're being utilized across the board. One of the things that we're working on is to create a national community health worker virtual platform.
So therefore, we'll be able to connect with one another and we'll be able to learn about what is going on in each state across the country because the legislative policies are different and the utilization of CHWs can look different from state to state. And so we want to, I'm curious about how CHWs are utilized in other states and they're just curious about how we're being utilized as well.
And we want to capture all that data in one virtual platform. Also, we want to be emergency responsive and we want to be prepared for emergency. So we want to be able to communicate and have that free flowing communication throughout state to state. So I'm still learning by leaps and bounds.
But it's expanding.
Strategy, yes.
It's expanding nationally, which is cool. So Clarence, I'm going to put you on the spot, although I don't know if this is a spot, but community. I mean, that's kind of a torch that you carry professionally and how to keep conversations going in a community. Obviously, this has a community perspective to it. We have other professions that are having that tagline as well.
Community pharmacists, community paramedics, et cetera, et cetera. And they each have their, shall we say, professional niche of services. But Clarence, for you, it's like... how is it that you're perceiving your community or the communities that you serve, certainly through HUMAN, how is it that you see the people embracing the services of a community health worker?
I think, and I said this before, I think that they're one of the most underutilized resources that we have in our community. My position at HUMAN really is to to create the opportunity to enhance the education and the resources for community health workers. One of the concerns that I had many times is that it's more than the title.
It's a very valuable position in our community that we should ensure that that person who has that title has the necessary resources and abilities to to fully effectively serve the community. So I have a different take on community health workers.
Number one, I value them very, very much, but I'm also very, I'm gonna use the term critical and not in the sense of negativity as much as I am very concerned that they have the best. I know that they're good. I know, I know that they can make a difference and I don't like seeing them, uh, minimized in terms of the work.
And that's really one of the reasons why I got to ask that initial question of mine is that, uh, they are trusted messengers and the ones that are really, really good are the ones I really, really want to work with.
Yeah.
And so that's, that's, that's the piece for me. And that's the piece that you man plays is that, um, we want to be very supportive of those organizations and those individuals that are actually really, really doing the work so that our community can become healthier.
So that's really my- I get it. I get it. You know, for our listening audience, you know, what's kind of an underlying theme that I'm hearing here is this idea of trust. Okay. It's easier. You know, it's like, you know, Angela, you said, don't you trust your aunt? And, you know, it's like even titles sometimes create more trust.
So I encourage our listening eyes to listen to the show that Clarence and I did on trust. And then listen to this show. It's a really interesting segue into, you know, what community health workers can do for us. So last thoughts. So let's start with Nasadeer. I mean, if you, all right, so Nasadeer, we've talked about, you know, how to get people
more information out to the public, et cetera, about how to utilize community health workers, et cetera. But what's one point that you really want the audience to really know?
One point that I would really like to get out to the audience is that is that CHWs are the backbone and to our community, to be honest, when it comes to
um in the health care field um they are among the backbones i mean they're not the only ones obviously i mean we have all different you know health care providers that are the backbone to the community but they are among the ones um because first and foremost um uh in the midst of the covet times i should kind of just kind of uh retracking a bit chws were among uh
you know, those were on the, you know, just like the forefront fighters and that were, you know, working with the nurses and the doctors, you know, out in the field and, working at the testing sites and working at the vaccine sites. And so I just want just the overall community to know that CHWs are a lot more than what they are being ought to be.
And we are here to get that message out, like just loud and clear to the community and just to kind of educate everyone about the importance that CHW is and the roles that they hold and the responsibilities that they basically have. So just know that CHWs do exist and they are the backbone to our community.
So Rachel, besides saying ditto, what might you add to that?
Yeah, I think that the COVID-19 pandemic and the uprisings around the murder of George Floyd really helped people in Minnesota who have access to all the best Minnesota has to offer realize that there are a lot of inequities here in Minnesota and helped show all of us, again, that the health of those who are most affected by negative health outcomes really do affect the entire community.
And so I think this is a really exciting opportunity to capitalize on sort of the things we learned from that and to say, having community health workers on the ground that people trusted embedded in many different communities in Minnesota to help give accurate timely information to communities around the COVID-19 pandemic saved countless lives.
And I think that was at a point where we really didn't have community health workers everywhere that they need to be. And so we have this opportunity right now to
to get community health workers everywhere they need to be so that when things like the pandemic happen, every community in our state can have access to accurate information from someone that looks like them, someone they trust, and that we can all get through those things with less negative outcomes. So I think this is like a very, very exciting time in Minnesota where
sort of people in power and people with privilege are realizing how vital these kinds of roles are and there are is more opportunity more funding more support more momentum. And we can really build up an infrastructure, so that when things get hard again or when there's specific hardships in specific communities, we can really address them. from the grassroots.
So I'm really, really excited about where Minnesota is at right now. And I think that, you know, our team and many other teams are really working hard to capitalize on that momentum and to move the CHW profession forward.
You know, I'll tell you if, you know, going through the pandemic when I was at the health department, If we could have, if there was truly a communication infrastructure that was stronger and in place at the time, utilizing, in this case, community health workers as kind of a conduit, oh my God, we would have been...
at least in Minnesota, I could claim that we would have been in a much better situation. So hopefully, to your point, Rachel, we've learned from that and we can be more proactive going forward when we have those kinds of situations. Angela, last thought here.
My last thought is CHWs, as we said before, we're frontline public health professionals. So we run into situations when others run out. We bridge those gaps between communities and health and social systems. We understand individuals. We understand the communities. We understand the cultural dynamics. We understand how to navigate systems.
We understand the complex relationship with helping our clients and patients learn how to manage diseases and how to create better health because we come from these communities and we've utilized many of these resources that are in our own community. And so our outreach efforts can improve health policy for individuals in underserved areas because we build those communities capacity.
through a trusting relationship. We use encouragement and liaison tactics to help individuals who are seeking care. We keep them connected to their treatment processes. We help them adapt preventative health behaviors. that can result in overall better health, not only for that individual, but for those communities, because they're not straining and taxing those organizations and health systems.
And so there's a proven scientific backing that there's a three to one return on the utilization of a CHW. So that means for $1 invested in a CHW salary, health and social systems saves $3 per client across the board.
It's kind of a slam dunk. Absolutely.
Absolutely.
Let's see. Vanya, CHW doula perspective.
You know, the CHW profession is, to me, miraculous in the way that we can tap into several different trainings and still be a community health worker no matter what the other titles are. Great point.
Great point. Yes.
And so that is really somewhere that I carry a lot of my CHW skills and the things that I've acquired as far as learning and training over the years. I make sure that my doula clients know that I'm also a community health worker. which I think plays into a bit of a more reassurance role for them because I am comfortable going into hospitals.
I am comfortable working alongside doctors and nurses and other staff that maybe a newer doula who doesn't have CHW experience is not able to, you know, be comfortable with right away.
Yeah. You know, these are great points. OK, Kristen. All right. This is your this is your last torch song. Here we go.
OK, well, I'll speak to the leaders, the funders, the administrators and public health and health care and community organizations and government that, you know, as you've heard, community health workers are really a culturally responsive, effective organization. evidence-based workforce with a return on investment.
They play a key role in addressing chronic disease prevention and management, addressing social determinants of health, and reducing health disparities and diversifying the healthcare workforce. So that's my overall kind of plea to the leadership.
And definitely a worthwhile statement. Okay, Clarence. Not only are you my trusted colleague here, but you're also one of them. So let's hear your perspective.
My last word. We run in when others run out, but we need support. We need respect. We need to have the backing of the community. professional community. Our community knows our value. We just want to make sure that other people provide us with the kind of support that we need in order to do a more effective job to make our communities healthier.
Beautiful. I mean, wow. If we could just encapsulate these last lines in a communication piece, wow, wow, wow, right? I want to thank everybody. This has been really educational, and I hope it's incredibly useful for our listening audience. So thank you once again. So everybody on the health chatter lines here, we've got great shows coming up.
We have one coming up on a follow-up on suicide and what's going on in the nation. There was a great report that's just come out from the state of Minnesota. We've got three or four shows coming up on mental health. We have Senator John Marty from the Senate coming on a show to talk about health policy. And then imagine this.
Clarence and I are gonna do a personal reflection on our journey so far on Health Chatter. So these are all great shows coming up. Thanks to everybody and keep health chatting away.
Hi, everyone. It's Matthew from Behind the Scenes. And I wanted to let everyone know that we have a new website up and running, HelpChatterPodcast.com. You can go on there. You can interact with us. You can communicate with us, send us a message. You can comment on each episode. You can rate us.
And it's just another way for everyone to communicate with Stan and Clarence and all of us at the Help Chatter team. So definitely check it out. Again, that's HelpChatterPodcast.com.