Transcript Exploring New Job Opportunities as a CHW/CRS

Exploring New Job
Opportunities as a CHW/CRS
CHW/CRS Annual Conference
May 9, 2014
Topics
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What is a CHW?
What is a CRS?
Where are CHW’s employed?
What are the essential skills of CHW?
What are the responsibilities of a CHW?
What are employers paying for CHWs?
Future job outlook for CHW?
Community Health Worker
 Community Health Workers (CHWs) are
frontline public health workers who are
trusted members of and/or have an
unusually close understanding of the
community they serve.
(American Public Health Association, 2008)
Community Health Worker
 This trusting relationship enables CHWs 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.
 CHWs also build 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.
(American Public Health Association, 2008)
Federal Definition
 Community health workers provide a link
between the community and health educators
and other healthcare workers and develop and
implement strategies to improve the health of
individuals and communities. They collect data
and discuss health concerns with members of
specific populations or communities.
 Included in 2010 Standard Occupational
Classifications.
Bureau of Labor Statistics, U.S. Department of Labor, Occupational
Outlook Handbook, 2014-15 Edition, Health Educators and Community
Health Workers.
HISTORY
 In the early 1960's, community health workers
played a significant role in the development of
community health centers and in programs in
many developing countries, promoting
literacy, family planning, immunization, and
other economic development activities.
 While formal participation of community health workers in
health and human services programs in the United States has
been documented since the 1950's, it was not until the 1960's
that the federal government began supporting community
health worker programs as vehicles for expanding access to
health care for underserved communities
Community Health Worker Network of NYC
HISTORY
 By the 1970's, the role of community-based assistance had gained
increasing importance. Despite advancements in healthcare that
improved the quality of care, not everyone was able to access the
benefits of this care due to increasing costs, limited access, and
reduced interpersonal communication between service providers
and their patients.
 To address this lack of access, community health workers were
increasingly employed to serve as sources of advice, information
and support, and bridge the community to the health care service
delivery system.
 Current estimates indicate that there are more than 120,000
community health workers serving communities throughout the
United States.
Community Health Worker Network of NYC
Employment of Community Health Workers by State, May 2013
Bureau of Labor Statistics, U.S. Department of Labor, Occupational
Outlook Handbook, 2014-15 Edition, Health Educators and Community
Health Workers.
CRS
 The CRS is a person in recovery from a mental
health or addiction related disorder. The CRS
provides peer support services, serves as a
consumer advocate, provides consumer
information and peer support for consumers
in emergency, outpatient, or inpatient
settings.
Indiana's Integrated Care Community Health Worker and Certified
Recovery Specialist Training and Certification Program
CHWs and CRSs
 Are Certified Recovery Specialists Community Health
Workers?
 Are all Community Health Workers Certified Recovery
Specialists?
 CRSs are a specific subset of CHWs.
Common Titles
 Community health workers go by many
titles depending on:
 where they work,
 who they work for,
 and what they do.
 Ideas?
Common Titles
 Common titles include:
 Health Coach
 Community Health Advisor
 Family Advocate
 Health Educator
 Liaison
 Promoter
 Outreach Worker
www.explorehealthcarears.org
Common Titles
 Common titles include:
 Peer Counselor
 Patient Navigator
 Health Interpreter
 Public Health Aide.
 In Spanish-speaking communities, community
health workers are often referred to as health
promoters or promotores(as) de salud.
www.explorehealthcarears.org
CHW Titles in Indiana
 Indiana CHW Survey respondents (184) said:
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19% CHW
12% Community Health Educator
6.5% Outreach Worker
5.4% Community Health Representative
3.8% Certified Recovery Specialist, Patient
Navigator, or Peer Educator
 42% Other (In title: 12% Coordinator , 8% Nurse)
Indiana Community Health Worker Workforce
Assessment Surveys. October 15, 2012
CHW Titles in Indiana
 CHW Employers (26) reported:
 46% CHW
 3.8% Community Health
Educator, Certified Recovery
Specialist, Patient Navigator,
Promotor(a)
 39% Other (Health Access
Indiana Community Health Worker Workforce
Workers)
Assessment Surveys. October 15, 2012
Where do CHW’s Work?
Where CHW’s work
 Community health workers (CHWs) often live in the
community they serve. They spend much of their
time traveling within the community, speaking to
groups, visiting homes and health care facilities,
distributing information and otherwise connecting
with local people.
 Some community health workers work in health
facilities, providing case management, client
education, interpretation and follow-up care. Others
are employed by government agencies and nonprofit
groups to provide community organizing, health
education, Medicaid enrollment and preventive care
services in the field.
www.exploreheathcarears.org
Top Industries Employing CHWs
25%
20%
19.1%
15%
14.1%
10%
8.4%
6.7%
5%
5.5%
0%
Individual and
Local
Family Services Government
Outpatient
Care Centers
Hospitals
Office of
Physicians
Bureau of Labor Statistics, U.S. Department of Labor, Occupational
Outlook Handbook, 2014-15 Edition, Health Educators and Community
Health Workers.
Organizational Settings in Indiana
50%
44.8%
45%
40%
35%
30%
29.1%
26.4%
25%
24.5%
20.7%
20.7%
20%
15%
10%
5%
0%
7.7%
1.3%
0.0%
Health Plan,
Managed
Care
Organization
0.9%
Hospital
3.4%
0.0%
Local Health Medium or
Department Large Clinic
CHW's
School
2.7%
0.0%
2.7%
0.0%
Small Clinic State Health
Department
1.1%1.4%
University
Community
Based
Organization
Employer
Indiana Community Health Worker Workforce Assessment Surveys. October 15, 2012
Rural – Urban Distribution of CHWs
in Indiana
216 Respondants
140
120
100
80
60
40
20
0
Metropolitan
(60,000+)
Micropolitan
Small Town (2,500
(10,000 to 49,000)
to 9,999)
Rural (Less than
2,500)
Indiana Community Health Worker Workforce Assessment Surveys. October 15, 2012
Service Delivery Venues for CHW’s in
Indiana
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Community Based Organization (44%)
Clinics (43%)
Community Center (40%)
Homes (38%)
Hospital (38%)
Schools (34%)
Worksites (33%)
Churches (30%)
Indiana Community Health Worker Workforce Assessment Surveys. October 15, 2012
Service Delivery Format for CHW in
Indiana
 One to one (87%)
 Telephone (68%)
 Community meetings or
forums (52%)
 Group class (45%)
 Texting (17%)
Indiana Community Health Worker Workforce Assessment Surveys. October 15, 2012
CHW Skills and Job Duties
Key Characteristics of CHWs
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Interpersonal warmth
Trustworthiness
Open-mindedness
Objectivity
Sensitivity
Competence
Commitment to social justice
Good psychological health
Self-awareness
Understanding
Milwaukee Area Healthcare Alliance
Essential Skills of CHW
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Communication skills
Interpersonal skills
Service coordination skills
Capacity-building skills
Advocacy skills
Teaching skills
Organizational skills
Knowledge base about the community, health issues
and available services
Milwaukee Area Healthcare Alliance
CHW Core Skills by CHWs and
Employers in Indiana
96%
100%
80%
85%
79%
77%
100%
82%
100%
86%
71%
66%
60%
85%
81%
69%
69%
58%
51%
70%
67%
66%
40%
26%
20%
0%
CHWs
Employers
Indiana Community Health Worker Workforce Assessment Surveys. October 15, 2012
ROLES
 Substantial literature exists that examines the roles,
responsibilities, and benefits of community health
workers in health programs throughout the United
States.
 From these evaluations, the majority of researchers
conclude that community health workers have
contributed positively in promoting health and
increasing utilization of services.
 Significant recent studies have focused on articulating
a distinct CHW scope of practice with associated
roles, tasks and skills.
Community Health Worker Network of NYC
Federally Defined Roles
Community health workers do the following:
 Provide outreach and discuss health care concerns with community
members
 Educate people about the importance and availability of healthcare
services, such as cancer screenings
 Collect data
 Report findings to health educators and other healthcare providers
 Provide informal counseling and social support
 Conduct outreach programs
 Ensure that people have access to the healthcare services they need
 Advocate for individual and community needs
Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook
Handbook, 2014-15 Edition, Health Educators and Community Health Workers.
Job Responsibilities
 Helping individuals, families, groups and communities
develop their capacity and access to resources, including
health insurance, food, housing, quality care and health
information
 Facilitating communication and client empowerment in
interactions with health care/social service systems
 Helping health care and social service systems become
culturally relevant and responsive to their service population
 Helping people understand their health condition(s) and
develop strategies to improve their health and well being
 Helping to build understanding and social capital to support
healthier behaviors and lifestyle choices
www.exploreheathcarears.org
Job Responsibilities
 Delivering health information using culturally appropriate
terms and concepts
 Linking people to health care/social service resources
 Providing informal counseling, support and follow-up
 Advocating for local health needs
 Providing health services, such as monitoring blood pressure
and providing first aid
 Making home visits to chronically ill patients, pregnant
women and nursing mothers, individuals at high risk of health
problems and the elderly
 Translating and interpreting for clients and health care/social
service providers
www.exploreheathcarears.org
CHW Roles by CHWs and Employers
in Indiana
100%
89%
85%
90%
80%
70%
60%
89%
80%
77%
62%
62%
56%
65%
58%
56%
52%
46%
50%
40%
30%
30%
20%
28%
19%
29%
20%
Research
Office
Support
10%
0%
Cultural
mediation
Health
Education /
Promotion
Assuring
Access to
Care
Counseling Community
and Support Advocacy
CHWs
Direct
Services
Employers
Capacity
Building
Health Issues Addressed by CHWs in
Indiana
 81% of CHWs reported that CHWS work on
defined health issues.
 Top 5 Issues Reported by CHWs:
 Diabetes (44%)
 Nutrition (39%)
 Tobacco Control (37%)
 Mental Health (31%)
 High Blood Pressure (30%)
Indiana Community Health Worker Workforce Assessment Surveys. October 15, 2012
Most Pressing Needs of Those Served
as Identified by CHWs in Indiana
 Health Information (77%)
 Disease Management (66%)
 Social Support (58%)
 Transportation (47%)
 Employment (54%)
Indiana Community Health Worker Workforce Assessment Surveys. October 15, 2012
Compensation Data
Annual Mean Wages of CHWs by State, May 2013
Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook
Handbook, 2014-15 Edition, Health Educators and Community Health Workers.
Percentile Wage Estimates
Percentile
10%
25%
50%
(Median)
75%
90%
Hourly Wage
$9.96
$12.91
$16.64
$21.78
$28.31
Annual Wage
$20,720
$26,860
$34,610
$45,310
$58,890
Industry
Hourly Mean Wage
Annual Mean Wage
Individual and Family Services
$15.25
$31,710
Local Government
$19.14
$39,820
Outpatient Care Centers
$16.50
$34,320
Hospitals
$21.82
$45,390
Offices of Physicians
$17.08
$35,530
Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook
Handbook, 2014-15 Edition, Health Educators and Community Health Workers.
CHW Wages Paid as Reported by
Employers in Indiana
40%
36%
35%
30%
24%
25%
24%
20%
15%
10%
8%
8%
5%
0%
No
$7.25 to $10.00 $10.01 to $12.50 $12.51 to $15.00
compensation
More than
$15.00
Indiana Community Health Worker Workforce Assessment Surveys. October 15, 2012
CHW Workplace Benefits as
Reported by CHWs in Indiana
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
81%
77%
72%
65%
59%
14%
14%
10%
Indiana Community Health Worker Workforce Assessment Surveys. October 15, 2012
CHW Job Outlook
Job Outlook
Job Growth 2012-2022
 Employment of CHWs is
projected to grow 25% from
2012 to 2022, faster than the
Total, all
average for all occupations.
occupations
 Growth will be driven by
efforts to improve health
outcomes and to reduce
healthcare costs by teaching Community Health
Worker
people about healthy habits
and behaviors and
utilization of available
0%
health care services.
11%
25%
10%
20%
30%
Bureau of Labor Statistics, U.S. Department of Labor, Occupational
Outlook Handbook, 2014-15 Edition, Health Educators and Community
Health Workers.
Job Outlook
 As healthcare costs continue to rise, insurance companies,
employers, and governments are trying to find ways to
both improve the quality of care and health outcomes,
while curbing costs. One way is to employ CHWs, who
teach people how to live healthy lives and how to avoid
costly diseases and medical procedures.
 CHWs help people understand how to manage
their condition and avoid unnecessary trips to the
emergency room.
 CHWs help people understand how what they do
affects their health.
Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook
Handbook, 2014-15 Edition, Health Educators and Community Health Workers.
Job Outlook
 For many illnesses, such as breast cancer and
testicular cancer, finding the disease early greatly
increases the likelihood that treatment will be
successful. Therefore, it is important for people to
know how to identify potential problems and when
to seek medical help.
 The need to provide the public with this kind of
information is expected to result in an increased
demand for community health workers.
Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook
Handbook, 2014-15 Edition, Health Educators and Community Health Workers.
Job Outlook
 Federal health reform will increase access to medical
care, such as preventative screenings.
 Community Health Workers will be needed to direct
patients in obtaining access to healthcare services.
 In addition, a number of state and local programs
designed to manage conditions such as diabetes and
obesity include community health workers as part of
intervention teams.
Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook
Handbook, 2014-15 Edition, Health Educators and Community Health Workers.
CRS Specific Job Outlook
 There is a strong need for workers specializing in the
mental health field. Over the next six years, jobs in the
mental health professions are projected to grow 37
percent. And those new jobs don't necessarily require
advanced degrees.
 There are many entry-level jobs that require an
undergraduate degree or GED. Entry-level jobs are in
demand because of demographic and policy changes —
such as patient navigators and community health workers.
 Psychiatric rehabilitation professionals are focused on
working with people with various mental health conditions
so they can really be in the community — to live, to work,
to socialize, to move back into the community and have a
regular life there.
Health Care Industry Week highlights demand for jobs in
mental health. April 9, 2014 NJBIZ
CHW/CRS: The Future’s So Bright…