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Community Health Workers Aren’t Medically Trained but Help Rural People Manage their Health Care and Their Conditions


Posted: 26 Apr 2017 07:37 PDT
By Melissa Patrick

Kentucky Health NewsAs health advocates at the April 24 Kentucky Voices for Health annual meeting discussed how to reduce health disparities and assure health equity in the state, a model of integrated care that includes community health workers resonated as a possible solution.”I really believe in the community health worker model,” said Keisha Cornett, health education coordinator for the Montgomery County Health Department in Mount Sterling. She added later, “Everything that we’ve talked about, about health equity, community health workers can play a very important role in. The goal is to empower individuals to take an active role in their health care, their health and also in their environment.”CHWs aren’t trained medically, but are trained as patient advocates who come from the communities they serve. They help their clients coordinate care, provide access to medical, social and environmental services, work to improve health literacy and deliver education on prevention and disease self-management. Cornett noted that patients will often tell their CHW things they would never tell their doctor, such as not having adequate transportation to get to the pharmacy or not having enough money to buy their medications. CHWs work to understand what their clients need on an individual level and then meet them where they are, she said. The federal Bureau of Labor Statistics says Kentucky had 710 CHWs in May 2016 with an annual average wage of $38,290. Cornett said some providers have voiced concerns about CHWs providing health education. But she said it’s important to allow CHWs to work at the top of their skill set, adding, “We are just encouragers” who “never go out of the scope of what we can do.”

Montgomery County’s CHW program, called “The Bridge” (“El Puente” for Latino clients) is funded by a federal Health Resources & Services Administration grant and focuses on chronic disease self-management and education. It largely serves clients whose incomes are less than 150 percent of the federal poverty level.

Cornett explained that CHWs connect people to services that help improve their health, like the Kentucky Diabetes Prevention and Control Program, which teaches diabetes self-management, or the Kentucky CARE Collaborative, a heart-disease and stroke-prevention program with a focus on high blood pressure.

Cornett pointed to an ongoing survey that shows clients have reduced emergency room visits; are more likely to have a medical home; have better medication adherence and have shown a drop in their A1C levels, a test for blood sugar.

She said the local diabetes self-management education class recently increased from four participants to 12, and 11 of the participants were from the CHW program. The CHWs have also created a diabetes support group, which they will lead for a month before turning it over to the members.

CHWs recently formed the Community Health Worker Association, which is working with the CHW Workgroup of the state Department for Public Health to standardize training across the state. Cornett said they are getting close to having the certification and curriculum approved.

“CHWs are an evidence-based model to address the health care concerns that we have . . . and really [gets] people involved in their own health care,” she said.

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