When unhoused, uninsured or people without a regular clinician need medical care, they often go to the emergency department (ED) or call 911. The cost of these visits and strain on ED staff is significant, and many visits are preventable. But in many communities, our health care system is not well-suited to provide the support these individuals need to navigate their care effectively and access the services they need.
Enter the community health worker (CHW), a critical partner in the care system who provides individuals the resources they need to prevent repeat ED visits. By connecting people with housing, mental health and other social services while at the hospital, CHWs help keep them safe, out of the ED and on a path to better coordinated medical care.
We know that, for people experiencing homelessness, having a kind, compassionate person they can trust and talk to about their needs can make all the difference. In Los Angeles, Providence Little Company of Mary Medical Center has been working to train and hire more CHWs to perform these essential services in clinical settings so they can help the most vulnerable navigate services and get the care they need.
While CHWs in Greater Los Angeles provide crucial one-on-one support to community members in need, most CHWs do not have many opportunities for continuing education or formal training to develop their careers in the health care industry. Providence saw this gap and has focused resources and energy on building partnerships to more effectively incorporate CHWs into clinical settings.
With support from Cedars Sinai Medical Center and a grant from the California Governor’s Office of Business and Economic Development, Providence partnered with the Charles R. Drew University School of Medicine and Science (CDU) to create the Community Health Worker Academy in 2019.
CDU is one of the most ethnically diverse four-year private nonprofit colleges in the U.S. It is designated as a Historically Black Graduate Institution and is the only academic health sciences center in Los Angeles. Due to its diverse student population reflecting the community’s demographics and its commitment to reducing health inequities, CDU was Providence’s ideal community partner to co-develop a health care training program centered around social justice.
Providence approached CDU in 2018 to partner on a program that would provide career development for people interested in health care and build a pipeline of trained CHWs prepared to support the greater community. From 2019 to 2020, Providence caregivers and CDU professors created the evidence-based curriculum for CHW interns, with plans to launch its first cohort in January 2021. As full-time, paid interns, CHW Academy trainees learn about care management, receive onsite training in a Providence clinical setting or with a partner health care organization, and graduate well-prepared to care for patients.
With more than 200 applicants for just 26 available spots in the program’s first year, Providence sees a promising future for people looking for health care training outside of traditional roles. “It’s clear the interest is there,” says Rosie Salazar, CHW Academy Project Manager at Providence Little Company of Mary.
The program is also designed to reduce as many barriers to participation as possible. Applicants are required to have a high school diploma or GED, and many partners are specifically looking for Spanish-speaking CHWs. “We wanted to prioritize those who are just starting out in health care, who don’t have a college degree or means to pursue other postsecondary paths. This program will give them space to grow in the CHW field and serve a crucial role in our community,” says Salazar.
Though the COVID-19 pandemic moved trainings online and limited in-person learning in 2020, the program helped CHWs expand their knowledge and skills, and, with renewed energy, serve even more community members. “I have never received this type of training. It was detailed, friendly, and interactive,” says Vianey Caro, a Providence CHW Homeless Navigator who had more than 10 years’ experience helping homeless individuals navigate resources before joining the Academy. “It reminded me why I’m here and gave me more energy and passion to continue doing this important work.”
Caro works in the ED, and with limited resources available in-person, she makes phone calls to build relationships with people who need an advocate, working with nearly 30 individuals each month. “I connect them with insurance, tell them where to go and who to ask for. It takes a while to build these relationships, but it happens,” says Caro. “Working toward social justice is hard, but I know why I’m here. I’m making a difference in the community.”