Removing barriers to care | Community health workers
Community health workers are trusted front-line public health care workers who serve as a vital bridge between the community and the health care system. They understand local cultural differences, respond to pressing health needs, and foster strong relationships with community members. Providence is deeply committed to CHW programs that are meeting the health needs of our communities, helping people navigate complex systems, reducing health inequities, and providing cost-effective care close to home.
In their roles CHWs wear many hats, including educator, community builder, health screener, coach, behavioral health aid, and counselor. They also serve as a liaison between under-resourced populations and social services to help improve access to culturally competent, quality care.
Providence CHWs have been in the field supporting community members for years, but in 2021 we launched an expansion, with new programs in 12 service areas across the seven states we serve. Early in the year, these programs responded to the COVID-19 pandemic by distributing personal protective equipment, managing contact tracing, and administering tests and vaccines. As COVID-19 vaccines reduced severe illness, CHWs turned their focus to other pressing community needs such as perinatal care, cardiovascular health, behavioral health, diabetes prevention and treatment, and continued social service coordination.
Using population health data and input from community members and partners, Providence Alaska identified four neighborhoods in Anchorage – Airport Heights, Fairview, Government Hill, and Mountain View – for a CHW pilot program that launched in the middle of 2021. The program received $2.4 million from Providence’s systemwide health equity investment to fund one CHW in each of the four neighborhoods, and eight in total over three years.
Since the launch of a pilot community health worker program in mid-2021, more than 2,300 individuals have been helped in Anchorage neighborhoods.
As local residents with deep knowledge of their community, the CHWs began conducting outreach, coordinating needed services, providing educational materials, and dismantling barriers to access so that more community members could receive culturally competent and convenient care and services. Since the launch of this pilot program, this team of diverse and experienced people has connected with more than 2,300 individuals and helped them navigate systems that felt impossible to traverse alone.
Providence partnered with several local nonprofit organizations to avoid duplication of existing services. The CHWs were also enrolled in the Alaska Department of Labor and Workforce Development’s apprenticeship program to receive national certification and advance their long-term career opportunities.
Providence Little Company of Mary and Charles Drew University School of Medicine and Science formed a partnership in 2019 to create the Community Health Worker Academy, a paid six-month internship and workforce development training program for a diverse cohort of professionals just starting out in health care careers.
As part of their internship, community health worker trainees worked with six different clinics and hospitals to provide more than 7,500 people with access to services and programs.
After reviewing 450 applications, the program launched in 2021 with two inaugural cohorts, totaling 26 trainees. Both cohorts received online and in-person training in care management and relationship building, mentoring, and coaching. The academy also provided continuing education sessions and weekly one-on-one check-ins with a dedicated program manager.
As part of their internship, trainees worked with six different clinics and hospitals to provide more than 7,500 people with access to services and programs. The first cohort of 11 CHWs graduated in July 2021 with new confidence about working in a clinical setting and engaging with community members. The second cohort is scheduled to graduate in early 2022.
The community health worker program at Providence St. Mary Medical Center in Walla Walla is changing hearts and minds and meeting people out in the community. The highly-skilled, community-based workforce is expert in resource navigation and connecting clients with culturally competent care and services.
Brian, a Providence community health worker in Walla Walla, Wash., talks with a client.
In 2021, the hospital expanded its CHW program from two to six. Two are dedicated promotoras, or bilingual and bicultural health workers who develop and nurture personal relationships with community members that are authentic and consistent. The promotoras’ ability to connect with individuals and families in their first language of Spanish helps eliminate a critical barrier to receiving needed care. They help coordinate and advocate for medical insurance, prescription medication support, preventive screening appointments, and essential services such as Meals on Wheels.
In 2021, the Providence St. Mary’s community health worker team made more than 5,500 individual touchpoints with patients and community members.
CHWs are also a bridge between the hospital and people experiencing homelessness. At the peak of the 2021 heat wave when temperatures reached 117 degrees in Walla Walla, CHWs distributed cold water, ice and other cooling aids to unsheltered people on a daily basis. The supplies were funded through Providence’s community benefit investment. Additionally, CHWs partnered with the City of Walla Walla to pilot a community paramedic program that pairs a paramedic with a CHW when responding to emergency calls. In this model, the paramedic can focus on medical care while the CHW can focus on social determinants of health.*
COVID-19 has made community health work even more important as health disparities widened and people have, at times, been hesitant to visit a hospital or clinic. CHWs play a critical role in Providence’s ongoing response to the pandemic and to many other health needs. They deliver care in a community setting that is convenient and provide health information that is relevant and informative to our neighbors.
*Social determinants of health include factors like socioeconomic status, education, neighborhood and physical environment, employment, and social support networks, as well as access to health care. Addressing social determinants of health is important for improving health and reducing longstanding disparities in health and health care.