Community Health Workers Extend a Practice's Influence

With the advent of the Affordable Care Act, millions of Americans are able to obtain access to care while providers are under increasing pressure to contain costs. Serving on the front lines of healthcare delivery, community health workers play a vital role in helping providers address both of the aforementioned developments brought on by the ACA.

How vital?

“The future of the American healthcare system will go through community health workers,” says Jason Turi, associate clinical director, Camden Coalition of Healthcare Providers. “They compliment, support, and extend the work of providers.”

The role of the CHW

Turi explains that CHWs often provide desperately needed psychosocial support to patients and family members, both in the community setting and in their homes, through outreach. They communicate as a peer to patients and family members.

“And that’s really important,” he says. “It really helps to move folks forward in a care plan, toward their goals. It helps them feel comfortable with those relationships. They also help with navigation of very complex systems.”

The US healthcare system, together with all the social and human services, and community resources associated with it, is not easy to navigate. CHWs, Turi says, accompany patients and their families as they navigate a complex and sometimes fragmented system.

“Our community health workers speak both of the 2 dominant languages here in Camden—English and Spanish,” Turi says. “And they can communicate directly with patients and families in those languages. They also have a tool belt of skills that they can use. They can be trained in mental health. They can be trained on how to navigate the insurance system. And, they have a deep knowledge of local resources and how to connect people to those resources and reinforce those connections.”

Turi says it’s important to understand that CHWs are not volunteers. They’re paid, benefited positions with growth opportunities, including educational, leadership, and speaking opportunities.

“We have a community health worker, Jessica Valles, who is on a nursing track,” he says. “Not everyone goes that way. Some folks go into social work. But she’s based here in Camden. She has a family. So the return on investment to the community is big.”

Part of the team

Turi points out that CHWs do not work on their own. They work under the supervision of a nurse, or registered nurse, or social worker as part of a multidisciplinary team. For example, if a primary care physician wants to implement a chronic disease management plan for a patient with diabetes who also has other social issues, the physician will work with a multidisciplinary team with the ability to outreach. That’s where the CHW comes into play.

“They engage patients in their home with their families, or at work with the resources they have,” Turi says. “The importance is taking care beyond the hospital or beyond the medical practice and into the patients’ lives; into their community or their homes, where health really is created.”

As care shifts more toward population health management, Turi believes this liaison type of role—whether it’s community health workers, community-based nurses, or social workers—will become even more important for physicians to connect with.

“And,” Turi adds, “here’s the value added. “Community health workers actually help in bringing folks back to the practice. Some patients haven’t been there in years. They go with them to their appointments, help arrange transportation, reinforce the plan that has been put together with the provider, and be able to put that plan into action when they leave.”

In other words, CHWs can have a positive impact on the medical practice.

“Imagine your practice living beyond the walls of your office,” Turi says. “CHWs, working with the team, can maximize the impact of primary care practices.”

Making the connection

What’s the first step physicians should take to better utilize community resources? Turi says he hears the same question coming from CHWs wanting to connect with medical practices. He suggests examining your community, seeing what services are being offered by various entities, and starting a conversation.

“Here in Camden, we have this community health institute, organized folks who are doing community health work. And we always ask them, ‘Have you talked to the local primary care provider? Cause if you linked up with them, you could really complement each other and there could be a strategic partnership there.’”

The important thing is to start small, and get to know your community.

“There are probably folks looking for you too,” he says. “You probably have informal connections that you don’t even realize.”