What is a CHW? Today s Agenda 9/6/17. Community Health Workers and Pharmacy Technicians: Allies in Promoting Patient-centered Care

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1 Community Health Workers and Pharmacy Technicians: Allies in Promoting Patient-centered Care Michigan Society of Pharmacy Technician Presentation Priscilla Hohmann Program Manager, MiCHWA September 16, 2017 Flint, Michigan Today s Agenda 1. What is a CHW? 2. Discuss the role of CHWs in Michigan practice settings. 3. Discuss the role of CHWs on care team 4. Explore the potential overlap between CHWs and Pharmacy Technicians 5. Explore the ways CHWs and Pharmacy Technicians may complement each other to enhance patient care. 6. MiCHWA Overview 7. Q & A What is a CHW? A Community Health Worker (CHW) is a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. This trusting relationship enables the CHW 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. Source: American Public Health Association,

2 What is a CHW? (continued) A CHW also builds individual and community capacity by increasing health knowledge and selfsufficiency through a range of activities such as outreach community education informal counseling social support advocacy. Source: American Public Health Association, 2009 Key Question to Keep In Mind How does the CHW role compare to that of a pharmacy technician? tt Be prepared to share your observations during this presentation. CHW CORE ROLES 1. Cultural Mediation: With individuals, communities, and health and human services organizations. 2. Provide culturally appropriate health education and information 3. Care coordination and case management 4. Coaching and social support 5. Advocating for individuals and communities 6. Building individual and community capacity 7. Implementing individual assessments 8. Conducting outreach 9. Participating in evaluation and research 2

3 CHW CORE SKILLS 1. Communication Skills 2. Interpersonal and Relationship-building Skills 3. Service Coordination and Navigation Skills 4. Capacity Building Skills 5. Advocacy Skills 6. Education and Facilitation Skills 7. Individual and Community Assessment Skills 8. Outreach Skills 9. Professional Skills and Conduct 10. Evaluation and Research Skills 11. Knowledge Base tt Examples of Michigan CHW Job Titles CHWs on care teams CHW role on a care team is multifaceted Accessing community resources Offering informal therapeutic support Motivational Interviewing Medication adherence interventions (chronic conditions) Accompanying patients to medical appointments At clinics and at patient s home Video: 3

4 Evidence supports the effectiveness of CHWs on care teams 1 Studies have shown CHWs to be effective members of care teams in the management of chronic conditions, such as diabetes and hypertension by: Providing educational counseling (health behaviors, not taking meds) Assisting with medication education and management Helping patients get prescriptions filled and/or refilled Communicating with health care providers about patient needs, barriers, and wishes Encouraging medication adherence with memory aids Supporting patients with multiple conditions Motivational interviewing 1 Allen, CG, Brownstein JN, Satsangi A. Escoffery C. Community Health Workers as Allies in Hypertension Self-Management and Medication Adherence in the United States Prev Chronic Dis 2016; 13: The Community Guide. Cardiovascular disease prevention and control: interventions engaging community health workers. ttp://thecommunityguide.org/cvd/chw.html. CHWs, Medicaid, and MI Care Teams ACA program: Health Homes Michigan program: MI Care Teams (July 2016) with Michigan Primary Care Association (MPCA) FQHCs and Tribal Health Centers (THCs) Eligibility: Medicaid or Healthy Michigan Patients with: Depression and/or anxiety and one of following conditions: Heart Disease COPD Hypertension Diabetes Asthma CHWs and Pharmacy Technicians How does their work overlap? Identify two ways in which the CHW role and pharmacy technician roles overlap, based on what you ve heard today. 4

5 CHWs and Pharmacy Technician Connections Encourage and practice patient-focused care Medication reconciliation/medication management Assist with patient medication refills Facilitate patient communication with pharmacists. What happens when you combine the two? CPhT-CHW! CPhT-CHWs in the SafeMed Program 3 (a care transitions program) Objective: Expand the role of CPhTs to include CHW component to improve transitions of care. CPhT-CHWs: Engage in patient outreach after d/c Home visits and/or phone follow up Pharmacist Extenders: Obtain medication histories Assist in medication reconciliation and identification of potential drug therapy problems Reinforce medication education provided by pharmacists 3 Bailey JE, Surbhi S, Bell P, Jones A, Rashed, S, Ugwueke, M. SafeMed: Using Pharmacy technicians in a novel role as community health workers to improve transitions of care. Journal of America Pharmacists Association, 56 (2016)

6 CPhT-CHWs training in the SafeMed Program 3 Patient Communication Skills Motivational Interviewing Medication history taking Teach-back techniques Drug disposal practices Basic disease management 3 Bailey JE, Surbhi S, Bell P, Jones A, Rashed, S, Ugwueke, M. SafeMed: Using Pharmacy technicians in a novel role as community health workers to improve transitions of care. Journal of America Pharmacists Association, 56 (2016) Patient Outreach teams with CPhT-CHWS Increases in home visits Increases in telephone follow up rates Helped identify possible drug therapy problems SafeMed CPhT-CHW Program Challenges Transitioning to enhanced role Increased documentation requirements Concerns that new scope of work was outside what was permitted by state pharmacy board regulations 6

7 SafeMed CPhT-CHW Program Conclusions 3 Trained CPhT-CHWs are equipped to: improve care transitions for high utilizing populations Target medication therapy management with pharmacists through home visits and telephone follow up. Michigan Community Health Worker Alliance (MiCHWA) Our mission is to promote and sustain the integration of community health workers (CHWs) into health and human services organizations throughout Michigan through coordinated changes in policy and workforce development. TheProblem CHWs Face CHW programs often depend on grant funding, which is time-limited. Unstable program funding affects the CHW workforce and the impact they have in their communities. We believe that CHWs are essential for the improved health of Michigan s vulnerable populations. 7

8 MiCHWA Curriculum MiCHWA s Role: Convener. CHWs, health plans, policymakers, stakeholders Employers, educators, communities Annual statewide meetings Advocate. Work directly with statewide organizations and communitybased groups Build strategic partnerships across the state Voice. Foster and support CHW voice in everything we do! MiCHWA Structure & Governance Steering Committee Management Team Working Groups Education & Workforce Policy & Finance Communications CHW Network Evaluation Advisory Board Steering Committee Membership Value and Proposition Group Ad-Hoc Groups / Sub-Committees Source: Michigan Community Health Worker Alliance, CHW Network and Education & Workforce MiCHWA Working Groups Groups CHW Network Increase CHW participation Increase awareness of MiCHWA & CHW profession Promote CHW networking and social events Promote professional development opportunities Education & Workforce MiCHWA Certification procedures (CE, grand-parenting) Launch MiCHWA registry MiCHWA CHW curriculum implementation/evaluation 8

9 MiCHWA Working Groups cont d Communications Increase MiCHWA social media presence Promote MiCHWA and MiCHWA website Policy & Finance Potential CHW payment models Work with EAPC Policy Work Group CHW sustainability and partnerships MiCHWA s Partners MiCHWA 4 Current Curriculum Organization Focus Areas 1. Standardize and Expand CHW Education MiCHWA CHW core competency curriculum training 2. Certification & CHW Registry MiCHWA-managed certification 3. CHW Sustainable Financing Convene stakeholders to promote policies that support CHW payment models 4. CHW Awareness & Recognition CHW Month, Statewide Survey 9

10 MiCHWA 1. Standardize Curriculum CHW Education Core-competency based MiCHWA CHW training: 1. Role, Advocacy and Outreach 2. Organization and Resources: Community and Personal Strategies 3. Teaching and Capacity Building 4. Legal and Ethical Responsibilities 5. Coordination, Documentation and Reporting 6. Communication Skills and Cultural Competence 7. Healthy Lifestyles 8. Mental Health MiCHWA MiCHWA Curriculum CHW Training Course 126-hour course (8-hour classes) Individual and group assignments Includes role-play and experiential education activities Regular check-in quizzes and assignments Roughly participants per training Employer-driven 1. Expand CHW Education (through MiCHWA MiCHWA Curriculum CHW Trainings) 16 training cohorts to date Over 260 CHWs successfully completed MiCHWA CHW training Regular curriculum content development and updates Ongoing evaluation 10

11 New CHW Instructors to teach the MiCHWA CHW curriculum Five new MiCHWA-trained instructors Extensive self-study, 2.5 day in-person intense training 16 hours of observation Evaluation New instructor curriculum in development MiCHWA Training Locations 1. Grand Rapids 2. Dearborn 3. Flint 4. Battle Creek (New!) 5. Muskegon (New!) 6. Traverse City (New!) 7. Marquette (New!) MiCHWA is actively seeking out new training sites! 2. MiCHWA Registry & Certification Registry features to include: 1. CHW profiles 2. CHWs can post CHW trainings and CEUs completed 3. Employer profiles 4. Job postings 5. Instructor profiles 6. CHW Trainings 11

12 Celebrating August CHW Appreciation Month! Statewide celebration of CHWs Recognition of CHWs as a profession State proclamation Promote CHW profiles on MiCHWA facebook Questions? For more information: info@michwa.org 12