CMMI-CHW Project: HCH Collaboration Julia Dobbins November 27, Health Care & Housing Are Human Rights

Transcription

1 + CMMI-CHW Project: HCH Collaboration Julia Dobbins November 27, 2012 Health Care & Housing Are Human Rights

2 + Introduction The purpose of this webinar is to discuss the collaboration between the HCH and the Council We will cover reporting requirements, the role of the CHW, and supervision Next week, we will have a webinar that centers around the collaboration with your hospital Health Care & Housing Are Human Rights

3 + What is this project? Health Care Innovation Award funded through the Centers for Medicare and Medicaid Services in the US Department of Health and Human Services Facilitated by the National Health Care for the Homeless Council Darlene Project Manager Julia Project Coordinator Zak Data Specialist

4 + This is us in people form Darlene Project Manager Julia Project Coordinator Zak Data Specialist

5 + Goals of the Project 1. Add 15 CHWs to the staff of 10 Health Care for the Homeless (HCH) sites in 10 communities nationwide. 2. Provide training for newly hired CHWs 3. Establish peer navigator relationships with persons experiencing homelessness who are high-users of Emergency Departments by managing patient transitions of care from hospitals to medical homes at HCH sites. 4. Demonstrate decreased hospital utilization by targeted homeless patients, resulting in decreased Medicaid/Medicare and uncompensated care costs. 5. Demonstrate improved health status, quality of life, quality of care, and patient experience

6 + Triple Aim of CMS Improve Health Care by decreasing the use of the ER, Improve the Health of the patient through education, connective services, moral support, etc, Cost Reduction to the safety net hospitals participating through the decline of ER use

7 + 10 Participating Cites Boston, Massachusetts Boston Health Care for the Homeless Program Chicago, Illinois Heartland Health Outreach Durham, North Carolina Lincoln Community Health Center Houston, Texas Houston Health Care for the Homeless Program Hyannis, Massachusetts Duffy Health Center

8 + 10 Participating Cites Manchester, New Hampshire HCH Manchester at CMC Community Health Nashua, New Hampshire Harbor Homes, Inc. Omaha, Nebraska Charles Drew Health Center San Fernando, California Northeast Valley Health Coorporation Santa Clara, California Valley Health Care for the Homeless Program

9 + Project Timeline Fall 2012 Hire and Train CHWs January 2013 CHWs begin building their caseloads January March, 2013: Julia doing site visits March 2013 NHCHC Annual Conference All CHWs will attend Ongoing Training Data Collection Conference Calls Site Visit June 2015 Project Ends

10 + Roles & Responsibilities of the CHWs The Community Health Worker (CHW) helps increase access to health services for people who have experienced homelessness through outreach, education, and peer support. This position provides a variety of specialized services to special populations. The CHW is expected to have an understanding of mental illness and addiction, being willing and ready to engage with clients who struggle with these issues at all levels. The CHW is responsible for promoting behavior changes, assisting with linkages to appropriate health care services and assisting individuals with self-management of chronic diseases.

11 + Roles & Responsibilities of the CHWs CHW will be responsible for connecting patient with follow-up services, i.e. transportation, specialty services, housing, employment, disability determination, etc. Develop relationships with area social service agencies to build knowledge of the resources available to clients. Visit clients to develop relationships and promote harm reduction. Provides basic advocacy, assessment, planning and casework services. Provides culturally and linguistically appropriate services and health education to clients.

12 + Roles & Responsibilities of the CHWs Maintain a professional disposition while working with a multidisciplinary health care team. Coordinate transportation for clients to/from appointments, including accompaniment as needed Documents each patient served, conducts intake interviews, monitors client progress, maintains logs and statistics. Completes accurately, and in a timely manner, all-necessary forms, case recordings and statistical reports, and submits such documentation to his or her supervisor within designated timelines.

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14 + NOT the role or responsibility of the Community Health Worker Clinician Psychiatrist or Psychologist Lawyer Superhero Case Manager The Catch-All

15 + Connected to the Community Dependable, Responsible, and Reliable Persistent, Creative, and Resourceful Friendly, Outgoing, and Sociable Qualities of an Effective CHW Mature Honest, Respectful, and Patient Open- Minded/Non- Judgemental Empathetic, Caring Compassionate

16 + Integrating and Supporting your CHW

17 + Supervision is all about good client care. Charles McConnell, author of The Effective Health Care Supervisor

18 + Functions of Supervision Administrative Provide organizational structure to facilitate work getting done Address barriers Educational Provide information Assess gaps in knowledge and skill Promote continuing education Supportive Enable staff to mobilize required emotional energy Address emotional barriers to providing effective care Decrease stress Ken Kraybill, MSW

19 + The Skillful Supervisor Understands the importance of supervision Initiates regularly scheduled supervision meetings Communicates effectively Provides constructive feedback Employs progressive discipline steps when needed Ken Kraybill, MSW

20 + The Skillful Supervisor Is aware of and accepts own limitations and strengths Has the courage to expose vulnerabilities, make mistakes, and take risks Is invested in the development of the supervisee Accepts and celebrates diversity, is tolerant and respectful Has a sense of humor Ken Kraybill, MSW

21 + The Skillful Supervisor Practices self-care Ken Kraybill, MSW

22 + Trauma Work Demanding and requires the use of one s self and a relationship with the client Necessitates both containment and often re-visiting of painful issues Requires vulnerability & empathy

23 + Trauma Exposure Response The transformation that takes place within us as a result of exposure to the suffering of other living beings The ways in which the world looks and feels like a different place as a result of the work we do. Laura Vandernoot Lipsky, Trauma Stewardship

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25 + Trauma Exposure Response Sense of self/ identity Worldview Personal Relationships Spirituality Physical body & function

26 + This is what we strive for

27 + Supervisor s Role

28 Questions? Concerns? Thoughts or Feelings? The project described was supported by Funding Opportunity Number CMS- 1C from Centers for Medicare and Medicaid Services, Center for Medicaid Innovation. Its contents are solely the responsibility of the authors and do not necessarily represent official views of HHS or any of its agencies.

29 + We are here to help! Darlene Julia Zak