Community Health Workers
Message from the Chair
On April 23, Arizona Gov. Jan Brewer signed into law a measure which will allow police to determine a person’s immigration status, if they are stopped and there is “reasonable” suspicion they are in the country illegally. As APHA members prepare to attend the upcoming Annual Meeting, whose theme is “Social Justice: A Public Health Imperative,” we need to give thought to all people living in the country, no matter how they entered. Many public health programs including CHW programs offer services to people regardless of immigration status. The new Arizona law, taking affect on July 29, should be of concern to all of us. This sounds like profiling to me; as an African American in the United States I understand this is not far-fetched. There are many immigrants in the United States, and those who do not look like Caucasian Americans are being singled out. Even sadder, Hispanic Americans must be prepared to prove their citizenship on demand.
I wonder what side effects the law will have and question whether or not they are intentional or not. Many Hispanic families are moving from Arizona, similar to the exodus which happened in 2007 when the state passed a law to enhance penalties for businesses which hired undocumented workers. I’m concerned not only for the adults, who may be unable to find work to support families, but also for the children. The children suffer when their parents are unable to buy food, afford shelter and clothing. Many families in our border states and elsewhere are mixed status families. We are setting up laws which may intentionally separate parents and children; we should be ashamed.
According to a USA Today article, "Hispanics Moving Out of Arizona", appearing on Wednesday, June 9, 2010, children are leaving schools at alarming rates in Hispanic communities. The Elementary School District, largely Hispanic, recently lost 70 children. During the same period last year only seven children left the school system. This is extremely alarming to me. All children in the United States should have equal access to education. We know the relationship between education and health. I only hope these children being pulled from schools in Arizona are enrolled in other states, but who knows? Although Arizona is in the news and being singled out, other states may follow.
Our new health care reform law made no provisions for the undocumented. They are not even able to buy into the insurance exchanges with their own money. his may have been the opening many states were looking for to put the wheels of discrimination further in motion. As community health workers and promotores(as), we promote access to health care and social services. By the nature of our work, for the populations and communities we serve, we don’t ask to see documentation before offering our services, nor should we. I offer a silver lining to be found in these new challenges. This is an opportunity for community health workers and promotores(as) to find common ground to promote social justice. This is yet another opportunity for the field to have our unified voice heard though policy development. We cannot be silent bystanders.
I urge all of us, promotores(as) and CHWs alike, to become engaged. We need to work together to ensure the communities we care about, and are members of, are not further discriminated against. Social Justice is a public health imperative and we are members of the public health work force!
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Specific Provisions in Health Care Reform Bill (HR3590) Affecting CHWs
CHWs are mentioned specifically in several places in the reform bill, and there is strong potential to include CHWs in implementation of several other sections. CHWs and their supporters should work with allies in state and Congressional delegations to make sure these things are carried out!
Sections referring specifically to CHWs:
National Health Care Workforce Commission (Sec. 5101) – includes CHWs in definition of primary care professionals (5101(i)(1)).
Grants to Promote the Community Health Workforce (Sec. 5313) – Directs the Director of CDC to award grants to promote positive health behaviors and outcomes for populations in medically under-served communities through the use of community health workers.
Area Health Education Centers (Sec. 5403) – requires AHECs to “Conduct and participate in interdisciplinary training that involves physicians, physician assistants, nurse practitioners, nurse midwives, dentists, psychologists, pharmacists, optometrists, community health workers, public and allied health professionals, or other health professionals, as practicable.” (5403(c)(1)(D))
Provisions Which May Be Pursued for CHW Roles:
Hospital Readmission Reduction (Sec. 3025) – high potential for CHW role in meeting these standards.
Community Health Teams in Support of Patient-Centered Medical Homes (Sec. 3502) – natural role for CHWs as part of these teams.
Patient Navigator Program (Sec. 3509) – reauthorized through 2015. As implemented by HRSA, grants under this program heavily favor employing CHWs as Navigators.
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Exciting CHW Section Program Set for APHA 138th Annual Meeting in Denver
The CHW Section will be sponsoring a variety of innovative and compelling sessions at this year’s Annual Meeting. The program is comprised of two Poster Sessions, one Roundtable Session, one Training Session, one Invited Session and four Scientific Sessions. The sessions, all embracing this year’s theme, “
Social Justice: A Public Health Imperative,” will provide in-depth and interactive opportunities to understand how community health workers are the cornerstones of social justice and public health.
Session themes include:
Establishing Successful Community Health Worker Business Models: What Works
Developing CHW Associations and Networks: Opportunities and Challenges
Social Justice and Health Care Reform
Innovative CHW Curricula: New Educational Models
Perspectives of CHWs on Social Justice Issues Affecting the Health of Our Communities
Supporting Community Health Workers as Members of Health Teams: Policies and Systems
CHW Curricula That Provides Skills Strategies and Methods to Combat Social Injustices Affecting the Health of our Communities
Becoming Involved, Addressing Social Injustice Issues - CHW Workshop
Community Organizing and Mobilizing for Social Change
Social Entrepreneurs: CHW Contributions to Health Literacy, Medical Homes and Health
We will continue to have two of our largest business meetings during the evening hours in order to ensure everyone’s participation. They are the Education y Capacitacíon Committee and our General Business meeting. Dates and times of all business meetings, sessions, and the CHW Section Social Hour are available online, and registration is now open: www.apha.org/meetings. Other business meetings open to the membership of the Section are Member Orientation, CHW Section Policy Committee, and the CHW Section Program Planning Meeting.
When you register, don’t forget to make sure you name the CHW Section as your affiliation. Looking forward to seeing you in rustic yet modern Denver for the richest CHW Section program ever!!
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Section Members Collaborate to Publish an Article in the July issue of Health Affairs, The Policy Journal of the Health Sphere
Section members have worked together over many years through connections forged at APHA to create what can be called a “Community of Practice.” Through this “community” they have supported one another’s efforts to promote CHWs on the home front in states where many important policy changes take place. As a part of this, a group of Section members worked together over a year’s time to write and submit an article about important state advocacy and policy developments aimed at supporting CHWs.
The idea for article came from a CHW Section panel at the 2008 Annual Meeting facilitated by long-time Section member Dr. Nell Brownstein of the Centers for Disease Control and Prevention who recognized the importance of the stories of state successes. She mentored the author team in writing the article.
The article, appearing in the July 2010 issue of Health Affairs, highlights policy efforts in two states, Massachusetts and Minnesota; advocates from both states were members of the article author team. In the Massachusetts story, learn about how CHW leadership has played a vital role in moving the field forward and in Minnesota, read about ground-breaking policy that allows CHWs in that state to reimbursed through Medicaid for their services. The article also presents guidance aimed at the development of health policy and programs to support the sustained integration of CHWs. The authors also discuss the value of CHWs in the implementation of health reform.
Watch for it:
Rosenthal L, Brownstein JN, Hirsch GR, Willaert AM, Rush C, Holderby LR, Fox DJ, Scott JR, Community Health Workers, Part of the Solution: Promising State Policy Change Supporting the Integration of Community Health Workers into Systems of Care. Health Affairs. In Press July 2010
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CHW Employers, Other Stakeholders Hold Statewide Meeting in Texas
A groundbreaking statewide meeting was held in Houston June 17-18 to discuss joint action to move the CHW work force forward in Texas. Despite having certification of CHWs since 2003, the field has not progressed in other areas of policy, and CHW employment is still dominated by short-term grant funding.
At the “Summit” meeting, Texas employers presented examples of their own internal evidence of a positive “return on investment,” and participants discussed strategies for reaching common ground and taking action to promote positive policy change. Keynote speakers included Dr. Eduardo Sánchez, former state health commissioner and now medical director for Blue Cross Blue Shield of Texas, and Gail Hirsch of the Massachusetts Department of Public Health. Other key participating organizations included the Gateway to Care Collaborative in Houston, Project Access Dallas, East Texas AHEC, the Texas Public Health Association and the Texas Health Institute, as well as university Health Science Centers from Houston, Galveston, San Antonio and Lubbock.
Further details on outcomes from this meeting will be reported in our next newsletter!
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CHW Section Policy Committee Update
The APHA Policy Committee met in May and has continued the discussion on its mission is to engage and organize members who will work to respond to, analyze and help shape public policy at the national, state and local level related to the Community Health Worker profession. One of the subcommittees under this group is working on developing a Evidence Based Research Matrix. The committee will be developing standards and a system on how to list and organize the studies, which will include both published and unpublished studies so that it is user friendly depending on who our audience is. A second committee will be working on developing a CHW state initiative matrix, which would include areas in CHW work force, policy development, education and CHW associations/networks per state. This will be a great way to keep updated on happenings in other states, and an organized system to connect with those doing the work. Lastly, the Policy Committee is working on ways to include CHWs on the APHA pre-session on health care reform.
This committee meets the second Friday every other month. Our next meeting is scheduled for July 9 from 9:00-10:00 a.m. Central time. If you are interested in being a member of this committee, please contact Jewel Bell at firstname.lastname@example.org or Anne Willaert at email@example.com.
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Meet Your CHW Section Leadership
In 1994 Durrell Fox became a member of the APHA New Professionals Special Primary Interest Group (SPIG) which, in the early 2000s, became the Community Health Worker (CHW) SPIG and, as of 2009, is now the CHW Section. From the mid 1990s to the present, Durrell has held numerous leadership positions for the Section. These roles include serving as a member of our CHW Section Executive Council from 2002 to the present and serving as the CHW SPIG Chair Elect from 2002-2003 and then Chair from 2003 to 2005. In 2005 Durrell also began serving as an APHA Governing Councilor, a role he still plays today.
In 2007 Durrell joined APHA’s Action Board as a member and subsequently went on to become the vice chair, and then chair of that group (2009 to the present.) Durrell also serves on APHA’s Joint Policy Committee, which he joined in 2008, a committee which he currently chairs. Finally, Durrell became an APHA Executive Board Member in 2009 with a term until 2010. With his extensive participation, Durrell has really given APHA an opportunity to see a CHW in action.
Durrell comes by his activist life naturally having grown up in the home of a community activist and African Nationalist; his mother, Gloria Fox, is a community leader and statewide elected official in Massachusetts. Durrell reports that the family was always involved in marches and community mobilization efforts. During his high school years he stayed active in both the community and in college, where he led the Black Students Association at Suffolk University in Boston. Durrell shares that at the end of college he decided to get a job in the corporate world, remembering all the years of being poor. This venture was short-lived as he quickly recognized that he preferred social justice work, which he continued during those years doing youth related volunteer work. In 1990 he formally began work as a CHW with youth at Martha Eliot Health Center and Children's Hospital in Boston. He also coordinated a youth Summer Jobs Project for several years with another community based organization in Roxbury, Mass. Durrell still works to do street outreach today as he is able, and he holds tight to his identity as a CHW representing communities that need a voice, especially facing the challenges HIV and AIDS.
Maria Lourdes Fernández
On our first ever “Section” officers’ ballot is the name of Community Health Worker and Arizona CHW Network (AzCHOW) co-founder Maria Lourdes Fernandez. Maria was proposed by the Nominations Committee to run for the position of Section Chair-Elect; a nomination that received noteworthy support from her colleagues who committed to sustaining Lourdes’ participation in APHA including our next several annual meetings. Given a current vacancy in the Chair-Elect position, the position will begin in August of 2010 and run through APHA’s Annual Meeting in 2011, when the Chair-Elect will become Section Chair.
A native of Mexico, Lourdes brings a fresh perspective to APHA as a new member as of last fall. But Lourdes is not new to CHW advocacy; she has been giving una voz (a voice) to CHWs and the communities they serve ever since she began her work as CHW some 12 years ago in southern Arizona. Throughout this time Lourdes has been based at the University of Arizona as CHW/Promotora and Program Coordinator working on numerous projects in the Arizona–Sonora, Mexico border region. Before her formal work as a CHW, Lourdes was a public health aide in a local hospital in the same region. In Mexico, Lourdes worked in health care and nursing administration also in the border region.
Lourdes has been a participant in both state level and national level efforts to organize CHWs. As already noted above, Lourdes has been involved with AzCHOW since it was established in 2001. During that time she has consistently served as an officer in various roles including network president. Representing AzCHOW in 2005, Lourdes attended a meeting in the Washington, D.C., area sponsored by the Center for Sustainable Health Outreach (CSHO) that led to the establishment of the American Association of Community Health Workers (AACHW). For several years she participated in the steering committee of AACHW and came to understand the many challenges of bringing together CHWs from across the nation from varied communities and cultures. She is also a regular participant in the annual CHW Unity conference, also established by CSHO, where she has continued to develop an understanding of CHWs’ work and networks across the United States. As an active organizer of AzCHOW statewide meetings, Lourdes brings a depth of understanding about the value and capacity of meetings, like our annual APHA meeting, to bring individuals together both for learning and networking.
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CHW State Network in Texas Gets Offer of Help from APHA State Affiliate
Spurred by local organizing groups in Houston, El Paso, San Antonio and the Brownsville-McAllen area (Lower Rio Grande Valley), committees are working toward Texas’s first statewide CHW network. There was great enthusiasm for action in Houston’s fourth annual local CHW conference (April 9), and statewide conference calls have been held. The groups are urging a statewide CHW conference within the next year.
At the April 9 Houston conference, the Texas Public Health Association was approached about assisting the new statewide organization to get started. TPHA has agreed to sit down with CHW network leaders to see what kind of assistance would be most useful.
State public health associations have been valued supporters of CHW networks in Massachusetts, Oregon and elsewhere. If you have not been in contact with your State Public Health Association, you may want to reach out to them. For links to all of these groups, go to the APHA website: http://www.apha.org/membergroups.
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CHW Association and Network Corner: CHWs Are Organizing
Across the country, at all levels (statewide, locally and nationally), CHWs are organizing professional associations or networks. CHW associations advocate for CHWs and the communities they serve. They give CHWs a means of gaining additional skills, accessing support and recognition, and sharing resources and strategies with peers. This regular newsletter feature highlights the ongoing organizing efforts of CHWs across the country.
We urge CHWs to contact their local networks and get involved! If there is no network in your area, think about starting one. Contact the network nearest you for information and strategies about organizing. We recognize the enormous energy and commitment of CHWs as they organize. We also know that this is only a partial list of CHW associations. If you know of others, please let us know! Contact Newsletter Editor Gail Hirsch at: firstname.lastname@example.org or (617) 624-6016.
National CHW Associations
American Association of Community Health Workers: Durrell Fox email@example.com and Pam Chapman firstname.lastname@example.org, Co-chairs.
APHA CHW Section: Lisa Renee Holderby, Chair, (617) 275-2813, email@example.com; http://www.apha.org/membergroups/sections/aphasections/chw/
National Hispanic CHW Association: Zeida Estrada, Chair, firstname.lastname@example.org, (281) 222-9643
National Association Community Health Representatives: Cindy Norris, President, PO Box 1064, Sells, AZ (502) 471-3487 email@example.com; http://www.nachr.net/
State/Regional CHW Organizations
Arizona Community Health Outreach Workers Network (AzCHOW), Of, By, and For Community Health Outreach Workers; http://www.publichealth.arizona.edu/azchow/ Flor Redondo, Chair; firstname.lastname@example.org
The Community Health Worker/Promotoras Network, Maria Lemus, Executive Director, Vision Y Compromiso, 2536 Edwards Ave., El Cerrito, CA 94530; (510) 232-7869; (510) 231-9954 fax; e-mail: email@example.com, or Maria at firstname.lastname@example.org
REACH-Workers – the Community Health Workers of Tampa Bay. Please contact Michelle Dublin, chairperson of the network, at (727)588-4018 or Michelle_Dublin@doh.state.fl.us
Georgia Community Health Advisor Network, Gail McCray, Department of CH/PM Morehouse School of Medicine, 720 Westview Drive, Atlanta, GA 30310-1495; Ph: (404) 752-1645, email@example.com
HAWAII – in process of forming CHW organization. Leimomi Shearer, CHW firstname.lastname@example.org 69-A Railroad Ave, Hilo, Hawaii 96720
Chicago CHW Local Network. Contact Laura Bahena. 1436 W. Randolph St. 4th Floor,Chicago, IL. 60607. Telephone (312) 243.4772 ext. 225. Fax 312.243.4792. E-mail email@example.com
Community Outreach Workers Association of Maryland, INC. (COWAM), 259 North Lanvale Street, Baltimore, MD 21217, (410) 664-6949 or (410) 669-7960, Carol Payne, firstname.lastname@example.org
Massachusetts Association of Community Health Workers (MACHW), Cindy Marti, Policy Director, email@example.com, 434 Jamaicaway, Jamaica Plain MA, 02130, (617) 524-6696 x108; www.machw.org.
Michigan CHW Coalition, Celeste Sanchez at firstname.lastname@example.org; (616) 328-4475.
Minnesota CHW Peer Network out of the Minnesota International Health Volunteers,
122 W. Franklin Ave. #522, Minneapolis, MN 55404, Anita Buel, Vice Chair, AnitaBuel2004@yahoo.com, Grace Anderson, Chair email@example.com or Andrea Leinberger (staff) (612) 230-3254 firstname.lastname@example.org
NEW JERSEY – no CHW organization but the NJ CHW Institute is supporting the development of CHW groups. Contact person Yvette Murry, Community Health Worker Institute, NJ AHEC/ UMDNJ-SOM, email@example.com; 42 Laurel Road E., STE. 3200 Stratford, NJ 08084; (856) 566-6724.
New Mexico Community Health Workers Association (NMCHWA), P.O. Box 81433, Albuquerque, New Mexico 87198, firstname.lastname@example.org, www.nmchwa.com (505) 255-1227
Statewide: Community Health Worker Network of New York State, http://chwnetwork.org/id49.html
New York City -Community Health Worker Network of NYC; 425 E. 25 Street; New York, NY 10010; (212) 481-7667 Sergio Matos, Executive Director Sergio@chwnetwork.org or Romy Rodriguez, Chair, Romelia@chwnetwork.org; Web site: http://chwnetwork.org/
Rochester - Rochester Outreach Workers Association (ROWA), Latisha Williams, Chair, (585) 274-8490, Lwilliams@monroecounty.gov
Ohio Community Health Worker Association, Vivian J. Anderson, M.A., President, phone (614) 466-2247, email@example.com; http://www.med.wright.edu/CHC/programs/ochwa.html
Oregon Community Health Workers Association, 9000 N. Lombard Street--2nd Floor, Portland, OR 97203, (503) 988-3366, ext 28686, Teresa Ríos, firstname.lastname@example.org, or Veronica Lopez Ericksen, email@example.com
Rhode Island, In the process of forming a CHW Association; Shavon Smith, CHW, (401) 270-0101 ext 133; firstname.lastname@example.org; 270 Elmwood Ave, Providence, RI 02907.
South Texas Promotora Association, Weslaco, Texas, Merida Escobar, STPA President/CEO, P.O. BOX 350, San Juan, Texas 78589, (956) 383-5393; MESCOBAR94@sbcglobal.net
Washington Community Health Worker Network; Lilia Gomez - (360) 786-9722 (ext 230) - email@example.com; Seth Doyle - (206) 783-3004 (ext 16) - firstname.lastname@example.org
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APHA Membership Information
For those of you who are not members of the CHW Section or APHA itself, please consider joining us! If you are a member of APHA, the CHW Section also welcomes you to join us as a primary member.
If you are unable to select the CHW Section as your primary affiliation in APHA, please consider electing the CHW Section as a secondary section, and you will receive our CHW newsletter!
For those of you who are not yet members of APHA, there are many options for membership:
· A Special Community Health Worker subsidized membership ($65 annually for those whose income is under $30,000 annually);
· A consumer subsidized membership ($65 annually for those who do not derive income from health related activities);
· A Student/Trainee subsidized membership ($50 annually for those enrolled in a college or university or occupied in a formal training program);
· Regular membership is $160 annually.
Memberships include all benefits such as the American Journal of Public Health and The Nation’s Health. For details on how to become a member of APHA and how to designate the CHW Section as your Section, please call (202) 777-APHA. You can also check out APHA's website at http://www.apha.org or e-mail email@example.com.
In the event you cannot become an official member of APHA, we still need your wisdom, support, knowledge and power. Please feel free to contact any of the officers listed in this newsletter about the CHW Section and how you can be involved.
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APHA Initiatives on Transportation and Public Health
As we all appreciate, our health is profoundly affected by our transportation decisions and options. Limited opportunities for physical activity, higher exposure to poor air quality, higher incidences of adult and childhood obesity and greater prevalence of asthma and cardiovascular disease are a few of the inequities brought by poor transportation policies.
As part of our effort to enhance crosscutting activity and knowledge among various APHA members and sections, APHA is developing advocacy materials and helpful information related to the links between transportation and public health. If anyone is interested in learning more about this initiative, sharing success stories or lessons learned, or establishing a new Forum on Transportation and Public Health, please reach out to us! Interested members are asked to contact Eloisa Raynault at firstname.lastname@example.org.
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APHA 2010 Community Health Worker Section Executive Council
Lisa Renee Holderby
Maria Lourdes Fernández
Carl H. Rush
Community Resources, LLC
Center for Sustainable Health Outreach
University of Southern Mississippi
Governing Council Representative
Action Board Representative
New England HIV Education Consortium
and Massachusetts Association of
Community Health Workers
Teresa M. Hines
Continuing Medical Education
Paul L. Foster School of Medicine
Massachusetts Department of Public Health
Education y Capacitación Committee Chair
Immediate Past Chair
Community Health Worker Network of
NYC and Columbia University
Mailman School of Public Health
Tel: (212) 304‐6415
Health Education Industry Partnership
Ohio CHW Association
Nominations Committee Co-chair
E. Lee Rosenthal
University of Texas at El Paso
Nominations Committee Co-chair
Virginia Center for Health Outreach
Liaison Committee Co-chair
Migrant Health Promotion
Liaison Committee Co-chair
University of Arizona
Tel: (520) 419‐2671
Centers for Disease Control & Prevention
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Community Health Workers Newsletter Archives