the role of the certified community health worker / chronic care … · 2019-04-25 · mental...
TRANSCRIPT
The Role of the Certified Community Health
Worker/Chronic Care Professionals:
How they can affect those in treatment &
recovery as it relates to chronic illness
Paul Conrad, B.S., CCHW-CT
Director of Training and Workforce Development
ASPIN
© 2019 ASPIN
Today’s Objectives
Attendees will:
Be able to Identify the different classifications and training standards for
CCHWs, CCHWCRSs and CCHW-CCPs
Understand how chronic conditions adversely affect mental health,
treatment, and recovery.
Learn how CCHW/CCPs can help educate clients in ways to better manage
their chronic conditions.
Be able to calculate how CCHW-CCPs can help to reduce treatment costs in an
organization.
Learn how to complete the process for obtaining the CHW-CCP certification.
© 2019 ASPIN
Who is ASPIN? is ASPIN?
ASPIN, a 501(C) 3 not for profit network, that operates four major service lines:
Behavioral Health Service
Professional Training And Workforce Development
Grants Management
Health Improvement
“The mission of ASPIN is to provide innovative educational programs,
resource management, program development, and network management in
collaboration with all healthcare entities to address health disparities and
whole health management.”
© 2019 ASPIN
ASPIN Community Health Worker
Certification Evolution
Core
CHW Certification
Certified Recovery Specialist
Health Enrollment Navigator
Chronic Care Professional
Additional CHW Specializations
© 2019 ASPIN
First: A ReviewWhat are CCHWs, CCHWCRSs, CCHW-CCPs?
© 2019 ASPIN
What is a Community Health Worker?
The 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 or service delivery.
(American Public Health Association)
© 2019 ASPIN
CHW Job Titles: a Sample
• Community Health Worker
• Case Manager
• Navigator
• Clinical Director of Addictions
• Child Welfare Specialist
• Addictions Technician
• Behavioral Health Technician
• Diabetes Educator Navigator
• Hope Specialist
• Employment Specialist
• Entitlement Specialist
• Residential Advisor
• Program Coordinator/
Director
• Probation Officer
• Project Coordinator
• Residential Coordinator
• Sickle Cell Care Coordinator-
Educator
• Skills Development Specialist-
Trainer- Specialist
• SA Class Facilitator
• Team Leader
• Veteran Support Coordinator
• Vocational Rehab Specialist
• Wellness Coordinator
• Wraparound Facilitator
• Youth Care-Specialist
• Medical Assistant
• Member Connections
Representative
• Intake Receptionist
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• Outreach Coordinator
• Path Care Facilitator
• Healthy Lifestyle Coordinator
• Health Promotion Consultant
• Health Improvement Program Director
• Customer Service Representative
• Healthcare Advocate
• Financial Specialist
• BX Specialist
• At Risk Youth Care Worker
• ED Patient Care Navigator
• Promotura Coordinator
• RN PNCC Project Director
• Security Supervisor
• Executive Director
• Breast Feeding Counselor
• Crisis Call Manager
• Correction Navigator
• Cook
• AIRS Specialist
• ACT Team Leader
• ADL Specialist
• Employment Coordinator
• Engagement Specialist
• Medicaid Social Worker
• Hybrid Care Facilitator
• Director of Training and
Workforce Development
There are between 95 to 125 different job
titles for CHWs
The Occupation: Certified Community
Health Workers
Are an emerging fast growing paraprofessional workforce.
Typically have deep roots or shared life experiences in the communities they serve.
Work in all geographic settings, including rural, urban and metropolitan areas.
Are dedicated individuals who function along a continuum ranging from individual and community development to service delivery and promoting community empowerment.
Often help link people to needed health care information and services
Serve as a bridge between the community and the health care, government and social service systems.
© 2019 ASPIN
The Core Competencies of the
DMHA CCHW Training Curricula
HRSA- Health Resources Administration CHW Competencies
SAMHSA – Substance Abuse & Mental Health Services Administration Peer Core
Competencies
VA -Veterans Administration Peer Support
INCHWA- Indiana Community Health Workers Association
Family and Social Service Administration- Indiana Medicaid
© 2019 ASPIN
CCHW Training Skills Set
Client Engagement/Working
with Individuals
Consumer Outreach/Teaching
Skills
Whole Health Coaching/Issues
of Chronic Illness/Setting
Health Goals/Intro to
Behavioral Health/Addiction
Communication Skills
Motivational
Interviewing/Questioning
Confidentiality/Personal
Safety/Boundaries /Ethics
Capacity Building and Advocacy
Skills
Service Coordination and
Navigation
Managing Finances & Health
Insurance
Advocacy and Community Roles
Cultural Understanding
© 2019 ASPIN
What is a Certified Community Health
Worker/ Certified Recovery Specialist?
A Community Health Worker with a special focus, they are Community Health
Workers providing specialty support for persons in recovery.
A CRS must be in recovery from a mental illness and/or addiction.
They must willing and able to support the recovery of others.
They must satisfy additional required training ( 16 hours) and education
resulting in dual certification.
The “CRS” designation is an additional, advanced certification.
© 2019 ASPIN
What is Chronic Care Professional- Certified
Health Coach? Health coaches educate and support clients to achieve their health goals
through lifestyle and behavior adjustments.
Supported by the World Health Organization, Institute of Medicine.
Builds skills in four core competencies: population health improvement,
chronic conditions (25), lifestyle management, and health coaching.
Is recommended for non-clinical team members such as Community Health
Workers, program leaders, or consultants who support health and chronic care
improvement.
© 2019 ASPIN
How Do Chronic Conditions Adversely
Affect Mental Health?
And How Does This Contribute To Addictions?
© 2019 ASPIN
Mental, Physical, and Social Health are Linked
© 2019 ASPIN
American College of Physicians
In 2017, the American College of Physicians announced an official
recommendation to treat opioid use disorder like any other chronic illness,
with a focus on long-term management of the disease.
Given the often complex medical and behavioral health needs of individuals
with opioid use disorder, focusing on coordinating care and ongoing contact
are important actions in addressing these long-term challenges.
© 2019 ASPIN
Known Risk Factors Of Addiction Include
Poverty
Unemployment
Family history of substance abuse
Personal history of substance abuse
Young age
History of criminal activity or legal
problems including DUIs
Regular contact with high-risk
people or high-risk environments
Problems with past employers,
family members and friends
(mental disorder)
Risk-taking or thrill-seeking
behavior
Heavy tobacco use
History of severe depression or
anxiety
Stressful circumstances
Prior drug or alcohol rehabilitation
© 2019 ASPIN
© 2019 ASPIN
Some Numbers
Mood Disorders and Chronic
Physical Conditions
Mayo Clinic
© 2019 ASPIN
The Relationship between Mental Health,
Mental Illness and Chronic Physical Conditions
Canadians who report symptoms of depression also report experiencing three
times as many chronic physical conditions as the general population.
Canadians with chronic physical conditions have twice the likelihood of also
experiencing a mood or anxiety disorder when compared to those without a
chronic physical condition.
One out of every two Canadians with major depression and a co-existing
chronic physical condition report limitations in their day-to-day activities
© 2019 ASPIN
Mood Disorders and Chronic Physical
Conditions
© 2019 ASPIN
Mental Illness and Chronic Physical
Conditions
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Mental Illness and Physical Health Risks
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Psychiatric Medications
and the Body
© 2019 ASPIN
Depression and
the Body
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Effects of Mental Illness on Social and
Cognitive Function
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Feedback Loop of Chronic Physical
Conditions and Mental Health
© 2019 ASPIN
Mental Illness and Respiratory Disorders
© 2019 ASPIN
Chronic Disease, Mental Illness, and
Substance Use in Adults – Washington State
© 2019 ASPIN
Barriers to Accessing and Utilizing
Healthcare
Social Determinants of Health
Not Having or Knowing How to Use Health
Insurance
Stigma of Mental Illness
Diagnostic Overshadowing
Fewer preventive, specialist, and surgical
consultations© 2019 ASPIN
Population Health Affects U.S.
© 2019 ASPIN
Costs of Chronic Disease
© 2019 ASPIN
We Can Make a Difference!
© 2019 ASPIN
How Can CCHWs & CHWCRSs Who Are
Trained as CCP Health Coaches Can
Positively Impact Outcomes For This
Population?
© 2019 ASPIN
Integration of Care
© 2019 ASPIN
Enhanced
Training
© 2019 ASPIN
Primary Care – provide prevalence and screening training for mental illnesses; including co-occurring conditions.
Behavioral Health – provide prevalence and management training for physical health conditions; including co-occurring conditions.
CCHW-CCPs – provide training on chronic health conditions, enhanced motivational interviewing, and disease self-management techniques.
The CCHW in a
“Clinical Setting”
Role
In clinical settings, CCHWs can receive referrals from providers to assist patients that would benefit from additional support and education.
In an ED, CCHWs can assist in transitioning individuals to seeking sustainable treatment and ongoing risk reduction.
CCHW/CRS ( peer support) services have been found help to reduce ED visits and in-patent stays.
CCHWs are also a strong addition to patient care teams and can positively influence outcomes for individuals with opioid use disorder.
© 2019 ASPIN
© 2019 ASPIN
“Trusted
Community
Members and
Peers Of
Affected
Patients”
Support long-term recovery by helping
to address social determinants
Increase access to care and improve
the quality of care
Emotional support and mentoring to
individuals affected by addiction
Talk to family members
Provide education about addictions and
how to effectively navigate treatment.
Disseminate information within the
community
Reduce stigma by actively discussing
these topics in an informal and non-
judgmental manner within the
community
An Example From IndianaIU School of Medicine Care Plus Program:
CARE Plus is offered at IU Health Methodist Hospital. When a baby is born at
Methodist with neonatal abstinence syndrome, a therapist and community
health worker meet the mother to inform her about the program. If the
mother chooses to participate, the therapist and a community health worker
continue meeting with the mother and baby while the baby is in the neonatal
intensive care unit and teach the mother how to care for herself and her
baby.
Once mother and baby leave the hospital, the community health worker
continues to build relationships with the participating mother and other
caregivers in the baby’s life. The community health worker acts as a support
and connects the mother to resources she may need, such as food, clothing,
housing, therapy and addiction recovery programs.
© 2019 ASPIN
Care Plus
© 2019 ASPIN
The community health worker’s goals include reducing behaviors that contribute to infant mortality, such as helping mothers or caregivers recover from drug addiction, quit smoking, take care of their mental health, learn safe sleep practices and more.
They act as a coach and support system to encourage healthy behaviors and provide resources to mothers and caregivers recovering from opioid addiction who choose to participate in the CARE Plus program.
ROI Study by Magellan Heath Insights found that those that received peer support
cost the health plan significantly less after six months compared to those that
received standard case management; they also had less emergency room
visits and inpatient hospitalizations.
A study conducted by the Washington State Institute for Public Policy found a
ROI of $1.25 for every $1 spent on peer-delivered substance use programs
In Indiana: Effective July 1, 2018, the Indiana Health Coverage Programs
(IHCP) will provide reimbursement for services provided by CHWs. Coverage
for CHW services applies to all IHCP programs subject to limitations
established for certain benefit packages, for dates of service (DOS) on or
after July 1, 2018.
CHWs are required to be employed by an IHCP-enrolled billing provider and to
deliver services under the supervision of IHCP-enrolled provider types
Source: provider.indianamedicaid.com/ihcp/Bulletins/BT201826.pdf
© 2019 ASPIN
How is Indiana Helping?
© 2019 ASPIN
Governor’s Workgroup on Community Health Workers
Indiana Medicaid Reimbursement for CHW services
ASPIN ACCEPT: Becoming Dually Certified as a CCHW/CCP
ASPIN’s Chronic Care Education & Professional Training Program
Helping people get jobs with the right education and training!
© 2019 ASPIN
What is ASPIN ACCEPT?
• ASPIN’s Chronic Care Education & Paraprofessional Training
• Offered Through a Grant funded program through HRSA
(M01HP31262– Behavioral Health Workforce Education and
Training Program )
• An Experiential Training and Certification Internship Program
• A unique opportunity for Indiana
• 80 hours of combined training and workforce experience at no
cost to the students!
© 2019 ASPIN
Why does ASPIN ACCEPT exist?
CCHW’s and Chronic Care patient education professionals are a fast growing segment of the healthcare industry
50/92 counties in Indiana are Medically Underserved Populations
A strong need for paraprofessionals in both the primary care settings as well as community mental health care settings
Many Hoosiers that need a job do not have the credentials or the training that they need for the jobs they want or are available
This Program can help applicants get the job they want or the experience they need.
© 2019 ASPIN
Qualifications
© 2019 ASPIN
Applicants must :
Be 18 years or older
Be a current resident of Indiana
Have a minimum of a High School diploma/GED
Certifications
© 2019 ASPIN
Certified Community Health Worker (CCHW)
3 week online course/testing
All online with support from Certified ASPIN instructors
Chronic Care Professional (CCP)
4 month long course
Self-study manual provided
Facebook/Skype facilitated study groups
The ACCEPT Process – 80 + Hours
© 2019 ASPIN
Certified Community Health
Worker (CCHW)
Certification
20 hours
Web-based
Successful
Completion
Chronic Care Professional (CCP)
Certification
40 hours
Web-based
Field placement
Behavioral Health
10 hours
Successful
Completion
Successful
Completion
Field placement
Primary Care
10 hours
Successful
Completion
Employment
and/or
College
Job Experience
Credit
But I’m Already a
CCHW or CCHWCRS!
If you are a DMHA CCHW or CCHW/CRS in
GOOD STANDING
you can also qualify for this program!
Contact the ACCEPT Program Coordinator:
Chris Morrison
317.536.4682
© 2019 ASPIN
Training Topics
© 2019 ASPIN
CHW Training Topics
© 2019 ASPIN
Session One Session Two Session Three
1. Program Introduction 7. Communication Skills 13. Motivational Interviewing
2. Core CHW Skills 8. Practices That Promote Health
and Wellness
14. Coaching Consumers for
Positive Health Outcomes
3. Ethics 9. Physical Health/Chronic
Disease Overview 15. Tobacco Treatment
4. Diversity/Cultural
Competency
10. Behavioral Health Overview 16. Group Facilitation Skills
5. Conflict Management
11. Substance Use Disorders 17. Advocacy, Collaboration and
Teamwork
6. Technology 12. Integrated Care Model 18. Securing Employment as a
CHW
CCP Core
Competencies
Four core competencies:
1.) Population Health Improvement
2.) Chronic Conditions
3.) Lifestyle Management
4.) Health Coaching
© 2019 ASPIN
CCP Training
Topics
© 2019 ASPIN
Understanding Chronic Conditions (25)
Assessing Healthcare Quality
Improving Chronic Care
Foundations of Population Health Development
Strategies for Population Health Improvement
Measuring the Outcomes of Population Health Programs
Placements
Primary Care Setting (10 Hours)
Hospital, Health Clinic, or Physician Office
Behavioral Health Setting (10 Hours)
Community Mental Health Centers
Gives participants a chance to view the work in a real-time setting
OR
Credit for work currently being performed!
© 2019 ASPIN
Continuing Education – Recertification
CCHW – 14 Credit Hours per Year
CCP - 15 Credit Hours per Year
© 2019 ASPIN
Thank You!!
Contact Us:Paul M. Conrad
Director of Training and Workforce Development
317.536.4681
www.aspin.org
© 2019 ASPIN
Behavioral Health Workforce Education And Training (BHWET)
“The ASPIN Chronic Care Education Program Training project is supported by the Health Resources
and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS)
under grant number M01HP31262-01-00 for $1,200,0000 for a four year period. This information or
content and conclusions are those of the author and should not be construed as the official position
or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.”
References https://www.apha.org/apha-communities/member-sections/community-health-workers
https://www.tes.com/lessons/RPNNv5XlfvON6g/sociological-perspectives
Substance Abuse and Mental Health Services Administration, Report to Congress on the Nation’s Substance Abuse and Mental Health Workforce Issues (Rockville, MD: US Department of Health and Human Services, January 2013), https://store.samhsa.gov/shin/content/PEP13-RTC-BHWORK/PEP13-RTC-BHWORK.pdf.
https://mhpsalud.org/opioid-crisis-community-health-workers-chws/
https://www.ajmc.com/focus-of-the-week/treat-addiction-like-a-chronic-disease-acp-recommends
https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/in-depth/how-opioid-addiction-occurs/art-20360372
https://magellanhealthinsights.com/2018/06/14/the-lived-experience-factor-in-fighting-the-opioid-epidemic/
https://www.dualdiagnosis.org/mental-health-and-addiction/
https://ontario.cmha.ca/documents/the-relationship-between-mental-health-mental-illness-and-chronic-physical-conditions/
© 2019 ASPIN