Project Accomplishments
Minnesota Community Health Workers Program
Mankato, MN
Featured Article
Medicaid Reimbursement
In 2008 Minnesota Community Health Workers will begin to receive Medicaid reimbursement for their services.
“We’ve been funding community health worker programs since 1988,” notes Pauline M. Seitz, director of the Robert Wood Johnson Foundation Local Funding Partnerships program. “The biggest challenge these projects face is not in establishing the value of the workers, but in securing third-party reimbursement and providing an organized curriculum of study leading to certification. The Minnesota Community Health Worker (CHW) project has overcome these challenges and offers a new national model to integrate CHW’s into the health professions.”
New college curriculum
In 2004 a statewide coalition of higher education, rural and urban health care systems, third-party payers, community health workers, funders and other public and private organizations created the original Minnesota Community Health Worker (CHW) Project to address critical health care workforce issues. Now their well-tested and finalized Community Health Worker Curriculum is available to educational institutions outside of Minnesota.
This standardized 11-credit curriculum is the centerpiece of the project's CHW training and workforce development initiative. It offers new career paths within the health professions, new employment opportunities for community health workers, and recruitment from the low-income and first-generation communities to be served—including Native Americans and Southeast Asian, Latino and East African immigrants.
“The Minnesota Community Health Worker Project is changing the system of care in significant ways,” says Seitz. “The graduates are reducing cultural and linguistic barriers to care while increasing the diversity of people entering the health professions.” Seitz adds that, “Their training as community health workers also opens possibilities to help them advance professionally as well as to fulfill emerging needs in the health care system.”
The job of a community health worker
Project director Anne Willaert explains, “CHWs serve as a crucial bridge between specific cultural groups and the health systems that serve them. In some cases, CHWs help patients obtain health coverage, make medical appointments and follow through on treatment recommendations. In other cases, CHWs provide outreach, referral and education about specific health issues such as diabetes or teenage pregnancy. Typically, they are bicultural and bilingual individuals whose effectiveness stems from their membership in and understanding of the communities they serve, combined with their training.”
The duties of community health workers vary across the organizations that employ them and the populations they serve. However, trained CHWs are in demand. According to the Minnesota Healthcare Education-Industry Partnership (HEIP), studies show that 67 percent of CHW employers plan to hire additional CHWs in the future, 33 percent of these employers are recruiting and 84 percent would hire additional CHWs if they had funding.
Strong coalition
Former LFP deputy director Sandra Lopacki accompanied Willaert to Texas for an invitational conference on community health workers in 2007. “The Minnesota project is a national model,” notes Lopacki. “They demonstrated how important it is to bring everyone to the table from the beginning: providers, payers, educators, health professionals, experienced community health workers and funders. Their success is a credit to their remarkable coalition.” (See the list of project partners.)
Blue Cross and Blue Shield of Minnesota Foundation helped launch the coalition by commissioning the initial studies of the state’s CHW workforce. The findings identified the need for standardized, competency-based training to establish the community health worker as a recognized vocation that could be instrumental in expanding the size, diversity and cultural competence of the health workforce. Subsequently Blue Cross Foundation funded HEIP to develop a CHW curriculum through a collaborative process and then nominated the project to the Robert Wood Johnson Foundation for their LIFP matching grant.
"Community health workers break down many cultural and linguistic barriers to care,” states Joan Cleary, Blue Cross Foundation vice president. "For all Minnesotans to be healthy, we need to address these needs for a growing portion of our population.” Research shows that patients who speak a primary language other than English and don’t have access to an interpreter are less likely to access preventive care, seek cancer screening, keep appointments or comply with treatment.
Strategic Planning
From the beginning careful planning has gone into the expansion of the program from one campus to another in the large Minnesota State College and University System. One objective is not to train more CHWs than can be hired. “We are very encouraged by the success so far,” says Willaert. “Of the 211 who enrolled in the training course, there are 152 graduates (including 36 people in the class of 2007). Forty-two graduates are employed in newly created CHW jobs. Completing the program's six modules and internship confers credits that may be applied towards a degree in healthcare, education or social services.
The CHW Policy Council has been strategic in considering how to professionalize the CHW role and how to make their employment a financial win-win for health care organizations. “Our next goal is to demonstrate to insurance companies and other payers that the time a CHW spends with a patient should be billable and reimbursable, especially in the areas of illness prevention and chronic disease management,” says Willaert. She is also working with the American Public Health Association to get a Community Health Worker Definition added at the U.S. Bureau of Labor Statistics.
One-Page Fact Sheet
As this project approached the end of their LFP grant period, this one-page report of project objectives and accomplishments was presented at a Local Funding Partnerships annual meeting. Please read the report.
