Network for East Texas Rural Health 2010 Outreach Program and Network Development Grantee Meeting Washington, D.C. August 2-4

Program Overview Network formationNetwork formation FundingFunding Hiring processHiring process CHW trainingCHW training Expanding the CHW programExpanding the CHW program Evaluation, process tracking and data collectionEvaluation, process tracking and data collection Challenges/lessons learnedChallenges/lessons learned

Network Partners Piney Woods Area Health Education CenterPiney Woods Area Health Education Center Texas Department of State Health Services (Public Health Service Region 4/5N)Texas Department of State Health Services (Public Health Service Region 4/5N) East Texas Community Health ServicesEast Texas Community Health Services East Texas Health Access Network (ETHAN)East Texas Health Access Network (ETHAN) Southeast Texas Regional Planning CommissionSoutheast Texas Regional Planning Commission –Southeast Health Access Network (SETHAN)

Service Area The service area includes Jasper, Nacogdoches, Newton, Red River, Sabine, San Augustine, Tyler, and the rural areas of Hardin, Jefferson and Orange counties.The service area includes Jasper, Nacogdoches, Newton, Red River, Sabine, San Augustine, Tyler, and the rural areas of Hardin, Jefferson and Orange counties.

Funding Received Rural Health Network Development Grant 9/1/08 – 4/30/11Received Rural Health Network Development Grant 9/1/08 – 4/30/11 Network partners contributed resourcesNetwork partners contributed resources

Who are the CHWs They are carefully chosen community members who participate in empowering trainings so they can help promote good health in their own communities. They areThey are a strong link between their communities and health and social service providers. Network (contract vs. AHEC employee)Network (contract vs. AHEC employee) Hiring processHiring process –Develop CHW job description –Recruit applicants to apply

The CHW Training CHWs trainedCHWs trained CHW sites educatedCHW sites educated New CHW Apprenticeable OccupationNew CHW Apprenticeable Occupation

Additional Funding Opportunity to expand NetworkOpportunity to expand Network –Federal Social Services Block Grant awarded to state

Process for site selection Identify sites CHW services can be utilizedIdentify sites CHW services can be utilized –Maintain CHW after funding ends –Advocate for CHWs Contact potential sites to assess interestContact potential sites to assess interest –Schedule meeting to present the value of CHWs Finalize CHW hiring processFinalize CHW hiring process AB C

Network Expansion Burke Center Mental HealthcareBurke Center Mental Healthcare Cherokee County Health District (two clinics)Cherokee County Health District (two clinics) Head Start Child Development CenterHead Start Child Development Center Hope Project (FQHC)Hope Project (FQHC) Memorial Health Systems of East TexasMemorial Health Systems of East Texas Nacogdoches Alcohol and Drug Abuse CouncilNacogdoches Alcohol and Drug Abuse Council Nacogdoches Memorial HospitalNacogdoches Memorial Hospital

CHW Roles The CHWs work duties vary by employment location, responsibilities can include: helping individuals, families, groups and communities develop their capacity and access to resources including health insurance, food, housing, quality care and health information;helping individuals, families, groups and communities develop their capacity and access to resources including health insurance, food, housing, quality care and health information; facilitating communication and individuals’ empowerment in interactions with health care/social service systems;facilitating communication and individuals’ empowerment in interactions with health care/social service systems; helping health care and social service systems become culturally relevant and responsive to their service population;helping health care and social service systems become culturally relevant and responsive to their service population; helping people understand their health condition(s) and develop strategies to improve their health and well being;helping people understand their health condition(s) and develop strategies to improve their health and well being; helping build understanding and social capital to support healthier behaviors and lifestyle choices among people;helping build understanding and social capital to support healthier behaviors and lifestyle choices among people;

CHW Roles delivering health information using culturally appropriate terms and concepts;delivering health information using culturally appropriate terms and concepts; linking people to health care/social service resources;linking people to health care/social service resources; providing informal counseling, support and follow-up;providing informal counseling, support and follow-up; advocating for local health needs;advocating for local health needs; providing health services, such as monitoring blood pressure and providing first aid;providing health services, such as monitoring blood pressure and providing first aid; Making home visits to chronically ill patients, individuals at high risk of health problems, and the elderly; andMaking home visits to chronically ill patients, individuals at high risk of health problems, and the elderly; and Translating and interpreting for individuals and health care/social service providersTranslating and interpreting for individuals and health care/social service providers

Needs of Clients- ETHAN Medical homeMedical home Dental servicesDental services Information and referralInformation and referral Within an emergency medical situationWithin an emergency medical situation Medication assistance (MAP)Medication assistance (MAP) Managing Diabetes or chronic diseaseManaging Diabetes or chronic disease Smoking cessationSmoking cessation Changing living situationChanging living situation Health educationHealth education Medical equipmentMedical equipment (Health Equipment Loan Program) (Health Equipment Loan Program)

Successes Network formedNetwork formed Network expansionNetwork expansion Piney Woods AHEC CHW instructors trainedPiney Woods AHEC CHW instructors trained Training siteTraining site Increased employment opportunities for East TexasIncreased employment opportunities for East Texas CHW recognized as apprenticeableCHW recognized as apprenticeable –Coastal AHEC submitted to U.S. Department of Labor

Evaluation, process tracking and data collection Identify ways to better address the healthcare needs of the target populationIdentify ways to better address the healthcare needs of the target population –ETCHNA Uniform data collection formsUniform data collection forms Demonstrate program successesDemonstrate program successes –(“If it isn’t documented, it didn’t happen!”) Identify areas to promote CHW professional developmentIdentify areas to promote CHW professional development –Provides quality control Help secure fundingHelp secure funding –Provides the necessary data to show the need, return on investment, and potential for improved outcomes

Challenges/Lessons Learned Under-estimating time commitmentUnder-estimating time commitment Educating healthcare community on CHW capabilitiesEducating healthcare community on CHW capabilities Integrating the CHWs into the work placeIntegrating the CHWs into the work place Surviving program expansionSurviving program expansion

Janis S. Ritter, MEd Center Director Lurah Bryant, CHW Program Coordinator Piney Woods AHEC Nacogdoches, TX