Maine Community Health Worker Initiative: Maine CHW Inventory
December 2, 2013
Agency Name/
Entity & Contact
Info.
MEPCA Patient
Navigation
Approach/
Kim Humphries
207.621.0677
Portland Public
Health- Bankole
Kolawle
207.874.8773
Name /Definition of
CHW/ Shared or Paired
Trait
Definition
Source
No paired trait but
cultural competency is
part of training. Also,
integrates patient
perspective to better
understand the
community, as well as
the sub-populations.
Responsibilities are
shared across team, can
divide it to work for
them. “…defining patient
navigation as a “process”
rather than a “person”
…the navigation team is a
critical component. The
purpose of the project is
to improve patient care
across the continuum of
care. Achieved by
improving referrals, early
detection and
streamlining system
within CHCs
Community Health
Outreach Worker:
emphasize the outreach
component of their work.
MA-PNav
Prog.
MACHWA
A
P
H
A
N
Population
Served
Recruitment
Methodology
Training/
Supervision
Salary/
Stipend
($$$)
Base of
Operation
Individual
participating
FQHCs define
the population
they would
target (i.e. for
breast, cervical
and colorectal
health and
other chronic
conditions).
N/A Varies based
on capacity of
individual FQHC
and make-up of
team. No prerequisites
48 hour coursebased on MA
curriculum. Online plus two onsite training
sessions (14
weeks).
Supervision
varies by FQHC.
Navigation
team
members are
all employees
of FQHCs.
Most of work
goes on in the
practice/FQHCs
but also building
relationships to
community
resources/entitie
s (i.e. AAA and
Healthy ME
Partnerships). It
is the HC staff
who make these
connections.
Y
Thirteen
racial/language
/ ethnic
communities.
For FTEs because
hired under PPH
follow city HR
expectations.
CHOW Training35 hour mixture
of MA, AZ & NY
curriculums-
4 FTE CHOWs
(Somali,
Spanish,
French,
4 FTE CHOWs are
housed at City
Hall & at clinical
sites (Riverton,
Maine Community Health Worker Initiative: Maine CHW Inventory
December 2, 2013
CHOWs are indigenous to
their communityaddressing, structural,
culture & language
barriers. Shared
language, country of
origin and culture.
Maine Migrant
Health Program
Promotora/Camp Health
Aide Traits shared: ag
work, language, and
race/ethnicity. CHWs are
community members
who promote health in
their own communities.
They provide leadership,
peer education, support,
and resources to support
community
empowerment. As
members of minority and
underserved populations
they are in a unique
position to build on
i.e. Cambodia,
Vietnamese,
Serbia, Swahili,
Chinese,
Sudanese
(Acholi/Nur),
Russian,
Spanish, etc.
MHP
Y
Farmworkers
Each FTE CHOW
has an advisory
committee, from
these CHOWs are
recruited, also
Faith Based &
Community
Leaders.
Previous
involvement
w/PPH.
core
competencies
(10 hrs.), health
specific topics (9
hrs.).
Arabic)
Supervised by
PPH Staff and
Clinical Partners
(assigned
coordinators at
each site- MMC,
Mercy, PCHC,
etc.)
Maximum 39
CHOWs (13
communities)
Outreach basedcamp visits,
recommendation
s of previous
CHAs or other
peers, postings in
camps
10 hour- basic
training on core
competencies
followed by 2-3
hours on specific
health
issues/initiatives
. Face to face
supervision
2x/month
$100/week
(expectation
of 10 1 on 1
contacts or
group
education
Contracted &
Per Diem
CHOWs-
Mercy, India,
Fore River).
Clinical Sites
provide space.
Also working in
So Portland,
Westbrook- i.e.
Cumberland
County.
Per diem are
actually
employees of
City
MMHP- CHA
Project
Coordinator
spends 70+% of
time during
season in harvest
areas. In 2013
MMHP will have
12-14 CHAs all
live and work in a
labor camp.
Maine Community Health Worker Initiative: Maine CHW Inventory
December 2, 2013
United Somali
Women- Fatuma
Hussein, Executive
Director
207.753.0061
Frannie Peabody
Center- Jennifer
Putnam, Director of
strengths and to address
unmet health needs in
their communities….
Same cultural
background, language,
system they work in, lot
of commonalities with
the people they serve.
Same community- i.e.
Acholi speakers for
Sudanese members. 1015 different language
groups spoken by staff.
“Outreach Worker” tend
to try to match them to
the community that they
Y
Refugee &
Immigrant
PopulationsAfrican &
Middle Eastern
Ethnic Groups,
Somali,
Sudanese,
Rwanda,
Burundi, Somali
Bantu, Angola,
Chad, Egyptian
Cultural and
language (written
& spoken) skills
are most
important to
assess. Language
proficiency and
background
checks are part of
screening.
Going to take a
lot of effort to get
cultural
knowledge base
increased.
Trauma/needs
high important to
important we
recruit from
within our
communities
Y
MSM, IDU,
Asylees (falling
under category
Typically put
word out in
community that
Traininginterpretation
basic training.
Orientation for
new staff,
training-40 hour
advocacy
(DV/SA), health
systems training,
role of CHOWs,
2006 training
from folks in
MA- chronic
disease, system
of CHOW,
partnerships
w/providers &
community
agencies, and
job shadowing.
Grass roots
outreach & then
skills needed to
do this work in
community. Also
act as a trainer
Training- FP
orientation- CDC
HIV CTR training,
Mostly
employees
(.80 FTE) and
a few contract
positions to
CMMC
Lewiston, Auburn
and there is an
office in Portland
(Riverton)
I FTE 2 PTserving MSM/
1 FTE female
Based out of
(Store front)
Portland and
Maine Community Health Worker Initiative: Maine CHW Inventory
December 2, 2013
Programs
207.774.6877
serve, esp. with MSM
prevention work.
Area Agency on
Aging- Jess Mauer,
Executive Director
207.592.9972
Enhanced options
counseling thru “ADRC
Counselors” AAAs is also
aging and disability
resource centers
(ADRCs). ARDC grant
collaboration with CCTs
and PCMH sites to do
options counseling & go
into the home to do
assessment (2.5 hours)
on home risk, barriers to
managing health,
nutrition needs,
of women at
high risk).
US
Agency
on Aging
they would be
serving.
M Disabled adults Need to get back
and adults 60
to me on this
years and older.
CCT enhanced
project it is 50
years and older
(top 3% of
medical users).
Agency is
serving about
130K
individuals per
year (not
rapid testing
training,
outreach and
safety training.
Cultural
competency
training. Do
some shadowing
of the work.
Lots of
continuity
amongst staff.
Supervised by
director of
programs and
some clinical
supervision (not
required).
All ARDCs are
trained in
Coleman model.
One universal
assessment tool
and
documentation
data collection
tool so training
is done to match
these
instruments.
Depending on
where ARDCs
serving IDU
community as
well as asylee
community
Also do some
stipended
outreach
Ogunquit offices.
Full-time.
Employees, 5
ADRCs under
CCT project.
Working
collaborativel
y with
healthcare to
improve care
and decrease
costs.
Based out of the
5 regional AAAs
employed as an
ARDC.
Maine Community Health Worker Initiative: Maine CHW Inventory
December 2, 2013
EMHS (AAA)
Lanie Abbott
lwabbott@emhs.or
g
Amistad Peer
Coaching Pilot
Chris Monahan
207.773.1956 (no
call back)
medication mgmt. issues.
SES & physical needs &
potential harms- work in
PSP with medical
provider. Traits sharedpeople who have been
around for a long time,
most are social workers.
Grounding in
understanding the
population.
“Patient Advisors”service line or practice
define their involvement.
No common definition
developed yet, Evolved
from PCMH expectation
for patient/family
advisory role.
“Peer Coach” refers to a
person who has been
diagnosed with a mental
illness and has reached a
level of stability in his or
her recovery process that
he or she can work with
necessarily by
ARDC).
PCMH
N
Patients- Scope
of Involvement
is how to
inform work of
practice to be
better- i.e.
processing
patient
complaints
Looking for
mixed
demographicsage, family
status
Patients who can
get out of the
way of their
storyrecommendation
s of frontline staff
will know who is
available, and
then using the
provider or nurse
care coordinator
to do actual ask.
Beginning to use
social media.
are housed will
define the scope
of their work
and what
background is
required of
them.
MaineHealth is
using LCSWs as
part of their
CCTs.
Developing a
toolbox/resourc
e for individual
practices with
tools- how do
you make it
worth time of
staff & patients
Provide a
healthy meal.
Because of staff
time is intensivethere is some
consolidation of
patient advisory
groups (i.e.
Inland and
Sebasticook
Family Health).
Maine Community Health Worker Initiative: Maine CHW Inventory
December 2, 2013
Somali Cultural and
Development
Association- DD
Swan non-profit
coach
207.773.3430
Portland
Community Health
Center
Laura Gottfried
207.874.2141
and relate to their peers
who may be experiencing
feelings of anxiety, fear,
apprehension, etc.
Community Health
Outreach Worker/CHW is
used interchangeably.
“CHOWs” are matched
on shared language and
culture
“Community Health
Outreach Workers” of
PPH placed at HC for a
couple of hours per
week. Two volunteers at
HC are trained as
CHOWs. One of whom
completed the Stanford
Chronic Care Model.
MA
CHWA
Y
Refugees/
Immigrants
Mohammud does
most of the
recruiting
through his
connections
amongst other
medical
interpreters,
community
contacts, &
shelters.
MA
CHWA
Y
Kiera Moss,
logistical point
person for PPH
Staff & is
Outreach
Manager. Once
chronic care
piece is up and
running clinical
The volunteers
approached us to
get involved, one
of whom is a BOD
member, the
other is a family
member.
DD/PCHC
provide
supervision. All
CHOWs need to
be certified
medical
interpreters.
They have
completed the
CHOW training
available under
the
CHANNELS/PPH/
UNE project.
Also trained in
content of
MEHAF /ACA
collaborative
and thru PCHC.
Both completed
CHOW training
with City of
Portland/
CHANNELS
project.
To date 9
have been
trained and
are receiving
stipends for
specific
activities.
Based out of
office on Elm
Street, many of
the community
events are done
at Franklin Twrs.
May have
received
stipend for
training &
travel- no
ongoing
financial
support
180 Park Ave. site
only
Maine Community Health Worker Initiative: Maine CHW Inventory
December 2, 2013
Catholic Charities/
Refugee
ResettlementKaren Balicki
523-2711
Cultural life Skills TrainerDoing group-level
orientation (Portland &
Lewiston) one is focused
on community the other
on culture. Also a group
bus tour, car seat
trainings. Donation
distribution of winter
clothing. One on one
w/families (i.e.
EBT/grocery shopping
/laundry/household/tras
h disposal. Parenting
skills, more rarely.
Ref
Rstlmt
Def.
N
Tribal Health
Departments
(Maliseet,
Penobscot,
Passamaquoddy)
Community Health
Resource Worker
CC Transformation
Grant- Alex
Understanding and good
relations with tribal
member.
Responsibilities include
home/safety
assessments, BP
screenings, posthospitalization home
visits, health education
IHS
Y
SW will act as
supervisor.
Refugees from
Somalia and
Iraq coming
directly from
home country.
Lewiston more
secondary
wave.
Relationship
w/ IHS HC
means that a
service (i.e.
post hospital
visits) are tied
to individual
being a patient
of HC.
Recruited based
on skill
development/
training
experience.
Varied depending
on how Tribe
funds/defines
scope of work
(i.e. everything
from GED to
nursing degree
All CHR positions
are first posted to
Life Skills
training from
BU. Over 100
hours of training
in psych rehab
and skill
development
(i.e. training
people). Part of
refugee and
resettlement
team. Under
contract with US
State Dept.
services include
CM, Employee
CM, and Cultural
OrientationReception &
Placement
Services.
Dependent on
role- i.e. if CHR is
a nurse there
will be clinical
supervision, but
inevitably leads
up to HC
Director.
Employee
Portland only in
Lewiston (2
days/month)
Income from
health
center/IHS
support. Two
of tribes have
vacancies due
to lack of
funding. All
are employ-
Depends on how
the job is
structured within
the Tribal Health
Center.
Maine Community Health Worker Initiative: Maine CHW Inventory
December 2, 2013
London/Houlton
Band of Maliseets
Cell: 207- 538-1916
MDI Hospital/
HRSA Diabetes
Community
Outreach ProjectDeb Turner (207)
460-2581
and community activities.
They are either unusually
close or a member of the
tribal community. They
understand the
community, share
practices, common
interests. IHS definition
guides this
role/individual at each of
the tribes, but depending
on who is in it, their role
might be different. In
this liaison role the CHR
is often the face of the
health center, the trusted
individual who advocates
on behalf of the patients.
Adjunct to supplement to
professional doing care
management.
Community Health
Volunteers mostly doing
diabetes prevention
groups. Have longest
programming in Swan’s
Island. Shared trait was
used but not exclusively
bc/of grant pressures.
Focused on MDI Hospital
service area.
Commun
-ity
health
coach
definition
from
NDPP.
N
Community
activities are
more broadly
available. There
seems to have
significant focus
on elders
the tribal
community which
is customary
hiring procedure;
if it is not filled it
is shared with the
greater/broader
community.)
High risk of
type 2 diabetes
or already
diagnosed with
type 2 diabetes.
Promoting
screenings &
getting care.
Engage
community
members to
increase
awareness or
risk & then
High interest in
community
service, passion
about health
education &
prevention. In
our opinion
would participate
well & engage
well in
community.
ees of Tribal
Health
Center.
Basic hospital
orientation, halfday project
introduction,
instruction in
diabetes
prevention
program.
Pairing/
shadowing with
trained
facilitator who is
also supervisor
(nurse & SW).
Volunteercurrently have
5, new group
in 2014.
All services are
provided in
community. Since
most of the work
is doing the
prevention
group- health
center on Swans
in Bar Harbor
using YMCA, SW
Harbor- primary
care clinic.
Convenient
locations.
Maine Community Health Worker Initiative: Maine CHW Inventory
December 2, 2013
getting folks
into NDPP.
A Community Health Worker (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 of service delivery.
A CHW also builds individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach,
community education, informal counseling, social support and advocacy. (American Public Health Association, 2009)
Assist individuals and communities to adopt healthy behaviors. Conduct outreach for medical personnel or health organizations to implement programs in the
community that promote, maintain, and improve individual and community health. May provide information on available resources, provide social support and
informal counseling, advocate for individuals and community health needs, and provide services such as first aid and blood pressure screening. May collect data
to help identify community health needs (Bureau of Labor Standards, 2010)
Maine Community Health Worker Initiative: Maine CHW Inventory
December 2, 2013
Conclusions







The inventory is not exhaustive in including all programs that might have one or two characteristics shared with CHWs, it is a convenience sample and
looks to represent the different approaches folks in Maine are taking to engage patients in a new way, outside of the traditional medical model.
Not one entity identified the APHA definition as their working definition. That is not to say, that respondents didn’t identify with the definition when
they heard it or identify with key components, but it was not named as such. If the CHW project is going to aspire to using this definition, there may
need to be some coalescing to get everyone on the same page.
Definition is often tied to funding source or specific curriculum, meaning the intention behind common language is an important consideration, i.e. is it
to create shared identity? Serve as job description?
Many of the respondents felt they met the paired or shared trait through training or extensive experience. This will be an important assumption to
address when adopting a working definition as well as addressing recruitment and core competencies.
The vast majority of respondents indicated that the work of the CHWs is predicated by funding sources- i.e. asthma funding means asthma focus to
education and assessments not only in terms of content or focus, but more importantly, in terms of sustainability this translated into loss of CHW
services when grants ended.
Three of the respondents are all using the same training curriculum (i.e. UNE Channels/PPH project).
Wide diversity in terms of experience required, recruitment strategies, employment/payment structure, formal education, geography in where CHWs or
quasi-CHWs are working. Implications are for certification process i.e. there may be need for a graduated certification process or optional certification,
as well as an investigation of other state’s bare minimums related to education level.
Maine Community Health Worker Initiative: Maine CHW Inventory
December 2, 2013
Comments/Notes (i.e. other information that didn’t fit grid)
Consumer Engagement Committee- Bangor Beacon Project was precursor to patient advisory groups- which are required to get PCMH status. How can you get
vital feedback on what is going on. AAA Collaboration is part of the Pioneer ACO- Diane Walsh is CEO, suggested they be in the know about what is going on
within EMHS in the loop- opt out rate was only 4%.
Member Services Group within ACO (Beacon Health will have 20,000 Mainecare members and 60,000 lives) which will launch in 2014 to work beyond EMHS
USW- (provider training, in hospital interpreters, patient education on medications, disability)- lead screenings
PCHC= does PPH meet our needs, do we have needs that exceed what we offer. Do we want to have our own CHWs. We are a co-applicant on a grant
CHANNELS (UNE/PPH/PCHC). CHOWs spend significant amount of time at Riverton, all under City of Portland, two male CHOWs Sudanese & Somali who spend
limited number of hours with PCHC. City of Portland hiring a third who will be French speaking.
Jess- None of the money has funneled down to CBOs to make reform happen. Trying to build strong partnerships with CCT & PCMH to make sure that needs are
met which support an individual’s health or functionality. Most of the work is holistic in looking at needs of folks seeking services, addressing all of their needs.
Understanding the integration piece is key to keeping people healthy- referrals to primary care and chronic care model. Broad understanding of benefits
available. Want to expand that project w/ QC applied to CMS for 2nd round of SI grant requested $10M and has a broadly defined target populationunsupported dementia, risk of falls, polypharmacy use, etc.
MDI Hospital- Community health coach(member of CCT) is doing more comprehensive care, limited role of community health volunteer. Project is linked to the
CCT on MDI that is part of QC Pilots.