Please use the following citation when referencing this - PowerPoint PPT Presentation

Please use the following citation when referencing this information/data : Colorado Community Health Worker and Patient Navigator Collaborative-Regionalization Subcommittee and the Colorado School of Public Health. “ Colorado Community Health Worker and Patient Navigator Statewide Survey ”. Conference Presentation, Public Health in the Rockies, September, 2013.

+ Community Health Worker/Patient Navigator Collaborative: The Colorado Overview and Future Trust Directions Colorado Public Health Association Chris Armijo September 20, 2013

+ PN and CHW Evidence Some Sufficient Evidence Evidence Source: Colorado Patient Navigator Training Program

+ Overview of Community Health Worker/Patient Navigator Workgroup

+ Goals of CHW/PN Workgroup  Identify and agree upon roles and competencies of patient navigators (PNs) and community health workers (CHWs).  Identify and develop training pathways for PNs and CHWs in Colorado.  Collaborate to create sustainable funding for patient navigators and community health workers.  Develop policy solutions that align patient navigation/community health worker/promotor groups around the state into a more structured body in order to engage in the above work.

“Coming together is a beginning. Keeping together is progress. Working together is success.” -Henry Ford

+ CHW/PN Language and Terms  Little emphasis on profession “identity”  Mainly focus on roles and competencies  Stressing sustainability and reimbursement as a key outcome

+ Overview of CHW/PN Workgroup • Currently over 100 members • Represent a number of health fields and roles in health • Geographically diverse • Represent a variety of different perspectives

+ CHW/PN Subcommittees Definitions Competencies Regionalization

+ Coordinatio n of Resources Stage 1 and Professionalization Services Competencies Financing and Reimbursement Regionalization Credentialing Definition Training Certification Curricula

Regionalization Subcommittee Andrea Dwyer-Chair Regionalization Subcommittee University of Colorado Cancer Center Colorado School of Public Health

Background As Workgroup/Collaborative formed-clear that CO is rich in CHW/PN resources. While advancing the field and examining definitions and competencies, good to think about linkage of people and resources throughout CO. Nearly 15-20 people attend each meeting – statewide representation

Statewide

Regions

Regionalization Committee Spearheaded Statewide Survey 1) learn about who, what and where: services, research, training and policy are delivered/underway in Colorado and 2) utilize information to create a directory/resource guide for Colorado constituents and colleagues 3) Statewide forum for Patient Navigation and Community Health Work

Survey Design Providing Direct Services  How Do They Identify  Services-Who, What, Where Managing Services  How Do They Identify  Services-Who, What, Where Research Training Policy

Response Information Response truly statewide, representation from every CO County 259 completed responses 134 incomplete/partial responses Survey Results to Be Shared

Possibilities of Where We’re Going Survey Results to Help Link CHW and PN and services they provide to CO constituents Resource Directory: Linkages 2-1-1 United Way Phone and Database Identify Needs and Gaps Understand more about who people are and how they define themselves Contribute to Body of Literature-Manuscript Partnerships with Other States

Please use the following citation when referencing this information/data : Colorado Community Health Worker and Patient Navigator Collaborative-Regionalization Subcommittee and the Colorado School of Public Health. “ Colorado Community Health Worker and Patient Navigator Statewide Survey ”. Conference Presentation, Public Health in the Rockies, September, 2013.

+ Patient Navigation, Community Health Work and Care Coordination in 2013 Community Health Worker, Colorado Statewide Patient Survey Navigation Communities Regionalization Results Sub-Committee September 20, 2013

Survey Methods and Background • Online survey using the REDCap database/Participant email Developed by the Colorado CHW/PN workgroup • Disseminated to workgroup members, clinical and community • members, coalitions and programs Modified-snowball sampling method • • Difficult to assess response rate/denominator Survey Structure • Section I: Persons actually delivering the service/care to clients • Section II: Persons directing or managing programs • • Section III: Persons involved in training • Section IV: Persons conducting research Section V: Persons involved in policy work/advocacy • + Section VI: Persons who are not currently involved but have an • interest • Response data • 259 completed responses 134 incomplete/partial responses •

+ I. Examine who/groups: i. Community Health Workers/Patient Navigators/Case Managers/Care Coordinators/ Promotores Today’s ii. Managing iii. Training Agenda iv. Research v. Policy and Advocacy II. Examine specific focus/ activities by group III. Examine work/activity settings by group IV. Examine activities at Colorado county level V. Examine training programs/gaps in training VI. Examine funding mechanisms VII.Todays presentation v. expanded presentation

Respondent Roles and Work Focus* Overall Survey 70% Response (n=259) 28% 24% 14.0% 6.0% + *multiple responses permitted CHW=Community Health Worker; PN=Patient Navigator; CC=Care Coordinator; CM= Case manager; PM=Promotora

Counties Served by All Respondents (n=259) # of Individuals

+ CHW/PN/CC/CM/PM Roles (n=182) Employment/ Volunteer Roles Patient Navigator 60 Care coordinator 32 Community Health Worker 31 Case Manager 21 Other 18 Promotora 7 Percent

Counties Served by CHW/PN/CC/CM/PM (self-described) (n=182) # of Individuals

Counties Served by CHW/PN/CC/CM/PM X Median Household Income # of Individuals (n=182) )

Community Health Worker, Patient Navigator and Health Promotor Workgroup Subcommittee Working Definitions CDC Community Health Worker Definition (CDC): An individual who works almost exclusively in a community, health worker, promotores, or patient community setting. They serve as connectors navigators, care coordinators and case managers between health care consumers and providers to promote health among groups that have traditionally lacked access to adequate health care. This individual is uniquely qualified as connectors because they live in the communities in which they work.

Community Health Worker, Patient Navigator and Health Promotor Workgroup Subcommittee Working Definitions Harold Freeman Patient Navigator Definition (HF): An individual who works primarily in a medical setting but can be also work in a community. This individual informs people about the need for certain recommended examinations and provides timely access to such examinations, eliminates any barriers to timely care across the entire health care continuum and integrates a fragmented healthcare system for the individual patient.

Community Health Worker, Patient Navigator and Health Promotor Workgroup Subcommittee Working Definitions University of North Caroling Health Promotor Definition UNC: An individual who works in a medical setting and also works in the community. This individual has received training to perform some examinations and screenings to assist in medical diagnosis. This individual bridges health care access for individuals that are reluctant to participate in regular care settings, and utilizes their knowledge and experience as a critical function of patient guidance to confirm the immediate need for medical attention. This person is generally recognized through community leadership as a person of trust and confidence that is vested in the health of their community.

Identifying Roles Community Health Workers (n=57) 26% 49% 25% Community Health Worker Patient Navigator Health Promotor No Response

Identifying Roles Patient Navigators (n=109) 6% 25% 20% 49% Community Health Worker Patient Navigator Health Promotor No Response

Identifying Roles Case Managers (n=38) 5% 24% 24% 47% Community Health Worker Patient Navigator Health Promotor No Response

Identifying Roles Care Coordinators (n=58) 8% 28% 19% 45% Community Health Worker Patient Navigator Health Promotor No Response

Identifying Roles Promotores (n=13) 23% 54% 23% Community Health Worker Patient Navigator Health Promotor No Response

+ Medically Underserved 63 47 Children CHW/PN/ Undocumented 46 43 Physically Disabled CC/CM/PM: 41 Homeless Rural/Frontier Communities 39 Special 37 Mentally Disabled Populations Pregnant Women 35 32 Refugee and Recent Immigrants Served* Persons with Substance… 30 28 Veterans (n=182) Lesbian, Gay, Bisexual,… 25 21 Migrant/Seasonal Farmworkers Specific Racial/Ethnic Groups 18 Other 9 3 Not Sure * multiple responses permitted Percen t