Sustaining Community Health Worker Programs in KY

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The growing impact of Community Health Workers (CHWs) in Kentucky has been notable in recent years. While their origins in Kentucky go back to 1994, milestone events such as the development of the Kentucky Association of Community Health Workers (KOCHW) in 2016, launch of a CHW certification program in 2019, and receipt of a CDC grant to expand and strengthen the workforce in 2021 have expanded their presence.  Alongside this growth, much focus has been placed on the operational and financial sustainability of CHW programs. On March 19, the Kentuckiana Health Collaborative (KHC) partnered with the KOCHW and Kentucky Department for Public Health (KDPH) to host a Community Health Forum dedicated to discussing strategies and lessons learned for sustaining CHW programs.

As defined by the American Public Health Association, “community Health Workers are frontline public health workers as well as trusted members of the community.” Dr. Connie White, Deputy Commissioner for Clinical Affairs at KDPH, kicked off the forum by giving an overview of the many roles that CHWs can play as frontline public health workers, including providing health coaching, promoting health literacy, assisting with health system and social service navigation, and more. As of the morning of the forum, Kentucky had 252 certified CHWs employed at organizations in all but four counties in the Commonwealth. Dr. White highlighted the value of CHWs through both qualitative and quantitative data collection methods. For example, Kentucky Homeplace valued their CHW services to clients for a three-month period in 2023 at a staggering $7,061,023.94. Other impressive data points shared by Dr. White included 28,360 referrals to social services and 34,908 referrals for health conditions from CHWs in 2023. Anecdotal stories from CHWs and their impact across the state will be highlighted in the upcoming edition of the annual CHW Stories of Success Report.

Another important development in strengthening CHW sustainability was the passage of HB 525 in Kentucky in 2022, a bill allowing for reimbursement of CHW services from Medicaid. Commissioner Lisa Lee of the Kentucky Department of Medicaid Services joined the forum to speak about HB 525 and give an overview of the accompanying regulations. Providers were eligible to bill Medicaid for CHW services as of July 1, 2023. To be eligible for reimbursement, CHWs must be certified through the KOCHW. Billable services include health system navigation, health promotion and coaching, and health education and training. They must be delivered according to a plan of care and ordered by a physician, physician assistant, nurse practitioner, certified nurse midwife, or dentist. While there are still aspects to work out regarding the regulation of HB 525 and how CHW services are being reimbursed, Commissioner Lee laid out next steps to improve the process including developing guidance for providers, focusing on dental billing, and continued data monitoring and reporting. The Kentucky Department for Medicaid Services is a national leader among other state Departments in supporting CHWs.

Many CHW programs across the Commonwealth have been exemplary in their growth, organizational leadership, and support of the CHW profession. As part of the forum, a panel of leaders from various programs came together to share their knowledge in financially and operationally sustaining CHW programs. The panel was moderated by Lindsay Nelson, COO at the Kentucky Health Center Network. Jessica Hoskins from CHI Saint Joseph Health introduced their program and highlighted their mission driven interviewing and hiring processes, ensuring their CHWs have the skills and community connectedness to thrive in their role. Brooke Perkins from Primary Plus talked about the innovative approaches that they have taken to quantify the value of CHW work and use the information to leverage leadership and community support of their program. Janikaa Sherrod from Volunteers of America Mid-States built off this information to discuss their successful approach to financial sustainability through blending funding streams for their programs. The panel was completed with Tiffany Taul-Scruggs of Sterling Health Care, whose program has been strongly supported by the implementation of workflows and clear, concise organizational operations. While the panel highlighted strategies for supporting the business of CHW programs, their passion for the work they do day in and day out to change the lives of their fellow community members was palpable.

As CHWs expand, as does the need for resources that can support them. KYLoop is one of those resources. Emily Beauregard, Executive Director of Kentucky Voices for Health, closed out the forum with a presentation on this resource built specifically for outreach specialists throughout the Commonwealth. On KYLoop, CHWs and other health professionals help each other by sharing best practices, successes/challenges, and lessons learned. Users can also access subject-matter experts and resources on healthcare, food, housing, childcare, transportation, and vaccines.

Resources from the forum can be found here. The KHC, KOCHW, and KDPH have an ongoing partnership to continue the positive trajectory of CHWs and CHW programs throughout Kentucky. For more information on the KOCHW and CHWs, go here.

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