Community Health Workers Legislation

February 2, 2017

Community Health Workers (CHW) serve as key frontline public health workers, who help individuals and communities get the access to the health care and other social services they need to live their healthiest life.  They are vital toward achieving health equity for individuals and groups of individuals who lack the access to the health care system and who face difficulties in getting the best outcomes.

States have used a variety of methods to promote the recognition and integration of CHWs including legislative efforts, Medicaid state plan amendments, and Medicaid state waivers. To date, 20 states have started or moved toward a CHW certification and/or training process.  Did you know there is legislation to statutorily define CHWs in Connecticut? SB 126, introduced by Senator Terry Gerratana, is critical legislation that would support and expand the use of community health workers in cities and towns across Connecticut.

This legislation is a first step toward the full recognition and eventual integration of CHWs into health care teams across the state! Health Equity Solutions views this as an important piece to achieving health equity! Given this, we fully support the legislation. On February 10th, HES along with other advocates from across the state, testified in support SB 126 at the Committee of Public Health’s public hearing. Connecticut would become one nearly 20 states who recognize and/or certify the CHWs.
I wanted to share the views of some supporters of the legislation who either came in person to testify or submitted written testimony. All excerpts are being shared with permission.

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Tekisha Dwan Everette, Ph.D. Testimony on behalf of Health Equity Solutions
HES strongly supports the full recognition, integration, and sustainability of Community Health Workers (CHWs). CHWs extend beyond the traditional four walls of health care institutions and work within communities to improve health and health outcomes. The American Public Health Association defines a CHW as “frontline public health workers who are trusted members of and/or have an unusually close understanding of the community served.” This trusting relationship enables CHWs 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.
HES believes it is critical to move forward with a pathway to full integration, recognition, and sustainability of CHWs in Connecticut. To do this, we urge the Public Health Committee support SB 126, as we believe the state should develop a statutory definition of CHWs and outline their roles. Furthermore, we believe there has been substantial evidence, research and work product produced on CHWs and respectfully submit that it is time to make a definitive plan toward certification of CHWs in Connecticut.

Sarah Diamond, Ph.D. Testimony, Diamond Research Consulting & CT Health Fellows Leadership Network member
A growing body of evidence supports the integration of CHW into the health care system as a means to improve health care outcomes for health disparity populations, while also lowering costs for payers. Community health workers (CHW) are trusted individuals from their communities, who have local knowledge, access, cultural and linguistic competency, and the training to assist other medical professionals with improving health for health disparity populations. Rigorous research has shown that CHW can deliver value and reduce costs for payers by: 1) educating and motivating individuals to adopt healthy behaviors so as to help prevent and/or manage chronic diseases, 2) assist patients with adherence to medical guidelines, 3) improving care coordination, and 4) strengthening communication between patients and providers, among other benefits.

Significant reductions reported …visits ranged from 23%–51% and in hospitalizations ranged from 21%–50%. Also, one trial showed a significant reduction in urgent care visits at 60%.
The formal integration of CHW into CT’s health care delivery and payment system will be a strong investment in improving health care for all. This integration will also support improved data collection and evidence to demonstrate that improvements in value and cost savings are being achieved…. As economic inequality is a significant underlying driver of health disparities, this proposed legislation has ramifications for advancing health equity and the economic vitality of our state.

Supriyo B. Chatterjee, West Hartford Resident & CT Health Fellows Leadership Network member
An ACA 2013 rule change gave State Medicaid programs an option to pay Community Health Workers to provide prescribed preventive services. Community Health Workers are trusted members of their community and share similar ethnicity, language and socioeconomic positions with other members. They can bridge the sociocultural gaps between members and local health and social service providers. They can be instrumental in mitigating mistrust that individuals may have of healthcare organizations. Addressing social and behavioral determinants of health can bring achievement in health outcomes at lesser costs.

Milagrosa “Millie” Seguinot of the Community Health Worker Association Testimony

As you see on this definition, Community Health Workers are the answer to help eliminate health disparities in CT. Including Community Health Workers as part of the medical team will give the community the opportunity to better access services, follow up with appointments, make sure that they have someone to advocate for them, better understand instructions related to how to take medications, and make sure that providers are aware of what the patient is taking in case the individual suffers from different chronic diseases like diabetes, asthma, and hypertension. The Community Health Worker is the bridge that is missing at this moment between our communities and our health system. CHWs help individuals in need better manage their health issues and, at the same time, looks at a person as a whole.

To see what others had to say, visit the public testimony portion of the Public Health Committee’s website.