What Is A CHW?
- Question: What is a CHW?
- Answer: A community health worker 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 worker 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 community health worker 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.
(National definition as per the American Public Health Association.)
- Question: What is the process for becoming a certified CHW?
- Answer: There are three parts to the certification process. The written exam is designed to assess knowledge and consists of 19 true-false questions and 13 multiple-choice questions. The second part is a performance based demonstration (i.e. role play) which tests CHWs’ knowledge, behaviors, and skills in assessing needs, counseling, building capacity, and referring to different resources, among other skills. CHWs are given a scenario and a staff members from the CCC acts as a community member. The staff has been trained as a “standardized community member” with clear prompts/script. The final aspect of certification is a professional portfolio. This is a collection of samples in different areas (work, volunteer experiences, training/education, and references), that documents the CHW’s work, experiences, skills, and accomplishments. Instructions for compiling a professional portfolio can be found at this link: Assessment Portfolio FINAL.
- Question: What does it cost to get a CHW certification?
- Answer: There is no application fee. Most CHWs receive 90 hours of training from the Multnomah County Health Department Community Capacitation Center (CCC) sponsored by their organization or by receiving scholarships. Background checks are done by the Oregon Health Authority (OHA) for free, however, if a CHW has to do fingerprinting, OHA does not cover that cost.
- Question: How is the cost of CHW certification covered by the state of Oregon?
- Answer: There are a number of funding sources that cover the cost of CHW certification. The Program Manager salary is paid through the Medical Assistance Program (Medicaid program) general fund. The Administrative Specialist is funded through Centers for Medicare and Medicaid Services State Innovation Model (SIM) Grant through Sept 2016. Background check costs are funded through the Medical Assistance Program general fund. Certification registry is paid through a combination of funds from the Medical Assistance Program general fund and grant funding.
- Question: How do certified CHWs prove to clinics, agencies, etc. that they are a certified CHW?
- Answer: The OHA maintains a list on its website that employers can consult.
- Question: What is the average entry-level wage for a CHW in Oregon?
- Answer: The average starting wage for an entry-level CHW is about $9-15/hourly. Some CHWs may make between $15-22/hourly depending on experience and additional nursing licensure.
- Question: Has anyone experienced employers feeling threatened by the CHW Association? I.e. that it could become a union?
- Answer: No, generally if employers are aware of state CHW associations, they are supportive of strategic planning or uninvolved with it. Providers have occasionally expressed concern about whether CHW professional development could take on the character of union organizing, but that has not emerged as a practical “threat” to employers in any state we’re aware of. The opposite is more generally the case: health sector employers are looking seriously at opportunities for improving health outcomes, quality of care, and cost containment through integration of CHWs into their workforces. Discussions about CHWs scope of practice and the relationship of CHWs to other health-related workforces are part of this process. As the CHW movement for professional status gains traction—at the same time that innovations in care coordination, CHW integration, and health financing take shape—CHW leaders are carefully considering opportunities and threats related to CHW roles, compensation, benefits, supervision, training, and career ladders. The CHW movement is affected by the organization of power within health systems, but CHWs are seen as a resource to strengthen health providers, not as a threat to them. (Via “CHW State Networks Strategic Planning: How and Why” webinar)
- Question: What are some tips for writing a CHW job description?
- Answer: Be innovative with the job description, and focus on talents. What TALENTS are you looking for in the individual? e.g. “The ability to calmly react to a burning building; Being OK in a flexible environment, as we learn together” etc… What would make this person a better fit for Head Start, rather than a structured health care system? What are the specifics that are important to the population that this person will be working with? Use plain language; e.g. “Knowledge of children and families either through a formal setting, or through parenting, grandparenting, fostering, etc. children yourself” Specify that the candidate possess CHW Certification or the ability to possess CHW Certification within the first six months of employment.
- Question: What are some qualities to look for in candidates for CHW positions?
- Answer: It is most important that a CHW is the best MATCH to the organization AND population-at-need. (Sometimes, those aren’t one in the same…) Training does two things, 1) Give them those hard-skills to perform their job well and 2) Gives them a better understand, or creates, the passion to help their self-identified community/culture. “If I have a woman…a wife of a rancher…who makes dinner every Sunday for her family of 22, she could possibly relate very well to another female, who also has a large family and dinner every Sunday— regardless of race and ethnicity. Sometimes, it is the situation that dictates who is needed as a support. ” Now…the tough part is finding that person who relates to 90% of the situations…
- Question: How do you balance the funder or program needs vs the needs of the Community Health Workers support, recognition and professional development advocacy?
- Answer: Effective organizations base their strategic goals on their own missions, aspirations, histories, capacities, partnerships, and assessments of community needs and assets. If a CHW Association has a funding partner, it’s likely the funder already respects the organization’s leadership and work and will appreciate and respect an internally-directed strategic planning process. In such a case, the organization would be smart to engage the funder’s program officer somehow in the strategic planning process. The easiest—and perhaps most common—way to do this is to interview the program officer during the research phase of strategic planning. Input from the funder can be valuable in various ways to the strategic planning process. But note we begin the answer to this question by saying the answer “should” be no. As a practical matter, it’s hard and probably ill-advised not to consider the funder’s priorities when crafting strategic goals, particularly if that funder contributes a significant portion of the organization’s financial operating support. So strategic planning requires a balance of creative thinking about organizational goals (and related policy and program priorities) and pragmatic thinking about available resources. It’s likely if an organization already has funding, there won’t be much, if any, “disconnect” between the organization’s goals and work the funder is willing to support, unless 1) the organization decides to change direction in a significant way, or 2) the funder changes its priorities (this happens!). If an organization changes direction or undertakes innovative new work, then new funding sources will probably have to be identified anyway.
- Question: With such a wide variety of CHW titles, did you find it difficult to get those with other titles to engage as CHW’s?
- Answer: This question seems to involve two related issues: 1) the challenge of deciding who to involve in strategic planning, particularly when non-CHWs are involved in your CHW association, and 2) the challenge of building a common CHW identity, recognizing that CHW is a professional designation covering a lot of different job titles.We recommend that the people who participate directly in your strategic planning process—those making decisions about the focus, timing, and process of planning and actually attending planning meetings—should be “insiders,” that is, people who are already committed to and deeply involved with the organization. There will likely be a mix of CHWs and non-CHWs, and your organization will need to decide what the most helpful or appropriate mix should be. Since the point of building CHW associations is to advance CHW empowerment, it is important to make sure you have active CHW participation and a strong CHW “voice” at all levels of your planning process. That may be achieved differently in different states, depending on the number, experience, and confidence of your CHW leaders and their relationships with non-CHW allies.In addition to the “insiders” most involved in the strategic planning process, we recommend you consider involving CHWs outside of your leadership circle—regardless of their job titles—and also other external partners in the strategic planning process. Typically, this is done during the research phase of developing your strategic plan through surveys, in-person or phone interviews, and/or talking with groups of CHWs who may be meeting anyway in other settings. For instance, if there’s a CHW training program nearby, you may be able to arrange a focus group with CHWs there to provide input about strategic questions you’re considering.If CHW allies are leading the formation of CHW associations in their states, they should recruit CHW leaders and figure out how to support them in the early stages of organizational development and planning. Strategic planning, as we’re discussing it in this webinar series, would be premature in such cases.Finally, CHW associations often include the challenge of building a professional identity for CHWs among their strategic planning goals and objectives. Your association’s leaders probably already understand the challenges of getting CHWs in different settings and with different job titles to identify as CHWs. If there was an easy way to do this, it would already be done, so it may be very useful not only for your state but for the national CHW movement for you to think strategically about how to assure more CHWs understand they are “under the umbrella” and that they have opportunities to cooperate with one another through your state’s association. (Via “CHW State Networks Strategic Planning: How and Why” webinar)
- Question: How do I receive approval for a proposed continuing education curriculum?
- Answer: You will need to complete a CEU Training Program Application here: http://www.oregon.gov/oha/oei/Pages/thw-approved.aspx