Establishing a Certification Program for Community Health Workers

By Vicki Veltri

Senate Bill 859 directs the Department of Public Health (“DPH”), to establish a certification program for community health workers. Positioned in clinics, neighborhoods, homes and workplaces, community health workers complement clinically trained healthcare teams by facilitating access to healthcare, social services and community support.

They are uniquely-qualified public outreach professionals who utilize knowledge about the culture, socio-economic needs and available resources in the communities they serve to bridge gaps in healthcare access, enhance care coordination, reduce health disparities and improve health outcomes.

Community Health Workers (CHW) have been complementing clinical services in Connecticut for decades, helping healthcare providers to more effectively identify the challenges patients in their community face. It is well accepted that the concept of health includes far more than physical health.

To help Connecticut residents be and remain healthy, a thoughtful care delivery model must consider not only the standard clinical and quality metrics, but also the impact of social determinants of health on each person’s ability to achieve and maintain this goal.

CHWs, with their intimate knowledge of the community in which they work, and the challenges unique to the population in that community, fill a crucial place in the care continuum, using this experience to connect the clinical setting to what happens in the person’s home, neighborhood and workplace. Comprehensive analysis of the benefit of including CHWs on the care team demonstrates that CHW models in Connecticut enhance access to care, promote consumer education, facilitate disease prevent, and improve health outcomes for populations they serve.

“Community Health Workers, with their intimate knowledge of the community in which they work, and the challenges unique to the population in that community, fill a crucial place in the care continuum”

A September 2018 report submitted to the Public Health Committee by OHS’ State Innovation Model Community Health Worker Advisory Committee (“CHW Committee”) detailed the benefit of developing standardized training and credentialing programs to formalize community health worker qualifications, as well as to increase visibility and recognition of the profession. The CHW Committee also detailed 18 recommendations to facilitate the development of such a program.

Certification serves several important functions for the community health worker, as well as Connecticut’s health system, by promoting greater understanding of the value the CHW model offers, providing recognition of the excellent work that CHWs already do, boosting the sustainability of the workforce, which is expected to grow and become increasingly valuable to our health systems, and promoting clear, consistent and responsive competency-based training for this workforce.

Finally, as care delivery models continue to evolve, developing a certification path for CHWs in Connecticut promotes the fiscal sustainability of these models by boosting workforce retention, facilitating specialization, and providing a path for insurers to reimburse provider practices for these services which, we must remember, help to reduce the overall cost of care.

SB 859 recognizes the importance of developing a mechanism to encourage the growth of this workforce, and tasks the DPH with the development of a CHW certification program. However, the CHW Committee, through which OHS and DPH convened key stakeholders across the care delivery spectrum, recently developed detailed recommendations for such a program.

Accordingly, in recognition of these well researched and stakeholder approved recommendations, and in collaboration with DPH, we are developing alternative bill language for your consideration that incorporates the excellent work already done, and that enables DPH to more easily facilitate the implementation of this important initiative.

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Victoria Veltri is Executive Director of the state Office of Health Strategy. This legislative testimony on Senate Bill 859 was filed in March. The bill was approved by the Committee on Public Health and revised by the State Senate, which requires the Department of Public Health (DPH) to establish a certification program for Community Health Workers (CHW) by January 1, 2020. It was referred it to the Committee on Appropriations on May 9.