HJBR Nov/Dec 2022

COMMUNITY HEALTH WORKER PROGRAMS 22 NOV / DEC 2022 I  HEALTHCARE JOURNAL OF BATON ROUGE   stuff that they wouldn’t tell their doctor,” said Ochsner Health SystemVice President of Clinical Improvement Kenny Cole, MD. “They’ve become an extension of both RN- level care managers and the licensed clinical social worker.” “CHWs generally have more time to listen,” said Ashley Wennerstrom, PhD, director of the Louisiana CHW Institute at LSU Health Sciences Center New Orleans. “CHWs are great at learning about a patient’s life and what their motivations are and help- ing them set goals based on what really mat- ters to them.” She offered an example of a CHW helping a future grandmother to set a goal to quit smoking before the birth of the grandchild. As NewOrleans East Hospital Chief Nurs- ing Officer C.J. Marbley recalled the origins of a CHW partnership between his LCMC hospital and the Louisiana Department of Health, he mentioned the goal of closing a 25-year life expectancy gap between two NewOrleans neighborhoods that exist only 4 miles apart. “It’s not just about improving health and living longer,” he said. “It’s what living longer does to a person, to a family and to a community, and how it stabilizes that family in that community.” To address this disparity, LCMC Health launched a $1.5 million, two-year CHWpro- gram that will serve communities in eight ZIP codes, using interdisciplinary teams that include CHWs, nurse navigators, and health centers, we knew that community health workers needed to be part of that model,” said Ochsner HealthAssistant Vice President of Outpatient Case Management Alison Glendenning-Napoli. To support this effort, Ochsner designed a 12-month apprenticeship programwhere CHWs receive training in SDOH, public health, care management, goal setting, and more. They also receive clinical certifica- tions as medical assistants and phleboto- mists to aid in understanding the clinical side of the patient. Following training, they become embedded in clinical teams with social workers and nurses at community health centers and primary care clinics. “Motivational interviewing is probably the heaviest focus in our CHWcurriculum,” said Ochsner Health Population Health Manager Steph Most. “Digging in, asking those open-ended questions. That’s where the patients are like ‘wow, this person really cares about me. They really want to help me.’”She also explained the value of having a CHWconduct an SDOH needs assessment with a patient before that patient visits with a health center’s primary care clinicians. “It helps make sure they’re prescribing medi- cations that a person can afford, that they’re scheduling specialty visits somewhere the patient can actually access,” she said. “[CHWs] are forging trusting relation- ships with patients, and patients open up to them and sometimes even tell them CHWs are trusted individuals who come from the communities they serve. They pro- vide a range of services, including health promotion and coaching, care planning with the patient and clinical-care team, health system navigation, and resource coordina- tion. In June, the Centers for Medicare & Medicaid Services (CMS) approved Loui- siana Medicaid coverage for these services when ordered by a licensed physician, advanced practice registered nurse, or a physician assistant. According toAmerica’s Health Rankings, in 2021, Louisiana ranked last among all 50 states in health outcomes. These challenges included the following: • Areas with limited access to affordable, healthy food options. • Physical inactivity. • Multiple chronic conditions. • Obesity. • Premature death. • Violent crime. • Low high school graduation rates. In 2020, Ochsner Health and a broad group of stakeholders launched the “Healthy State” initiative with the goal of lifting Louisiana’s health ranking into the top 40 by 2030. As part of this initiative, Ochsner Health committed to opening 15 community health centers in underserved parts of Louisiana, including Baton Rouge and New Orleans. “When we heard about the community As healthcare providers, Medicaid Managed Care Organizations (MCOs), and other stakeholders collaborate statewide to improve Louisiana’s national health ranking, a growing number of clinical teams are relying on community health workers (CHWs) to help them target social determinants of health (SDOH) needs that drive health outcomes.