Community Health Workers Serving Greater Roles in Health Care


KANSAS CITY, Mo. – At Truman Medical Centers, it was a chronic patient who berated nurses and, in one instance, draped his room with the contents of his food tray.

At the Kansas City CARE Clinic, it was a woman with diabetes who would not take her medication.

The link between the two is that they both received help from outreach specialists known as community health workers. A local group is working to make that type of help more prevalent in the metropolitan area.

Operating as the Community Health Worker Committee, and organized through the Mid-America Regional Council (MARC), the group spread the word about their efforts at a forum last week. It drew about 60 people from throughout the medical community.

“All of us need advocates at some point in our lives,” said Barbara Wiman, a committee member who works on health care issues at the Institute for Workforce Innovation at Metropolitan Community College. “And sometimes when we are dealing with medical issues, we can’t do it ourselves, because our mental frame of mind is not there and we can’t just say I need to do this, this, this and this.”

Community health workers, she said, provide a bridge between a patient’s healthcare provider and community-based services.

Wiman helped oversee a pilot course taught by the community college last year, in which 24 students took a 156-hour training course to become community health workers.

Committee members said they would like to see the Missouri and Kansas Medicaid programs cover the services provided by community health workers and are working to try to make that happen.

Expanding job opportunities for students who train for community health worker also is important, said Scott Lakin, director of MARC’s Regional Health Care Initiative.

He said advocates could build a strong case to hospitals that the workers would be cost-effective hires.

According to data presented at the forum, a safety-net hospital system in Denver reported a return on investment of $2.38 for every $1 spent on a community health worker. The savings came in avoiding medical procedures the patient would have needed otherwise.

Committee member Dennis Dunmyer, director of community services at the KC CARE Clinic, also presented findings that an Arkansas program reduced its Medicaid spending on long-term care by about 24 percent through the use of the workers.

Community health workers can be of value in the private sector as well, Lakin said. For instance, they could work in conjunction with corporate wellness programs.

“We’re going to have to get real creative in how we deliver care,” he said.

Amanda George said she left the forum encouraged that community health workers could fit in an agency that is not a direct-care provider.

She is training and development supervisor for Empowering Individuals Through Advocacy and Support, which serves clients with intellectual and developmental disabilities in Jackson County. She said a community health worker could be of real value for the organization’s health and wellness initiative.

“It seems so accessible — like we can do this,” George said. “It fits so well with what we are doing.”

Linda Brown, patient care coordinator at Hope Family Care Center in Kansas City, Mo., said the forum discussions reinforced her philosophy of working with patients.

Even if they are difficult to deal with, she said, “we’ve just got to keep pushing for that glimmer of light in the person — push past the smoke screens they are throwing up.”

That’s what they did at Truman with their angry patient, said Florence Adegoke, a community health worker at the hospital.

By connecting him with social workers and psychologists, Adegoke said, they learned a lot of his behavior stemmed from his fear of dying in a nursing home. Both his parents had died in nursing homes.

Once they were able to work through that issue, Adegoke said, things changed: “Now, he is everyone’s friend. Nobody believes he is the same guy.”

At the KC CARE Clinic, Rebecca Burns, manager of care coordination for the clinic, said staff discovered that their diabetic problem patient was not taking her medications because she did not know how to take it. She was too embarrassed to tell anyone that she could not read.

Once she divulged that, staff used pictures to tell her how to take the medication.

That led to another success.

“She is now currently taking literacy classes and she is learning how to read and write — such a cool story,” Burns said.

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