Rural health transformation dollars will support community health workers
Image courtesy of Bria Grant
The community health worker profession is set to see a boost thanks to federal dollars meant to transform rural healthcare.
So far, the Department of Health Services has received $203.7 million to support rural health initiatives. DHS expects $1 billion over five years.
Some of those dollars will promote the adoption of community health workers as a way to improve health outcomes for low-income and underserved individuals with chronic health conditions, according to the state’s application for the money.
DHS will provide grants to rural health providers to support the workers and then study the return on investment, with an eye toward developing a Medicaid state plan amendment to sustain services long term.
Bria Grant, principal for the Wisconsin Community Health Worker Network, said community health workers help patients and families address barriers to their well-being, find resources and achieve better health outcomes.
Community health worker is an umbrella term for a range of professions that include doulas, health navigators and violence interrupters. They help people secure housing, access healthy food and have safe neighborhoods, all factors that play a role in health.
The ranks of the profession grew during the COVID-19 pandemic, when federal dollars supported messaging on social distancing, mask wearing and vaccination. That money is now sunsetting, and Grant is looking at how to support the workforce further.
“They have a tremendous return on investment,” she said in a recent interview with Wisconsin Health News.
Grant is also executive director of UniteWI, a community health organization.
Edited excerpts from her interview are below.
WHN: The state is looking at Medicaid coverage of community health workers’ services. Why is that important?
Grant: We have pushed for this for a very long time, starting with Rep. Bob Gannon, (R-West Bend), prior to his passing, and under (Gov. Scott Walker’s administration) with (former DHS Secretary) Kitty Rhoades and (former Medicaid Director) Heather Smith, who recognized early on that this is a model we can afford to have a heart for. How do we make it happen?
This is a unique approach to reimburse for social determinants of health work. It’s not something that has been done historically. UniteWI, the fiscal agent for the network and the developer of a lot of the work across the state, earlier on was able to secure a 1115 waiver for reimbursement of social determinants of health. It served as the first model to demonstrate that this can be done: having G-codes associated with connecting people to housing; getting them educated on diabetes, hypertension and cardiovascular management; and being able to better support prenatal care coordination.
WHN: There’s no state certification for community health workers. Do you see a need for that?
Grant: We need to do a couple of things. We need to create more credibility around the workforce. We launched the community health worker apprenticeship, which gave us a little more credibility at the national level for the workforce at the U.S. Department of Labor. That credential is a yearlong program, which is 2,144 hours to become a certified community health worker through apprenticeship. That’s very technical because there is no certification for the state.
With that, we’re able to then introduce some things to the Department of Safety and Professional Services, so we can begin to look more so at the credentialing of the workforce, which will help us have that provider status with Medicaid.
This is something I have personally worked on for almost 20 years, as I used to work for the state Legislature. I came in under Gov. Walker’s administration and advocated with those individuals who, to the surprise of many, were all on board with some of this. That’s the reason why we were able to secure the 1115 waiver back in 2017 and it’s been bipartisan-supported as we’ve advocated for this work.
Shifts in Medicaid take a long time. Shifts in policy take a long time. When we have this type of catapulting of resources into the effort, it does help the work get done.
WHN: What are some of the next steps for the profession?
Grant: We want to continue to demonstrate the credibility, the validity and the need. We’re helping employers understand how to embed those community health workers into their operational budgets and helping the community know how to access and utilize community health workers as a provider with the healthcare team. This is emerging, and understanding is growing across the board.
We’re working on how we can help other people understand their commitment to this workforce. Because it’s unique in its scope of work, we recognize that everybody should invest in community health workers … We have manufacturing companies that recognize, ‘My workforce is not well. I need community health workers to help them get connected to the resources and services so that they can be better workers, better assembly line workers, so that their families can be well and so they can have all the things that make them a more productive person.’ This is a very unique approach for being able to standardize and sustain this type of work.
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