Center for CHW Excellence Secures Funding in State Budget

By: Carrie Baker, President & CEO, Health Impact Ohio

Health Impact Ohio (HIO) is excited to announce that the state of Ohio’s biennial budget for fiscal year 2024-2025 included a provision that created and funded the Ohio Center for Community Health Worker Excellence. Spearheaded by Health Impact Ohio, this public-private partnership will include Board of Directors, including CHWs, The Ohio Network of Certified Pathways Community HUBs, The Ohio CHW Association, state departments, and other stakeholder organizations. This funding will enhance and highlight the CHW workforce in our state, which has grown exponentially over the last several years, and appropriated $2.5 million each year of the biennium. 

Background

Community Health Workers are trusted individuals that are deployed in communities across the state to help individuals navigate the complexities of their life situations, mitigate health and social risks, and help individuals meet goals and better outcomes. Approximately half of Ohio’s over 1000 CHWs are working in a model called a Pathways Community HUB, or a nonprofit network of employers deploying CHWs in each Certified region. HIO operates the Central Ohio Pathways HUB, serving Franklin, all contiguous, Ross and Marion Counties. Through enacted law that originated in the Ohio Senate, and with the support of the Ohio Commission on Minority Health, which has a large role in supporting the HUB model, there were 5 HUBs in 2019, there are now 12 HUBs across the state serving over 70 Ohio counties.  

Once known in the legislature as a solution to impact minority infant mortality, CHWs in the HUB model or not are now in every facet of our health, health care, and human services systems-CHWs are working in hospitals, community-based organizations, behavioral health clinics, public health departments, federally qualified health centers, free clinics, and even schools. CHWs are finding medical homes for their clients or keeping clients in a suitable home by supporting connecting clients with rental and/or utility assistance resources, they are diverting from costly emergency room visits and diverting clients from jail. They were and still are a huge part of debunking myths in vulnerable populations during the COVID-19 pandemic. CHWs ensure families have food, they are on the front lines of decreasing substance use disorders and getting clients help for mental health issues, and they are assisting clients in attaining consistent transportation, attaining work, and filing taxes-all the while educating their clients about why these items are necessary, why diabetes A1C levels matter, the importance of medication adherence, how to prevent stroke for at-risk individuals.  

Continuing their important work with pregnant populations, CHWs continue to promote infant vitality. In our HUB, our CHWs work to ensure clients attend all prenatal appointments, have suitable housing, receive parenting education and any additional services: cribs, WIC enrollment, breastfeeding support and insurance enrollments. These CHWs are also serving other members of the pregnant client’s household, ensuring the family support needed is there when the new baby arrives. In the Central Ohio Pathways HUB, our healthy-birthweight, post 37-week gestational age rate was 98% in 2022.  

Connecting Statewide Initiatives through the CHW Center for Excellence

The growth of this workforce has exceeded current policy. While Ohio has several infrastructures to support CHWs, such as the Ohio Commission on Minority Health, the Board of Nursing, and the Ohio Department of Health, there as gaps we need to address collectively for CHWs to continue to thrive in Ohio, even outside of the HUB model. There has not been a CHW workforce study since 2018; employers struggle to hire new CHWs or bring on CHWs in practicum placements needed for Ohio Board of Nursing Certification. While there are 17 CHW certification programs approved by the Ohio Board of Nursing, CHW Supervisors lack a formalized Supervisor program and no one entity has been approved for CHW-specific continuing education requirements. Data for the collective deployment of CHWs to crisis situations in our state is a goal; Support for technology to accurately capture, articulate and gain reimbursement for the great work CHWs do, and its interoperability with other health and healthcare systems needs to be addressed. A Center, or “home” for all CHWs in Ohio will address these gaps and strengthen a workforce that has largely grown under-the-radar, quietly impacting the lives of thousands and thousands of Ohioans each year.  

Ohio Center for Community Health Worker Excellence Key Goals: 

  • The deployment of CHWs in disaster relief, non-Medicaid (in-kind) payments for work done by Community Health Workers, and funding statewide CHW events.

  • The implementation of statewide, diverse, multi-sector technology and enhancements (such as referral platforms, the Ohio equity mapping tool, HUB technology, etc.), which support CHWs’ role in serving clients.

  • The Center will commission and publish a workforce/evaluation report on the state of the Ohio CHW workforce including the total number of CHWs employed in Ohio, work settings, certification status and any barriers/challenges, average, hourly wages, annual salaries, and employment, funding sources, including state and federal grants and reimbursement sources.

  • The Center for CHW Excellence would commission a website and/or create other electronic tools that synthesize resources (social media, etc.) for CHWs, CHW certification, recertification, job postings, continuing education, workforce guidelines, and other pertinent information for current or potential CHWs across Ohio. Site resources would have diverse partners and highlight other funded projects such as:

    • Those providing CHW support via self-care management and training for CHWs in Ohio to reduce burnout and increase workforce effectiveness

    • CHW Supervisor Certificate Class

    • Appalachian CHW recruitment

    • The Statewide CHW Mentorship Program

    • The Center will facilitate a single point of contact continuing education for CHWs as approved by the Ohio Board of Nursing and offer at least the minimum necessary amount of CEU hours each two years for free statewide to certified CHWs.

We are grateful to our legislative sponsors of this language, Representative Jay Edwards and Representative Darnell Brewer for their effort to include this initiative in the House version of the budget and fighting to have it restored in the conference committee process. Our thanks to Governor DeWine for his ultimate pass of the budget that included this important next step in CHW development and coordination in Ohio.

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