sustainability

Institute of Medicine Discussion Paper on Community Health Workers, Part 2

Clayton Velicer, MPH

In part 1 of this blog we highlighted several policy developments for Community Health Workers (CHWs) and looked at some of the challenges facing the CHW workforce as outlined in the Institute of Medicine’s (IOM) recent discussion paper.

The IOM made 4 recommendations for the future of the CHW workforce (Note: these were written for California but are relevant to other states). In this blog, we’ll look at those recommendations and discuss their current status.
1) “Implement statewide infrastructure for CHW scope of practice, training, and certification that covers the role of CHWs in providing team-based primary care”
The IOM recommends assessing and defining the professional and practical skills of each member of the primary care team. The idea is that health care practices can maximize cost-effectiveness, quality, and outcomes if every member of the team operates at the top of their licensure and skills.

Defining a common scope of practice for CHWs…

Institute of Medicine Discussion Paper on Community Health Workers

Clayton Velicer, MPH

In the past month, we’ve seen an increase in news coverage of Community Health Workers (CHWs) as they take on bigger roles in the US healthcare system. A feature in Modern Healthcare highlighted successful CHWs programs in Minnesota, New Mexico and Pennsylvania. Meanwhile, Florida became the latest state to establish certification for CHWs.

On February 4th, the Institute of Medicine (IOM) released a discussion paper on CHWs. In this blog, we take a look at the benefits and implementation challenges outlined in this paper.
Community Health Workers Save Costs
The authors of the IOM paper cite that CHWs save costs for providers. For example, CHWs produced a return on investment of 4:1 when working with children with asthma and a return on investment of 3:1 for Medicaid enrollees with unmet long-term care needs.

According to the authors, if the cost savings for CHWs were the “results for a clinical trial for a drug, we would likely see pressure for fast…

Comparing Diabetes Support in 3 Countries

Clayton Velicer, MPH

Our website has frequently promoted peer support and community health worker programs around the world including programs in Afghanistan, China, Australia, and India.

In this week’s blog, we discuss the findings from a recent article that compares the peer-led MoPoTsyo program in Cambodia with diabetes support programs in two other low- and medium- income countries (DR Congo and Philippines).
DR Congo
The program in Kinshasa, DR Congo includes 80 primary care centers (called Kin-Reseau) that deliver diabetes care as part of its basic package. The program was founded 40 years ago by a missionary doctor that trained the health center staff to decentralize care. The centers offer a weekly health center visit and bi-monthly medical consultation by a trained doctor that includes glucose and blood pressure measurements and foot care. Medicines are offered at subsidized rates and patients on insulin receive their injections at the health center with a nurse’s…