The State of Montana has received funding in a two-year grant from the CDC to Address Health Disparities and Advance Health Equity Among Populations that are at High-Risk and Underserved.  The funding is part of the federal COVID response under the American Rescue Plan.  The CDC specifically required a carve out of funds for rural areas.  One of the significant uses of those funds will be to support the salaries, benefits and expenses of Community Health Workers and/or Community Integrated Health (Community EMTS or Paramedics) in each of Montana’s counties. 

 

 

Community Health Worker (CHW) vs. Community Integrated Health Professional (CIH)

CHW CIH

Lime health team

Community health workers are paraprofessionals who work in partnership with clinical care teams to improve patient and community health outcomes. CHWs are members of the communities they serve which gives them a unique understanding of the needs of the community.

Example services provided:

  • Increase health knowledge
  • Community outreach an education
  • Patient advocacy
  • Address social determinants of health
  • Address barriers to healthcare
  • Medication adherence

Grey ambulance

CIH is a new and evolving health care provider role in which paramedics and emergency medical technicians provide additional services to help patients access care in non-emergency situations.

CIHs are trained to provide additional services which can include:

  • Post discharge follow-up
  • Preventative care
  • Chronic disease management
  • Referrals to community health services
  • Medication management and set up
  • Home safety checks

Who is Managing the CDC Health Disparities CHW/CIH Project?

MT DPHHS is contracting the Montana Office of Rural Health/Area Health Education Center at Montana State University to manage this project. 

Who can apply for CHW and/or CIH Funds Through the CDC Grant?

Critical Hospitals and other hospitals have the first opportunity to access these funds.  Other organizations can access the funds if CAHs or other hospitals in a county or community decline the funds. A county or community may also wish to form a consortia or partnerships with the hospital. For example, there may be a partnership involving a critical access hospital, local public health department, and a senior center.  Hospitals and/or community members may propose a collaborative approach that meets the requirements the funding while being responsive the local community workforce and capacity issues.

There is funding specifically designated for Tribal organizations to deploy CHWs or CIHs. 

There are two options for hiring CHWs or CIH:

  The host organization directly hires a CHW and/or CIH The host organization contracts with Montana Health Network (MHN)
How funding is provided for the position A subaward will be made to the host organization to hire the CHW or CIH, with funds for salary, benefits, supplies and travel.

MHN will receive funding under the DPHHS CDC grant to manage the salary, benefits, and expenses related hiring the CHW or CIH.

Employee Management The host organization will manage and supervise the activities of the CHW or CIH. The host organization will manage and supervise the activities of the CHW or CIH. Additionally, MHN will provide all employment functions including payroll, annual evaluations, benefits, workers’ comp coverage, and liability.
Reporting Responsibility The host organization will meet the terms of the sub-award in providing requested data, narratives, and financial reporting. MHN will meet the terms of the sub-award in providing requested data, narratives, and financial reporting. MHN will coordinate with the facility to collect data required.
Who selects the CHW or CIH? The host organization is responsibility for recruiting, hiring, and day to day supervision of the CHW or CIH. MORH/AHEC will provide materials and training to assist. The host organization is responsibility for recruiting, hiring, and day to day supervision of the CHW or CIH. MORH/AHEC will provide materials and training to assist
On-Going Assistance The host organization will receive free supervisor training, free training for the CHW/CIH, and on-going technical support The host organization will receive free supervisory training, free training for the CHW/CIH, and on-going technical support
 
 

Training will be provided by MORH/AHEC for all newly hired CHW/CIH.  They will complete the 85 hour MT CHW curriculum or the Community Integrated Heath Curriculum approved by the Montana Board of Medical Examiners.  MORH/AHEC will coordinate all training.

Training can be completed after hiring as an on the job experience.

Two care coordinators will be hired to provide technical support to the facilities participating in the project.  Care coordinators will be individuals with credentials as an RN or LCSW who have knowledge and experience in care coordination.  The care coordinator will provide guidance to host organizations in how to integrate CHWs and Community Integrated Health (CIHs) into the care team; to develop care coordination strategies that utilize CHWs and CIHs; and to provide on-going support and training to CHWs and their supervisors.

The host facilities will receive the following assistance from the Regional Care Coordinators:

  • Onsite and phone consultation with facilities hosting CHWs or CIHs
  • Guidelines and templates for care coordination
  • Organizing and delivering training for supervisors, CHWs, CIHs and other key staff
  • Scheduling regular resource team meets among the partners to problem solve cases and scenarios
  • Providing assistance on documentation and reporting
  • Assuring that data required for reporting to CDC and DPHHS is collected and provided to the MT Office of Rural Health/AHEC

Facilities will have the opportunity to have supervisors participate in free training provided by the national leader in CHW supervisor training – CHW Salud.  This is an online training and will be offered throughout the grant period CIH supervisor training will be coordinated through national community paramedicine programs and provided free to supervisors.

Informational sessions will be scheduled for Spring 2022.  Facilities will be surveyed to identify interest in participating in the program.  For critical access hospitals participating in this program, the application process with be similar to the Small Hospital Improvement Program (SHIP) operated by MORH/AHEC.