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Author: Cindy Martin

MACHW Advocates for Living Wage

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The Massachusetts Association of Community Health Workers (MACHW) commissioned the University of Massachusetts’ Center for Social Policy to prepare a report on the skills and wages of community health workers (CHWs).[1] Community health workers are a unique and increasingly significant part of the healthcare and public health workforce. There is national consensus on core CHW roles and skills,[2] and the Patient Protection and Affordable Care Act (PPACA) recognizes CHWs as an important health occupation for improving health outcomes and reducing costs.

The commissioned report found, however, that CHWs in Massachusetts receive considerably lower pay than those in occupations that require some similar skills. In response, MACHW is recommending that employers consider adopting the following minimum salary range for CHWs:

Experience Salary
Entry 0 – 2 years $38,000- $42,000
Mid-Career 2- 5 years $42,000- $46,000
Senior 5+ years $46,000+

To date, most CHWs are not paid living wages. In 2016, according to the Massachusetts Department of Public Health, CHWs in Massachusetts earned an average of $34,220 a year.[3] Research shows that that the CHW workforce is predominately women of color who likely support children. Using the MIT Living Wage Calculator for Massachusetts, the living wage for a single adult with 2 children is approximately $68,600 in annual earnings for a full time, year-round worker. We acknowledge living wages differ across the state. For example, a living wage for a single adult with two children living in Boston is $71,718 a year compared to $61,152 for those living in Franklin County. We also recognize the importance of acknowledging years of experience to improve retention rates.

The demand for CHWs is growing and without a corresponding increase in wage growth, it will become more difficult to recruit, hire and retain CHWs.

 

[1] University of Massachusetts’ Center for Social Policy. Community Health Workers: Wages, Skills and Roles. Boston, MA; March 2018.

[2] Rosenthal EL, Rush CH, Allen CG; Project on CHW Policy & Practice. Understanding scope and competencies: a contemporary look at the United States community health worker field: progress report of the community health worker (CHW) core consensus (C3) project: building national consensus on CHW core roles, skills, and qualities. 2016.

[3] Massachusetts Department of Public Health. Massachusetts Statewide CHW Workforce Surveillance Survey. Boston, MA; November 2016.

 

 

Backstage with Keynote Speaker, Dr. Thea James

By Corina Pinto

When I first heard Dr. Thea James speak, I felt vindicated. She said, “it’s not about filling the gaps, it’s about eliminating them.” Finally, a physician articulated the way I have always viewed community health work and advocacy. Community health workers (CHWs) strive to eliminate gaps in healthcare, not simply providing a temporary fix. I had the honor of interviewing Dr. James, a senior leader at one of the largest accountable care organizations (ACOs) in Massachusetts, who is leading the way for integrating CHWs into healthcare teams. Conference participants will have a chance to hear her speak on May 3rd but let’s learn more about her first…

How can CHWs help in removing gaps and not just filling them?

Dr. James: For CHWs to remove gaps, the system requires a paradigm shift in the way that health outcomes are achieved. The biggest barrier CHWs have to eliminate gaps is the mindset of the current system. If the system’s interpretation of health care delivery is based on episodes and not about the root causes, the impact of CHWs will be limited. The goals of our current health care system and the goals of our patients are misaligned. Healthcare needs to understand what people want.

Also, CHWs do great work in simply engaging people, which has a huge impact. CHWs ask the question, “What matters to you? What’s important to you?” Those questions make a difference in patient’s lives.

Where does that misalignment between the goals of the health care system and the goals of patients/community stem from?

Dr. James: It stems from how we [physicians] are educated and trained. We are trained to function based on episodes not root causes. Now, new interns who are coming in to be trained at BMC receive a social determinants of health training where they go through a real case study and have to find the root causes to illness instead of just pushing medications and moving on.

Have you worked with CHWs before?

Dr. James: In 2006, the Mayor of Boston asked us to start a violence prevention program. We began to look at other models and saw that the measure of success was based on things like re-injury, incarceration and I thought why are we setting such low bars for people? In designing our program, we decided to set high bars and expectations for not only our patients but also our community health advocates (CHWs). We started off with just two community health advocates and now we have nine. One of the best outcomes we’ve had is with a community health advocate that we hired. He was 23 years old, shot a couple of times and was previously incarcerated. Five years later he had an MBA.

Why do you use the title “community health advocates” instead of “community health workers”?

 Dr. James: We chose the name because we did not want the employees to be seen as a social service worker. We want them to be advocates first in all areas that they find themselves in, whether that be in navigating a housing situation or finding any resource. We did not want to title to limit what the advocates did.

Do you have any words of wisdom or advice for CHWs to be successful in the new ACO landscape?

Dr. James: Yes, you will have to wait and see. That will be the topic of my address during the CHW Conference on May 3rd!

Call for Nominations: 2018 MACHW Awards

The Massachusetts Association of Community Health Workers (MACHW) wants to recognize and honor the outstanding service, dedication, and excellence of individuals and groups of individuals who serve their communities as Community Health Workers (CHWs).

In 2018, three awards will be given. The “Outstanding CHW of the Year Award” will recognize one outstanding CHW for her/his/their service and excellence. The “Outstanding CHW Supervisor of the Year Award” will recognize one outstanding CHW Supervisor for her/his/ their service and excellence. The “Outstanding CHW Program of the Year Award” will be given to a group of outstanding CHWs. Please refer to the group packet to apply for these awards. Applications due April 13, 2018.

The Caring Health Center, Inc. Community Health Worker Program receives the 2017 Massachusetts Outstanding CHW Program of the Year Award

All MACHW awardees will be announced and recognized at the 9th Annual CHW Conference, which will be held in Norwood, Massachusetts on May 3, 2018.

New Employer Resources

A successful community health worker (CHW) program needs a thoughtful plan for recruitment, supervision and training of CHWs, their supervisors and the larger team. Employers can save their organizations time and resources by tailoring their standard HR processes for this specialized workforce.

MACHW can help. Our new Employer Resource Center is an online and onsite resource for accountable care organizations (ACOs), hospitals, community health centers and other social service providers considering or currently implementing a CHW program. Our goal is to both improve program effectiveness and improve CHW retention and satisfaction.

Online, employers can view evidence-based practices for designing and implementing CHW programs. Employers can also post and search job descriptions in real time.

Need more? MACHW also offers onsite consultation and training. We are proud to announce we now offer a 20 hour training for new hires. The training will ready CHWs to understand and work within ACOs and systems of care. The training will also provide tools for communicating effectively with their care teams and with patients with complex chronic conditions. This training is the product of a partnership between MACHW, the Justice Resource Institute (JRI), and the Center for Primary Care at Harvard Medical School.

For technical assistance or training needs, contact Lissette Blondet at [email protected].

MACHW Grows Reach

First, we’d like to publically acknowledge and thank Jackie Toledo for all her efforts to promote CHWs over the last 4 years. MACHW will miss her dearly and we wouldn’t be where we are today without her. We wish her the best of luck in her next endeavors.

Moving forward, MACHW is excited to announce we are able to expand our reach with the help of Jaime Berberena, Corina Pinto, and Cindy Martin. As a Regional Chapter Coordinator, Jamie will be developing a MACHWita in the Southcoast. Corina, our new Membership Coordinator, will be developing MACHWitas in Boston and the Northeast. Lastly, Cindy is enhancing our communications efforts by regularly updating our website and Facebook page.

 

Meet Newest Staff Member, Corina Pinto!

I grew up in East Boston and an important part of my identity is that I’m first generation Honduran American. When I graduated from the University of Vermont in 2015, I came back to East Boston looking for a way to serve my community. My first role was as a CHW for the East Boston Neighborhood Health Center. I had the opportunity to serve children and families who were new to this country or first generation. I appreciated being able to serve children who reminded me so much of myself growing up and be a role model to them.

What inspired you to be a CHW?

During my junior year in college, I had the opportunity to conduct research on reproductive rights in Peru. During my time there, I lived with Taquileños on the island of Taquile where they spoke primary Quechua. In working with the people and the medical staff on Taquile, I learned about the importance of cultural competence in community health. During my senior year, my interest in community health grew. The first place I looked for a health related job was at my primary care’s office, which is at the East Boston Neighborhood Health Center. They had a CHW position available although to be honest, I wasn’t sure what that really meant until I started the job.

What inspired me to stay in that role is when I realized how much of being a CHW relied on my lived experiences and my love for my community. Those are the cornerstones of our work. I invested whole-heartedly into my profession and appreciated being able to bring my whole self to the job. I feel like that is a unique opportunity other professions don’t get. That’s what makes us (CHWs) good at the job, because we are serving the community we love, wholeheartedly.

How did you get involved with MACHW?

As I became more comfortable with the CHW role, I began to see the blatant health inequities. These inequities are substantial and systemic; I was searching for connection with other CHWs to learn if they were facing the same issues. At the time, I was the first and only CHW at my work, but I was able to connect with CHWs at the Boston Public Health Commission. Through BPHC, I was invited to participate in a think tank hosted by MACHW. That’s the first time I learned about MACHW and met the MACHW team.

What is your role with MACHW now?

Currently, I’m the Membership Coordinator, similar to a CHW Organizer. My job is to create, pilot, and facilitate professional development modules and to launch MACHWitas in Boston and in the Northeast.

What do you see as some of the challenges and opportunities for CHWs in MA?

Reflecting on my own experience as a CHW, one of the challenges was enhancing my own self-determination so I could continue to make an impact on my community despite the systemic barriers in the workplace and community. I know as a CHW in a health center, it was hard to maintain my own sense of importance and effectiveness when there are other staff members that don’t necessarily see it yet. Eventually we made a great team, but it took a time to build trust and understanding of how our roles could work together to best serve the patients.

Another challenge of integrating more CHWs in healthcare systems is maintaining our heart identity. Many (if not most) CHWs talk openly about the love we have for our communities and that language needs to stay central to our work. It’s not something that can be quantified the way other professional skills can be measured. How do we maintain that piece while still remaining credible and legitimate to other professions?

One opportunity for CHWs is the implementation of Accountable Care Organizations throughout the state of MA. This is a way for our work to be covered by insurance. It is a great opportunity for CHWs to demonstrate the depth of our impact on the health of the communities we serve if we are given sustainable resources to do our job well.

Another opportunity for CHWs is to get involved with MACHW. No CHW should ever feel alone. We have an opportunity to create a system of connectivity. All CHWs, regardless of experience, can feel a part of something larger than themselves and feel connected to other CHWs in the region and possibly the country.

Our work is important and we are stronger together. CHWs are in tune with what is going on in our communities and if we’re all coming together to advocate for our communities, we can make a powerful impact. There is great opportunity for CHWs to collectively advocate for our communities.

What impact are you hoping to have with MACHW and beyond?

I hope to be able to create professional development modules that are really thoughtful and relevant to the CHWs in MA. I also hope to create a culture of connectivity among CHWs across the state. I want them to feel heard and that they’re part of the development of the workforce. I want them to have a way of regularly vocalizing the challenges and opportunities they experience. I hope to help create a continual feedback loop between what MACHW is doing and what’s going on in their workplace, community, and region.

Board Member, Rainelle Walker-White, Receives Award!

From left to right: Jennifer Bennet (former Executive Director), Mary Kathryn Fallon (Financial Manager), Rainelle Walker-White (Assistant Director) and Dr. Nancy Oriol (Founder and President) of the The Family Van at the awards ceremony.

Congratulations to MACHW’s Board Member Rainelle Walker-White on receiving the Boston Alliance for Community Health (BACH) 2017 Healthy Community Leadership Award which “celebrates Bostonians who have taken on a leadership role to improve the health of their community and address racial and ethnic health inequities.”

Rainelle Walker-White is the Assistant Director of The Family Van and has over 25 years’ experience in the field of health care delivery for hard to reach populations. She has been employed by the Family Van for 20 years and has served as its supervisor for over eight. Ms. White holds a Bachelor of Science Degree in Human Service. She also has certificates as a Generalist Health Educator as well as Nursing Assistant and Home Health Aid. She has a working knowledge of the effectiveness of mobile health services, particularly the effectiveness of health screenings relating to cardiovascular disease, hypertension, diabetes, reproductive health (including family planning), prenatal care, cancer screening and management, STDs, and HIV/AIDS. Ms. White also conducts many workshops in the community educating people about the importance of health care and wellness. Ms. Walker-White can be reached at [email protected].

Consider Giving to MACHW

Dear MACHW family,

This holiday season, please consider giving a gift to the Massachusetts Association of Community Health Workers (MACHW) to help us continue improving the lives of community health workers (CHWs) and the future of the profession.

DONATE

In 2017, we worked hard to address four areas of concern for CHWs in Massachusetts. Here were some of our successes:

​1. CHWs must have salaries that recognize their skills and experience. This year MACHW…

  • Developed recommendations for salary ranges based on level of experience.
  • Launched a campaign educating accountable care organizations (ACOs) and other employers to adopt these ranges.

2. CHWs must have ongoing access to training. This year MACHW…

  • Worked with MassHealth to designate funding for continuing CHW training programs ACROSS the Commonwealth.
  • Partnered with CHEC-Boston and JRI Health to create a “Mobile CORE Competency Training” to ensure training availability in those regions that do not have a CHW Training Program.

​3. CHW employers must have access to dependable information and support, so they can create and manage programs that enable CHWs to best serve their clients. This year MACHW…

  • Created the CHW Employer Resource Center which provides information, tools, training, and technical assistance to employers of CHWs.

4. CHWs and their employers must have access to up to date information about jobs, training opportunities, certification changes, etc. This year MACHW…

  • Launched a new website with national, state, and regional information relevant to the workforce and their employers.

Help us continue our work by making a tax-deductible donation today.

DONATE

With gratitude,

Lissette Blondet

Executive Director
Massachusetts Association of Community Health Workers
95 Berkeley Street, #201
Boston, MA 02116
P: 617.292.5061
[email protected]

Call for Presenters, 9th Annual CHW Conference

We invite you to help us shape the 9th Annual CHW Conference by submitting a breakout session proposal by Dec 8th. For more information, see flyer. 

The goal of the conference is to strengthen our efforts to promote and firmly advance the CHW profession.  It is dedicated to CHWs and CHW allies and will feature presentations on key CHW workforce and program development issues. It will provide networking opportunities and innovative tools to bring to your practice and program.

Breakout sessions will cover three key themes (such as, but not limited to):

CHW Program Development:  

  • Models for CHW career development opportunities
  • Effective strategies for CHW supervision
  • Innovative CHW program models that include:
  • Effective protocols, workflows, and tools  
  • Effective recruitment and retention strategies
  • Strategies for system-wide collaboration and partnerships
  • Strategies for management of stress and empathy fatigue issues among staff
  • CHW program evaluation

CHW Professional Development and Skill-Building

  • CHW certification in MA
  • The role of CHWs in racial equity work
  • Core competencies for CHWs
  • Special health topics for CHWs
  • Motivational Interviewing/Patient engagement strategies
  • Identifying resources to meet patient needs
  • CHW leadership skills  

Policy

  • Accountable Care Organizations and the role of CHWs
  • Sustainable Financing for CHW Services
  • Demonstrating Return on Investment

MACHW launches first MACHWita in the Southeast!

MACHWitas, or “little MACHWs” in Spanish, are being developed because CHWs wanted us to decentralize our efforts, so we’re taking the show on the road! We will create that safe space for CHWs to reflect, support, and learn from their peers in their region. We’ll also be able to give hands on assistance with the certification application.

A message from Jamie Berberena, MACHW Regional Chapter Coordinator for the Southeast MACHWita:

To date, we have held two Professional Development Forums (PDFs) where dozens of CHWs from across the region came together to support each other, share resources and best practices as part of a professional network, and learn from subject matter experts about innovative strategies to meet the complex needs of clients.

Our third PDF is scheduled to take place Tuesday, October 17, 2017 at the Wareham Public Library.

Here are some comments from CHWS who attended past forums:

  • “I liked the chance to come together and share with other CHWs.” 
  • “I enjoyed the discussion and hearing other people’s stories.”
  • “Nice setting and well organized.”
  • “The resource sharing was very helpful.”
  • “I am looking forward to doing this again.”
  • “I appreciate hearing how others do their work and troubleshoot problems working as a team.”

For more information about the Southeast MACHWita, contact Jamie Berberena at [email protected].

Update from January 2018: For more information about MACHWitas developing in Boston and Northeast, contact Corina Pinto at [email protected].