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1: CHWs and HCH |
4: Training CHWs |
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2: CHW Roles and Responsibilities |
5: Supervision of CHWs |
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3: Hiring CHWs |
6. CHW Integration and Support |
4. Training CHWs
“Clearly, there are plenty of other causes of homelessness besides untreated mental health issues, unresolved trauma, and cognitive disabilities, but these are the issues I seem to work with the most” ~ Community Health Worker
State Initiatives
Training resources for CHWs, both online courses and in-person classes, are abundant and readily available. In an effort to create more sustainable opportunities for CHWs in the workforce, many states have begun standardizing their trainings and developing certification programs. Currently, 30 states offer some type of standardized training for CHWs. Eleven states have certification programs for CHWs with seven more in the process of developing certification programs.
For more information about state initiatives and laws regarding CHWs, visit the NASHP’s State Community Health Worker Models.
Core Competencies
Within the HCH setting, CHWs should build their knowledge around the primary issues client’s face. The following table describes topics and issues pertinent to delivering care to people experiencing homelessness, core questions the CHW should be able to answer, and a sample of training resources.
Topic |
What the CHW Needs to Know |
Resources |
Substance abuse and addiction |
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Mental health diagnoses and treatment |
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Trauma response and trauma informed care |
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Cognitive disabilities and traumatic brain injury (TBI) |
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Common chronic diseases, treatments, medications, and specific challenges |
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Harm reduction |
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Confidentiality |
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Cultural humility |
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Basic medical terminology |
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The core competencies listed above will help CHWs better understand clients and the ways they can assist clients in navigating the health care system. In addition to these competencies, there are skills CHWs need to develop because of their close work with complex and vulnerable individuals. The following topics are important to revisit on an annual basis, either through formal training or supervision, in order reinforce the knowledge and skills needed for their day-to-day work and to prevent burn-out.
Topic |
What the CHW Needs to Know |
Resources |
Establishing and maintaining healthy boundaries |
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Understanding the stages of change |
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Processing grief and loss |
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Self-care strategies |
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De-escalation techniques |
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Motivational interviewing |
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Professional Skills Training
For some CHWs, this job may be the first time or the first time in a long time they have worked in a professional setting. There are certain skills and behaviors people who have worked in an office or clinic setting have learned that may not be in the repertoire of a new CHW. CHWs who have never worked in a professional atmosphere may have difficulty acclimating to the culture, learning the work ethic, and being productive at their jobs. In a study on the impact of CHWs on patient behavior conducted by The U.S. Public Health Service (USPHS), researchers found some CHWs who were new to the workforce had “high absenteeism rates, wore inappropriate clothing, and/or did not know how to speak in a professional manner to patients on the telephone or in person.”[i] CHWs need guidance from their supervisors and may need additional training. Here are training topics to consider:
- Typing skills
- Checking, sending, and organizing email
- Conference call etiquette
- Time management
“Our CHW’s computer skills are slow but she’s so good at what she does that it’s not that important. Computer and writing skills are a plus but shouldn’t take priority.” ~ Supervisor, Massachusetts
PROJECT SPOTLIGHTEncourage the CHW to take advantage of any opportunity to learn more about what’s going on in their community. A CHW in Massachusetts had the opportunity to tour of a local prison and she shared that this experience increased her understanding of the trauma of incarceration. Often members of the HCH client population have spent time incarcerated, so familiarizing herself with the realities of prison life helped in her outreach to formally incarcerated clients. She says “I recommend all CHWs do something like that in their community. It really makes a difference.” |
CHW Trainings Resources
Peer Specialist Certification Program
According to the Department of Behavioral Health, “A certified peer specialist is an individual living in recovery with mental illness and/or substance use disorder or a family member who has been trained and certified by the Department of Behavioral Health to assist others in recovery and wellness. A certified peer specialist is a model for personal recovery and performs a wide range of tasks to assist individuals to regain control over their lives and their own recovery process.” Hours of training required, fees, and eligibility criteria vary by state.
Minnesota has a statewide competency-based CHW educational program based in accredited post-secondary schools across the country. This 14 credit program is a blend of classroom and field-based learning. At minimum, a high school diploma or GED is required. Fees vary based on location.
City College of San Francisco: Community Health Worker Certificates
The CHW Certificate Program at City College of San Francisco is a 20 unit program, designed to prepare individuals for work in community-oriented health and social service fields. Classes are offered in the evenings and the certificate takes approximately 2 semesters to complete. Students also complete an internship of 128 hours at a clinic or community organization. The fee is currently $36 per unit.
References
[i] Zuvekas, A, L. Nolan, C. Tumaylle, and L. Griffin. (1999). Impact of Community Health Worker on Access, Use of Services, and Patient Knowledge and Behavior. Journal of Ambulatory Care Management, 22 (4)