(front row) L to R, Linda Austin (Desha County); Easter Walker (Chicot County); Brenda Reaves (Desha County), Billie Neal (Desha County), Joann Spencer (Lincoln County); Brandy Haley (MCHNS/ Supervisor), and Jan Turner (Regional Patient Care Manager and Regional CHW Supervisor).
Key to the success of the initiative is the role of the community health workers (CHWs). There are nine CHWs – three for each county – especially trained for STAR.Health. These women, ages 35 to 55, know about the communities where they work because that’s where they live. Following a successful first year of work, the program was consolidated and upgraded. Rather than the part-time staffing necessary at first to limit costs, CHWs now work full-time to promote health in three fields: maternal-child health, oral health and chronic disease management. They are based in the local health units and are supervised by public health nurses. Their core work is to contact and interest those who are at greatest risk for poor health or educational results, and then link them to the health professionals they need, as well as an array of local and state public service agencies.
Year One Results
In their first year, the CHWs collectively made 5,482 public contacts. Of those, 1,111 were personal and substantial, with 49 percent taking place in the clients’ homes. Another 30 percent took place at various community sites and 21 percent were at the county health unit. The purpose of most of these contacts was to assess the needs of the client and provide referral assistance. The type of problem and the kind of assistance that was needed varied greatly. In some cases, a CHW might inform the clients of a resource and provide them the phone number and address of a provider. In other instances, the CHW would schedule appointments, help the client complete a form, arrange for transportation or provide child care.
Examples of some common services CHWS provided are:
- Helped pregnant teens talk to parents about their unintended pregnancy. This included setting up access to prenatal care and family planning services once the baby was delivered.
- Ensured that newborn babies and their mothers got WIC nutritional services
- Assured that children got timely immunizations
- Helped patients get prescriptions filled for doctor-prescribed drugs, especially for chronic diseases such as hypertension and diabetes
- Reached out to encourage children to get health screening (EPSDT) services, either through the local health unit or through their private physician.
- Helped gain ARKIDS coverage for community youth, overcoming common misconceptions that children were ineligible
- Helped individuals get Medicaid spend-down coverage if they had previous unpaid medical bills
- Provided assistance to the local health units by following up on missed appointments for immunizations, maternity services, family planning, etc., either by telephoning clients or making home visits
Examples of specific services CHWs provided to individual clients (some personal identifiers omitted to comply with HIPAA) are:
- Helped a child with high medical bills get ARKIDS health insurance when her caregiver thought the program was only for healthy children
- Helped a suicidal adolescent stay in school until after her baby was born and arranged family planning services so she could avoid another unwanted pregnancy
- Provided help to a young mother with many children to get back in school
- Assisted a young father who lost his income due to identity fraud. Since his pre-paid cell phone could not support the long “on-hold” waits when he called to report the problem, a CHW set up an appointment for him in the regional Social Security office and arranged transportation.
- Arranged for a child to get needed surgery by getting ARKIDS coverage reinstated. Coverage had been mistakenly terminated because of misinformation about the parents’ income level.
CHWs recorded an additional 4,371 contacts during the first year of STAR.Health in which they helped organize group sessions on health education, held health screening sessions in public sites and provided information to the general public on health related services.