Florida Cancer Coalition Goal III Sub Committee



Florida Cancer Coalition Goal III Sub Committee

Community Health Worker Initiative

A Year in Review 2011

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|Florida Community Health Worker Coalition |

|A statewide partnership dedicated to the support and promotion of the CHW profession in Florida |

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|The Florida Community Health Worker Coalition is a passionate group of volunteers dedicated to the promotion of the community |

|health worker profession in Florida. The Coalition has five working groups. |

|From the website: |

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Community Health Worker: A Year in Review

I. Purpose Statement

II. Introduction: Current Landscape of Community Health Workers in Florida

III. Phase I: Capacity Building (October 2010 – October 2011)

a. Stakeholders Identified

b. Face-to-Face Meeting: June 2-3, 2011

c. Committees Formed

d. Action Items Developed from Face-to-Face Meeting and Beyond

e. Definition of Community Health Worker Developed

f. Taskforce Becomes Florida Community Health Worker Coalition

IV. Next Steps

a. Phase II: Project Expansion

b. Phase III: Sustainability

V. Conclusion

VI. Appendix I: Stakeholders

VII. Appendix II: Community Health Worker Face-to-Face Agenda: June 2nd & 3rd 2011

VIII. Appendix III: Workshop Details

IX. Appendix IV: Policy Brief

X. Draft Bill by Policy Partners

I. Purpose Statement

The Florida Community Health Worker Taskforce initiative began in October 2010 and has seen substantial accomplishments over its first year. From its inception as a stakeholder taskforce, it has grown quickly into the more organized Florida Community Health Worker Coalition (Coalition), comprised of dedicated volunteers striving to educate, advocate, and communicate on behalf of community health workers (CHWs) in Florida.

The Coalition would like this report to serve as a historical reference that outlines the Coalition’s activities throughout Phase I, by providing a brief description of the current landscape in Florida that CHWs are facing. This includes outlining the key issues, detailing the taskforce to coalition transition, and summarizing the Coalition’s projected plans for expansion and sustainability. Additionally, this document will provide a baseline for tentatively identifying the Coalition’s next steps in expansion and sustainability efforts.

Through the combined efforts of all involved stakeholders, the Coalition will continue to make gains through partnerships, communication, legislation, education, and advocacy.

II. Introduction: Current Landscape of Community Health Workers in Florida

CHWs are known by many names, including promotores de salud, patient navigators, and lay health advisors. They possess important skills, community knowledge, and unique abilities in reaching vulnerable, low-income, and underserved members of the community. In Florida, the wide range of services provided by CHWs include helping aging populations, managing chronic diseases and teaching chronic disease prevention, coordinating safe sex education among youth populations, encouraging healthy behaviors among pregnant women, and teaching pre- and postnatal care.

Florida offers unique challenges to the CHW due to the diverse nature of the demographics represented throughout the state. Current census data offers new insight on exactly how diverse Florida’s population is. With a population of almost 19 million, more than one in five Floridians are persons of Hispanic or Latino origin. Twenty-five percent of the state’s population lives in a home where a language other than English is spoken.[1] Thirteen percent of the population lives in poverty. The map (above) illustrates Florida’s population change from April 1, 2000 to April 1, 2010. Florida experienced a growth rate of 17.6 percent, adding 2,818,486 residents.[2] In addition, chronic disease and cancer incidences in the state are continually on the rise. “In Florida, almost one of every three deaths was due to heart disease and almost one of every four deaths was due to cancer in 2002.”[3]

Phase I: Capacity Building (October 2010 – October 2011)

Over the last year and a half, the Coalition established itself by building stakeholder support and developing an infrastructure for continued growth.

Visioning:

Cancer Control and Research Advisory Council (C-CRAB) ()

The 34-member governor-appointed C-CRAB, meeting with the regionally based Comprehensive Cancer Control Collaboratives, identified promotion of CHWs as a key strategic initiative for two of the four goals of the 2010 Florida Cancer Plan. These included: develop workforce, improve access to care, and reduce health disparities. The C-CRAB Goal III Subcommittee championed the effort and set out to create momentum for the task.

a. Stakeholders Identified

C-CRAB, the Cancer Program [including the Comprehensive Cancer Control Program (CCCP), the Breast and Cervical Cancer Early Detection Program (BCCEDP), the Colorectal Cancer Control Program (CRCCP) and the CCCP-Policy, Environment and System (CCC-PES) Change Program], and the Bureau of Chronic Disease Prevention and Health Promotion partners at the Florida Department of Health (DOH) developed and contacted a list of possible stakeholders. From that initial group of interested stakeholders, other potential stakeholders were identified. These potential stakeholders added differing points of view that made the Coalition more representative of Florida’s demographics, health care needs, and CHW labor force. Monthly telephone calls with a growing number of stakeholders began in October of 2010. These telephone calls centered, at first, on exploring materials available on research and experiences with CHW programming. (See Appendix I for complete list of taskforce [later Coalition] members.)

Key Issues of Interest

The Florida Community Health Worker Taskforce identified the following key issues:

• Institute a standard definition of CHWs in Florida.

• Establish a database of CHWs.

• Standardize training and curriculum standards for CHWs.

• Pursue the passage of a proclamation or bill that recognizes the efforts of CHWs throughout Florida.

• Continue recruiting membership and stakeholder support.

• Pursue reimbursement for CHWs through Medicaid and private insurance.

POSTER for WORKSHOP—LOGOS of PARTNERS

b. Face-to-Face Meeting: June 2-3, 2011

After months of planning and developing a strategic network of stakeholders, C-CRAB with funding from the CCC-PES grant hosted a CHW Taskforce meeting on June 2-3, 2011, which was facilitated by the CCC-PES staff Nearly 50 stakeholders attended, representing a broad spectrum of services, demographics, and health issues that CHWs contend with in Florida. (See Appendix II for a complete list of speaker summaries and brief bios.)

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c. Committees Formed

At the two-day CHW Taskforce meeting, four committees were planned and formed by considering the key issues listed above. The attendees chose from four breakout groups: Networking/Communications, Sustainability, Curriculum, and Policy. As the Taskforce developed, these groups became committees. A preliminary step in developing the committee structure was to designate a team leader and a Department of Health facilitative staff person for each committee. After a SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis, participants defined and categorized action items. The committees then claimed key action items for which they would take lead responsibility.

In developing the committees’ focuses and purposes, stakeholders were asked to determine how the committees might relate to each other. The chart below was an exercise to depict how each committee (element) might drive progress in relation to the others. The arrows show influence. Note that networking was considered the most commanding driver for all the other needed processes, concluding that emphasis needs to be placed on networking, especially for the start-up.

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The momentum of the June meeting continued in committee meetings held via conference calls, which most committees held monthly. The calls were (and continue to be) used for action item updates and discussions about next steps.

Based on the experiences of the rapidly growing Coalition, the original committee structure has changed. Since some of their action items overlapped, the Networking and Sustainability groups combined efforts. Two new committees, Research and Practice, were formed later in the year when the need to focus attention on these aspects was identified.

The following description of the committees includes their Phase I activities.

Networking and Sustainability Committee

Goals:

➢ Increase the diversity of enrollment and participation in the Coalition.

➢ Investigate opportunities for in-person meetings.

➢ Develop an infrastructure for the Coalition (whether through bylaws, charter, or information membership agreement).

➢ Develop tools to improve communication between Coalition members and non-members.

Accomplishments:

➢ Facilitated the development of Florida’s consensus definition for a CHW

➢ Facilitated the decision to move from a taskforce to a coalition

➢ Targeted outreach to individuals and organizations to become active members

➢ Developed a new website, . This website will interface with the existing website housed at the University of Florida and will include information on upcoming Coalition meetings and other Coalition business.

➢ Developed outreach materials, including a recruitment brochure and an employer benefit brochure

➢ Developed a coalition logo for branding

Work in Progress:

➢ Continued progress in updating website to be more user friendly

Policy Committee

Goals:

➢ Create an identity for CHWs statewide by coming to a consensus on a definition.

➢ Provide evidence, specifically return on investment and the current economic impact of CHWs throughout the state.

➢ Review other states’ legislation for models to move forward.

➢ Create talking points to guide legislative efforts.

➢ Enlist champions for policy and systems change.

Accomplishments:

➢ Produced an evidence-based policy brief that demonstrates the diverse population reached by CHWs and the impact that CHWs have on integrated health delivery in Florida. The policy brief also displays the economic impact of CHWs. The policy brief has been distributed to interested parties. (See Appendix IV: Policy Brief.)

➢ Created talking points to help any Coalition representative while they are presenting to interested audiences:

➢ Created a legislative priorities list to help guide legislative efforts

➢ Created a draft bill in response to legislators’ requests

Work in Progress:

➢ Continued outreach to stakeholders and continued grassroots formation to influence the Coalition’s mission specific to the Policy Committee

➢ Continued outreach to champions in Florida’s Legislature to drive policy formation

Curriculum Committee

Goals:

➢ Establish core elements of standards for curriculum

➢ Establish curriculum review panel

➢ Establish requirements for certification process/training requirements

Accomplishments:

➢ Surveyed CHWs and Coalition members to determine the core competencies and skills of CHWs in Florida. Identified nine competency areas

➢ Presented survey results at the November 2011 Coalition meeting.

Work in Progress:

➢ Developing a tool to examine the established CHW curricula, which will lead to a standard curriculum certification in Florida.

Research Committee-Newly formed

Goal:

➢ Promote interdisciplinary collaborative research activities that will support the profession

➢ Promote continuous outcomes data collection to support the profession of CHW in Florida through creation of common outcome measures

d. Action Items Developed from Face-to-Face Meeting and Beyond

The following is a timeline of action items that were identified during the face-to-face meeting in June, and have since been accomplished.

➢ “One pagers” were created to identify each committee’s specific action items.

➢ Coalition members agreed upon a definition of CHWs in Florida.

➢ The taskforce name evolved to become the Florida CHW Coalition after agreement from general membership stakeholders.

➢ The Networking and Sustainability committees merged since many of their action items were the same.

➢ A website and brochure were developed to recognize CHWs in Florida, solicit new membership to the coalition, and share information.

➢ The Policy Committee developed a policy brief which:

o Defines CHWs and describes the essential role they have as part of Florida’s integrated health delivery team;

o Summarizes the research that demonstrates the effectiveness of CHWs and return on investment generated by including CHWs in the health system; and

o Acknowledges the creation of the Florida CHW Coalition.

➢ The Curriculum Committee developed a pilot survey for distribution to CHWs and stakeholders to identify the core competencies and skills of effective CHWs.

e. Definition of Community Health Worker Developed

The Coalition’s adopted definition of a CHW was announced during the August 10, 2011 conference call. Members of the Coalition consulted national definitions and definitions used by other states before deciding on the definition of CHWs that will be used in Florida. Closely reflecting the definition used by the American Public Health Association, Florida’s definition is:

"A CHW is a frontline health worker who is a trusted member of and or has an unusually close understanding of the community served. This trusting relationship enables the CHW to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery. A CHW also builds individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support, and advocacy. Some activities performed by the CHW include providing information on available resources, providing social support and informal counseling, advocating for individuals and community health needs, and providing services such as first aid and blood pressure screening. They may also collect data to help identify community health needs."

f. Taskforce Becomes Florida Community Health Worker Coalition

With its new identity, the Coalition will be institutionalized as an active, recognized group working on issues affecting CHWs and supporting their advancement in the Florida healthcare system. The general membership meets monthly by phone for group updates and larger group decisions when warranted. Each Coalition committee meets as it deems necessary to accomplish its tasks. To promote the Coalition’s mission and activities to as many current and potential stakeholders as possible, meeting minutes are posted on the Coalition’s website, . (See Appendix III: Meeting Minutes)

III. Next Steps

a. Phase II: Project Expansion

Based on the needs of the stakeholders, Coalition members determined that two more committees should be formed: research and practice. The Research Committee compiles evidence-based research to continue driving the Coalition’s grassroots efforts. The Practice Committee obtains input based on the practical experience of CHWs to further the goals and objectives of the Coalition. The addition of these committees will enhance the Coalition’s ability to promote CHWs as a recognized profession in Florida.

b. Phase III: Sustainability

Sustainability will be critical for the Coalition when moving forward. Securing the goal of sustainability will be achieved through the combined work of the committees. It is essential that the Coalition work to advocate on behalf of CHWs and educate the appropriate entities regarding the necessary services CHWs provide. The ultimate goal of future sustainability for the Coalition will be to have CHWs recognized as valuable and contributing members of Florida’s integrated health delivery team, and to illustrate their return on investment by improving health outcomes and lowering healthcare costs.

IV. Conclusion

By involving diverse groups of stakeholders from a wide variety of organizations and by researching models from other states, the Florida CHW Coalition has engaged CHWs and other stakeholders from multiple sectors across Florida. The Coalition is poised to move forward in accomplishing its goals of recognition of CHWs as valuable members of the healthcare team and establishment of a certification process for CHWs. The future of the Florida CHW Coalition is important to improving the healthcare system in Florida. By supporting the critical role CHWs play in Florida’s integrated health delivery system, the initiative will provide CHWs with recognition and illuminate the positive impact they provide to the most underserved Floridians.

Note: Two CHW related bills were introduced during the 2012 legislative session (see Appendix V)-. While not a product of the Coalition, several members of the Policy Sub Group were instrumental in the drafting.

V. Appendix I: Stakeholders

(Please alphabetize this list by last name)

|Name |Organization |Title |

|Alma Y. Dixon |Bethune-Cookman University (B-CU) |Executive Director Health Equity |

|Amanda Hunt |Department of Health (DOH) Heart Disease &|Staff Assistant |

| |Stroke Prevention | |

|Amy Ramsay |Health Education |Analyst |

|Andrea Stephenson |Health Council of Southeast Florida |Executive Director |

|April Schenck |University of South Florida |Community Health Worker |

|Beatriz Cymberknofp |Treasure Coast Health Council |Community Health and Program Planner |

|Betsy J. Rodríguez |National Diabetes Education Program |Deputy Director |

|Betsy Wood |DOH Bureau of Chronic Disease Prevention |Bureau Chief |

| |and Health Promotion | |

|Brandi Yant |American Indian Shawl Circle |Community Health Advocate |

|Brendaly Rosemond |University of Miami |Manager/Health Educator |

|Brian Rivers |Moffitt Cancer Center |Faculty |

|Carl H. Rush |Community Resources, LLC |Principal |

|Catherine Howard |DOH Diabetes Prevention & Control Program |Medical Health Care Program Analyst |

|Cheryl Kerr |St. Petersburg College |Human Services Program Director |

|Christina Tuero |Health Council of South Florida, Inc. |Health Planning Services Coordinator |

|Claude Earl Fox |Florida Public Health Institute |Executive Director |

|Clement Gwende |Moffitt Cancer Center; University of South|Assistant Member & Associate Director of |

| |Florida (USF) |Diversity |

|Clifton Skipper |DOH Breast & Cervical Cancer Program |Health Education/Outreach Coordinator |

|Colleen Reinart |Migrant Health Promotion |Program Director |

|Coni Williams |USF Center for Equal Health |Community Health Workers/Lay Health |

| | |Advisors |

|Deb Glotzbach |DOH Heart Disease & Stroke Prevention |Community Health Educator |

| |Program | |

|Dee Snell |B-CU |Program Manager |

|Denise Kerwin |St. Petersburg College |Director |

|Edna Apostol |Gulfcoast South Area Health Education |Chief Executive Officer |

| |Center (AHEC) | |

|Erin Kay Sologaistoa |Florida Association of Community Health |Migrant Heal |

| |Centers (FACHC) | |

|Ernesto Reyes-Arrechea |University of Miami |CHW/Research Assistant |

|Eugene Charbonneau |Liberty County Health Department (CHD) |CHD Director |

|Fabiola Garcia |PAEC Migrant Education |Recruiter |

|Folakemi T Odedina |University of Florida |Professor of Pharmacy & Director of UFPDC |

| | |Community Outreach Program |

|Fran Ricardo |Rural Women's Health Project |Director of Development |

|Gail Dixon |Center for Prevention Workforce |Project Director |

| |Development | |

|Gaye Williams |Central Florida Family Health Care |CEO |

|Glenique Hampshire |DOH Asthma Program |Disease Prevention Nurse Consultant |

| | |Educator |

|Ivette Lopez |Florida Agricultural and Mechanical |Associate Professor |

| |University (FAMU) | |

|J. Rudy Reinhardt |Heartland Rural Health Network, Inc. | Director |

|James McCloud |Genesis Health Services |Founder/President/CEO |

|Jane Burgess |Workforce Florida, Inc. |Program Director  |

|Jasmine Calhoun |Florida State University |MPH Intern, Dept of Health |

|Jeannette Palencia |Moffitt Cancer Center |Senior Community Outreach Worker |

|Jeannie Economos |Farmworker Association of Florida |Pesticide Safety & Environmental Health |

| | |Project Coordinator |

|Jessica Bishop-Royse |DOH Arthritis Program |Health Educator Consultant |

|Joan Cleary |Minnesota CHW Alliance Program |Administrator |

|Josephine Mercado |Hispanic Health Initiatives, Inc. |Executive Director |

|Karen Simons |DOH HIV/AIDS Program |Health Educator Coordinator |

|Kathy MacNeill |Heartland Rural Health Network, Inc. |Associate Director, Diabetes Master |

| | |Clinician Program |

|Ken Peach |Health Council of East Central Florida |Executive Director |

|Kim Schuknecht |Premiere Community Healthcare Group |CEO |

|Kristen Wells |USF Center for Evidence-based Medicine and|Assistant Professor |

| |Health Outcomes Research | |

|LaShonda T. Coulbertson |Moffitt Cancer Center |Senior Health Education Specialist |

|Laura Lenhart |Moffitt Cancer Center |C-CRAB Liaison |

|Leda Perez |Collins Center for Health Policy |Vice President |

|Linda Paige |Moffitt Cancer Center |Sr. Community Outreach |

|Liz Morales |Hispanic Health Initiatives, Inc. |Professor of Medical and Allied Health |

| | |Science |

|Lolita Dash-Pitts |USF Center for Equal Health |CHW/Lay Health Advisor |

|Luz Corcuera |Healthy Start Coalition of Manatee County |Program Director |

|M.R. Street |DOH Healthy Communities Program |Program Analyst |

|Maisha Standifer |USF Center for Equal Health |Coordinator for the Community Engagement |

| | |and Outreach Core |

|Maria Cabrera |American Cancer Society |Director of Health Initiatives |

|Maria Granado |Lake County |Community Health Worker Program |

|Maria Pouncey |Panhandle Area Educational Consortium |Migrant Education Program Project Director|

|Marilyn Mesh |Suwannee River AHEC |Administrator |

|Marisela Ruiz |Department of Economic Opportunity |Senior Monitor Advocate |

| |(formerly AWI) | |

|Mary Bowers |DOH Breast & Cervical Cancer Program |Program Director |

|Megan Wessel |American Cancer Society |Director |

|Melissa Hill |Premiere Community Healthcare Group |Outreach Coordinator |

|Merritt Martin |Moffitt Cancer Center |State Legislative Affairs Director  |

|Michele Mule |Elder Affairs |Supervisor |

|Michelle Dublin |Pinellas CHD |Certified Family Support Worker in |

| | |Community Health |

|Miranda Paschal |FACHC |Clinical Quality Coordinator |

|Maureen Mann |Holy Comforter Hospital |Executive Director |

|Monica Hayes |DOH Office of Minority Health |Assistant Director Office of Minority |

| | |Health |

|Myron Jackson |Moffitt Cancer Center |Research Coordinator, III |

|Natali Ramirez |Department of Elder Affairs |DOEA Health and Wellness Specialist |

|Pascal Jean-Pierre |University of Miami |Assistant Professor at University of Miami|

| | |Miller School of Medicine |

|Peter Willems |Hispanic Health Initiatives, Inc. |Director of Operations |

|Rachel Hernandez |Migrant Recruiter |Program |

|Rita Victoria Diaz-Kenney |FAMU Institute of Public Health |Consultant |

|Robin Levy |Rural Women's Health Project |Director of Education |

|Sandra Schoenfisch |DOH Emergency Medical Operations |Project Leader |

|Sarah Cawthon |DOH Diabetes Prevention & Control Program |Health Education Program Manager |

|Sean Dickerson |Moffitt Cancer Center |Research Coordinator, III |

|Shannon Pressey |University of Florida |Research Programs Coordinator |

|Socrates E. Aguayo |Amerigroup Community Care |Director of Community Outreach |

|Susan Allen |DOH Heart Disease & Stroke Prevention |Program Administrator |

| |Program | |

|Susan Derrick |Centers for Disease Control and Prevention|Public Health Advisor-Cancer Division |

|Susan Fleming |DOH Cancer Program |Program Administrator |

|Susie Lloyd |Suwannee River AHEC |Professional Development and Professional |

| | |Education Manager |

|Sylvia Salazar |Premiere Community Healthcare Group |Outreach Coordinator |

|Tina Zayas |Indian River CHD |CHW Employer |

|Virna Dapic |Health Outcomes and Behavior |Postdoctoral Fellow |

|Daniel M. Washburn |DOH Heart Disease & Stroke Prevention |Health Education Specialist |

| |Program | |

|Zenesha Barkley |B-CU |Faculty |

Appendix II: Community Health Worker Face-to-Face Agenda: June 2-3, 2011

Community Health Worker’s Task Force Meeting

June 2, 2011

10:00 am – 5:00 pm

Aloft Hotel Tallahassee Downtown

200 North Monroe Street

|Registration |Brittany Lange |9:00 am |

|Welcome |Annette Phelps |10:00am |

|Introductions and Ground Rules |Steve Shelton |10:05am – 10:30am |

|Ice Breaker Activity | | |

|Key Note Speaker |Dr. Leda Perez |10:30am – 11:00am |

| | | |

|Morning Break | |TBD |

|What is Happening - National Level |Carl Rush – Texas |11:00am – 12:30 pm |

| |Joan Cleary – Minnesota | |

| |12:30pm – 1:00 pm |

|LUNCH | |

|What is Happening - Florida |See attached presenter listing |1:00 pm – 4:00 pm |

| | | |

| | | |

|Afternoon Break | |TBD |

|Questions, Answers and Comments |Steve Shelton |4:00pm – 5:00 pm |

| |Group | |

|Adjourn | |5:00pm |

Community Health Worker’s Task Force Meeting

June 3, 2011

8:30 am – 3:30 pm

Aloft Hotel Tallahassee Downtown

200 North Monroe Street

|Review of previous day |Steve Shelton |8:30am – 9:00am |

|Strategic Planning Discussions |Steve Shelton |9:00am – 10:00am |

| | | |

|Morning Break | |TBD |

|Break-Out Discussion Groups: | |10:00am – 12:00am |

|1) Policy/Systems | | |

|2) Sustainability/Financial | | |

|3) Networking/Communications | | |

|4) Curriculum/Certification | | |

| | | |

|Group Findings Discussion (Reconvene) | |12:00am – 12:30pm |

| |

|WORKING LUNCH |

|Subcommittee Action Planning | |12:30am – 1:30pm |

| | | |

| | | |

|Afternoon Break | |TBD |

|Review of Action Plans/Wrap-Up | |1:30pm – 2:30pm |

|Next Steps/Directions for Task Force Members/Charter | |2:30pm – 3:30pm |

`

Appendix III: Workshop Details

The June 2-3, 2011 meeting included the following presenters with a brief overview of their contribution:

Name: Steven Shelton

Title/Affiliation: Assistant Vice President for Community Outreach, University of Texas Medical Branch (UTMB), and director of the East Texas AHEC program

Topic: Facilitator for the two days

Contact Info:

Phone: (409) 772-7884

Email: steve.shelton@utmb.edu

Facilitator, Steven Shelton, is Assistant Vice President for Community Outreach, University of Texas Medical Branch (UTMB), and director of the East Texas AHEC program. He is on the faculties of the School of Health Professions (over 30 years) and School of Medicine (over 20 years) at UTMB, and is course director of the third most popular SOM 4th year selective course. He has over 20 years experience in program development and administration. He and his administrative team have successfully received and managed over $30 million in grant and contract funding. He has worked extensively with community and campus partners to design and implement a wide array of health workforce enhancement programs. He has served in national leadership roles and as an international consultant for health workforce policy, planning and development.

Name: Annette Phelps

Title/Affiliation: Director of the Division of family Health Services (DOH)

Contact Info:

Phone: 850-245-4102

Fax: 850-414-6091

Email: annette_phelps@doh.state.fl.us

Annette Phelps is Director of the Division of Family Health Services at the Florida Department of Health. Active at state and national levels, she currently serves on the Board of the Association of Maternal and Child Health Programs (AMCHP). She has actively promoted the integration of preventive health services across the lifespan and at the national level has encouraged the AMCHP and National Association of Chronic Disease Directors to work together for their common interests in prevention. In May of 2011 the University of South Florida College of Public Health named her Florida’s Outstanding Woman in Public Health.

Topic: Welcome -“Why is the Time Right for Community Health Workers”

Summation

A considerable body of research indicates that community health workers (CHWs) are effective in improving chronic disease care and health outcomes.[4]

-They can help improve health care access and outcomes; strengthen health care teams; and enhance quality of life for people in poor, underserved, and diverse communities.1

-A summary of findings by the Agency for Healthcare Research and Quality suggests CHW interventions can serve as an effective means of improving knowledge outcomes health care utilization for hypertension, mental health, and asthma.[5]

-Promoting the CHW workforce in Florida is a win-win: Not only can we improve patient outcomes and reduce health care costs; we can also create jobs by developing a viable career path for this needed health profession.

Name: Dr. Leda Perez

Title/Affiliation: VP for Health Initiatives at the Collins Center for Public Policy

Contact Info:

Phone: (305)767-4632

Email: lperez@

Leda Perez is Vice President for Health Initiatives at the Collins Center for Public Policy in Miami, Florida where she leads efforts to promote promising practices and policies to improve access to quality health care for the people of Florida and the nation. From 1999–2003 she was the project director for Community Voices Miami, based at Camillus House, an organization in the service of homeless people. In 2003, Leda joined the Collins Center for Public Policy, where she was the director for Community Voices Miami until 2008. Most recently, she has consulted for the United Kingdom’s Department for International Development ‘s Medicines Transparency Alliance (MeTA) in Lima, Peru.

Topic: Community Health Workers in Florida: Reflecting on the Past; Gaining Momentum for the Future

Summation

Through the Community Voices: Healthcare for the Underserved National Initiative, a national void was filled with the premise to find the best practices and policy alternatives for health care. From this, CHWS became a part of the work of every project site. CHWs are in the position and have the “unique ability” to be current in the health and social issues that need to be addressed and they are able to fill the specific needs of their communities. Because CHWs are part of the same communities they serve, the aspect of recognition and payment are critical. Nationally, health care systems present the challenge of prevention and management of chronic disease as well as individuals with special and complex needs. Within Florida, the numbers show that there is a need for CHWs; there are more than 4 million uninsured, higher than average unemployment, high number of incarcerated people and highly distressed neighborhoods. Opportunities for change are occurring right now. The National Health Care Reform offers coverage expansion, a redesign of how care is delivered and cost containment. CHWs can result in improved health outcomes, lower health care delivery costs, reduction in health inequities and other pertinent outcomes.

Name: Carl Rush, MRP

Title/Affiliation: Community Resources LLC

Contact Info:

Phone: (210)775-2709

Cell: (210)241-3983

Email: carl@

Carl Rush has worked full time for and with Community Health Workers (CHWs) for over 14 years. He is currently developing an educational project for the Centers for Disease Control and Prevention (CDC) to prepare their state grantees to advocate for policy change to promote employment of CHWs. He is serving as a subject matter expert for the federal Office of Women’s Health in expanding their CHW leadership training initiative based on the Border Women’s Health Promotora Institute. He served as the first Director of the New Jersey CHW Institute (2004-2006), where he continues to serve as a curriculum and business development consultant. Carl was coordinator of the CHW program at Northwest Vista College in San Antonio from 2001 to 2004.  He was a lead author on the CHW National Workforce Study for the HRSA Bureau of Health Professions (2007).  He has also consulted for Migrant Health Promotion, the CHW National Education Collaborative (U.S. Department of Education) and the Massachusetts Department of Public Health. He was named by the Centers for Medicare and Medicaid Services (CMS) to their national Health Disparities Technical Expert Panel for the Medicare program in 2008. He serves as Secretary of the CHW Section of APHA, and is a member of the APHA Education Board and Governing Council.

Topic: What’s Happening from a National Level Perspective Affecting CHWs

Summation

Presentation covered a current national perspective on the CHW field: this included opportunities for CHW employment under the federal Affordable Care Act; other new initiatives by federal agencies, including a CHW policy education initiative by the CDC; and strategies for policy action in other states around CHWs.

Name: Joan Cleary

Title/Affiliation: Minnesota Community Health Worker Alliance, Interim Director

Topic: What’s Happening – Minnesota Model

Contact Info:

Phone: (612) 250-0902

Email: joanlcleary@

Summation

The presentation covered three major topics: the Minnesota (MN) CHW Story, Looking Ahead, and Considerations for Florida CHW Field-building. Within Minnesota, field-building included sustained commitment, strong leadership, comprehensive approach and partnerships. A 14-credit competency-based curriculum was created in Minnesota that leads to a certificate and is currently for sale to other academic institutions outside of Minnesota. The MN CHW Alliance meets monthly and focuses on CHW Professional and Leadership Development, Education, Policy & Research and Workforce Development. In respect to Florida, the following advice was given: consider your opportunities and challenges (health care reform, allies and champions, budget, etc.), create field-building for CHWs through workforce development, leadership and training & development and know where to start.

Name: Susan Fleming

Title/Affiliation: Program Administrator

Topic: DOH

Contact Info:

Office: (850)245-4368

Fax: (850)921-8510

Email: susan_fleming@doh.state.fl.us

And

Name: Laura Lenhart, MS

Title/Affiliation: Moffitt Cancer Center

Topic: Describing the Origination of the CCRAB/DOH CHW Initiative

Contact Info:

Phone: 904-207-8352

Email: lenhart.laura@

Summation

Ms. Fleming and Ms. Lenhart briefly reviewed the scope of the Florida Cancer Control and Research Advisory Council (C-CRAB) and their interest in CHWs, the F. Lee Moffitt Cancer Center connection, the priorities and strategies outlined in the 2010 Florida Cancer Plan, and explained the Centers for Disease Control and Prevention funding that assists the CHW taskforce., They went on to describe the early beginnings of the taskforce over the past six month and the resultant burgeoning CHW Taskforce Initiative.

Name: Alma Dixon, EdD, MPH, RN

Title/Affiliation: Executive Director, Health Equity – Odessa Chambliss Wellness Center; Professor of Nursing, Bethune-Cookman University

Topic: Community Health Workers Research and Training Institute

Contact Info:

Email: dixonal@cookman.edu

Summation

This presentation focused on the CHW Research and Training Institute, the nuts and bolts of a CHW, issues to consider and looking ahead at the challenges and opportunities that are available. The program objective of the CHW Research and Training Institute is to train unemployed, part-time, low-skilled workers to become CHWs, have appropriate job placement of CHWs in partnership with the Florida Work Force Development Program and to establish effectiveness of the CHW training program and institute.

Name: Shannon Pressey, MS

Title/Affiliation: Research Programs Coordinator, Pharmaceutical Outcomes and Policy, UF College of Pharmacy

Topic: Community Health Workers Work Force Analysis Overview

Contact Info:

Office: (727)394-6162

Email: spressey@cop.ufl.edu

Summation

The presentation described the work force evaluation, which was a seven-week work plan (February 15 – March 28, 2010) that was focused on developing and supporting CHWs. The project was undertaken by the University of Florida College of Pharmacy under a Florida Department of Health contract. The primary agency for the CHWs planning activities is the Department of Health. The Florida Department of Health subcontracted with the University of Florida to provide management for the overall planning process as well as coordination of activities. The two key activities and goals were to (1) develop, oversee and maintain a website that is dedicated to the support and promotion of the CHW profession in Florida, and (2) conduct a workforce analysis of the CHW profession by surveying CHW employers.

Website: floridachwn.cop.ufl.edu

Name: Sean Dickerson

Title/Affiliation: Center for Equal Health (Moffitt Cancer Center & University of South Florida

Topic: Overview of Comparative Effectiveness Research for Eliminating Disparities (CERED) and the role of CHW’s as an intervention for AA men.

Contact Info:

Phone: (813)745-6602

Email: sean.dickerson@

Summation

The presentation included information on the investments and activities that contribute to core-related comparative effectiveness research. These include: research, human and scientific capital for CER, data infrastructure for CER and dissemination and translation of CER findings. In terms of African-Americans, certain barriers to healthcare were also mentioned such as mistrust and fear. The end of the presentation consisted of the Lay Health Advisor (LHA) structural model and training approach and what the next steps are for CERED.

Name: LaShonda Coulbertson, MPH, CHES

Title/Affiliation: Senior Health Education Specialist, Moffitt Cancer Center

Topic: M-POWER – Moffitt Program for Outreach Wellness Education and Resources

Contact Info:

Phone: (813)745-8826

Email: LaShonda.Coulbertson@

Summation

Moffitt’s Community Education and Outreach Program began in 1999 with four key objectives: to increase and deepen community relationships through partnership building, to provide education on the prevention of cancers through health education, to provide access to resources for cancer screening and to initiate pilot projects and research to address cancer health disparities. Renamed M-POWER in July 2004, M-POWER has several programs under its wing – mobile mammogram screening and voucher program, health fairs and health education. Housed in the state designated cancer center, M-POWER’s programs focus on providing cancer prevention/screening, education and resources to women(Witness Project, Haitian Outreach Program), men (EmpowerMENt Project),children (Moffitt Healthy KIDZ), as well as training for individuals and community organizations (Resource Development, Capacity Building ) which reach both diverse and underserved communities throughout Tampa Bay and around Florida. M-POWER also conducts CHW trainings teaching individuals the core principles of CHWs with a targeted focus in cancer education. Focal topics for CHW trainings include breast, cervical, and prostate cancers, and healthy lifestyles.

Name: Marsha Davis, Community Development Coordinator

Rhonda Johnson, BS, MBA, Project Director

Title/Affiliation: The Magnolia Project

Contact Info:

Email: mdavis@, rhondajohnson@

Summation

The Magnolia Project focuses on providing low cost health exams, family planning, prenatal care, HIV/STD screening and treatment, and “free” pregnancy tests. Their objective is to improve the health and wellbeing of women during their childbearing years by empowering the community to address medical, behavioral, cultural and social service needs.

Name: Colleen Reinert, MPH

Title/Affiliation: National Capacity-Building Director, Migrant Health Promotion

Topic: Promotor(a) de Salud Programs and Training and Techincal Assistance

Contact Info:

Phone: (800)461-8394 ext 1015

Email: creinert@

Summation

Migrant Health Promotion uses the Promotor(a) model to provide culturally appropriate health education, outreach and community development to migrant and other farm worker and isolated communities. They produce several programs such as the Camp Health Aide Program and National Capacity-Building Assistance. Within the communities in which they serve, they benefit farm workers by breaking down stigmas, offering referrals to appropriate health care providers, identifying barriers and several other benefits.

Name: Fran Ricardo

Title/Affiliation: Rural Women’s Health Project

Contact Info:

Email: rwhp@

Summation

Ms. Ricardo provided a brief verbal presentation on what the Rural Women’s Health Program mission is, in addition to giving examples of their work within communities, including breast cancer awareness projects, working with youth to create their own materials to combat smoking and HIV/AIDS prevention, and community specific guides to inform citizens of county health department numbers, and disease control.

Name: Karen Simons (Brandi Yant, CHA)

Title/Affiliation: Health Education Coordinator, Bureau of HIV/AIDS, Prevention Section (FL DOH)

Topic: The Shawl Circle

Contact Info:

Phone: (850)245-4444 ext 2625

Email: Karen_simons@doh.state.fl.us

Summation

The Shawl Circle’s – Hoktvke Yekc, main goals are to educate American Indian women about HIV, breast and cervical cancer and the importance of prevention, empower American Indian women to take charge of their health and the health of their family and community, increase American Indians women’s awareness of health resources available throughout the state and to establish and strengthen relationships between the American Indian community and the FL DOH. All of this accomplished the identification and training of community health advocates (CHA). The program is designed to be simple, flexible and remain sustainable.

Name: Jerry Nokis Mekko Lang

Title/Affiliation: American Indian Advisory Council for the Bureau of HIV/AIDS

Contact Info:

Email:jerryjan@

Summation

Mr. Lang provided a verbal presentation on his work with the Native American population with an emphasis on cancer, HIV/AIDS, and tobacco prevention and education.

Name: Brendaly Rodriguez-Rosemond

Title/Affiliation: University of Miami – South Florida Center for Reducing Cancer Disparities

Topic: SUCCESS, CHWs in South Florida and the DHHS/OMH National Steering Committee for Promotores/CHWs

Contact Info:

Phone: (305)243-8433

Email: b.rodriguez5@miami.edu

Summation

Ms. Rodriguez-Rosemond presented on the success and activities of community health workers in South Florida, and nationally. Additionally, she educated the group on the National Steering Committee of Promotores de Salud (CHWs), and their aims, which include: national recognition, a national database of community health worker networks, and a bilingual website with resources. She also spoke on research being conducted at the University of Miami on the impact of community health workers/Promotores on health outcomes.

Name: Marilyn Mesh, MEd, MAc

Title/Affiliation: Executive Director, Suwannee River AHEC

Topic: Florida AHEC Network: Community Health Workers

Contact Info:

Email: mmesh@srahec

Summation

An AHEC program within one of the state’s medical schools supports the Florida Area Health Education Centers, which covers all 67 counties in Florida. This allows AHEC to draw resources from the medical schools and help in addressing health issues of the local area. AHEC began the process of preparing for and training CHWs in FY 2001-2002 when the FDOH funded the Cardiovascular Disease Prevention (CVD) initiative. In order to target medically underserved populations, the initiative adopted the CHW model and by 2007, there were over 100 AHEC trained CHWs within the state of Florida. In 2008, AHEC adopted a new curriculum that was based on national standards. These included 8 competencies that are essential to the success of CHWs and the implementation of health promotion programs. AHEC pursues the concept of partnerships with nonprofits, educational institutions, faith based organizations and other local/state groups. Currently AHEC is working to provide professional credentialing to their CHWs, build career opportunities as well as identify and retain community partners.

Appendix IV: Policy Brief

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APPENDIX V—2012 Florida Senate Bill 886

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[1] U.S. Census Bureau, State and County Quick Facts: . Accessed from the web on 09/29/11.

[2] Map: Florida Office of Economic and Demographic Research – Economic and Demographic News for Decision Makers 2011 Volume I

[3] Florida Department of Health Chronic Disease Epidemiology Surveillance and Evaluation: Accessed from web on 10/31/11.

[4] Community Health Workers as Interventionists in the Prevention and Control of Heart Disease and Stroke

J. Nell Brownstein, PhD, Lee R. Bone, RN, MPH, Cheryl R. Dennison, CRNP, PhD, Martha N. Hill, RN, PhD, Myong T. Kim, RN, PhD, David M. Levine, MD, ScD (Am J Prev Med 2005;29(5S1):128–133)

[5] Outcomes of Community Health Worker Interventions Agency for Healthcare Research and Quality

U.S. Department of Health and Human Services. 2009

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