Community Health Workers for COVID Response and Resilient Communities Update
By: Brittany Daniels, Director of Operations & Communications, Health Impact Ohio
In September 2021, Health Impact Ohio was “awarded a 3-year, $5 million dollar per year grant from the Centers for Disease Control and Prevention (CDC) to manage a statewide, comprehensive initiative to engage Community Health Workers (CHWs) around the state to provide coordinated connection to COVID-19 education, care, and social services” (News Release, Health Impact Ohio). As we are now halfway through our first year of the grant, we are examining our training efforts thus far and looking ahead to see how we can augment future training to better meet our CHWs where they are. Working in conjunction with our evaluation team, we have received invaluable feedback from subcontractors, HUB leadership, and, most importantly, CHWs from across the state regarding the impact, useability, and relatability of the trainings offered to this point, and how trainings should be modified in the future. This feedback allows Health Impact Ohio to provide evidence-based, timely information surrounding COVID-19 and related community issues while meeting the educational needs and interests of CHWs statewide to help better connect their clients to the resources they need.
“Health Impact Ohio aims to provide comprehensive, inclusive, and actionable training on COVID-19 and its effects, both medical and social, on different populations in our communities across the state so that we can better understand and address the immediate and long term needs of our Ohio communities,” said Carrie Baker, President & CEO, Health Impact Ohio.
Since our first training in December, in conjunction with our training partners, we have covered several topics on COVID-19 and community issues related to COVID-19. Our training partner, Partners In Health, presented concepts including what COVID-19 is, how the COVID -19 virus works, variants, vaccines, boosters, therapeutics, and dispelling myths about the COVID-19 virus and COVID-19 vaccines. Partners In Health also provided specific training on vaccines in pregnant and breastfeeding people and vaccines in children. Additionally, our training partner from Nationwide Children’s Hospital provided education on behavioral economics messaging and offered evidence-based tactics rooted in behavioral economics on approaching and connecting with clients regarding COVID-19 education and vaccination. Our training partners from The Ohio State University have also delivered an overview and progress update on the Equity Mapping Tool to be utilized by CHWs participating in the grant to use in their daily work to serve their communities.
In March, we facilitated a housing panel to discuss how the COVID-19 pandemic affected and exacerbated issues surrounding housing and access to essential social services during the pandemic. These topics included how to help clients maintain housing if experiencing financial difficulties, how to apply for affordable housing, how and where to obtain housing assistance, and how to find available housing once aid is received. CHWs from across the state raised valid concerns about barriers they have faced helping their clients maintain, find and secure affordable housing and shared tactics and resources they utilized to successfully close pathways for their clients.
This month, we hosted a CHW from the Ohio Hispanic Coalition to discuss the impact and outreach in Latinx and Hispanic communities concerning COVID-19. CHWs discussed issues impacting the Latinx community, including their lack of access to COVID-19 education and the complexities surrounding their ability to obtain healthcare, health insurance, or other social service assistance. Participants provided options for finding evidence-based information in Spanish and other languages, and ways to help CHWs build trust within the Latinx community to connect with their clients and become trusted messengers with strong ties in their community.
These trainings and our Community Health Worker Advisory Council create a legitimate space for CHWs to voice their expert opinions and share their knowledge statewide with their peers to work toward improving and uplifting the current CHW workforce. "Health Impact Ohio recognizes that the pandemic is ever-changing and is prepared to adapt trainings as necessary to address those changes. As we look toward planning for the second year of this initiative, we want to keep in mind the specific issues our CHWs have raised to provide more targeted, in-depth pieces of training on the actual needs our CHWs see in their communities every day,” stated Heidi Christman, Chief Operating Officer, Health Impact Ohio. Our CHW Advisory Council plays a critical role in these efforts by meeting monthly to participate in deep dive focus group discussions. These discussions cover an array of topics, including behavioral economics messaging tools, needs and wants from the Equity Mapping Tool, the effectiveness of information utilized from training with clients, training experience improvement, self-care, and sharing barriers and success stories.
Health Impact Ohio is proud to be working with and learning from such a diverse, experienced group of CHWs and partners to help push Ohio forward in improving health equity and access through the lens of COVID-19 and beyond. We look forward to executing our training schedule for the remainder of the grant year, covering topics such as the impact and outreach in populations with intellectual and developmental disabilities, reflections on the COVID-19 pandemic and CHW impact from managed care organizations, and advanced care planning and considerations amid a pandemic, and more.
Click here to read Health Impact Ohio’s News Release quoted above.
Health Impact Ohio Welcome’s New Board Members
By: Brittany Daniels, Director of Communications & Operations, Health Impact Ohio
Health Impact Ohio is excited to announce the appointments of two new members to our Board of Directors. The organization is welcoming Reem H. Aly, ESQ, Chief Strategy and Transformation Officer at Groundwork Ohio, and Adjunct Instructor in the College of Public Health at The Ohio State University; and Dr. Ayaz Hyder, Assistant Professor in the College of Public Health, and Core Faculty in the Translational Data Analytics Institute at The Ohio State University.
This announcement underscores Health Impact Ohio’s commitment to enter 2022 with a more determined focus on improving social drivers of health, health equity, healthcare access and quality for all individuals in every community. The organization has been committed to seeking out new, diverse thought leaders in our community to address local and state health and healthcare issues in a more comprehensive, equitable manner. We sought guidance from our Board of Directors, community partners, and Health Impact Ohio leadership to find new board members whose goals, expertise, and interests align with our mission and vision.
Aly currently serves as the Chief Strategy and Transformation Officer at Groundwork Ohio; an organization that works to educate key decision makers in Ohio about the importance of quality, early learning, and health development as the most transformative strategy to increase the life-long success of Ohio’s children and lay a strong foundation for economic prosperity in the state. In her role as Chief Strategy and Transformation Officer, Aly provides organizational leadership, oversees the development and implementation of Groundwork’s Centers of Excellence including the Center for Family Voice, the Center for Maternal and Young Child Health, and the Center for Early Learning, and spearheads the organization’s data, equity, and accountability efforts. Aly also serves as an adjunct faculty member at The Ohio State University in the College of Public Health who holds a Juris Doctorate and Master of Health Administration, as well as a Bachelor of Science in Psychology and a Bachelor of Arts in International Relations from The Ohio State University.
“Health Impact Ohio is excited to welcome Reem Aly to the board and engage the unique perspective she brings around early childhood learning and health development, maternal and young child health, health value data, and healthcare policy, along with her project proven commitment to health equity” stated Dan Paoletti, President, Board of Directors, Health Impact Ohio.
Prior to joining Groundwork Ohio, Aly served as Vice President of Policy and in-house legal counsel at the Health Policy Institute of Ohio (HPIO), where she led efforts to provide Ohio policy makers and health stakeholders with high quality, objective information that was relevant to their policy decisions, with a particular focus on health equity, maternal and child health, and the intersections of the healthcare system and population health. She also co-led the development of HPIO’s Health Value Dashboard, a tool to track Ohio’s progress towards health value. Additionally, Aly worked as a Consultant and Administrative Resident at Nationwide Children’s Hospital and has legal experience working at the Online Computer Library Center, Inc. (OCLC) and Bricker & Eckler, LLC.
Hyder is an Assistant Professor in the College of Public Health and Core Faculty in the Translational Data Analytics Institute at The Ohio State University. He has experience building research and data collection infrastructure with a diverse group of traditional and nontraditional Central Ohio public health partners, including those focused on health equity, COVID-19 school-based surveillance, addiction prevention and treatment, and food systems. Dr. Hyder is also skilled at identifying stakeholder needs for data-informed decision making and meeting those needs in cooperative ways.
Prior to serving as Assistant Professor at The Ohio State University, Dr. Hyder was a Research Associate at the University of Toronto and completed Postdoctoral training at Yale University. He also holds his PhD in Biology from McGill University and obtained a Bachelor of Science in Biology from McMaster University. His current areas of research and study include COVID-19, Systems Science, Agent-Based Modeling, Birth Outcomes/Infant Mortality, Environmental Epidemiology, Air Pollution, Citizen Science, Opioid epidemic, Food insecurity, Smart Cities, and Health Economics.
Health Impact Ohio has been working with Dr. Hyder in his role at The Ohio State University College of Public Health for several years. In our shared passion for using data for public health impact and decision making, we have had the opportunity to collaborate on several public health centered projects, integrating social determinant of health (SDOH) data with more traditional health data to foster real change and improvement in access to quality preventative health care.
In March 2021, Dr. Hyder rapidly developed the current version of the Equity Mapping Tool (EMT) and worked with Central Ohio partners to operationalize it within their daily workflows with Community Health Worker (CHW) deployment and engagement strategy. Working with the state health department and local health departments (LHDs) and health systems, Dr. Hyder has been the driving force behind creating equitable vaccine access for marginalized populations in Central Ohio. He has been a true partner in collaborating with Health Impact Ohio to incorporate our SDOH data to drive decisions around community health efforts in the COVID-19 pandemic. So much so, that our collaboration grew into a funding opportunity from the Centers for Disease Control and Prevention to spread and scale the EMT, which has been successfully piloted in Franklin County Public Health at the height of the COVID-19 pandemic, to Pathways Community HUBs (PCHs) across the state. He will also work to train CHWs in participating HUBs and LHDs on how to use the EMT in day-to-day delivery of services and in support of the COVID-19 public health response; and to discover new uses for the mapping tool by identifying and developing case studies from specific HUBs and disseminating those case studies more widely across all participating CHWs, HUBs and LHDs in Ohio.
“Dr. Hyder’s willingness and eagerness to collaborate and share his expertise in data-driven equity promotion made asking him to join our board an obvious one. The way he and his team work to address the issues facing marginalized communities in Ohio connects directly to our mission at Health Impact Ohio: optimal health outcomes for all people in every community through community engagement and data collection and integration, as well as strategy development and deployment. Having his unique perspective to inform and make that mission actionable will be vital to our organization. We look forward to his perspective becoming an integral part of our board discussion and decision making for years to come” shared Paoletti.
As we look forward to the collective impact Health Impact Ohio, our board, staff, and community partners will strive to achieve in 2022, we would also like to acknowledge our board members who retired from Health Impact Ohio’s Board of Directors in 2021. On behalf of Health Impact Ohio’s Board and Staff, thank you to Doug Anderson, Thomas Hadley, and Bruce Wall for your service, support, and contributions given to Health Impact Ohio and Ohio communities throughout your term. We are grateful for your shared knowledge and experiences that enriched our organization and helped lead us to where we are today.
To learn more about Reem and her work, see her bio at Groundwork Ohio.
To learn more about Ayaz and his work, see his bio at The Ohio State University.
Using ACE Screenings to Mitigate Long-Term Adverse Outcomes
By: Tanikka Price, Education Director of the Central Ohio Pathways HUB, Health Impact Ohio
Growing up as a little Black girl in the Linden area of Columbus, Ohio, I got good grades and did well in school. However, I was constantly in trouble for disruptive behavior, such as fighting. Teachers and caregivers would continually ask me, “What is wrong with you?” Perhaps the better question would have been, “What happened to you?” My behavior was directly related to my Adverse Childhood Experiences (ACEs), but I would not learn about that framework until my later years.
I was introduced to the ACEs framework while working as a Community Health Worker (CHW) in 2011 at Moms2B, a prenatal support program at The Ohio State University. ACEs are potentially traumatic events that occur during childhood. The ACEs framework is a ten-item questionnaire designed to assess exposure to specific trauma in childhood (between the ages of 0 and 18). The ACE questionnaire allocates points for each trauma category experienced. Categories include physical and emotional abuse, neglect, and household dysfunction. An ACE score of four or more can have a detrimental impact in adulthood, with a higher propensity for dysfunctional relationships, future violence victimization, morbidity rates, and lifelong health outcomes. ACEs are linked to toxic stress, mental illness, substance misuse, promiscuity, domestic violence, and chronic health problems in adulthood.
Minority groups have long been encouraged to pursue higher education to escape toxic environments. I grew up believing that higher education was necessary to achieve success. I found, though, that as I amassed degrees and certifications, including a law degree, I still struggled in other areas of my life. I questioned if ACEs were the cause of discrepancy between my educational success and my quality of life. I speculated that I was not alone, that there might be other Black women with high ACE scores who felt this same pressure to succeed, fear of failure, and worse, the fear that they would never be good enough.
After working as an attorney and a Supervisor of CHWs, I saw firsthand the myriad of ways ACEs impacted Black women and contributed to health disparities. I was surrounded by intelligent women who had been impacted by ACEs, and were now in domestic violent situations, or using unhealthy coping mechanisms to survive. I saw myself in these women and wanted to assist them in overcoming their childhood trauma.
The desire to further understand and help women overcome the negative impact that childhood trauma was having in adulthood influenced my Doctoral. Candidate dissertation topic. In 2014, I enrolled in Northcentral University, and focused my dissertation on exploring how ACEs impacted educational attainment in the lives of other African American women. My dissertation, “A Phenomenological Study of the Impact of Adverse Childhood Experiences on Educational Attainment in the Lives of African American Women” highlighted the experiences of 18 women with ACEs, and their perceptions of how it impacted their lives and educational pursuits.
My hypothesis was that women who had completed their educational pursuits would be more successful and have a higher sense of self-efficacy than those who had less education. However, the research I conducted demonstrated that rather than education dictating success, it was their ACEs. My research indicated that the most prevalent negative outcomes for adults with high ACE scores were attempted suicide, teen pregnancy, and mental illnesses. Knowing a client’s ACE score can help CHWs to better understand their clients’ lived experiences, which can then help to direct their clients to the appropriate services and resources through the Central Ohio Pathways HUB. Despite the negative outcomes the women experienced, themes of grit, motivation, resilience, and self-efficacy emerged from their stories. Self-efficacy, the belief that one can do what they set their mind to, proved to be more important than educational attainment in predicting success in the participants’ lives.
My research uncovered interventions that could mitigate ACEs, including integrating trauma-informed behavioral therapy at schools, for children like me who frequently get asked, “What is wrong with you?” when acting out. Being screened for ACEs as a child can help mitigate the long-term negative effects of ACES. Mentors, teachers, and coaches to be educated in trauma-informed care so they can refer adolescents to be screened for ACEs and ensure that they receive appropriate interventions. Parents and guardians of these children also benefit from an ACES screening to identify the intergenerational effects of ACEs. Evaluating these scores can help to ensure that people are getting the help they need.
Learning about ACEs changed the trajectory of my life. My life’s work began when I committed myself to educating others on ACEs and started implementing strategies to assist in working through trauma. While ACEs are traumatic, they no longer have to result in adverse outcomes.
To learn more about the Central Ohio Pathways HUB, please email HUB CEO, Jenelle Hoseus, at [email protected].
New Year, New Us: HCGC Is Now Health Impact Ohio
By: Carrie Baker, President and CEO
The Healthcare Collaborative of Greater Columbus (HCGC) is excited to announce that we are rebranding in 2022. Over the next few months, thanks to the innovative thinking of our Board of Directors, we will transition to Health Impact Ohio.
Since 1999, this organization, originally known as Access HealthColumbus, has evolved with the ever-changing landscape of health and healthcare in the region. We have enjoyed a very rich history of collaboration with Columbus and Central Ohio partners and catalyzed that work and those successful outcomes to broaden our reach and impact across Ohio. Health Impact Ohio as a name reflects and aligns with the work that we do, focusing on optimal health outcomes for all individuals in every community. And yet our roots, our organization location and frankly our hearts will always stay firmly grounded in the Central Ohio Region first and foremost. We invite you to learn more about our impact and evolution by reading our 2021 Impact Report.
Becoming Health Impact Ohio
Over the last 5 years it has truly been my honor to serve, sustain and help the growth of this incredible organization. Even in dealing with “change fatigue” we are all facing given recent times, HCGC has allowed me, personally and professionally, to see a bigger picture, to understand both and/or often multiple (!) sides of the proverbial coin when it comes to health and healthcare from individual, community and regional perspectives. I am grateful to see firsthand the brilliance of a neutral, community-created, collective impact nonprofit that serves, without bias, to bring every type of (often competing) health, healthcare, and community entities together.
In convening these amazing partners, we not only increase access and share, spread, scale and track efficacy of best practices in a way that lifts everyone up, but also, we work to address gaps from a big-picture point of view. HCGC and our partners address these gaps without blame or defensiveness, but instead with an eye toward increasing equity, trust, and data-driven collaboration to meet better outcomes, to reduce duplication, variation, costs all while enhancing health and healthcare quality and all consumers’ experience. Each day, our staff team wakes knowing we all get to work for an organization that is a “kick-starter” to attaining optimal health from a “systems” approach.
Given the changes we are all facing, as we reflected with our staff and Board Leadership on this organization’s goals and work over the last 23, then the last 5 years, and most especially when looking at our last 2 years at HCGC, we realized that times of major change have created exciting innovation and evolution for our small non-profit. As we looked ahead to our mission and vision in 2022 and beyond, we all kept coming back to the impact we have been so proud to make in the Columbus region and how that impact has spread across Ohio, through partnerships and collaboration with so many incredible organizations. We know our work in Central Ohio is and always will be our foundation. AND we all see tangible opportunities to do better, do more to reach more communities.
Given all of this, the official decision to rebrand to Health Impact Ohio was approved by our Board of Directors in late December 2021. A rebrand like this allows us to enter 2022 with an even more determined focus on improving social drivers of health, health equity, access, and healthcare quality through community engagement and partnership; multi-stakeholder training and coaching; data collection and integration; and strategy development and deployment. It is vitally important that our organization’s name, mission and vision, as well as our new strategic plan reflect where we have been, where we are now, and where we can build and support more areas in Ohio. I personally am so excited to continue our work with you to meet our common goals now and in the future.
Statewide Project Work
HCGC, now Health Impact Ohio, been awarded a 3-year, $15 million dollar per year grant from the Centers for Disease Control and Prevention (CDC) to manage a statewide, comprehensive initiative to engage Community Health Workers (CHWs) around the state to provide coordinated connection to COVID-19 education, care, and social services. The project will expand CHW’s participation in the overall public health response through case investigation, COVID-19 related education and information sharing, and most importantly, CHWs roles in eliminating barriers to accessing the COVID-19 vaccine.
The CDC initiative, titled Community Health Workers for COVID Response and Resilient Communities (CCR) will provide funding via Health Impact Ohio to 11 Pathways Community HUBs (PCHs) regions across the state. Each PCH is a member of the Ohio Network of Certified Community Pathways HUBs and, combined, are subcontracted with more than 70 community-based organizations called Care Coordination Agencies (CCAs) within their respective regions. There are currently 205 CHWs working in PCHs across the state who will expand COVID-19 care resource coordination through the CCR initiative.
Our Community Health Worker Certification program staff is working to provide access to our program to a statewide audience, already welcoming participants from past courses to join our CDC CCR trainings as a part of their practicum placement. Going forward, we will welcome CHWs from all around the state to receive their certification from our program, as well as participate in future CDC CCR trainings.
Another exciting statewide project that we are engaged in is the Heart Healthy Ohio Initiative (HHOI). Funded by the Agency for Healthcare Research and Quality (AHRQ) and operated by lead investigators at MetroHealth in Cleveland, HHOI aims to improve cardiovascular health for all Ohioans by reducing health disparities, improving blood pressure control, and reducing smoking rates through interventions in primary care settings. In this, our second year of the grant, we are working with statewide partners to coach and track healthcare quality improvements at the practice level in 55 practices across Ohio.
And, last but NEVER least, we always look forward to continuing collaborating with Ohio’s other Regional Healthcare Improvement Collaboratives (RHICs), Better Health Partnership in Cleveland and The Health Collaborative in Cincinnati, both of whom are making incredible local, regional, and statewide impacts themselves. We work in partnership with them to fill gaps in respective content expertise and collaborate to learn from one another. In June 2022, our three RHICs we will hold a joint conference in Columbus, open to all physicians, nurses, practice managers, and other providers across Ohio with a focus on The Future of Healthcare from the perspectives of equity, quality, workforce, payment, and policy. Registration information will be coming soon!
Change and evolution from upheaval can be a challenge-we all face these new challenges each day in all facets of our lives. More importantly, it is a unique opportunity to recommit to what each of us values most and evolve to meet the time and the need. I am so grateful and excited to continue working at HCGC, now Health Impact Ohio, and with you all: our Board of Directors, Columbus Medical Association and its Affiliates, our Central Ohio social service agencies and local health departments, the state agencies who have continued welcoming our participation and input, our national partners like Civitas Networks for Health (our national affiliate), Partners in Health, as well as our fellow RHICs and Community Pathways HUBs across the state.
We hope you stay tuned as we roll out our rebrand over the next few months, and as always, please reach out with any opportunities or great ideas to work in partnership!
Inspiring Self-Efficacy: Interview with HCGC Education Director, Dr. Tanikka Price
By: Future Ready Columbus
The Healthcare Collaborative of Greater Columbus (HCGC) is the convening force for healthcare in Central Ohio. The organization connects community members from infancy through senior citizenship with providers and healthcare resources.
HCGC is driven by the belief that all people in the Columbus region deserve to have the best possible health outcomes. This is only made possible when healthcare is high-quality, well-coordinated and affordable.
To accomplish this goal, HCGC designed and implemented the Central Ohio Pathways HUB— a program that connects physicians and community health workers (CHWs) to the most vulnerable people in our community.
This program is what attracted HCGC’s Education Director, Dr. Tanikka Price, to the organization to begin with. “When I learned about the hub model in 2012 it was so clear that this was what Columbus needed. Not only does it support community health workers, but it provides reimbursement to community-based organizations that need funding to be able to afford providing these essential services. These organizations are seeing the clients who are most in need. Through the HUB, we are able to advance population health,” Tanikka said.
HCGC has joined the Future Ready Columbus (FRC) family as one of our Future Ready by 5 (FR5) partners. As we build out our Health and Behavioral Health driver, we are thrilled to share more about the important work Tanikka and the entire HCGC team is doing to serve every family and community in Central Ohio.
We spoke to Tanikka about how HCGC and community health workers are impacting the health of Franklin County, and what community members can do to encourage self-efficacy in children to help them overcome early childhood trauma. Below are excerpts from that conversation.
Can you explain your position at HCGC and what you’re focused on accomplishing right now?
I came aboard at HCGC because I absolutely loved the Central Ohio Pathway HUB. I was supervising community health workers at my previous employer, but HCGC offered the opportunity to support and connect the CHWs and community-based organizations to the people who need them most. Through the HUB, we’re able to meet everyone where they’re at.
I recently received my Doctorate in Education from Northcentral University and as a result of that I was promoted to Education Director at HCGC. Now, I oversee all of our educational components. I’m really, really proud of our CHW certification program. We are able to certify people who are already doing community health work through the Ohio Board of Nursing. It’s a 12 week course and they complete a practicum that runs concurrently to it. They’re getting real world experience as a community health worker in a community-based organization.
How does someone qualify for the CHW certification program?
They have to have a high school diploma and be at least 18 years old. What’s really exciting is that our program is for anyone who cares about this work. Young people coming straight out of high school are sitting next to more experienced folks with masters degrees. They come from different backgrounds but the passion is what they have in common.
It has been so rewarding to bring people together from all walks of life in that classroom setting. We focus on social justice, reproductive rights, and other social determinants of health. We study the historical inequities that have brought us to where we are today— from redlining to the history of violence and discrimination, and how all of those things break into the very lived experience that our clients are experiencing each and every day.
Can you explain more about the research and work that you've done surrounding early childhood trauma and the adverse effects?
I wrote my dissertation on adverse childhood experiences and educational outcomes in African American women. 18 women participated in my case study where I researched whether having a high score on the Adverse Childhood Experience (ACE) Questionnaire made them more or less likely to graduate from high school and college.
If you answer yes to 4 or more out of the 10 questions you are likely to be associated with poor outcomes socially and physically. Everything from pregnancy, suicide, smoking, drug and alcohol abuse, domestic violence partnerships, obesity, high blood pressure, heart disease, even cancer. There is no area of life that's untouched by a high score.
My interest was to look at a group of women with a high ACE score–– half who graduated from high school or college and half who dropped out of high school or college–– and study the difference in these people's lives, how they process their trauma and how they describe their issues.
I expected all the high end graduates to be in the category of high performance but my research showed that the common thread in the most successful women in my group of 18 was self-efficacy.
I believe this ties to the work FRC is doing for children because self-efficacy is the belief that one wants to do what they set out to do and it can be taught. Children who see somebody with high self-efficacy that looks like them can then envision themselves doing the same thing. Even if it's not a parent encouraging self-efficacy in the child, other adults in a child’s life can inspire it.
We know 90% of brain development is complete by the age of five, so what can we do to kind of help encourage self-efficacy in the young children who reside in our community?
I think one thing is educating the providers and the educators on their impact. You’re not just a pediatrician or just a social worker or just a teacher. That's a lot of power. You can make a difference just by being kind, by making eye contact, by calling a person by their name.
Community members can get involved in mentorship. And mentorship doesn't have to be a huge time commitment. It could be as simple as taking a child to the library and reading with them once a month. Those things have a huge impact. Consistent adult presence is so important to children and libraries can fill in a lot of these gaps because they are free, safe and accessible.
Everybody wants to be seen and acknowledged. Even showing them books that have images and pictures that look like them is a way to inspire self-efficacy and give them hope in a hopeless situation. There is a children’s book for every situation now and that is so important. We need to make sure kids are seeing these so they can see themselves reflected in positive ways.
When you think about what HCGC and FRC are trying to accomplish in Columbus, how do you see the future taking shape for the children, families and communities throughout Franklin County?
The next thing we're going to have to do is help everybody, especially our children, recover from the pandemic. We really have to help families heal. That's why I do this work. If a mother or father can heal from childhood trauma it lessens the likelihood it will be passed to the next generation.
I saw the intergenerational effects of trauma in my study but I still have hope. I've never seen as many folks saying, “I’m struggling and I need a counselor. Can someone refer me?” People are ready to take off their masks. That gives me hope that we will be able to really heal families and ultimately raise children in healthier environments.
You can learn more about the Central Ohio Pathways HUB here.
You can learn more about the Future Ready by 5 Plan here.
Read Future Ready Columbus blog here.
Utilizing Appreciative Inquiry in Health Care
By: Caroline Carter, Chief Transformation Officer, HCGC
As Chief Transformation Officer at the Healthcare Collaborative of Greater Columbus, exploring change management approaches for organizational growth and development is a crucial part of the job. One of my preferred approaches to change management at the organizational level is Appreciative Inquiry (AI). My affinity to AI is the focus on positive psychology and strengths, and the intentional engagement of diverse people/roles/stakeholders’ contributions. The AI philosophy is that in every organization something works, and change can be managed through the identification of what works, and the visioning of where the organization wants to be - its preferred state. Participants walk away from an AI experience with a sense of commitment, confidence, and affirmation that they have been successful. They know how to make more moments of success.
This past summer, I was invited to be a guest speaker for Dr. Laura Santurri’s (Ph.D., MPH, CPH) doctoral level students, in their course on Management in Healthcare at the University of Indianapolis. I was able to discuss and share my experience designing and facilitating AI Summits.
I engaged in rich dialogue with the students, discussing the benefits of using AI as a change management technique. I shared stories and examples of my experiences using AI, particularly in health care settings. The traditional approach to change looks for the problem, and then attempts to find a solution. When we look for the problem, we find it and amplify it. We have little mental energy to focus on creativity and innovation. No judgement here, we are taught this approach from a very young age. And to be honest, it is sometimes the right approach - but not always. AI differs from the traditional change model in that it is future focused, and strengths based. AI starts where you are, that is your baseline, and identifies where you want to get to, and you work towards that goal, so you end up far beyond your baseline where you started.
After receiving my Certificate in Appreciative Inquiry from Case Western Reserve University in Cleveland, Ohio, I continued facilitating AI trainings and workshops across a variety of industries, including; healthcare, education, manufacturing, and innovation and technology. In 2007 I was published in the peer-reviewed journal Quality Management in Health Care, writing ‘An Appreciative Inquiry Approach to Practice Improvement and Transformative Change in Health Care Settings. I continue to use AI because it works well for system level change for organization transformation, and engages a myriad of voices and contributions.
AI assesses the assets and strengths that have been successful so far, and focuses on how an organization can continue to utilize those strengths to maximize success. This approach helps to envision results by capturing and portraying attractive images of the ideal and preferred future, which allows the team to then identify and create actionable steps to move the practice toward that ideal image. After the action plans have been implemented, the team can share their best practices and celebrate success.
I’ve had the opportunity to perform AI with HCGC both at the board and community level. In Spring of 2019, I was honored to lead a group of about 100 participatory stakeholders in an HCGC regional learning session through the AI process. The question explored was: “What is the ideal state of health and healthcare in the Central Ohio region?” - a question of possibilities. Visualizations were created in breakout groups, and the full group came back together to share their images of the ‘preferred state’ and discuss what it would take to create real change based on their visions of the future. The most inspiring thing happened when the room full of stakeholders from different (some competing) health systems, payors, and consumer backgrounds came to a uniform realization: we must, as a region of diverse stakeholders, share our data to improve the health and healthcare experience for all people in the Columbus region. These conversations spurred new and exciting partnerships and collaborations that have, in part, contributed to the culture of data sharing, utilization, and visualization to make informed and equitable decisions to contribute to the healthcare landscape in the region. HCGC feels strongly that going on an AI journey at that place and time contributed to our ability to be impactful partners in the COVID-19 pandemic response in central Ohio, as well as other important public health initiatives. Providing a safe, neutral space for stakeholders to come together and co-create the possibilities fostered an environment of inclusivity and collaboration that is still positively impacting our work today.
We will continue to find AI opportunities as we work to strengthen our organization at the staff, board, and community level. We look forward to continuing to engage partners in the community.
HCGC Ready to Launch Second Class of Community Health Workers in Certification Program
By: McKenzie Carter, Communications Manager, HCGC
After graduating the first class of the Central Ohio Pathways HUB Community Health Worker (CHW) Certification participants in June of 2021, the Healthcare Collaborative of Greater Columbus (HCGC) will start the second session of the program starting in September.
Under the leadership of Central Ohio Pathways HUB Education Director, Dr. Tanikka Price, the HCGC CHW certification team has been working hard to grow and evolve the curriculum and design of the program based on what we learned from the first session. A major aspect to planning for this session has been collected, analyzing, and applying feedback from the 17 graduates of the inaugural class. Certification staff are excited to incorporate these recommendations as we welcome our new cohort.
With an incoming class of 21 professionals from diverse backgrounds including age ranges from 25 to 61, various genders, diverse races and ethnicities, and varied previous CHW work, we are eager to learn from this group of impressive individuals who are sure to bring unique perspectives to the program. Our certification is again being offered free of charge for participants due to generous funding of our HCGC supporters.
HCGC continues to be grateful to the Care Coordination Agencies (CCAs) participating in the Central Ohio Pathways HUB (the HUB) who have had their CHWs participate in our certification program. Our first session of the program consisted of individuals who were all working as care coordinators for our CCAs in the HUB. We are very excited that the next session of the program will welcome individuals who are both already working in the HUB, and some who are not. Our CCAs have been generous in agreeing to welcome participants to complete their required practicum hours. Such collaboration is key to allow future CHWs to have real-life experience with some of central Ohio’s most impactful health and human service agencies.
Our first unit will focus on Certified Community Health Workers Improving Lives within Larger Health and Healthcare Systems, where we will focus on understanding the role and goals of CHWs, and CHW employment models, particularly the Community Pathways HUB Model. We will also describe ways for CHWs to manage stress and anxiety, and go over best-practice client engagement strategies. This unit also covers understanding social determinants of health, and how they connect to life expectancy and outcomes. We will highlight and brainstorm strategies to keep CHWs safe in various environments. This unit is designed to empower collaborative discussions, self-esteem, establish responsibility and professionalism, as well as develop professional relationships with certified CHWs in Central Ohio. Our second unit focuses on CHWs Role in Health Education and Health Promotion. This unit will guide the cohort to demonstrate general awareness of health care needs for individuals across the life span and related health care and social services. This includes understanding pregnancy, motherhood, and the early years of life and possible barriers and concerns, and how to mitigate those risks. A focus of this section will be on identifying chronic health conditions, as well as educating clients on possible risk factors and health behaviors that decrease risks. Chronic diseases that impact African American, Latinx, and Indigenous American communities including asthma, heart disease, and diabetes will be highlighted. The unit will teach CHWs how to recognize signs indicating changes in client’s health status, and how to educate others on healthy lifestyle choices. Delving deeper into health disparities, we will work to understand the behavioral, mental, emotional, and spiritual impacts on health, and discuss substance use and effects on health. This unit concludes with a collaborative discussion on the COVID-19 pandemic, incorporating data, case investigations, testing and vaccine advocacy, and resource coordination. The goal for this unit is for participants to become an effective self/client advocate and develop and improve interpersonal communication skills and health literacy. Our third and final unit will focus on At-Risk Communities. With an emphasis on health disparities and health equity, we will consider the health disparities in Franklin County, and work to understand specific client population considerations, including African Americans, LGBTQ+, IDD, opioid/substance abuse disorder clients, New Americans, Immigrant populations, Asian Americans, and Latinx populations. We will define cultural competence, and work to understand ethical issues in research on marginalized groups. Through collaboration and advocacy-oriented discussions, we will learn how telling and listening to stories centers minority voices, and counters economic stereotypes. This cohort will be able to end this unit with conflict resolution skills, the ability to adhere to privacy and confidentiality, and understand concepts of trust amongst professional teams, CHWs, and clients.
HCGC’s Central Ohio Pathways HUB CHW Certification staff is excited to welcome and collaborate with this new cohort, and discover all of the valuable experience and insight this new groups of individuals brings to our program. If you would like to learn more about the Central Ohio Pathways HUB Certification Program, please contact HUB Education Director, Dr. Tanikka Price at [email protected].
Working with the Community to Improve Health Outcomes: Investing in Quality Improvement
By: Grant Botley, HCGC Central Ohio Pathways HUB Data Administrator
HCGC’s Care Coordination Program, the Central Ohio Pathways HUB (the HUB) has experienced exponential growth since we began managing it in March of 2019. As a result of the increase in community need indicated by the continuous increase in clients served, HCGC seized the opportunity to introduce a quality improvement process designed to better serve HUB clients and maintain the viability of the Pathways HUB Model. HCGC has historically incorporated quality improvement principles into all of our organization’s work, and is excited to continue this process with the HUB. HUB staff have selected a variety of Quality Improvement (QI) initiatives, with the goal of increasing capacity to serve more clients from referral QI processes being implemented by our Care Coordination Agency’s (CCAs) under the leadership of HUB staff at HCGC.
Implementing a QI process for the HUB is multifaceted. The primary goal for all the CCAs is to maintain an acceptable ratio of billable to unbillable services by increasing enrollment rates of clients that are being referred into the HUB. We know that the longer it takes to be contacted by a CHW, the less likely a potential client is to continue with the enrollment process. Without adequate billable services, the Pathways HUB model is not sustainable, leaving our most vulnerable populations at further risk of poor health outcomes due to lack of access. Implementing a 48-hour time frame from referral to enrollment by a CHW is vital to ensuring that at-risk clients are welcomed into the HUB and begin the process of being connected to vital care and services to set them on a course to success.
CCAs have selected agency specific approaches to impact their billable to unbillable ratios. These quality improvement initiatives should increase the likelihood that clients are receiving timely high-quality service, evidence-based care coordination, and agencies are appropriately reimbursed, thus remaining viable entities with the capacity to serve more clients.
To impact the billable to unbillable ratio, some CCAs have intentionally opted to focus on increasing enrollment rates of referred clients, reducing the time it takes to make an initial contact with a client after they are referred to the HUB.
CCAs are embracing the Model for Improvement via the Plan-Do-Study-Act (PDSA) cycle. The PDSA cycle is a system by which organizations can test for change by establishing a plan to test the change (Plan), executing the test (Do), reflecting on and learning from the outcomes of the test (Study), implementing any changes that should be made to the initial test (Act)1. The PDSA cycle is a simple and powerful tool for accelerating quality improvement. This scientific method is used for action-oriented learning.
Our hope is that through this experiential QI process, CCAs will develop a culture of continuous improvement with the ultimate goal of building QI capability rendering each CCA the efficacy to identify and achieve their unique improvement goals on an ongoing basis.
HCGC’s team is committed to supporting HUB supervisors and CHWs to the highest degree possible. One aspect of that support includes daily engagement in the HUB data management system, Care Coordination Systems (CCS), to review data from the very beginning stages of an individual client to the time of the client’s discharge from the HUB. The HUB staff takes this manual review of all client data very seriously, as it is vital in ensuring that the important work of our CCAs and CHWs out in the community is reflected in our billing and quality processes on the backend.
HCGC and the HUB staff team are very much looking forward to working through this new QI initiative with our valued CCAs. Recognizing how much growth has occurred to get us here, we also know that there is always room to grow and improve. The HUB staff is confident that this process will allow the HUB to continue to serve HUB clients with dignity and respect, while providing them a quality service that will set them on the path to success and well-being.
For more information on the Central Ohio Pathways HUB, or on this QI initiative, please contact HUB CEO, Jenelle Hoseus at [email protected].
HCGC Celebrates Certifying First Class of Community Health Workers in New Program
By: McKenzie Carter, Program Manager, HCGC
Beginning in March of 2021, the Healthcare Collaborative of Greater Columbus convened a group of 17 professionals for our very first Community Health Worker Certification Program. This first cohort consisted of a diverse variety of genders, races, backgrounds, and experiences. With ages ranging from 23 to 64, this cohort brought more to the table than we could have hoped for. With funding from Aetna, this program was free for all of our participants. We had a wide range of agencies that had CHW’s certified through the program, including; Columbus Urban League, Ethiopian Tewahedo Social Services, Physicians CareConnection, Heart of Ohio Family Health, Primary One Health, The Breathing Association, Urban Strategies, and Wellness First.
Our first unit focused on understanding the roles and goals of Community Health Workers, and understanding CHW employment models, particularly with the Community Pathways HUB Model. Our cohort practiced Appreciative Inquiry and Motivational Interviewing, and explored Social Determinants of Health, and how they connect to life expectancy and outcomes. We discussed homelessness and housing in Central Ohio, and its relation to SDOH. Our second unit focused on CHW’s Roles in Health Education and Health Promotion. Our Cohort demonstrated general awareness of health care needs for individuals across the life span, and related health care and social services including; pregnancy and motherhood and early life barriers, and how to mitigate those risks, describing basic anatomy and physiology of major body systems and medical terminology, recognizing signs indicating a change in a client’s health status and educating on healthy lifestyle choices, understanding the behavioral, mental, emotional, and spiritual impacts on health, understanding the importance of oral care, explaining age-appropriate safety and injury prevention techniques, educating clients on becoming independent in their personal health advocacy. This unit also explored the COVID-19 pandemic in terms of data, the role of CHW’s in education, case investigation, testing, vaccinations, and resource coordination. Our third unit focused on targeting at-risk communities. Participants learned in depth about health disparities and health equity, learned about the health disparities in Franklin County, discussed how the legacy of the enslavement of Africans impacts racial disparity in America, explored ethical issues in research on marginalized groups, we defined cultural competence, and discussed the importance of telling and listening to stories that center Black voices.
More specific topics covered in this Certification were pertinent to the work that Community Health Workers do daily. This includes learning about Healthcare Models, establishing a Medical Home, client engagement, managing unconscious biases through curiosity, empathy, and compassion, discussing social determinants of health, learning about pregnancy, motherhood, and reproductive health, health literacy, behavioral health, wholistic health care, ACEs and health outcomes, and so much more.
This cohort truly brought energy, passion, and insight into this program. Our participants made this program successful in so many ways, from sharing personal narratives, exchanging stories and visions, to sharing their expertise. With that being said, at the Awards Ceremony, HCGC recognized Jabriel Harrison for his perfect attendance. His readiness to engage and participate was energizing during the past 3 months. We recognized Gabriella Craft for most improved, as watching her grow within the program was inspirational. We awarded Guy Tshimanga the Courage Award, as he shared his personal stories with the class, and even wrote a poem on Motherhood. We awarded Jabriel, Gabriella, Kate Curry-Da-Souza, and Luciana Smith the Outstanding Presentation Award for their presentations on the role of CHW’s in the medical system of care. And finally, Tifani Kendrick was awarded the First Annual Mark Redding Impact Award for exemplifying the legacy of community service, health equity, and inspiration in memory of the late Mark Redding, the co-founder of the Pathways HUB model.
If you would like to learn more about the Central Ohio Pathways HUB Certification Program, please contact HUB Education Director, Dr. Tanikka Price at [email protected].
Central Ohio Pathways HUB Joins Statewide Network of Certified Pathways HUBs
In Ohio, there are currently 10 Pathways Community HUB Institute Certified HUBs (HUBs). These HUBs have created a statewide network in order to support, grow, and sustain their model, with the goal of achieving health equity for all people in Ohio.
Managed by the Healthcare Collaborative of Greater Columbus (HCGC), the Central Ohio Pathways HUB (the HUB) acts as the Central Ohio regional HUB, training, certifying, and dispatching CHWs to use the model in order to reduce health care inequity in under-resourced communities.
The 10 Pathways Community HUB Institute Certified HUBs (HUBs) in Ohio have banded together to form a network, with the goal of supporting, growing, and sustaining the HUB model in the state.
HCGC took over management of the HUB in March of 2019, taking over the evidence-based system that guides Community Health Workers (CHWs) as they perform field work to identify and eliminate characteristic barriers to under-resourced clients’ good health outcomes. HCGC trains, certifies, and dispatches CHWs to use the HUB model in order to reduce health care inequity in vulnerable communities. Outside health care agencies, such as local health departments, federally qualified health centers, and other health and social service agencies, partner with HCGC to benefit from CHW training and certification, field support, and data.
At the core of the HUB model is the idea that social determinants affect health. When CHWs work with clients using the model, they tailor a plan to fit each individual’s specific needs across age, race, culture, geographic location, and gender. By recognizing obstacles to health—such as food insecurity or lack of reliable transportation—CHWs are able to connect clients to community-based resources that can improve health outcomes.
“The HUB has proven its effectiveness in making a substantial difference in clients’ lives,” says Jenelle Hoseus, Executive Director of the HUB. “By creating a network of Ohio HUBs, we will be able to collaborate on projects, such as providing education regarding the HUB model and Community Health Workers with government and policy leaders.”
The network will also allow the Ohio HUBs to amplify its united voice, scale innovation, and share technical assistance, support, and best practices with one another. The ultimate goal for the network is to achieve health equity for all people in Ohio.
“Rather than each of us working separately but diligently at the same goal in our own areas of the state, we can pool our knowledge and collaborate to have a greater impact on eliminating racial health inequity,” says Hoseus.
Since March of 2019, CHWs in the Central Ohio Pathways HUB have provided care coordination to 2,527 clients, completing over 12,200 connections to care and services. Overall, 192 CHWs from Ohio HUBs served 4,036 clients in those programs in 2020. HCGC and the HUB look forward to a fruitful collaboration with the other Ohio HUBS and making ever greater strides in its shared mission.