Projects

Pacific Hospital Preservation & Development Authority: Bridging gaps in health care access

Project Details

 

ICHS serves a variety of communities experiencing health access and outcome disparities, such as people of color who are low-income and/or limited English proficient (LEP), as well as immigrants and refugees. These communities suffer from higher rates of obesity, diabetes, and hypertension. Additionally, many immigrants and refugees lack health literacy and an understanding of the importance of preventive care. Interpretation and cultural understanding that are applicable to primary care settings, such as that provided by ICHS, can help overcome these barriers, and help patients practice preventive care.

To address these needs, ICHS provides a comprehensive health care team approach to managing chronic disease that includes nurses providing care management, registered dieticians providing nutritional assessments and support, and health educators providing self-management support. This project supports those patients who need additional support in meeting their health care goals by providing practice-based Community Health Workers (CHWs) to follow up to help patients navigate the health and community support systems to meet their health care plan goals. The project allows ICHS to meet the needs of all patients including those who are uninsured, have lost coverage in the last year, or those who are insured with high deductibles. PHPDA funding will fill the gap of potential 1115 Medicaid funds and still help ICHS innovate to meet the needs of complex patients.

The Improving Access Through Community Health Worker Coaching (IACWC) Project will broaden the range of CHW activity at ICHS by allowing existing patients to access the benefits offered by CHWs within the clinic setting. The CHWs at ICHS currently follow a lay health worker/outreach and enrollment model. As members of target populations, CHWs provide one-on-one advice, make referrals, and act as bridges between community members and the healthcare system. The IACWC Project seeks to broaden CHWs’ field of activity so that they act as culturally competent care coaches. This model is unique in that CHWs will actually have a panel of patients that they will follow up with and help to overcome barriers.

In this way CHWs can also focus their skills, experience, and knowledge inward so that specific patients can access them in a clinic setting as well as outside clinics. The pilot will begin by emphasizing services to existing ICHS patients with diabetes or hypertension who are struggling with social determinants of health needs. Regular consistent contact with CHWs will help these patients overcome barriers and access preventive care.

The IACWC Project CHWs will work with patients who have been referred to Care Management or Health Education by their primary providers. Care Management personnel or Health Educators will identify patients who could benefit from the CHW model. These patients will be referred to one of eight CHWs in the IACWC Project who can provide services in the patients’ preferred languages.


About Our Grantee

International Community Health Services

ICHS provides culturally and linguistically appropriate health services to improve the health of Asian Pacific Islanders and the broader community.

Visit International Community Health Services website here.


About Our Partner

International Community Health Services

ICHS provides culturally and linguistically appropriate health services to improve the health of Asian Pacific Islanders and the broader community.

Visit International Community Health Services website here.