KANSAS CITY, Mo. – Sue Brettmann is no newcomer to caregiving, having worked as a registered nurse in emergency rooms, intensive-care units and hospices for 30 years.
But when Christ Lutheran Church expanded its health care outreach, Brettman realized she was unfamiliar with area safety-net services.
Brettman’s work as a parish nurse at Christ Lutheran had mainly involved counseling church members and coordinating visits for ailing congregants — not, for instance, helping a newly unemployed worker find assistance.
That is starting to change, though, as Brettmann trains to become a community health worker — an emerging profession designed to help a variety of clients navigate the maze of social service agencies and medical providers.
Brettman is one of 24 students taking a six-week training course at Metropolitan Community College (MCC). The college is offering the free pilot course as part of a $2.2 million grant from the Missouri Department of Economic Development.
Community Health Workers
A community health worker can work in any number of settings — at safety-net clinics, social service agencies or faith-based organizations like Brettman’s church, for example.
Proponents say one of their main functions is to ensure that clients refill prescriptions and follow doctors’ orders upon discharge. Community health workers might also help a newly unemployed mother sign up for food stamps or Medicaid. Or even locate a community garden to help a client get lower-cost fruits and vegetables.
For Brettmann, the MCC course has already opened her eyes to a new way of approaching a common volunteer effort: the food drive. Next time Christ Lutheran has a food drive, she said, church members will be asked to provide healthy options.
“One of the things that came from the class is that in the pantries — even if the doctor may tell them to go on a low-sodium diet or with their diabetes, watch their sugar — they don’t always have access to the healthier foods,” she said. “So, that’s something that I took back right away.”
Taught at MCC’s Health Science Institute, the course drew more than 40 applications for the 24 available spots, said Barb Wiman, who helps coordinate the state grant for the community college.
The in-class portion of the 156-hour course runs from 2 p.m. to 6 p.m. Monday through Thursday. Students must also complete 60 hours of shadowing in some sort of clinical setting.
Organizers’ ultimate goal is to make the course an ongoing, fee-based offering at MCC and elsewhere. They also want Missouri to establish an official certification for community health workers, in part to make the service reimbursable through Medicaid.
Some employers — such as the Kansas City Free Health Clinic — also would like to see state certification of community health workers. Now, since the role is somewhat new and undefined, it’s hard to know exactly who to recruit into the positions.
Not just a lower-cost alternative
At the Kansas City Free Health Clinic, Community Services Director Dennis Dunmyer said they have already seen positive results from the four community health workers they have on staff. Each manages a caseload of about 30 to 35 patients.
For instance, a newly hired community health worker quickly solved a chronic problem that had routinely sent a couple patients to the emergency room of Saint Luke’s Hospital. Each had a hernia, Dunmyer said, and went to the emergency room to manage their pain.
The community health worker secured donated surgery time to fix the hernias.
That wasn’t a knock against the ER staff or the social workers at Saint Luke’s, Dunmyer said.
It’s just that there’s not much that hospital personnel — or safety-net clinic staff, for that matter — can do once a patient is out in the community, he said, even if they leave with explicit follow-up instructions.
Among the challenges that come with this relatively new position, Dunmyer said, is assuring current employees that community health workers are not just lower-cost alternatives to the work they do.
“By any stretch, I’m not proposing that they replace or take over the work of any case managers or social workers,” he said. “There is kind of a place for all them to do that type of work.”
The Health Forward Foundation is proud to partner with the Kansas Health Institute news service to provide weekly health stories about health and policy issues impacting the greater Kansas City region. This News Service is an editorially independent program of the Kansas Health Institute and the Health Forward Foundation and is committed to objective coverage of health issues.