Community Health Worker

Community Health Worker

The Community Health Worker (CHW) will work in and according to the training provided by the Pathways Model to eliminate or mitigate barriers to health and social services as identified through the client assessment. This position will work with clients that meet the criteria established by the local HUB. The CHW will serve as an advocate and link, connecting patients to appropriate community resources and services within the local HUB. The CHW will provide services in the home, community and office. CHW will document all client interventions and services provided. This is a results-oriented program and success will be measured by the completion of checkpoints within the established Pathways, and improved client self-efficacy and health care outcomes.

Responsibilities

Essential duties and responsibilities include but are not limited to those listed below. The CHW may be required to perform other duties as assigned. Under the supervision of the Pathways Supervisor, the CHW will:

• Work primarily out in the community, where she/he can more readily reach and be accessible to the patients.
• Be a patient advocate.
• Conduct standardized patient in-take and risk assessments.
• Based on the assessment, work to complete the assigned Pathways in a timely manner.
• Document all interactions and assessments in a timely manner, using Pathways documentation platform and Sea-Mar's EHR.
• Attend trainings and meetings by/for Pathways, Sea-Mar Community Health Centers, and other entities as assigned.
• Establish a trusting relationship with the target population, referred clients, and community partners.
• Identify and assist clients with client identified health and social service goals as appropriate.
• As appropriate, act as a cultural liaison between the health and human service system(s) and clients. Where appropriate communicate clients' cultural preferences and needs with health and human service system(s), community partners, etc.
• Assist in the development of strategies to address or eliminate barriers to care.
• Work collaboratively with the Program Manager, PCP, and other assigned personnel to make sure that all relevant client needs are identified and addressed.
• Collaborate with HUB partners to identify high-risk clients and assist in the coordination of care with Sea Mar Community Health Center and with other community partners and service providers.
• Demonstrate a commitment to the mission, vision and goals of Sea-Mar Community Health Centers including the ability to integrate Core Values of Community Health Workers as defined by the American Association of Community Health Workers: Access, Acceptance, Advocacy, Excellence, Learning, Partnership, Social Justice, Strength, Trust and Unity.
• Participate in ongoing assessment of the client and family needs to determine if expected outcomes are reached and to ensure implementation and/or adjustment of the service plan.
• Providing ongoing follow-up on treatment on PCP plans utilizing basic motivational interviewing and goal setting with clients/families.
• Follow-up with clients via phone calls, home visits and visits to other settings where clients can be found.
• Assist clients with completing applications and registration forms.
• Refer uninsured clients to an insurance Navigator/CSR to conduct eligibility determination, enrollment and follow-up.
• Help clients set personal goals, identify and overcome barriers to attending appointments (such as transportation and childcare).
• Provide referrals for services to community agencies and partner with other agencies as appropriate.
• Help clients connect with transportation resources and conduct appointment reminders to ensure patients are keeping their appointments and meeting their goals
• Attend regular staff meetings, trainings and other meetings as required.

Productivity Standards

• Maintains a caseload of up to 45 clients.
• Completes at least 8 successful contacts per day. This includes patient contacts, family/caregiver contacts, and hospital contacts.
• Documents on all activities performed with patients within 48 hours. Files will be audited on a regular basis to ensure compliance with Sea Mar policy and requirements of the Pathways funders.
• Completes monthly reports detailing caseloads, statistics, and outcomes.

Qualifications

• The Community Health Worker must be a recognized and trusted member of the community she/he is serving and
• Have the ability to communicate effectively verbally and in writing and utilize good listening skills.
• Ability to be an effective team member and be trusted to work independently.
• Maintain a clear understanding of the Federal, State, and community resources available.
• Provide unbiased and accurate education and/or referral(s), even if the clients' needs might be in conflict with personal viewpoint/belief system of the CHW.
• Be computer literate and able understand how to use the CCS Platform in an efficient manner.
• Demonstrate the ability to recognize potentially dangerous situations to self in the clinic, office, home and community settings and to take appropriate action.
• Be Knowledgeable of child/ dependent adult abuse/neglect and mandated reporting law RCW.26.44.30.
• Be knowledgeable about and have the interest, compassion, and ability to provide services to clients facing economic, emotional, physical, social, and other challenges which are impacting their health and health outcomes.
• Demonstrate a basic knowledge of chronic disease conditions.
• Engage in trainings and educational opportunities to continue to develop knowledge on chronic conditions or other issues affecting the client population.

• Recognizes that the focus of care is the client and understands that client participation and control of their own care is our priority.
• Maintains focus of agency on the following client centered principles:

• Empanelment
• Continuous and Team-based Healing Relationships
• Client-centered Interactions
• Engaged Leadership whose focus is the client
• Quality Improvement (QI) Strategy that is inclusive and dynamic
• Enhanced Access
• Care Coordination
• Organized, Evidence-based Care

• Must be professional at all times and able to maintain the understanding, physical health, emotional stability and personality suited to meet the physical, mental, emotional, and social needs of the population served.
• No history or evidence of alcohol or other drug misuse for a period of three (3) years prior to the date of employment, and no misuse of alcohol or other drugs while employed at this facility.
• Has not been convicted of a felony within the last seven years or ever been convicted of child abuse and / or any crime involving physical harm to another person nor be a perpetrator of substantiated child abuse.

Education, Certificates, Licenses, Registrations, and Medical Screening

Education And Experience

High school diploma or GED. Ability to read and understand documents such as documentation requirements, community resources, safety rules, other instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to communicate effectively one-on-one with clients, families, colleagues and community partners. Must be computer literate and be able to utilize computer documentation, researching community resource, etc.

Certificates, Licenses, Registrations

• This person must have a valid driver license, proof of auto insurance and a vehicle safe for daily
• use. Prior to hire this person must submit a driver's abstract demonstrating that s/he is safe to
• drive as deemed by Sea Mar's Health and Safety/Compliance Officer. Within the course of employment, a current driver's abstract may be requested.
• This person must receive an annual background check from Washington State Patrol.
• This position must obtain Basic Life Support (BLS) CPR within 90 days of hire date and is required to maintain current BLS CPR throughout employment.
• Must be approved to perform Pathways services by the contracted agency.
• Must complete Pathways training

Additional Requirements

• Pre-hire and annual employee health screening required
• Annual influenza vaccine required. Only exception is for employees with a medical or religious exemption approved by Administration. Employees with an approved medical or religious exemption must wear a mask at all times during the flu season.
• TB testing annually required.

Condition of Employment

The Pathways CHW must sign an oath of permanent confidentiality covering all patient related information and must receive a background check from the Washington State Patrol. The CHW must meet the organization's health screening requirements for tuberculosis screening and immunization status.

Language Skills

Bilingual English/Spanish in reading, writing and verbal skills are strongly