New Mexico Advances CHW Practice Through Professional Credentialing

Submission Date: September 2015

Entry Type: Case Study

State/Territory Submitted on the Behalf of: New Mexico

States/Territories Involved: New Mexico

Funding Source: State/local sources

Other Funding:

State funding

Domain Addressed:

Health Systems Strategies

Public Health Issue:

• Rates of high blood pressure, diabetes and prediabetes in New Mexico adults are rising and many in the state’s diverse population live in rural and frontier areas where the availability of primary care providers are extremely limited.
• To better serve diverse populations and improve the health of underserved communities the Institute of Medicine recommends including community health workers (CHWs) in multidisciplinary teams.
• CHWs are beneficial in improving knowledge and self-management for patients with chronic conditions like diabetes; reducing visits to emergency rooms, improving compliance with appointments, medications, and healthy lifestyles; increasing cancer screenings; and improving blood pressure control.
• The New Mexico Department of Health (NMDOH) set a goal to achieve certification for CHWs in the state in order recognize and elevate a long standing workforce, and to increase the use of these important and beneficial health care providers.

Project Objectives:

• To provide workforce development and achieve voluntary certification of CHWs to ensure standardized training.  To also develop (as needed) health career pipelines for these important health care providers.
• To reduce health inequities for New Mexico’s diverse communities through increased access to high-quality, cost-effective care and to ultimately support the integration of CHWs into health and social systems of care

Program Action:

A brief chronology of actions leading to reaching the CHW certification goal:

• 2003: The New Mexico Legislature passed Senate Joint Memorial 76 (SJM76) resulting in a request to the NMDOH lead a study to develop a community health advocacy program. New Mexico’s existing community health advocate model provided a starting point.
• 2006: The New Mexico CHW Advisory Council was established to carry out SJM76 objectives
• 2008: The NM DOH Office of Community Health Workers was established
• 2011: The NACDD diabetes consultants and Diabetes Council provided technical assistance to advance CHW certification through its Policy Technical Assistance and Training process where experts described how other states implemented CHW certification. A policy action plan was developed.
• 2014: Senate Bill 58 (CHW Act) was passed by the NM Legislature, providing for NMDOH certification of CHWs; providing for rule making, fees, criminal background screening and discipline relating to certified CHWs; and creating a board of certification of CHWs.
• 2015: The “Rule” was promulgated and a nine member NM CHW Certification Board was appointed by the Secretary of the NMDOH and Governor Susana Martinez. The Board assists in enacting the certification requirements and is administratively attached to the DOH.
• Based on their experience many long-time CHWs will be able to be certified by a “grandfathering” process. CHWs are first certified as generalists; then they may apply for certification in a specialty such as clinical skills, diabetes and asthma, or other area.

Data/Other Information Collected:

The Office of Community Health Workers will collect data on individuals seeking certification and will be able to capture:

• Geographic area of residence and employment
• Place of employment
• Number of years worked and/or volunteered
• Number of generalists certified
• Number of generalists certified with specialty tracks
• Number and type of specialty areas/tracks
• Languages spoken and language preferred
• Age and education
• Training and/or licenses or certifications held

Impact/Accomplishments:

• The New Mexico Department of Health (NMDOH) will begin the first certification program for CHWs in the state as a result of the passage and signing of Senate Bill 58 into law, the Community Health Workers Act.
• The NM DOH Office of Community Health Workers in partnership with CHWs, the Community Health Worker Advisory Council, Tribal CHR Programs, Navajo Nation CHR Outreach Program, and stakeholders, led the effort to establish infrastructure to initiate this voluntary certification for the estimated 800-900 CHWs in the state.
• CHW certification brings New Mexico closer to making CHWs a routine part of primary care and can help the state reach objectives set by their federal funding under the State Public Health Actions (1305) program, such as improving medication adherence and increasing the number of health systems that engage CHWs.
• Integration of CHWs into health and social systems of care will make it possible for primary care providers to work hand in hand with CHWs, allowing CHWs to provide follow-up with patients, language translation and a variety of services that the primary care provider cannot deliver.

Challenges/Lessons Learned:

The office of Community Health Workers (OCHW) has a limited staff of four full time employees to  achieve implementation of this initiative. However, with strong support from internal partners within the NMDOH, Health system Bureau, they have been sucessful in implementing the certification process. Great geographic distances between the frontier and rural communities add to the challenges of reaching the state’s population impacted by CHW certification.

Program Areas:

Public Health Practice

State Contact Information:

NM
Britt Catron, Chief, Health Systems Bureau
New Mexico Department of Health
Britt.catron@state.nm.us

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