The Community Health Worker (CHW) is a member of the health care team in our school based health center at Charlestown High School. The community health worker utilizes their experience, cultural, and linguistic knowledge to facilitate key components of patient’s treatment within the school setting. The community health worker will engage students, create a trusting relationship, supporting students and families in navigating important appointments and resources, attend school and community events to support student engagement in health center services. The community health worker will engage students in setting their own short-term goals and will track the benchmarks along the way toward the achievement of these goals and will closely communicate with the care team through the referral process. The CHW will aid students in the coordination and completion of appointments in our school based health center and other specialty care providers within New Health Charlestown and elsewhere as needed. In addition, the CHW will work with students and families to help decrease barriers to timely follow-up care. While the community health worker position is not a clinical position, it requires a good knowledge (ability to learn) of basic concepts and an understanding of when a referral to a licensed clinician is appropriate. The CHW will also participate in group health education initiatives at the school and will be responsible for coordinating a school health calendar of activities to promote health and prevention.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
- Provide community health work services for students and families identified by the school based health center team at Charlestown High School for various Social Determinants of Health issues.
- With parental consent or under the Minor Consent laws of the Commonwealth, assist students and parents when applicable to assess their eligibility for health insurance in Medicaid or any of the health exchanges and to facilitate enrollment.
- Engage in outreach efforts as determined by the school based health center team at Charlestown High School to meet students and community members “where they are”.
- Provide patient education that is culturally and linguistically appropriate.
- Complete an initial assessment with student and/or family and referring provider to identify specific areas of focus for the CHW role.
- Work with students and/or families and healthcare provider(s) to set goals for student’s medical care.
- Motivate students to meet their health goals.
- Work with students to identify and help students and families to address barriers of care.
- Provide culturally sensitive services to students and families from different cultures.
- Help students and families put systems in place in their own environment to assist with the management of their medical care.
- Help to address any logistical barriers; scheduling complications, transportation needs, etc., that would prevent a patient from showing up to their appointments.
- Help patients to develop their own plans for getting to various appointments for screening and diagnostic tests, and treatment services.
- Accompany students and families to speciality and imaging centers when needed to provide support and advocacy.
- As needed complete home visits to follow-up on key aspects of the patient’s care, to assess the in-home barriers to following recommendations made, and to engage patients in addressing those barriers.
- Maintain regular communication with the student’s medical providers through clinical messages in EPIC, emails, phone calls and case review meetings.
- Document each patient encounter in detail. Track benchmarks of progress in care-including short term goal completion along the way.
- Work with care team in the school based health center to reinforce health education messages-the importance of follow-up care, medication adherence, routines of self-care, etc.
- Refer to internal or external case management services when other issues are identified (i.e. hunger issues, domestic violence issues, etc.)
- Provide to advocacy, patient education and support in accessing community-based and hospital-based programs.
- Collaborates with Charlestown High School and NEWH Staff to ensure access to services.
- Promotes school based health center services to students through creative marketing events.
- Maintains a log of all students and families provided with community health work services, including health insurance enrollment as required by state and federal governmental entities.
- Maintains HIPAA compliance