Community Health Worker

The Transformative Role of Community Health Workers

Bridging Gaps in Healthcare Access

Community Health Workers (CHWs) are increasingly essential in providing comprehensive healthcare support in various communities. Their work spans educational outreach, healthcare advocacy, and specialized healthcare programs.

Reach Out trains and employs CHWs throughout the Inland Empire, and hopes to see these critical healthcare workers utilized more widely across the potential spectrum of applications. This post will consider:

  1. Who are community health workers?
  2. The critical importance of trust and cultural literacy for CHWs
  3. The spectrum of a CHWs work
  4. Who is a good fit and how is a CHW trained?

Who Are Community Health Workers?

According to Dr. Shermineh Davari, Director of Reach Out’s Inland Health Profession Consortium Department (IHPC), CHWs are individuals trained to assist their communities with a variety of healthcare issues. Dr. Davari's department, for instance, runs various programs such as work-based learning and mental health advocacy, with a special focus on Community Health Workers. “The goal is to find gaps and remove barriers to provide more equitable access to resources and services within our communities," she explains.

Mayra Mixco, a physician trained in El Salvador, is a program manager at Reach Out focused on the CHW initiatives there. “Community Health Workers inform communities about healthcare issues, help schedule various appointments, and focus on culturally appropriate outreach. They seek to connect as trusted community members, working in community spaces, including churches, consulates, and schools.”

Trust Comes with Cultural Literacy for CHWs

The cornerstone of effective healthcare provision by CHWs is trust. These workers share a cultural, linguistic, and social background with the communities they serve, which makes their role exceptionally vital. From providing healthcare education to serving as navigators and advocates, the CHW’s responsibilities are diverse. After specialized training, they are equipped to provide more equitable and inclusive services.

This trust allows CHWs to battle common myths and misconceptions about conditions and treatments that may exist in certain cultural communities. Mayra quoted a situation where she discovered that some community members believe that the diabetes treatment medication would make them go blind – when that is a risk of the disease itself. “The CHW knows our community, knows our culture, what we believe in, and what we do not believe in. They can actually come, get comfortable, and educate during a casual conversation, dispelling myths and misconceptions as they help access resources.”

The Spectrum of Work: What Do CHWs Do?

The scope of a Community Health Worker's focus can be expansive, varying by setting, healthcare system, and community. They might assist a diabetic patient in understanding their medication and monitoring blood sugar levels. They may also aid in appointment scheduling and running regular tests. 

CHWs go by various names, including health navigators and case managers. No matter the title, their focus remains on providing personalized, culturally sensitive healthcare support.

Who is a Good Fit for a Role as a CHW?

Typically, CHWs begin as individuals already recognized by their communities as trustworthy and proactive—people identified as "doers," "seekers," or "advocates." Mayra emphasizes that those who undergo training to become CHWs already possess a foundational skill set, which gets refined and directed through the program.

Reach Out's Training Programs

Reach Out (and many other organizations) actively train CHWs. We offer an 80-hour training program that not only covers health-related topics but also includes development of interpersonal and communication skills. Following the training, CHWs must complete 40 hours of field experience to get hands-on practice in the community, something Reach Out helps to facilitate.

New Funding Opportunities and Specialization

Funding is now being directed towards expanding the focus of CHWs to areas such as substance misuse. Dr. Davari and Mayra both emphasize that CHWs could play an essential role in de-stigmatizing substance misuse treatment and assisting individuals in recovery. The aim is to adopt a holistic approach, addressing not just the issue of substance misuse but also the factors that may be contributing to it.

Understanding Social Determinants of Health

CHWs are trained to be aware of the broader social determinants that impact health, including socioeconomic status, sexuality, and housing conditions. This knowledge allows them to provide services tailored to individual needs rather than taking a "one size fits all" approach.

The Future of CHWs

Public health departments are increasingly recognizing the importance of CHWs, especially as their services become medically reimbursable. CHWs can assist busy healthcare providers by taking the time to understand patients’ cultural and lifestyle nuances, such as food habits, thus enabling better healthcare outcomes.

CHWs and Reach Out are shaping the future of community healthcare in the Inland Empire by offering a blend of education, trust, and cultural understanding. As this role evolves, their contributions promise to make healthcare more equitable and accessible for everyone – a mission Reach Out shares. 

If you’re interested in learning more about Reach Out’s CHW training, learn more here and sign up!

Give Them the Tools

An innovative program empowers our youth to reclaim their mental health

In recent months, we’ve shared a lot about the state of mental health of the young people in our country and here in the Inland Empire, where Reach Out operates. It’s undoubtedly a crisis, as pointed out by Dr. Rocha in her talk at this year’s National Innovative Communities Conference, and the statistics are chilling. Numbers like these (suicide is the second leading cause of death among those 15 -24 years old; nearly 20% of high school students report serious thoughts of suicide) lead most reasonable people to ask one question: What can we do? 

Reach Out is working hard on the answer to this question, and that work has culminated in the launch of their Intervention Specialist program, currently entering its second year of active work in the Chaffey Joint Union High School District. 

What is an intervention specialist? 

Neither teacher nor staff member, nor technically a therapist, Intervention Specialists are specially trained counselors who staff on-campus wellness centers. These specialists are equipped with a wealth of information and knowledge about the variety of situations that teens might bring into the centers with them, and while they are not licensed therapists, they are trained to refer serious issues to appropriate personnel. 

Sophia Juárez, director of the program for Reach Out, explained the need the wellness centers address in the nine high schools where they are currently active. She explained that during the lockdown period of the pandemic, many youth in the IE experienced isolation, violence, abuse, or grief at home. Many of our kids returned to school dealing with issues they didn’t have the tools to address on their own, and these kinds of big feelings can turn into anger issues, depression, substance abuse, and even violence. 

“Our intervention specialists are there to help them learn to self-soothe and teach them how to manage their anger issues. And this is an opportunity for the kids to go in and learn, where they're given the tools to properly handle their emotions, so then they can go out and navigate in the moment without one of our intervention specialists holding their hand. One of the philosophies I like to use is: we educate them to equip them to empower them.”

Modeling Healthy Adult Relationships

Sophia, along with Intervention Specialist Program Managers Alyssa Montano and Josh Davis, talked about the wellness centers and those who staff them as adults offering the teens on campus a safe space. For some, it may be enough to just come in and sit, taking time to breathe and unwind. “We really work to make the centers welcoming to kids,” Alyssa noted. “We’ll have bean bag chairs and music playing, there are different activities and spaces where kids can read or journal.” 

Not all kids come in ready to unload their issues, and for many of them, trust is a key factor. “The program really puts the power back in the kids’ hands, and we let them know that we’re there if they want to talk, but that they also have the option of just getting a break. In fact, letting a kid who’s clearly struggling know that they don’t have to talk is often the key to unlocking that closed door,” Alyssa said. “Just letting them know they have that opportunity is critical. Especially if they never created a connection with a teacher or a counselor, because their trust in adults may have been broken in the past. We work hard at creating that place for them to just have that space and use it how they'd like to. Most of the time, once trust is established, kids are eager to talk. They need to.”

Sophia agreed, “I say this often to the staff, but this could potentially be the only healthy relationship these kids have with an adult.”

Intervention Specialists See and Hear the Kids of the IE

The heart of this program lies with the intervention specialists themselves. Each specialist goes through a comprehensive training and participates in ongoing training weekly, sharing best practices and key strategies. But beyond training, these are people who really want to make a difference to kids, who really believe in the impact they can have, one life at a time. 

“Sometimes,” Josh Davis noted, “It’s as simple as breathing. Giving a child the means to self-regulate, to know that they’ve got the tools to handle whatever they’re facing, is something that brings joy to these specialists. And beyond that, it’s about letting each individual know that their voice is heard, regardless of their truancy or substance abuse, or whatever issues they’ve got going on. Those issues don’t define them.”  

“We want to focus on letting kids know that their feelings matter, that they matter, and on giving them a safe space and tools to work through some really difficult challenges,” Sophia said. 

Via individualized conversations, a safe space to unwind, and a focus on arming small groups of students struggling with similar issues with tools to address those problems, the intervention specialists are making a real impact on the population of the Chaffey Joint Union High School District. According to last year’s records, more than 1500 members of the student population in the district signed into a wellness center at least once, with a total of more than 5,400 total visits. That’s an astounding amount of impact for a first-year program, and those at the helm of this effort expect to see that number increase. Via focused assessments geared toward generating data about issues and usage, Reach Out is working to build definitive proof that this program changes - and saves - lives. 

The Need is There

There is no question that the need for this type of resource-building intervention is there, and the number of students touched in year one only serves to emphasize that reality. 

“Sadly enough, we see so many things, so many situations come in and out of our wellness centers. But the best part is that we know that what we're doing is potentially impacting these lives long term,” Sophia said. 

And for the kid whose life is impacted for the better? That should be evidence enough that this program is working. 

Still, there are many more kids than there is funding for this program, something Reach Out hopes to help change. “We’d love to see funding for this program to expand to other districts,” Sophia noted. “And we’re working on it.” 

To learn more about the Intervention Specialist program and other efforts Reach Out is making on behalf of the kids of the Inland Empire, click here.

A nurse caring for an older patient

The Complex State of Healthcare in the Inland Empire

A fireside chat with Alison Elsner of the San Bernardino County Medical Society and Ruthy Argumedo of Molina Healthcare

In an insightful and enlightening chat, Reach Out brought two of our key partners together to discuss the issues facing the healthcare sector in our region and to explore how collaboration is making a difference.

Two Caring Individuals, Two Committed Organizations

Alison Elsner, the Executive Director of the San Bernardino County Medical Society, highlighted the shortage of physicians in California, especially in areas with low-income populations. She noted that, in certain places like the Inland Empire, the physician to patient ratio is as low as 1 doctor to every 9,000 patients. For Elsner, tackling this issue calls for collaborative strategies, including legislative advocacy, raising public awareness, and the continued advocacy of the ‘White Coat Program,’ which gives high school students and college students the chance to learn about the varied career paths within the healthcare field.

Ruthy Argumedo, Associate Vice President at Molina Healthcare, echoed Elsner's concerns, emphasizing the role of collaboration in mitigating the problem. According to Argumedo, one of the key challenges lies in recruiting and retaining healthcare professionals in underserved areas. Molina Healthcare's initiative 'Community Connector' aims to bridge this gap by connecting healthcare providers to the community. Argumedo also touched on the importance of wellness programs in improving overall health and addressing systemic issues.

Elsner’s organization represents physicians and advocates for policies to promote equitable patient access. Meanwhile, Argumedo's organization serves over 5.3 million members in 21 states, focusing on communities most vulnerable to health disparities. Argumedo, who has been with Molina for 16 years, works extensively in community engagement and partnerships, striving to address social determinants of health and close gaps in care services.

Both organizations partner with Reach Out to focus on healthcare workforce development, patient advocacy, and closing care gaps through collaboration with one another and with the community.

Reach Out is a Conduit for Collaboration

For both women, collaboration with Reach Out goes back several years, with Argumedo working with the organization for over 15 years. Her partnership started with the Latino Health Collaborative, a group that concentrates on health initiatives and social justice in the Hispanic community. They have expanded to various programs, with Argumedo highlighting the Mamás y Bebés campaign. This eight-week course focuses on mental health for new mothers, providing resources and giving them a voice in their care and in the care of their children.

Elsner highlighted the importance of Reach Out’s work in the Inland Empire and Southern California. Reach Out's commitment to workforce development and creating healthcare career pathways for young people is well aligned with the San Bernardino County Medical Society’s priorities. This shared interest led to a collaboration on the ‘White Coat’ program, which places high school and community college students in physician offices and practice settings to inspire them to pursue healthcare careers.

However, attracting and retaining healthcare professionals in the Inland Empire remains a significant challenge. Argumedo shared that often medical graduates and residents leave the state or shift to other regions due to better financial incentives or personal desires, driven by the significant weight of student loans to be repaid. Elsner also described the growing competition from employee-based medical organizations that can offer more regular hours and greater flexibility for providers. 

Healthcare is a Complex Problem in the IE

The discussion then moved to a critical component in the healthcare equation: the pay that physicians receive, particularly those dealing with Medi-Cal patients. Elsner pointed out the discrepancy in compensation between physicians under Medi-Cal, where reimbursement rates are about 50% of what Medicare offers, and Medicare reimbursements are already low.

Argumedo added another layer to the issue, by emphasizing the need to view it from two perspectives: providers and patients. In areas like San Bernardino and Riverside, both limited access to and fear of healthcare services are prominent. She elaborated that while there might be sufficient healthcare providers in certain regions, including federally qualified health centers, various factors may deter patients from seeking their services. These range from lack of education to fear of immigration raids. She cited instances where people avoided accessing healthcare services, even free ones, due to these concerns.

The problem is not only about having enough providers, but also about educating communities to overcome these barriers and fears. An example Argumedo mentioned was the need for people to understand when it's necessary to visit a provider instead of going to an emergency room.

As Elsner suggested, this is where Reach Out shines. Acting as a bridge between healthcare services and the community, Reach Out assists in educating the community on how to provide for their healthcare needs and benefit from available services to create healthier futures for their families. 

Meeting Basic Community Needs can Alleviate Some Healthcare Pressures

Later in the chat, Argumedo drew attention to the specific needs in communities, such as the need for diapers. Basic items like these can avert preventable emergency room visits and allow healthcare providers to focus their resources where they're most needed. In this way, collaboration plays a critical role in addressing both healthcare and community needs.

Elsner also introduced the concept of Adverse Childhood Experiences (ACEs) - early life traumas that have been found to negatively impact physical and mental health into adulthood. Both Argumedo and Elsner highlighted the importance of partnerships with organizations that understand and work towards mitigating ACEs. By focusing on these early experiences, they believe the cycle of healthcare issues can be interrupted, leading to better health outcomes overall.

Mental Health is Critical Too

The importance of mental health was underscored throughout the discussion. Elsner and Argumedo painted a clear picture of the cycle of healthcare shortages and their repercussions, emphasizing how they feed each other on an ongoing basis. Their organizations, alongside others, aim to interrupt this cycle, with mental health support being a crucial aspect of this strategy.

Drawing the conversation to a close, both Elsner and Argumedo stressed the passion and dedication that healthcare providers demonstrate every day. Dealing with complex issues, from language barriers to socio-economic challenges, these providers often find themselves providing more than just medical care.

This in-depth conversation ultimately shed light on the importance of understanding and supporting healthcare providers and the unique challenges they face. Above all, it emphasized that the goal of making a difference in the Inland Empire is a shared one, requiring collaboration and a genuine commitment to change.

Want to see the chat? We’re sharing it on our LinkedIn channel all month. Follow us here


Turning Ideas Into Action

The National Innovative Communities Conference Changes Lives and Communities

What if your community was more than just the place you live? What if it was an active, thriving part of your life, your landscape? What if the community itself inspired your family and neighbors to engage, to live actively, and to collaborate? 

Is it possible for a city to be an active force for betterment in the lives of those who live there? 

If you live in Jurupa Valley, you likely already know the answer. 

In this post, we’ll examine: 

  1. What does it mean to be a healthy city? 
  2. How the NICC conference played a direct role in creating Healthy Jurupa Valley
  3. The upcoming NICC conference in Riverside

What is a Healthy City?

Most people think of cities as non-active entities. We live in them. We work in them. They describe us in some ways, but other than being “from” a place, we don’t always think much about them. 

Reach Out would like to change that. And we have succeeded. Jurupa Valley is a fantastic example of the excellent community initiatives that can be inspired when leaders and community members come together to explore ideas. 

In 2011, the city founders of Jurupa Valley attended our conference and left brimming with ideas to create a city that wasn’t just a place people were “from.” They wanted to integrate community and art, emotional and physical well-being, along with a unifying sense of pride in ownership. And from that inspiration, the first Healthy City in the Inland Empire was born.  

Healthy Jurupa Valley: The Formation of a Healthy City

The overall structure of HJV relies on three distinct, yet interconnected sectors: the City of Jurupa Valley, Reach Out, and Community Leaders and Stakeholders. 

  • The City provides support from the City Council, City Manager and city staff to ensure health is embedded in the deepest layers of the city, and that healthy ideas are heard and acted upon, instead of getting tangled up in red tape. 
  • Reach Out provides the backbone structure for strong fiscal management, fund development, staffing for meetings and events, community and agency connections from work throughout the Inland Empire, and the knowledge and expertise about healthy communities and cross-sectoral collaboration best practices. 

The City of Jurupa Valley and Reach Out form the foundation of Healthy Jurupa Valley. 

  • Community leaders and stakeholders are like the construction crew building on top of the foundation: these are the people with the optimism, heart, and energy that make HJV’s resident-driven visions a reality. 
  • Jurupa Valley is dedicated to the vision of a healthy, thriving city that serves as an inspiration and example for what the power of connectedness can create.

Results of a Successful Healthy City Initiative Are Broad

Every year, Reach Out helps assess the success of the specific initiatives that the five action groups within Healthy Jurupa Valley have set forward as goals for that year. And with few exceptions, goals are met every year. 

Though many normal events and projects were postponed, canceled, or hosted online due to Covid-19, Healthy Jurupa Valley continued to make meaningful engagement with the community a priority, even in 2020. We estimate that HJV efforts reached 13,406 residents throughout the year. Consider the following stats that difficult year:

  • Direct Engagement with Collaborative and Action Team meetings: 450
  • Direct Community Outreach and Engagement through events and drive-thrus: 10,956
  • Indirect Education and Engagement via Social Media and e-Newsletters: 1,500
  • Program Engagement: 500
  • Partners Engaged: 115
  • Residents Served: 13,406
  • Volunteer Hours Served: 945

The results of a dedicated effort toward a healthy community go beyond statistics, however. 

They are visible in the murals painted in local parks, the beautification efforts made at schools, and the little free libraries dotted around town. They can be seen in the small business support offered at regular lunch and learn meetings, and in the vaccine equity efforts made to ensure education and vaccines were offered to all community members. They can also be felt in the ongoing substance abuse awareness efforts and partnerships between community organizations and law enforcement. 

This Year’s Innovative Communities Conference

Healthy Jurupa Valley is a great example of action stemming directly from the discussions engendered at the National Innovative Communities Conference, and we can't wait to see what kinds of measurable outcomes are inspired by this year’s conference, which happened June 13 & 14th at the Riverside Convention Center. 

The agenda included a variety of topics, but will feature keynote speaker Laura Coates, CNN host and Senior Legal Analyst. Attendees also heard from dynamic speakers at informative plenary sessions, including Dr. Somava Stout, from the Harvard T.H. Chan School of Public Health; Dr. Cid Pinedo, Chief Executive Officer of the Mexican American Opportunity Foundation; Public Health Director Kim Saruwatari; Medical Officer Dr. Geoffrey from Riverside University Health System; Dr. Evita Limon Rocha and more.

Session Topics included: 

  • Substance Use Disorders
  • Mental Health
  • Health Workforce
  • Family Wellness
  • Violence Prevention/Intervention
  • Restorative Justice & Youth Court
  • DEI and Racial Equity
  • Law Enforcement
  • Nonprofit/Community-based Organizations