Community Health Alignment Initiative (CHAI)
¿Por qué necesita Carolina del Sur el programa CHAI – Community Health Alignment Initiative (Iniciativa para la Alineación de la Salud Comunitaria)?
Según la American Community Survey – ACS (Encuesta Comunitaria Estadounidense) aproximadamente 521.147 habitantes de Carolina del Sur, o 10,04% del total de la población, no tenían seguro de salud en 2021. Esta cifra podría ser más alta hoy porque el gobierno federal ha ordenado a los estados que reinicien la revisión del estado de elegibilidad de los miembros de Medicaid y eliminen a aquellos que no califican a partir del 1 de abril de 2023. Es indispensable para Carolina del Sur que los trabajadores de salud comunitaria apoyen a los miembros de la comunidad para obtener seguro de salud y abordar otros factores determinantes de la salud (SDOH, por su sigla en inglés) que afectan su calidad de vida. El Programa CHAI fue diseñado para apoyar a estos miembros de la comunidad.
El programa CHAI es designado para satisfacer las necesidades de las comunidades en todo el estado de Carolina del Sur
El programa CHAI fue establecido por la Disposición 33.20 de la Legislatura de Carolina del Sur (South Carolina General Assembly Proviso) titulada Ley de Asignaciones 2023-2024 iniciativa para la rendición de cuentas y mejora de la calidad de Medicaid (Medicaid Accountability and Quality Improvement initiative 2023-2024 Appropriations Act) en 2023. Por medio de ésta se autorizó al SCDHHS (Departamento de Salud y Servicios Humanos de Carolina del Sur) a suscribir un contrato con el Center for Community Health Alignment – CCHA (Centro para la Alineación de la Salud Comunitaria) en un esfuerzo conjunto por ampliar el personal de Trabajadores de Salud Comunitaria (CHWs, en inglés), con el objetivo de mejorar los resultados en materia de salud para las personas que carecen de acceso a un seguro médico asequible, facilitando las conexiones con los recursos y el acceso a los proveedores de la red de protección social.
Organizaciones financiadas por CHAI
Las siguientes organizaciones están participando en CHAI Affinity Health Center, AccessHealth Horry, AccessHealth Spartanburg, AnMed, Browns Ferry Community Outreach (BFCO), The Courage Center, Greenville Free Medical Clinic, HopeHealth, McLeod Health, the Medical University of South Carolina (MUSC), PASOs, Prisma Health, Regenesis Health Care, Roper St. Francis Healthcare, Rural Health Services, y Tandem Health.
¿Por qué se estableció el programa CHAI?
El programa CHAI fue establecido por la Disposición 33.20 de la Legislatura de Carolina del Sur (South Carolina General Assembly Proviso) titulada Ley de Asignaciones 2023-2024 iniciativa para la rendición de cuentas y mejora de la calidad de Medicaid (Medicaid Accountability and Quality Improvement initiative 2023-2024 Appropriations Act) en 2023. Por medio de ésta se autorizó al SCDHHS (Departamento de Salud y Servicios Humanos de Carolina del Sur) a suscribir un contrato con el Center for Community Health Alignment – CCHA (Centro para la Alineación de la Salud Comunitaria) en un esfuerzo conjunto por ampliar el personal de Trabajadores de Salud Comunitaria (CHWs, en inglés), con el objetivo de mejorar los resultados en materia de salud para las personas que carecen de acceso a un seguro médico asequible, facilitando las conexiones con los recursos y el acceso a los proveedores de la red de protección social.
El County Health Rankings Population Health Model (Modelo de Salud Poblacional del Ranking de Salud del Condado) a continuación sirve como base para entender el por qué nos enfocaremos en aumentar el personal de CHWs para apoyar a las personas que no tienen seguro. Sabemos que, aunque la atención clínica es importante, sólo afecta un 20% de nuestra salud. Sin embargo, los comportamientos de salud, los factores sociales y económicos, y el entorno físico donde vive una persona afectan el 80% restante. Es en esas áreas en donde los CHWs, apoyados en sus equipos, organizaciones y socios, pueden ayudar.
¿Cuáles son los grupos poblacionales objetivo del programa CHAI?
Las 40 ZCTAs con mayores necesidades incluyen:
Aiken | 29801 |
Allendale | 29810 |
Anderson | 29624 |
Barnwell | 29817 |
Berkeley | 29436 |
Charleston | 29406 |
Charleston | 29405 |
Chester | 29706 |
Clarendon | 29148 |
Clarendon | 29102 |
Darlington | 29550 |
Darlington | 29532 |
Dillon | 29536 |
Florence | 29501 |
Florence | 29505 |
Florence | 29506 |
Georgetown | 29440 |
Greenville | 29611 |
Greenville | 29605 |
Horry | 29576 |
Lancaster | 29720 |
Lee | 29080 |
Marlboro | 29512 |
Marlboro | 29525 |
Orangeburg | 29048 |
Orangeburg | 29163 |
Orangeburg | 29115 |
Orangeburg | 29118 |
Richland | 29203 |
Richland | 29204 |
Richland | 29201 |
Spartanburg | 29302 |
Spartanburg | 29301 |
Spartanburg | 29306 |
Sumter | 29150 |
Williamsburg | 29590 |
Williamsburg | 29554 |
Williamsburg | 29556 |
Williamsburg | 29056 |
York | 29730 |
¿Cuál es el rol del Centro para la Alineación de la Salud Comunitaria?
El CCHA mantendrá la responsabilidad por el esfuerzo conjunto de ampliar el Programa de Trabajadores de Salud Comunitaria para cumplir con el objetivo de mejorar los resultados en materia de salud de las personas que carecen de acceso a un seguro médico asequible, facilitando las conexiones de las personas con los proveedores de las redes de protección social y los recursos comunitarios.
Funciones específicas del CCHA
- Mantener la responsabilidad por la Iniciativa para la Alineación de la Salud Comunitaria (CHAI).
- Determinar la manera de ampliar el Programa de CHWs a los entornos clínicos y comunitarios, de tal forma que guarde consistencia con la filosofía del rol de CHW y las mejores prácticas definidas por especialidad.
- Entregarle al SCDHHS un cronograma de la implementación del programa CHAI.
- Garantizar que los CHWs estén debidamente capacitados en las funciones previstas.
- Ofrecer orientación y expectativas a los adjudicatarios indirectos financiados en cuanto a cómo mantener los vínculos de los CHWs con la comunidad.
- Desarrollar un proceso para asignar fondos y disponer subcontratos de financiación a organizaciones clínicas y comunitarias, para contratar y apoyar a los trabajadores de salud comunitaria calificados con miras a lograr los objetivos del programa CHAI.
- Garantizar que cada establecimiento se enfoque en una/o más condiciones de salud y los determinantes sociales de los factores de salud que consideren más relevantes para las necesidades de las personas no aseguradas o subaseguradas que atienden.
- Entregarle al SCDHHS información programática y de evaluación de impacto, que será examinada con ellos periódicamente para ayudar a la operación y evaluación continua de la iniciativa.
¿Cuáles son las funciones de los CHWs que se financiarán a través del programa CHAI?
Abordar el acceso a la atención, uso apropiado de los servicios de salud, factores sociales determinantes de la salud, brechas educativas en salud, y otros servicios necesarios para que las personas cuenten con más herramientas y apoyo para cuidar su salud. Las funciones de un CHW incluyen:
- Facilitar la mediación cultural entre individuos, comunidades, y sistemas de servicios de salud/sociales
- Ofrecer educación e información de salud culturalmente apropiada
- Coordinación de la atención, administración de casos y orientación sobre navegación del sistema de salud y los sistemas de servicios sociales
- Ofrecer coaching y asistencia social
- Defensa de personas y comunidades
- Creación de capacidad individual y comunitaria
- Suministrar servicios directos
- Implementar evaluaciones individuales y comunitarias
- Realizar actividades de alcance comunitario
- Participar en evaluación e investigación
Los CHWs deberán realizar actividades de alcance comunitario y desarrollar alianzas comunitarias con las organizaciones que atienden a las comunidades objetivo para atraer a las personas que no tienen seguro, o que están en riesgo de quedar sin seguro. Al momento de la admisión, el CHW realizará una evaluación de las necesidades de salud y servicios sociales, el nivel de necesidad, y las fortalezas y debilidades de la persona. El CHW involucrará a la persona y a cualquier otro miembro del equipo o a los socios para establecer un plan de apoyo para la persona, a través de una de las funciones del CHW enumeradas arriba. Los CHWs también participarán en mediación cultural con proveedores, incidencia y creación de capacidad, cuando proceda y sea necesario, para atender mejor a las personas y comunidades respectivas.
¿Cómo debe el CCHA rendir cuentas de los fondos invertidos?
El CCHA presentará informes trimestrales y un informe de resumen final al Departamento de Salud y Servicios Humanos de Carolina del Sur. La información recopilada de las organizaciones financiadas se empleará para completar estos informes y es esencial:
- Detalles sobre la estructura, estatus y plan de trabajo del programa CHAI;
- Logros de proyecto en la contratación e incorporación de CHWs para atender a las comunidades identificadas;
- Obstáculos que se encontraron a lo largo del proyecto;
- Narrativas sobre cómo se lograron los objetivos del Center for Community Health Alignment y el impacto del programa CHAI sobre el personal de CHWs, los residentes individuales de Carolina del Sur, y los hospitales afiliados a los programas CHAI específicos;
- Resumen de mediciones, según corresponda, incluyendo indicadores de mejoras en salud y el número de personas cobijadas;
- Orientaciones a futuro y planificación de sostenibilidad; y
- Un listado de los socios del CCHA para cada informe trimestral.
Comité Asesor del Programa CHAI
Al recibir una notificación de financiación de parte del SCDHHS (Departamento de Salud y Servicios Humanos de Carolina del Sur), el CCHA (Centro de la Iniciativa para la Alineación de la Salud Comunitaria) convocó a un comité asesor conformado por CHWs (trabajadores de salud comunitaria), iniciativas AccessHealth, redes hospitalarias y otras partes interesadas para aportar comentarios y sugerencias y ofrecer orientación en torno al desarrollo del programa CHAI para el estado de Carolina del Sur. Este comité asesor está dividido en varios subcomités enfocados en Datos y Evaluación, Prioridades de Financiación, y Fidelidad del Programa de Trabajadores de Salud Comunitaria (CHW Program Fidelity). Tras la orientación impartida por estas personas, el CCHA tiene planeado implementar el programa CHAI a partir de enero de 2024.
El Comité Asesor del Program CHAI está conformado por las siguientes personas. Haga clic en sus fotografías para conocer más acerca de su labor en Carolina del Sur y mucho más.
Wilma Moore, CHW
Community Health Worker
Dara Brown, CHW
Senior Community Health Coordinator at Brookland-Lakeview Empowerment Center
Jodi Rodgers, CHW
Community Health Worker at Access Kershaw
Victoria Adewumi, CHW
Community Health Worker at the City of Manchester, NH
Mayra Lubov, CHW
PASOs Deputy Director
Terri Jowers, CHW
SCCHWA Interim Executive Director
Pennie Jewell, CHW
Community Health Worker at CHW Center for Research and Evaluation
Marek Calhoun, CHW
Director of Social and Community Services at CareSouth Carolina
Reeshemah McKelvey, CHW
Director of Access Health Tri-County Network
Carey Rothschild, CHW
System Director of Community Health Policy and Strategy at Spartanburg Regional Healthcare System
Sonya Del Rio, CHW
Director of Enabling Services at Tandem Health
Karen Nichols
Executive Director for the Upper Midlands Rural Health Network (UMRHN)
Zack King
Community Health Development Consultant
Holly Pope
Research Associate at C.A.R.E.
Angel Bourdon
Director of Community Health & Innovation with the SC Hospital Association (SCHA)
Mary Jones, PhD, MPH
Director of Workforce Development at the Arnold School of Public Health
Pam Gilliam
Director at C.A.R.E.
Noelle Wiggins
Co-Principal Investigator at the CHW Center for Research and Evaluation
Cyndi New
Self Regional's Director of Community Health & Health Equity
Acronym Glossary
- CCHA: Center for Community Health Alignment
- CHAI: Community Health Alignment Initiative
- CHW(s): Community health worker(s)
- SCCHWA: South Carolina Community Health Worker Association
- SCDDHS: South Carolina Department of Health and Human Services
Lista de correo electrónico de CHAI
Para inscribirse en la lista de correo de CHAI, complete este formulario.
Preguntas frecuentes sobre la solicitud de CHAI
¿Por qué sólo se utilizaron 40 ZCTAs (Áreas de Tabulación de Códigos Postales) para determinar la elegibilidad al programa?
Estamos comprometidos hacia un enfoque enérgico y equitativo para ampliar el personal de trabajadores de salud comunitaria (CHWs) en el estado de Carolina del Sur, utilizando nuestros limitados recursos con sensatez. Nuestra decisión de financiar las ZCTAs identificadas está basada en la información. Todas las 424 ZCTAs de Carolina del Sur presentan la necesidad de suplir la falta de atención a las personas. Sin embargo, hemos dado prioridad a la financiación según las desigualdades basadas en la evidencia, comenzando por las 40 ZCTAs de más alta necesidad. El enfocarnos en estas ZCTAs nos da la oportunidad de crecer a partir de nuestros futuros logros con este programa y reunir recursos adicionales para ayudar a un mayor número de personas en dichas comunidades identificadas en los próximos años. Esto es apenas el comienzo.
En algunas comunidades, existen enormes desigualdades en materia de ingresos y salud. Lo que significa que el programa CHAI se podría enfocar en las comunidades que aparentemente son de altos ingresos, pero en las cuales también viven miembros de la comunidad con bajos ingresos. No pretendemos dejar atrás a nadie. Para empezar a cerrar estas brechas, analizaremos más cuidadosamente las desigualdades en materia de salud en nuestro estado para adoptar un plan más equitativo que atienda a las personas más necesitadas de ayuda.
Contacto
Para más información sobre CHAI, por favor envíe un correo electrónico a chai@mailbox.sc.edu .
Carey Rothschild
Carey Justice Rothschild is the System Director of Community Health Policy and Strategy for Spartanburg Regional Healthcare System. A certified CHW herself, Carey has experience developing and managing programs to identify and address social needs and barriers to health. She belives that CHWs are an essential component in aproving health for individuals and of our larger communities.
Mary Jones
Dr. Mary Jones serves as the Director of Workforce Development and Adjunct Faculty at the University of South Carolina’s Arnold School of Public Health. She has worked in the field of Public Health in various sectors (state, non-profit, healthcare) for more than 15 years. Her research and public health experiences include chronic disease prevention, community engagement and organizing, health equity, collation building and sustainability, workforce education and training related to the translation of research into public health and health care settings, and program implementation/management/evaluation.
Dr. Jones is a United States Air Force Veteran and serves her community in multiple capacities. Dr. Jones serves as: an at-large board member for Wholespire (optimizing health and wellness in all communities); a member of the Advisory Board for the SC Breast and Cervical Cancer and Early Detection; member of SC DHEC’s Workforce Development Committee; member of the Richland County Alumnae Chapter of Delta Sigma Theta Sorority, Inc. (public service sorority); member of the Health and Wellness Ministry at First Northeast Baptist Church; member of the school improvement council in the Richland 2 school district
Noelle Wiggins (she/her)
Currently the Co-Principal Investigator of the CHW Center for Research and Evaluation (formerly, the CHW Common Indicators Project), Noelle has over 35 years’ experience working on teams that use popular/people’s education, the Community Health Worker (CHW) model, and participatory research and evaluation to advance health and educational equity. Noelle served as Assoc. Director of the landmark Natl. Community Health Advisor Study and co-wrote the study chapter that identified the core roles and competencies of CHWs. Noelle has a BA from Yale University, an MS from the Harvard School of Public Health, and a doctorate in Educational Leadership from Portland State University.
Dara Brown
Dara Brown, MPH is the Senior Community Health Coordinator at Brookland-Lakeview Empowerment Center. She has over 25 years experience in public health. Ms. Brown has experience as a community health worker working at the individual, group, and systems levels.
Holly Pope
As a research associate with the Center for Applied Research and Evaluation (CARE) at the Arnold School of Public Health, Holly’s research interests include the evaluation of how communities access services and information and community partners contribute to solutions through mixed methods, including in-depth interviews and focus groups. Holly specializes in using qualitative research methods in the context of quality improvement projects to inform stakeholders to address issues of racial equity.
Mayra Lubov
Mayra Lubov is a community health worker and the PASOs Deputy Director. She has more than 15 years of experience in serving the community through various roles in both the U.S. and South America. She truly believes that education is a powerful and vital tool for our communities to thrive.
Wilma Moore
I’m Wilma Jackson Moore from Spartanburg, SC. I work as a Community Engagement Coordinator for the United Way of the Piedmont, and am fortunate to be located in my neighborhood, the Highland Community. I am 63 years old and I have two wonderful children, Briana and Kiyounnie, who is now living with the Lord, and a beautiful grandson, Kace McCreary Means who just turned two. I have been working in community service since 2008 and I am a Certified Community Health Worker, graduating the inaugural class in 2020.
Terri Jowers
Terri Jowers, CCHW, is a Barnwell County native and founding member of the South Carolina Community Health Worker Association (SCCHWA). Currently, she serves as Interim Executive Director of SCCHWA.
Jodi Rodgers
I am Jodi Rodgers, a certified CHW and Access Kershaw Supervisor. I have worked with the Community Medical Clinic of Kershaw County and Access Kershaw since 2016. I live in Cassatt SC, but originally from Beckley WV. I graduated from Marshall University in Huntington WV in 2000 with a BA in Counseling. I am a sports mom to my 2 teenagers, so you will find me on the sidelines during my off time.
Cyndi New
Cyndi New, currently serving as Self Regional’s Director of Community Health & Health Equity, brings a wealth of experience from her dynamic 20-year career in healthcare. With a Bachelor’s in Nursing from Lander University and a Master’s in Business Administration from Anderson University, she has effectively blended her medical expertise with a strong business acumen. With certifications in Diversity, Equity, and Inclusion (DEI) and Results Based Accountability, New is dedicated to implementing comprehensive healthcare programs that prioritize health equity, social determinants of health, and community well-being, fostering healthier and more inclusive communities.
Karen Nichols
Karen Nichols, MBA, became the Executive Director for the Upper Midlands Rural Health Network (UMRHN) in June 2014. UMRHN is a 501(c)(3) organization founded in 2004 to enhance partnerships and collaboration among rural health and human service providers. In this role, Karen provides leadership in developing program, organizational, and financial plans and policies that fulfill the mission of the organization. The mission of UMRHN is to improve health in Chester, Fairfield, and Lancaster counties in South Carolina by increasing access to care, health promotion, and education.
Reeshemah Mckelvey
Ms. Reeshemah Mckelvey is the Director of Access Health Tri-County Network and has been employed with the agency for 10 years. Reeshemah oversees a team of Community Health Workers and Care Navigators who lead Roper St. Francis Health’s navigation of the chronically ill uninsured and underinsured patients’ population to include diabetes management and prevention efforts. MS. Mckelvey has over 17 years of experience in the Human Services and Population Health field. She has committed herself to advocating and serving marginalized populations in the Tri-County Area.
Victoria Adewumi
Victoria Adewumi, MA, CHW, MPH is a public health practitioner and Community Health Worker with over 10 years of experience in municipal, non-profit, K-12, higher education and faith-based organizational settings. Victoria’s work includes facilitating community empowerment and establishing health equity interventions for historically marginalized populations through coalition building, direct service, case management, policy and advocacy. Victoria is on the Leadership Team of the Community Health Worker Center for Research and Evaluation (CHW-CRE) where she supports the development of common process and outcome indicators to evaluate CHW programs globally. Victoria holds a BA/MA from the University of New Hampshire, and an MPH from Johns Hopkins University. Victoria is a current DrPH student at Johns Hopkins University, and was awarded both a MPH and DrPH Bloomberg Fellowship from the Bloomberg American Health Initiative.
Zack King
Zack King is a CHW ally and advocate that specializes in supporting organizational and collaborative efforts to advance the health and well-being of communities. Zack has a background in community health development, with a specific focus in advancing intersectional opportunities between healthcare organizations, public health, and community-based organizations. Throughout his career, Zack emphasized equity-oriented approaches that mobilize collective action, build authentic relationships, and grow the strengths of communities and organizations.
Penny Jewel
Pennie Jewell is a certified Community Health Worker with over 30 years of experience providing advocacy, care coordination, direct care, health education, social support, capacity building and case management. She is the founder of Athens Home Care Solutions (AHCS), an organization providing non-medical home care services in her community where she is currently developing strategies to integrate a Community Health Worker program. Pennie enjoys spending time with her children and grandchildren, playing pickleball and paddleboarding.
Sonya Del Rio
Sonya Del Rio is the Director of Enabling Services for Tandem Health in Sumter SC. Prior to her role at Tandem Health, she worked for the Department of Human and Health Services for 10 years as an Eligibility Specialist. She holds a B. A. in Human Services, an Associate‘s degree in Early Childhood Education and an Associate’s in Human Services. She is a Certified Community Health Worker, and a Certified Medical Assistant.
Angel Bourdon
Angel Bourdon is the Director of Community Health & Innovation with the SC Hospital Association (SCHA). In her role with SCHA, Angel leads community health and equity efforts through Healthy People, Healthy Carolinas (HPHC) and AccessHealth (AHSC) by supporting member hospitals, developing program strategy and providing technical assistance for The Duke Endowment-funded communities.
Previously, Angel worked with Prisma Health in Community Health and Information Technology. In those roles, she led the health system’s strategies for the Community Health Needs Assessment for 2016 and 2019, the launch and expansion of the school-based telehealth program and research and development of enterprise Business Intelligence and Population Health technology strategies.
Angel earned her Bachelor of Arts in Business Administration and Communication from Columbia College and Master of Health Administration from the Medical University of South Carolina. She is an avid volunteer and a believer of lifelong learning as a graduate of the United Way of the Midland’s Blueprint for Leadership program, SCHA’s Management Academy and a variety of other personal development programs. She also serves on several community boards and committees and received her Results-Based Accountability Certification from the Clear Impact Academy in 2021.
Marek Calhoun
Marek Calhoun resides of Darlington, SC and has lived in Darlington County since 2001. Marek currently serves as the Director of Social and Community Services for CareSouth Carolina’s Community Health Services Division. CareSouth Carolina is a Federally Qualified Health Center (FQHC) in the Pee Dee Region of South Carolina. Marek received his Associate’s of Arts degree in Management from Northeastern Technical College, a Bachelor’s of Arts degree in Psychology and Criminology from Coker University. He later received an Master’s of Arts degree in Community Mental Counseling from Webster University and a Master’s of Science degree in the Administration of Justice and Security from the University of Phoenix.
Marek is a member of the greatest fraternity in the world, THE Omega Psi Phi Fraternity, Inc. where he holds the office of Keeper of Records and Seal for the Chi Iota chapter in Florence, SC. Marek is a diehard Las Vegas Raiders fan. Marek enjoys cooking and spending time with his family especially his wife Eutashia and their new addition to the family, baby boy Darry. When ask what drive and motivates him, Marek says “I want to make a difference in the lives of people, that’s what drives me every day; knowing that I have touched and made a difference in the lives of those in the community we serve.”
Pam Gillam
Pamela Gillam is the Director of the Center for Applied Research and Evaluation (CARE) at USC’s Arnold School of Public Health. She provides expertise in mixed methods evaluation and research, quality improvement (QI) consultation, and strategic planning facilitation. She collaborates with state agencies, non-profit organizations, healthcare providers and other community partners to improve outcomes on various public health issues including maternal and child health, oral health, tobacco cessation, access to reproductive health services and cancer screening. For the past four years, she has been involved in the creation of a statewide strategy to better address social determinants of health.
Ms. Gillam is trained in Lean Six Sigma and the Institute for Healthcare Improvement’s Breakthrough Series Collaborative. She has a BA in Urban Studies from the College of Charleston and a MPA from the University of Charleston/USC.