AMCHP 2005 ANNUAL CONFERENCE
DELIVERING RESULTS, IMPROVING PREGNANCY & BIRTH
February 19-23, 2005
ESTRELLITA BERRY : Greetings kindred spirits, good morning-
UNKNOWN SPEAKER: Good morning.
ESTRELLITA BERRY: I’m going to have to do something first in-in the community that I love and serve we always have to give props to people and that just means proper respect. And we have here in our midst we have Mary Beth with HRSA and D.O.H. Folk and I have some fellow federal healthy start sisters and some state healthy start sisters. You all raise your hand. Now the first reason was to give props I was supposed to, the second is the hidden agenda and all of us always have hidden agendas. And the hidden agendas if you all got anything bad to say they’re going to come back and tell me. I’d like to start out by saying first of all we’re extremely proud of this opportunity that we had with the Workforce Development Program. We had three of our four outreach workers to participate in this endeavor. We also-we have a mix of disciplines. We also have doulas who are nurses’ assistants and they work in our federal project as well. And the doulas didn’t participate but our outreach workers did. We have a three-tier system as you see here.
Tier one is our indigenous workers who function in our QA role. And in our project we believe that QA is basically continuous quality improvement and they’re responsible for administrating our satisfaction surveys, for recruiting women into MCH services and participating in community health boards and activities. And when I say participate in community health boards and activities we strategically place our women in at least 40 different agencies. So anybody that has anything to do with MCH issues in our community we have representation there.
Tier two-two’s phase is we have one our perinatal support outreach workers and these ladies are responsible for the provision of case management to CHS participants. But they have a very minimum caseload and then the community outreach workers who recruit, administer satisfaction surveys, participate in the MCH activities and these are the ones who graduated from the ATD Program. As you can see in the tier one, this is GED, high school or college.
Tier three, and this is what we’re working towards now and actually have written a grant hoping that we get this for senior level outreach workers who serve as community health worker trainers for CHHS and other community based projects in the community. And this is for people who already have college degrees. We’re very varied in our disciplines so we have women who have completed GED to college graduates. Our theme was basically “Quitting Was Not an Option”. So when people come and have the hard times and they did, they had some serious hard times. When we say that the women was indigenous for the-from the community that we serve. Our women really mirror the women who they serve so they’ve suffered and endured the same hardships that you’ve heard talked about earlier with the life core perspective and what women have to endure throughout their life course. And so our whole thing was not to even allow them to think that they could quit. So when you came into my office you were only talking about how to strategize and what we could do to keep you in the program and what I needed to do to work with my staff to get you to that point where you needed to be.
Elements of a successful community health worker project model and this is what we really believe helped us to help our women to achieve that success with the program. Our upper management promote acceptance of our community health workers valued role and in our community and I don’t like the word paraprofessional, in fact, my staff and I are getting ready to coin a new term and we’re narrowing it down to three so this time next year you’ll hear what we’re calling the paraprofessionals but basically upper management really do promote acceptance and we have what we call interagency management team meetings and care coordination. And no one discipline carries more weight than the other. The other is nurturance and folk don’t believe many times that you don’t have to be nurturing in your work environment and we really don’t believe that to be true.
Just as we teach nurturance we have to give nurturance to our workers and accountability. Although many of the women come from the community that we serve and have come through and persevere through tremendous odds sometime we try to pick up the slack but at the point where we hinder them or-or prevent them from growing. And accountability is critical and so we really hold them to the same standards and in most cases even higher standards because we know people expect less. So we hold them accountable for the function and the work that they do. And always talking about having a successful attitude, not believing for the moment that you’re not going to do what you set out to do. And effective supervision I can’t say enough for effective supervision. When you’re talking about the number of hours that supervise management it was beyond our regular supervision. And regular supervision we usually have probably have .20 of you FTE, you’re talking more like .35 and .40 when they first start. So you’re talking about a lot of effort and assisting and walking the women through this piece.
Our criteria for our participation as the outreach workers were that: as we talked earlier, they were indigenous from the community we serve, they definitely had the ability to connect with the families and so this had to be women who are very much comfortable with going into the communities in the areas where people are very fearful of going, where many times you buddy up to go and you have to be very cognizant of when you go and when you don’t go, familiarity and comfort with neighborhoods as I said and satisfactory job performance. Probably one of the questions that we get asked the most was what was our standard satisfactory and not above satisfactory? And we believe that all the women that we employ and we have a rigorous, structured criteria for hiring so when the women come in our doors at the least they’re satisfactory. And so we believe that every woman that walked through our door in these disciplines has the potential to achieve a program such as this.
And what we wanted out of the joint venture with MCS and WFD program, what we really wanted was that for our staff to sharpen communications skills, we wanted them to have increased self-esteem and self-confidence in the work that they do, we wanted them to have increased knowledge and skill sets of what it is to be a community health worker, we wanted them to have increased competency and proficiency of their roles and their responsibilities in their scopal work, we wanted them to have increased partnerships. Our mission is to build community capacity, to reduce infant mortality and morbidity in a culturally, competent fashion and we wanted the women to be able to exude this at all times. Benefits we had many, benefits, generalization and application of knowledge in their personal life. And I can’t say enough for how much personal growth we saw with our women during this process. Systemic change which is key because we really feel in our community, Century Hills for a healthy start really do take an active role in being a catalyst for systemic change.
We don’t believe for a minute that we’re responsible for empowering anybody that’s innate it comes from within. However, we do truly believe that we can become doers for systemic change and for personal growth. And so one of the biggest positives that happens for us during the past three months which was the systemic changes that in our county we have local Healthy Start coalition which gets funded by Title V. We in our community are blessed that we have state Healthy Start and federal healthy start. Because we are a Healthy Start unit of the coalition for our county we have standard guidelines and protocols that we must adhere to. And one of the models-the models for the state Healthy Start was not one that had this component with community health workers in our community. We had gone to a medical model and so we went back to the table with the coalition and asked if they would be willing to allow our community health workers who’d gone through the ATD program to be case managers. And so they would be able to be case managers as well as outreach workers and they approved that and accepted that.
So for us that’s really big systemic change and the message it gives to the community is that these women do have very valued roles. Secondary gain, extended pride among family members, enhanced supervisory skills, garnering additional funds to increase outreach workers salary by 10 percent, promotion of continued academic development beyond the ATD and promotion of career focus. Our lessons learned: be prepared for jealousy among team members, be prepared for benign neglect, be prepared to spend more time job coaching and mentoring, be prepared for extensive allocation of your time and the bottom line for us that we’ve learned through this whole process and really is a confirmation and an affirmation of what we do is that we believe that our success is due largely in part because I have one of the most awesome teams in the world, management team and we really do believe that families have the inherent abilities to nurture and take care of themselves. And as long as we remember that we are conduits and catalysts for behavioral change that we can help them to achieve their goals. We love what our staff do, we love who they represent and most of all we love who they are. Thank you.