Putting The "Community" in Community HealthNovember 13, 2017
Community health worker apprenticeship program strengthens link between healthcare workers and the patients they serve.
In the American labor lexicon, apprentices are generally more associated with hammer and nails than blood sugar checks. But in 2016, the 1199SEIU Training and Employment Funds (TEF) sought to change that model and launched a groundbreaking Registered Apprenticeship Program. Fifteen hospital workers were trained to become Bronx-based community health workers (CHWs).
CHWs connect the local community with medical and social services. In their roles as frontline caregivers, CHWs work takes many forms: they communicate with doctors, help make patients’ home environments healthier and safer, create community education campaigns and assist with activities of daily living.
As the country’s healthcare system evolves, CHWs are expanding their scope of work and their ranks are growing; their number nearly doubled between 2013 and 2016. Concurrently, apprenticeships across the vocational spectrum are expanding, which provide faster routes to professionalization and help close classroom/worksite knowledge gaps.
The TEF pilot apprenticeship program is a collaborative effort of the Union, Bronx-Lebanon Hospital Center, The City of New York, Small Business Services through the New York Alliance for Careers in Healthcare (NYACH), and LaGuardia Community College, CUNY. The classroom portion of the program is conducted during paid release time and the apprentices’ own time. Students are required to attend classes, work with a peer mentor and complete 1,000 hours of on-the-job training. The diverse inaugural student body represented numerous classifications, ethnicities, genders and ages. Workers trained for specialization in four areas and several sub-specialties, including HIV/AIDS Education and Diabetes Care. (The program is now on its second cohort of participants, who are on track to graduate in a few months.)
CHW Christina Boynes began in 2014 as a dietary worker at Bronx Lebanon. She’s now a CHW specializing in family medicine, overseeing a caseload of 58 patients. Boynes’ clients have a wide range of health issues and acuity levels. Her work encompasses wellness, youth outreach and health maintenance. She works on an initiative to decrease Bronx residents’ exposure to HIV/ AIDS and Hepatitis. Boynes says she was attracted to the apprenticeship program because of its confluence with her professional and educational aspirations.
“I was already planning to go back to school for social work, so when I heard about the program I knew it was a perfect fit for me. It would help me get my feet wet and get a feeling for social work. It was also an opportunity to network with others who are already in the profession,” she says.
Jacelyne Bonilla, a Bronx Lebanon Community Education Assistant, was Boynes’ peer-mentor. The pair was a good fit: both are detail oriented and doggedly determined community advocates. Peer mentors are central to the apprenticeship experience. Much of the training is overseen by the mentors, whose work with students ranges from sounding board to patient care problem solver.
` “It’s a wonderful thing to share knowledge with someone,” says Bonilla, acknowledging the twofold benefits of the mentor-mentee connection. “I’m not bothered when people ask questions. This is the learning experience.”
“When you have that relationship, you want to help people do things for themselves. And you also want to show them how, so it’s a balancing act you have to learn,” she says. “It’s also a reminder for me about how we speak to doctors and our patients.
That we are efficient with our time in communication with doctors and compassionate when we speak to patients.” Certified Patient Navigator Danny Dei mentored Roberto Claudio through his CHW. Claudio and Dei agree that the totality of CHW’s responsibility can feel overwhelming at times, but ultimately the work and service to the people of the Bronx is a source of pride. Claudio specializes in Diabetes and Asthma education.
“We take a holistic approach to dealing with patients. We talk to doctors about community engagement, and because of our work we get to breathe healthier air,” he says, recognizing the Bronx’s stubborn asthma problem. Hospitalization rates for the disease are five times higher than the national average.
At the CHW’s May 31 graduation ceremony union officers, hospital administrators and co-workers were on hand to celebrate the group’s achievement.
Graduate Daryl Turmon glowed with pride as he shared the day with one of his biggest fans—his daughter Mariah, 7—and discussed what the future holds for him and his coworkers.
“This is paving the way for more healthcare workers to engage more deeply with the Bronx community,” he said.