New Haven Community Health Worker (CHW) Katia Astudillo helps dozens of her clients navigate the logistics of getting vaccinated and connects them with other health services. She even helps them find rental assistance.<\/p>\n\n\n
In and around New London, CHW Lizbeth Polo-Smith hands out flyers about COVID-19 safety and vaccinations at churches, laundromats, stores, warming centers for the homeless\u2014anywhere she can.<\/p>\n\n\n
As COVID-19 laid bare Connecticut\u2019s health care deserts, it now highlights the efforts of CHWs who labored in forgotten neighborhoods for years. In many ways, they have become a key factor in the state\u2019s public health response for marginalized communities during the pandemic.<\/p>\n\n\n
\u201cWe need an army of CHWs. The capacity is just overwhelming right now,\u201d said Giselle Carlotta-McDonald, executive director of Project Access-New Haven,<\/a> which employs CHWs in a partnership with Yale New Haven Hospital<\/a>.<\/p>\n\n\n But the pandemic has raised serious concerns about whether their work is sustainable in the long run. CHWs typically are funded by grant money, which advocates say is problematic.<\/p>\n\n\n \u201cWe are fully funded by grants and donations,\u201d Carlotta-McDonald said. \u201cI spend most of my time just looking for new funds for next year. Through the pandemic, we\u2019ve lost grants that were scheduled to come this year. Without the funding, I can\u2019t sustain it. It\u2019s just not sustainable. It limits, really, how much we can do.\u201d<\/p>\n\n\n Lifelines For Underserved Communities<\/strong><\/p>\n\n\n Astudillo, a CHW at Project Access-New Haven, spends a lot of her time lately doing vaccine-related outreach.<\/p>\n\n\n\n \u201cA lot of our clients are very hesitant of taking\u201d a COVID-19 vaccine, she said. \u201cThey don\u2019t know a lot about it. Some of our clients cannot read or write. There is a lot of education; our calls went from being 20 minutes to maybe 40 minutes.\u201d<\/p>\n\n\n She\u2019s also seen a surge in the number of people needing rental assistance. Many of the organization\u2019s clients are undocumented and don\u2019t qualify for federal resources, Astudillo said. She connects them with local organizations that can help.<\/p>\n\n\n Often, clients will share information with a CHW that they won\u2019t tell a medical provider or another professional, said Millie Landock, lead CHW at Project Access.<\/p>\n\n\n \u201cWe are one of them,\u201d <\/strong>said Landock, who has been a CHW for almost 15 years. \u201cWe speak what they speak. I know what you\u2019re going through because I was there. They see us as one of them. When we call them, they share the personal stuff\u2014their personal struggles, their personal life.\u201d<\/p>\n\n\n She adds: \u201cThe needs were still there [before COVID-19]. Now it\u2019s just, like, everywhere. The volume is just unbearable.\u201d<\/p>\n\n\n Polo-Smith, who works as a CHW at Ledge Light Health District<\/a> in New London, also educates people about the vaccines and helps them book and get to vaccine appointments. She spends part of her week passing out information in her community to anyone she can.<\/p>\n\n\n \u201cI deliver flyers everywhere that people can reach,\u201d she said. \u201cEverybody trusts me. I enjoy what I do.\u201d<\/p>\n\n\n CHWs live in the communities they serve, which is a crucial factor in their effectiveness, proponents say.<\/p>\n\n\n\n \u201cThis is not about us telling folks what to do,\u201d said Jennifer Muggeo, deputy director of Ledge Light Health District. \u201cThis is about someone from their community who has trusted relationships and connections, and who knows how to navigate the different systems, and who knows what the barriers are, and can hear what people are hoping for and can help them achieve it.\u201d<\/p>\n\n\n CHWs are especially critical in vaccine-related efforts, Muggeo said, as vaccination rates among people of color have trailed those of their white counterparts.<\/p>\n\n\n \u201cWe are really able to address the barriers that have existed for black, Hispanic and indigenous folks to get the vaccine,\u201d Muggeo said, including lack of computer or internet access, transportation hardships, and trouble understanding English-only forms and websites. \u201cWe have worked hard to take those pieces down as much as we can.\u201d<\/p>\n\n\n A Question Of Funding<\/strong><\/p>\n\n\n CHWs have various titles and employment structures. Some are employed by health departments or health districts, some by community-based organizations, and some by health centers or hospitals.<\/p>\n\n\n \u201cThey really are on-the-ground individuals that are helping to guide patients, especially those who have complex issues, language barriers and other social determinant barriers,\u201d said Tiffany Donelson, president and CEO of the Connecticut Health Foundation.<\/a><\/p>\n\n\n \u201cCHWs were so instrumental in getting to hard-to-reach populations and doing so in order to educate them\u201d in the pandemic\u2019s early days, Donelson said. \u201cThey were instrumental in doing the contact tracing. For those who did get COVID, they were exceptionally helpful in getting them to the needed resources. They are so needed as it relates to educating around the vaccine because they are trusted in their community.\u201d<\/p>\n\n\n\n The Connecticut Health Foundation, through grants and in partnership with the nonprofit 4-CT<\/a>, is funding 45 CHW positions throughout the state: in Bridgeport, Hartford, New Haven, Norwalk, Stamford and New London.<\/p>\n\n\n Before COVID-19, CHWs focused on various health-related issues. The Ledge Light Health District formed several years ago to address the opioid epidemic and social determinants related to asthma. Project Access started in 2009 to connect recently hospitalized patients with specialty care.<\/p>\n\n\n Now, CHWs are taking on a broader scope of work with no sustainable way to fund it. Project Access has six full-time CHWs, in addition to four full-time and two per-diem patient navigators who help uninsured patients access specialty care and address social health determinants, according to Carlotta-McDonald.<\/p>\n\n\n CHWs \u201care doing very, very important work, and we are constantly in a cycle of stressing and looking for the next grant funding to support their time,\u201d Muggeo said.<\/p>\n\n\n Some recent developments could help.<\/p>\n\n\n President Joe Biden\u2019s American Rescue Plan pledges to fund 100,000 public health workers who will work in local communities. According to the plan, they will provide services like vaccine outreach and contract tracing in the short term and then transition to long-term public health roles. The Centers for Disease Control and Prevention (CDC) expects to award grants to approximately 75 organizations through the program. But the grants will be awarded on a competitive basis, and not all entities will be funded.<\/p>\n\n\n Geralynn McGee, policy director of the Connecticut Health Foundation, said, \u201cThe support in the American Rescue Plan is helpful, but we should continue to consider how we can sustainably fund CHWs,\u201d she said. \u201cThis one-time cash infusion is still more like a grant.\u201d<\/p>\n\n\n About a year and a half ago, the Connecticut Department of Public Health created a certification for CHWs, which Muggeo said is an encouraging step in getting CHWs the recognition\u2014and funding\u2014they deserve. To date, 120 people have earned the optional certification.<\/p>\n\n\n \u201cI hope, as a state, we\u2019re able to look in a broader way\u201d at funding opportunities, Muggeo said.<\/p>\n\n\n State lawmakers are debating the next biennial budget amid a challenging financial climate. State Rep. Patricia Dillon<\/a> (D-New Haven), a deputy majority leader who sits on the Appropriations Committee and co-chairs its subcommittee on public health, said a bipartisan staff is researching if and how the budget may affect CHWs.<\/p>\n\n\n Donelson said that steady funding would make CHWs even more effective.<\/p>\n\n\n \u201cWe need to continue to figure out how we can support this workforce so they can really help us. We really need people who are boots on the ground. It\u2019s a question of funding them,\u201d Donelson said.<\/p>\n\n\n Cover Photo: Millie Landock, Lead Community Health Worker at Project Access New Haven, talks to a client on the phone while doing outreach to connect residents to health providers.<\/p>\n\n\n Publisher\u2019s Note: CTLN<\/a> and c-hit.org<\/a> collaborate to best serve the Connecticut Hispanic, Latino community.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":" New Haven Community Health Worker (CHW) Katia Astudillo helps dozens of her clients navigate the logistics of getting vaccinated and 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