Health outreach workers: Filling the gaps in care and support

October 23, 2014 § 1 Comment

By Marybeth Barker, Health Outreach Worker Manager at Commonwealth Care Alliance


Health outreach workers

There are a lot of things that influence health that aren’t medical in nature, like safe housing, access to food, and opportunities for social interaction. Nurses and doctors do their best, but many don’t have the training nor is it time or cost effective for medical professionals to take the time to help their patients with non-medical needs.

At Commonwealth Care Alliance we recognize that “Health is harder for some” and that is one reason health outreach workers are part of Commonwealth Care Alliance’s care team. Health outreach workers, sometimes known as “community health workers,” are professionals who help fill important gaps in care and support for thousands of individuals. To fill these gaps, health outreach workers are able to take time to listen and work with members on addressing what the member identifies as their most immediate need.


Hierarchy of needshealth outreacher worker

For example, a clinician may be working with a member to reinforce the importance of taking a medication to control their blood pressure or other medical condition.

However, that person’s main concern might not be their medical problem at all.  Instead, they might be worried about an overdue payment, a shut off notice, a pending eviction, or other stressful circumstance. Since stress is a recognized risk factor for poor health, negatively impacting and possibly exacerbating most medical conditions, alleviating stress is an important consideration in improving health.  Heath outreach workers are able to meet with an individual to listen, assist the member in recognizing their own strengths, gain a measure of trust and then engage the member in applying their own skill and ability toward solving or reducing the problems they have identified.

Services provided by health outreach workers

The assistance health outreach workers provide comes in many forms and, like our approach to medical care, it is tailored to meet the specific needs and circumstances of the individual member.  For example a health outreach worker might assist a member in obtaining public benefits such as food stamps or fuel assistance to relieve financial burden, or assist a person suffering from isolation with finding a social group.

In addition to working with medical clinicians a health outreach worker may work with a behavioral health clinician to provide support in assisting and guiding a member with serious issues of domestic violence or in getting treatment for mental illness. The role of the health outreach worker in this instance may be to encourage and accompany the member in getting to the therapy appointment the social worker has arranged, or perhaps to help the member obtain a restraining order for protection against someone posing a threat.

The most challenging and frequent request made to health outreach workers is for help finding safe and affordable housing.  The process is daunting and many need assistance with procuring the multiple documents required to complete the application process.

In addition to focusing on non-medical needs, Commonwealth Care Alliance health outreach workers are trained and certified to deliver group and one-on-one health education in member’s homes and in the community. Through attentive listening and the ability to tailor education to meet individual needs and circumstances, health outreach workers teach and engage members in using their own skills to self-manage diabetes and cardiovascular disease.

Listening, encouraging, teaching, engaging

Consistent with Commonwealth Care Alliance’s empowerment model of care, although expert in many areas, the role of a health outreach worker is not to “fix” problems for a member but rather to work with an individual in identifying and recognizing their own strengths and to then use those strengths to take action on their own to eliminate or reduce the stressors affecting their life. To do this an outreach worker takes time to listen, encourage, teach, and do what is necessary to engage a member in applying their own skills toward resolving a given problem.

Working as a team with the clinician and other member of the behavioral health staff, the health outreach worker clears the way for the clinician to better succeed in engaging the member in practices and behaviors that remedy a medical condition and promote health. It is through building relationship and trust that the Commonwealth Care Alliance care team seeks to foster each individual member’s sense of agency and readiness to take action and adopt behaviors related to improving their health. The health outreach worker plays an integral role in this process.


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