Audio file
THIT406 Fuse Final 1.mp3
#47 � People Helping People: How FUSE Changes Lives
Trina Filan
Thank you for joining us for this episode of talking health in the 406 where we'll one community under the Big Sky I'm Trina Filan a public health evaluator and I�m Margaret Mullins the social determinants of health program manager in January we talked with United Way of the Lewis and Clark area about housing houseless and public health. We're carrying that conversation forward today for a few decades now communities around the US have been connecting housing and healthcare using a framework called the permanent supportive housing. Saint Peter 's health in Helena is using a model of permanent supportive housing called FUSE which stands for frequent users of systems engagement our 2 great guests today are from Saint Peters health they'll be talking about their work with fuse and the importance of housing stability and wrap around services. I hope our most vulnerable community members Kaya Morris is the supervisor of community based services at Saint Peters health and Mark Nay is a community health worker with the fuse program at Saint Peter. Health by the way we will refer to community health workers as CHWS throughout this podcast so those 2 are. The same thing. Welcome to you both.
Margeret Mullins
As we discussed in our January podcast housing is intimately related to health and housing instability exacerbates or. To repeat a couple of statistics from the National Health care for the homeless council people who are unhoused have higher rates of illness and die on average 12 years sooner than the general US population people experiencing homelessness have at least twice the rate of chronic disease than people who are housed. For instance rates of diabetes are about 9% for people who are housed and about 18% for people who are unhoused rates of high blood pressure are about 29% for people who are housed and about 50% for people who are unhoused furthermore. According to the Montana healthcare foundation about 5% of patients account for about 50%. Of healthcare costs. We'll make sure to put links to some useful resources in the show notes. It's really important to under score that having stable housing opens the possibility for people to stabilize their physical and mental health Montana cities and healthcare systems have been investing in connecting unstably housed people to housing and healthcare for quite a few years now and Saint Peter 's health and Helena is one of those. Implementers. Kayla and mark can you each tell us about your roles at Saint Peters and how you got involved with the fuse specifically why don't we start with you Kayla.
Kayla Morris
Ah thank you so I actually worked at Saint Peters health for a few years prior to moving into this role and upon completion of my undergraduate degree in public health and Health Sciences. I noticed that there was a position available in our population health team and I thought that I would apply and so once I accepted the position I learned that this role is to implement our housing as healthcare program which was initially grant funded through the Montana healthcare foundation so at that time my whole goal was to figure out how Saint Peter 's health could get involved in the housing. Base and permanent supportive housing and really utilizing the fuse framework so some of that background work had already been completed in a prior planning grant with our partners which is great. And so once I got on board we got to work and from there we decided that community health workers would be a great way to move this work forward and that all too.
Mark Nay
Mark yeah thanks prior to working for Saint Peters health I was the street outreach coordinator for Good Samaritan ministries here in Helena. And so I worked directly with our unsheltered population in town. And and working with Good Samaritan I found my I found myself really connecting a lot with who was the current community health workers at the time so I worked real close and built a relationship with the community health workers and so when an opportunity came about about a year ago to. Apply to be a community health worker at seemed like a really natural fit for me and I was really fortunate to to get the position and and continue to work in this. Today.
Trina Filan
Awesome thank you very much we will talk more about CHW 's in a couple of questions from now but Kayla can you please tell us the when how and why of Saint Peters developing diffuse program in the first place.
Kayla Morris
Absolutely so the earlier time before buy time is going to be a little bit fuzzy but from my understanding I believe in around 2019 Saint Peters health was awarded a planning grant for looking into the housing as healthcare model that Montana healthcare foundation was doing across the state so it's my understanding that. Helena was a part of their second cohort so we were able to learn from some of the places before that so that initiated the initial work between Saint Peters health population health team and the United way of Lewiston park area and the health housing.
Margeret Mullins
Hey.
Kayla Morris
From there they worked collaboratively with a consultant the corporation for supportive housing who actually created the fuse process to really help bring fuse to our community and so through multiple public meetings and collaborations with our community. We decided to move forward on that implementation grant and so one reason Saint Peters health found it important to get involved in this work is just because of the link that housing plays on a patient 's health. So we know that a majority of our healthcare utilization comes from a small percentage of our population and those individuals often have unstable housing situations or don't have homes. To begin with. And so if we could intervene in an upstream approach and get community health workers on the ground. We'll connect patients with housing and help sort through all of their community needs and their wrap around services we would be able to implement their health outcomes in a greater way. For example our doctors and our nurses can provide the best care outstanding care evidence based care and if someone 's leaving the hospital and going back to an unsafe unhealthy living situation that care doesn't matter in a sense their living situation is going to prevent them from follow up care it's going to prevent them from. Taking their medications following their care plan and they're going to wind up right back in the emergency department or hospital with an exasperated medical condition. And while that's costly to our community members it also creates bottlenecks in our emergency department and having limited resources in a small town and a growing population at the same time that leaves a lot of concern so if we have people in an emergency department who don't necessarily need to be there and could have avoided that through either preventative primary care. Or simply going to primary care for the reason that they're on the emergency department. Before we run into a bed capacity issue and what happens there is you and I might need the emergency department for a heart attack or maybe we get in her car accident and we could show up and there would be no beds available for us and that's a concern and so as the areas on the hospital and emergency department we found it really important actually. To ensure that our community has appropriate access to care and that we can really impact the health outcomes of people who have limited access and high social determinants of health.
Trina Filan
And. It seems like the folks that are served by the fuse program have other systems engagement right so not just a lot of emergency department use but perhaps other systems in the community that need to respond to folks who might be in a crisis. You talk a little bit about those interconnected services and peoples complex needs and how fuse helps folks with all of that stuff.
Kayla Morris
Yeah I'd be happy to fix that but I actually think mark might be able to speak stuff better.
Mark Nay
Yeah that's that's a really good question and and you know outside of the individuals that we work with frequently accessing emergency rooms one of the things that we found is and particularly with being out on the streets and working directly with people on the streets. As we see often. Ah kind of high high utilization of law enforcement and so one of the things that happens is people moving their experiencing homelessness and living on the streets you know each day can really present its own crisis and so one of the things that happens is often 911 gets called. And law enforcement is getting dispatched to to the scene to help people and that can really have a negative effect on the individuals that we work with often many of them have a lot of trauma associated with with previous experience with law enforcement. So you know to be able to come more is a plain closed person and somebody associated more with medical care we've been able to really step in and intervene in situations within the community.
Margeret Mullins
And mark this is a little bit of an extension of that but could you just talk a little bit about why community health workers as a community health worker are integral to that success of a program like fuse you mentioned you know sort of intervening where law enforcement might come in other some other ways that you can explain how CHW 's are integral to that process.
Mark Nay
Well I think uh you know the greatest benefit that we have and that I've noticed for my own life is really just lived life experience and so you know speaking on my own life I I struggled with substance use and I my my own life was impacted by interactions with law enforcement and so. To have to have not just experienced the things that I've experienced but also to have learned how to come to the other side of those things I can offer really just a different perspective to individuals going through the crisises of their. Knives and oftentimes you know like law enforcement plays a very specific role and one of the one of the real neat things about a community health worker is we get the opportunity to play many different roles and so I think that's really just we can be kind of fluid in how we're working with people on the streets.
Margeret Mullins
That to me sounds you know when you talk about the success of the fuse program having somebody right out there it's one thing to have a program and let people know your program exists but to have somebody who's on the streets like you say with experiences that they can really make sure people understand what services are available to. I think that's I think that's amazing. How many clients mark? Do you work with on average?
Mark Nay
Uh it it it varies. Because of the real high needs of the individuals that we work with I I think really at the most that we would probably have would be 15 but one of the things that we really try to be attentive to as a community health worker and and and attentive to as part of the fuse team is responding to what our community presents to us so. Yes I might have you know anywhere from 10 to 15 people that I work with on a day-to-day basis. But that doesn't mean that we've shut down our services and so if we receive referrals we'll try to do we'll try to do a lot of spot interventions and if we can if we can go to the shelter if we can go to the streets or if we can go to another organization and intervene and help somebody kind of find a road to a better outcome that day. We're very willing to do that.
Margeret Mullins
Yeah remaining flexible though I guess through the whole process is pretty important how long do you spend in general like you have all these clients I know things are often an ongoing process is there sort of a a timeline or a beginning and end to to how some of that goes.
Kayla Morris
So what we've seen over the. Gosh almost 33 years at this point of this program is that the average participant is participating in a program for about a year and a half some will participate in the program for the rest of their lives however our few services are so so they're intensive right and they're ongoing so a lot of programs. Christy will work with individuals in different stages of their life I only work with you while you're on the streets I'll only work with you what's your house I'll only work with you for 6 months. And the whole point of our community health workers is to. Bridge that gap. And not to replace services but to ensure that our clients are connected to the right services around them and so that leads to long term ongoing engagement and so our community health workers really know their people they know the people they work with inside and out they're often a resource. For other service members in the community. And so if you're embedded in the fuse program and engaging in the program and working through the program it's it's on average about a year and a half until they're out of place where they are stabilized they have the right connections around them and our community health workers really can't start stepping back and when that happens there's still available by phone by e-mail by texting. By whatever means necessary however we see what people are stabilized but maybe moves to like a every few months check and just saying hey. I'm doing well. You know thanks for caring about me and supporting me on the other side of that mark was trotting about how we respond to our communities needs. And so we. Will work with people on an add-on basis so they're not fully in the fuse program but it's filling that gap meeting that immediate need and those are much shorter stents so that might be a day or a month or some?
Trina Filan
In between those lines right it sounds like CHW 's. Are a really important part of bringing the whole wrap around service safety net? Concoction that we have in town into a a wholeness right instead of there being a gap that people fall into CHW 's can be the bridge.
Margeret Mullins
To help people over that gap and into the next part of their journey it doesn't surprise me that you know when you mentioned some people are in it for a lot longer than that because people 's needs change obviously over time so you know one sort of serious situation or crisis may be diverted and another will surface right. It's very much work that continues all the time you know when I listen to. The variety of things that must come across your plate on any given day mark this is for you really I'm kind of wondering what sort of support does a community health worker need to be successful in this role because it seems to me you could get pretty exhausted maybe burnout in the process of. Trying to help so many people and so many different ways.
Mark Nay
Yeah that's that's a great question I I think first and foremost one of the things that that really I suppose prevents burnout in my life as I really really love what I do and so I found something that I'm passionate about something that I enjoy thoroughly and so but you know. Burnout it's not As for me is as common as it. You might think that it is but the other thing that's been really really important is I love the organization that I work for and I love the people that I work for and with and that includes Colette or other community health workers she's she's an incredible partner but also working in collaborating. Directly with with Kayla and Kayla really does a tremendous job of. Really supporting me and and I think the the the coolest thing is she really encourages me to be me and that that just I don't know it's a it's a really a comfortable place to work and it's and that makes it really easy to go to go do my job on top of that we we check in with each other. Frequently and and I'm given a safe space to really express what my needs are and what my frustrations are so I'm blessed like it's a what a great job what a great organization what a great team that IW.
Speaker
With.
Margeret Mullins
And what a fantastic thing to hear like that energy that you have for this job I'm sure resonates like in all the work that you're doing so that's that's excellent really nice.
Trina Filan
Yeah and I've seen you talk about your role both in your past work with good Sam's end in this context and it's clear that you're really passionate about helping the people you help and that it gives a lot of satisfaction so thank you for doing that for mark I've heard you talked before.
Mark Nay
Yeah thank you thank you.
Margeret Mullins
Also in a couple of different situations at conferences are are I think Saint Pete's had. Hi there panels last year that I was at and but at any rate I I'm always really amazed at your I sincerely your energy for the work that you do it's really 15 people at once I wasn't expecting I don't think that many at once like that's a lot and when I hear about the actual hands on stuff you do help people move like loads.
Mark Nay
Yeah.
Margeret Mullins
Stop get their stuff moved I'm thinking 15 people at once holy smells it's a lot.
Mark Nay
Yes hi and and yeah and so one of the things that I've had to learn in in this deal and it and it really is. Different than street outreach in some ways but the but the let's let's look at the 15 people that I work with and now that's juggling 15 people but within each one of those people it's helping them to juggle their very complex needs so you're not just juggling the people but you're juggling all of their needs and trying to keep track of that all. And and really. I guess point people to maybe what might be the best direction and the best outcome for them it can be it can be tricky it can be really yeah.
Margeret Mullins
Right yeah you can't just say 15 people and they each have a need each person.
Kayla Morris
No no OK yeah underneath and so for me actually started this project. Each have a.
Margeret Mullins
The same time it's yeah.
Kayla Morris
We looking at all the evidence based literature right they suggested community health workers should work with somewhere between 25 and 50 people each and so I was like well let's start with 25 and it was evident immediately that we need to back that down to 50 at Max or else no one gets the help. But they need.
Trina Filan
Yeah and you you need to have good relationships with all the different people in town right like you have to be able to talk to the police and the sheriff and the firefighters and the the mental health folks and food bank and the housing folks and all those.
Mark Nay
Hello there yeah. Well I think one of the things you know that I really look at in the role of a community health order is it's really becoming and becoming an expert in relationships and so. So you know it seems that I'm asked to do a lot of things but to you know to be an expert in building relationships is probably one of the most important thing that I that important things that I can do because if I can point people to who the experts are because I've had a because I have a good relationship with them that's really what's going to give the people the best outcomes. So being a certain who experts are.
Margeret Mullins
So. You make me think and I would have to look back at this CHW curriculum but actually you know that relationship building is that sort of a part do you happen to recall and that sort of CHW training if they do something like that.
Mark Nay
Oh that's a that's a good question I would imagine that that was a piece of it I also had a I think an understanding when I was doing street outreach is is really like my job was to. Uh kind of connect people and uh and help them to bridge the gap and so you know even in a community health worker a lot of times I get asked to be a counselor and I get asked to be a peer support and I get asked to have you know to be a doctor and I get asked to be a a licensed addiction counselor but the reality is is I'm none of those things. But uh I would be best served. Moved by knowing who those people are and so I can point people to somebody that does specifically that and so I think that's a a big part of our our job is to really bridge the gap back into the community and help a person to build a relationship not just with the healthcare system but to build a relationship with their community. You know if we can look at the community as a healthcare system in itself then we should we should be able to really help people have some pretty good.
Speaker
Sounds.
Trina Filan
Killa a lot of folks might be interested in the kinds of data you're able to gather from this great work that you do do you have any statistics cool stuff that you think folks would like to know.
Kayla Morris
Absolutely data is so important in these in these efforts So what we find is that within 6 months of working with the community health worker on average we see a reduction in acute healthcare utilization by 52%.
Trina Filan
Which is huge?
Kayla Morris
And that amounts to an estimated 1.3 $1,000,000.00 in healthcare charges so that quote was actually from the first 6 months of the program so that. Was specifically looking? At 30 patients that we worked with in. The first 6. Months other than that and what I can. Tell you is that. So far since April of 2022 we have worked with 82 fuse patients. 63 add-on patients so filling that short term need so a total of 145 individuals in our community with 2 community health workers of that we've helped 33 patients find housing of which 11 of them were housed in the last calendar year so Lilly hats off to our community health workers these are some of the most challenging individuals in our community. To find housing. Your last year alone our 2 community health workers completed 3200 patient contacts of which that was 1600 care coordination hours spent with patients 6 of our patients were successfully connected with inpatient treatment which is really. Just incredible. We.
Trina Filan
Have?
Kayla Morris
Provided 253 rides since we got a company vehicles through some grant work and donors and partnerships for our community health workers so we've really been able to help close that transportation gap that exists in Helena on the justice side of things we see that within the first 6 months of connecting to our community. Health worker there's a 66% reduction at Helena Police Department calls for. An 89% reduction in total incarcerated days and a 92% reduction in jail bookings and. Carlos and Park County detention center. So really impactful things that I think our community members. Care about just some additional stats we found that 37% of our fuse patients had zero emergency department visits after engaging with the community health worker which is huge and 78% of those fuse patients have less than 3 ER. That's host working with the community health worker when before that part of the requirements for being in the fuse program is being a super utilizer.
Trina Filan
So what constitutes super utilizer status.
Kayla Morris
So for the Hellenic use program a super utilizer would have 5 or more emergency department visits in a. One year look back.
Trina Filan
That is amazing and impressive work.
Kayla Morris
So the other thing that I think is important to call out is understanding that Saint Peter 's health is the only ambulance service provider in our county that's critical to public Health and Human safety and so prior to engaging with the community health worker I refuse clients had on average 3 and a half ambulance visits and within 6 months of engaging with the community health worker that dropped to one and a half. Everyone's visits and so given that we have a limited ambulance resource in our community but really just guarantees access for you and I if anything were to.
Speaker
Come up.
Trina Filan
That's really impressive uh information and it's. Is something that folks in our community should know right there are lots of folks who may not know exactly how much work is being done to bring stability and health and well-being to so many folks? In in our community so thank you for providing those data.
Speaker
Ah.
Margeret Mullins
Yeah and I kind of have a follow up question to that and you've answered some of this I mean we clearly know that the fuse program helps reduce emergency room visits and some of the statue just mentioned make the data make it clear the benefits but I'm kind of interested to know why it's important for an organization. Lake Saint Peters health to take a leadership role in health and in housing and healthcare.
Kayla Morris
It's a really great question so as the only health system in our area and the largest employer in our county. I would argue that we have a fundamental obligation especially as a non profit hospital to engage with our community and to meet our community 's needs on our community health needs assessments for multiple years we have identified housing chronic disease and substance use disorder as priority areas and this year we have access on there as priority areas. And so it's our responsibility not. You solve the problem but to help solve the problem. And so we. Can convene with our community partners and when we come together we can cross the silos of systems that are traditionally siloed and figure out how to work together and really better improve outcomes and so at Saint Peters health we're lucky that we're able to help be the capacity builders? And help me the backbone supporting organization to drive meaningful work further and our population health team does a wonderful job in this arena across multiple different sectors. And so really. Health systems have the ability to positively or negatively. Impact their community. And I feel very passionately about the fact that Saint Peter 's health cares about our community we care about improving our community we care about our partnerships with our community organizations and we care about utilizing the resources we have to improve health. Across our entire community and service area. Healthcare is so much more than just coming to the hospital when you're sick it's so much more than sick care it's not called sick care it's called healthcare and if we want to improve our community members health and well-being it starts with showing up at the table and understanding what our community needs and helping figure out how we can creatively meet those needs.
Margeret Mullins
Thanks Kayla that's uh that's uh an amazing outlook on how we should be treating healthcare and Helena is is lucky to have the fuse program in place in such great work going on it's amazing.
Trina Filan
So it seems like a program like fuse uh is probably not like a straight shot to wild success every single time right that it's not linear that you may have a couple of things that don't go quite right you need to keep pushing forward so. How? Do you keep the folks who need to make the decisions to keep your program going how do you help them see that bigger picture how do you help the community see that long term when some? Times things are tough.
Kayla Morris
There's a lot of a lot of scrutiny that can happen right especially when financial margins get tight and I think one thing that helps. Our organization understand who you don't see the work that our community health workers do everyday right I'm lucky that I get to speak with our community health workers I'm lucky to lead this team and I I feel like I have a fairly good understanding of what's going on on a day-to-day basis but not everyone does and so we really we start with showing the data and the impacts we have stories. Tell and and we have buy in from the people who I mean lots of people matter right but our physicians. Are physicians carry a weighted voice and our physicians? Love our community health workers there's so thankful for our community health workers they find so much value in how they're able to help their patients move forward our emergency department physicians we're starting a peer support program in our emergency department and one of the doctors said so that means we're going to have more mark Mays available in the emergency department all the time. That was huge right and so word spreads and it travels fast and just the outcomes and the support that they're able to provide to our patients and our nurses and our physicians and everyone else across our health system at all different access points. I think really helps to drive this forward and help our organization understand how important this work is to continue and hopefully expand someday with that said we have an excellent foundation team who helps us get philanthropic donations we write a lot of grants and we're really looking forward to the day that hopefully Montana Medicaid is able to. And provide reimbursement for community health worker. And so Medicare recently uh last year started providing reimbursement for community health workers which is great and helpful and so once we can get reimbursement across the system we'll really be able to expand community health workers not only within our organization but statewide mark do you have something to add.
Mark Nay
Yeah it was it was a really good question and and Kayla explained that really. But kind of the first thing that came to mind and and I'm not so much always involved in the community big picture look at this because I I'm more of the hands on day-to-day working with individuals but the first thing that came to my mind when we when we talk about sharing with our community what it is that we do is data and so that's a big. The big reason why we collect data is to show the what the impact is of actually helping people and what we've come to learn is that it is not just. The right thing to do to help those that need help in our community but it is also very cost effective to help people rather than not help people and so we want to paint a picture to our community and those that think any pockets within our community that thinks it's not worthwhile to help some of the people that were helping is as we can show them some of the the cost savings and the benefits. And and how the the overall cost savings do affect and impact our community now on a day-to-day basis and and you know really trying to stay steady. With people one of the things that I love about my job and the people that I that get referred to our program is oftentimes the the individuals that get referred to fuse many organizations have already worked with and they just don't know what to do with them and so we get the opportunity to. Really step in with really probably the most complicated in our community and I look at it as my job is to to to not push this person away but no matter what they have going on in their in their day is to keep showing up. For them and over time what happens and it doesn't happen immediately and as as you asked him the question there is an incredible amount of really ups and downs and successes and failures and forwards and backwards but what's important to build the relationship is we keep showing up and we keep showing up for people no matter what. And and in that overtime those little backward steps become less and less in forward progress becomes more and more and we're able to overtime and just through a real steady approach in not giving up on a person is. Uh point them to some just uh much better outcomes in their own life and and not just that but really help instill within each each patient that we work with beliefs in themselves and and you start to it's really incredible because you see human beings. That really believe in this idea that they can't they start to realize that they can and when they start to realize that they can incredible progress happens and we start to see them find build a relationship with their very best selves and that's a beautiful thing. To watch.
Trina Filan
Yeah you get to help people remember their essential humanity their dignity and their value as people in the world and that's wonderful and you make a really great point I mean you know some of those stories and some of the difficulties of moving forward.
Margeret Mullins
And moving backwards that's that's real life that's. Reality and you know you also mentioned data right people sometimes don't want to be bothered with numbers but the data you you know it's important to be able to show people what what that looks like on paper because some people don't understand what that boots on the ground day-to-day activity entails maybe they just relate to the numbers. And the dollar figures do matter too how does that work out for an organization like Saint Peters and so those things all come into play. OK you also brought up something Caleb about the doctors being so so supportive and and all the staff frankly it sounds like is supportive I think that's a really important thing to highlight that. When you're in an organization especially as big as Saint Pete you need to have some support from everyone involved it's really hard you can't act in a silo and something that's this huge and that has this much overlap with everybody in the?
Kayla Morris
System I think one of the most important pieces of really ensuring that our stakeholders understand the value of this work is knowing my audience right and so before before I answer someone 's question or communicate the value of this program it's really important for me to understand what they care about right because. I don't have 3 hours. Tell them everything that our community health workers do and how this impacts and so my ability to understand what pieces they're going to find the most valuable and tailoring my messaging to that I think is really really a key component right when we talk to our county and city officials they want to hear something different than our hospital executive leadership team. Who wants to hear something different then maybe a nonprofit who's just curious or maybe a concerned citizen who skeptical? Right and so really I think the relationships are community health workers have been able to build with our community the data that speaks for itself and just an understanding and an appreciation and a value and a belief in this program helps to drive that messaging.
Mark Nay
Whatever the things I really wanted to comment on as we talk about how our doctors and our care teams see us within our organization and they are really supportive of what we do and I think it's so important and the reason that we have community health workers is that allows the doctor to be the doctor and that allows the nurse to be the. Nurse and that lets me kind of step in and do the things that a doctor and a nurse that they shouldn't have to do they shouldn't have to be an expert in the community and they shouldn't have to be an expert in where does somebody go to get food that allows them to focus on really put all of their energy into the care of the people that they're working with. And allows us on the back end to take care of all of the things that we can help with within the framework. Of the community. And so I think that's a an incredible part of what it a community health worker. It does and as well when we talked about the the the community health work worker training that we did one of the things that really stood out to me was this comment that the role of a community health worker is to enhance the Caribbean offered by the care team and so we're really able to give voice give some voice within the community. If reminders to the people that we work with of what the doctor and the nurse is really looking and expecting from the them the? Awesome.
Margeret Mullins
Yeah and you you summed that up beautifully mark because it's really clear to us and some of the work that we do that healthcare providers themselves being asked more and more to address social determinants of health they lack capacity they may have the heart and the will but they don't have the capacity and as you just said. Community health workers really step in in that space to help them meet the needs.
Kayla Morris
And I just want to reiterate the the importance of the community health partners as it relates to social determinants of health is so important as we know 80% of your health outcomes are factors outside of medical care so you can provide the best medical care in the world and. Without addressing the social needs that individuals have that care doesn't it's not going to long term take the effect that we're hoping. Well and so having the experts in the social aspect right being able to meet patients where and really understand and get the true story that's going on because we feel comfortable with the community health worker to say hey I actually don't have a place to store my insulin that's why I haven't been taking it it's not because I'm afraid of needles is important and it's valuable and it helps us get. The outcomes we desire for our patients and our patients to get the outcomes that they they desire for themselves.
Margeret Mullins
Absolutely it's that that whole wrap around of services and need that people have and no one entity can fulfill it all this is so much great information we've asked a lot of big questions I I'm just curious if you have anything else you might want to add or you know to the conversation today.
Kayla Morris
You know I I might just say that if there is individuals who are listening who are interested in starting a community health worker program especially within the health system I encourage them to do it it it can be an uphill battle it can be difficult to help explain to stakeholders the importance and value of a community health worker especially if your state doesn't license them. Right I remember often hearing what do you mean you're going to send an unlicensed individual into a patients home to help them with their medical care plan and I understand why that that created some concern for individuals.
Speaker
So.
Kayla Morris
It's worth it though and and I encourage it and I think that there's some critical things that you'll learn along the way but one of the things we learn the most is our community health workers have a a debit card available to them that they can put just the random expense. Lot sometimes you need. To buy some more cup of coffee to get them to engage that day. And we want to make sure that we're not missing our ability to connect with individuals over a small expense having company vehicles that has allowed us to solve the transportation barrier in a community where we don't have fantastic public transport. And ultimately I think leadership is really important leaders need to really understand what's important for a community health worker and what that role looks like I often joke that if they're in the clinic too much they're probably not doing their job super well they need to be out in the community right and so. Sometimes you end up in situations I've heard about times or community health workers or primarily in the office and with being within those 4 walls defeats the purpose of the community health worker right it's to get them outside of those. And so really I think I would encourage any leader who supports community health workers to really listen to your community health workers to hear what their needs are to hear what their struggles are and a lot of them that safe place to vent their jobs are taxing and everything we can do to get out of their way and help remove other barriers and support them in it I think really. Adds long term value and success to your community health worker program.
Margeret Mullins
And Saint Peters health fuse program is certainly an amazing example of just that all of those things are happening in this community and your CHW 's are doing astounding work so I thank you.
Mark Nay
Oh well that was very well said by Kayla and I think if I was to maybe just to kind of close up I get asked a lot what what a community health worker does and here's what I would want people to know about what it is. We do is I look at it this way is is I help people create a road map to their own health and we look at health in 2 ways and we look at health as doctors and medicine and the standard healthcare system and that is a critical part of a person 's health but it's also really important to recognize and and I think my role as a community health worker. Is to help our community and individuals? There's no that the other part of health is what is your relationship with your community and how do you find health within your community how do you find connections how do you find food how do we make sure that you're insured how do you how do we make sure that you have the things that you need and how do we connect you to build a really healthy relationship with your community. And and if you can combine those 2 things doctors and medicine and a healthy relationship with your community then the outcomes for the person are really into.
Margeret Mullins
Thank you so much for that I think that's absolutely true and it's a living example right here in Helena so thanks again to both of you Kayla and mark for the time that you've taken today and thank you so much on behalf of Trina and myself and the crew behind the scenes thank you also to our guests. Who are working intently on developing comprehensive housing and care services for people experiencing housing instability in? Yes if you would like more information on what was discussed today visit our website at talking health and the406.mt.gov where there will be links to the information discussed and if you haven't already Please remember to rate review and subscribe to our podcast and until next time be healthy and be well.