One of the ways The Nicholson Foundation has worked over the past several years to improve the health of vulnerable populations in New Jersey is to support and help sustain initiatives to expand the number of Community Health Workers (CHWs).
Often members of the communities they serve, CHWs are frontline public health workers including home health aides, doulas, family resource specialists, health navigators, and peer counselors. Because of their intimate understanding of the cultures, languages, and challenges of their neighborhoods, CHWs are trusted by the people they serve. A base of evidence has long pointed to the effectiveness of CHWs, but over the past few years a marked increase in studies has demonstrated their value in improving health outcomes, lowering healthcare costs, and reducing inequities.
Guided by this evidence, The Nicholson Foundation in recent years has made the expansion of CHWs in New Jersey a strategy to address inequities in our healthcare system. The Foundation’s primary efforts to train and support CHWs to serve more people in the state have included:
Using CHWs to Lead Asthma Interventions
The Nicholson Foundation partnered with the New Jersey Department of Health (DOH) to launch the New Jersey Asthma In-Home Intervention Pilot Project, in 2017. This demonstration project employed CHWs to help families control environmental factors within their homes that trigger asthma. Over two years, CHWs made home visits to 172 children covered by Medicaid, ranging in age from 2-17, who were being treated for asthma. The program’s goals were to improve asthma outcomes, reduce healthcare costs, and demonstrate the sustainability and effectiveness of similar models. Early analysis shows that children enrolled into the program experienced fewer episodes of uncontrolled asthma than before the intervention. These improvements resulted in fewer missed school days, more children following a written asthma treatment plan, and caregivers missing less work because their children were sick.
Supporting Community Doulas
The Foundation worked with DOH and the State Medicaid office (a part of the Department of Human Services) to fund programs that recruit women of color and train them to become doulas. Doula care is associated with lower rates of cesarean sections, other obstetrical interventions, and health complications. Securing long-term funding to support doula care has been a key focus of this work. For example, a project stemming from the Nicholson-funded Medicaid Academy made it possible for DOH and State Medicaid staff to explore strategies to make doula work reimbursable by Medicaid. As a result of this work, since January 2021, New Jersey’s Medicaid program has been reimbursing for doula care. Furthermore, as the Foundation began winding down its work with the State because of plans to close in December 2021, it began partnering with The Burke Foundation on doula-focused grantmaking.
Founding the Institute to Train Future CHWs
Late last year the Foundation teamed up with DOH to create the Colette Lamothe-Galette Community Health Worker Institute, a program to train and certify CHWs. The Nicholson Foundation helped DOH secure a grant from the New Jersey Department of Labor’s Growing Apprenticeship in Non-Traditional Sectors program, which is the Institute’s primary funder. The Foundation also made a grant to Seton Hall University School of Law to assist with the Institute’s launch. The Institute is named for Colette Lamothe-Galette, a former Senior Program Officer who led The Nicholson Foundation’s CHW efforts until she passed away from COVID-19 on April 4, 2020.
The Nicholson Foundation hopes others will want to build on these efforts as expanded use of CHWs show promise in improving health, lowering costs, and addressing inequities in New Jersey.