Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs FEBRUARY 2023 AUTHORS Jacqueline Miller, BA; Amy Quan, MPH; and Susan Chapman, RN, PhD, FAAN, Healthforce Center at UCSF Contents About the Authors 3 Executive Summary Susan Chapman, RN, PhD, FAAN, is a pro- fessor of social and behavioral sciences in 5 Summary of Training Program Characteristics the School of Nursing at UCSF and is a fac- ulty affiliate of the Philip R. Lee Institute 13 Methodology for Health Policy Studies (IHPS) and 14 Appendices Healthforce Center at UCSF. A. Active and Future Programs Amy Quan, MPH, is a research analyst at B. Inactive Programs (Paused or Ended) Healthforce Center at UCSF. C. Program Content and Curriculum for All Programs Jacqueline Miller, BA, is a senior research 53 Endnotes data analyst with IHPS at UCSF and is affili- ated with Healthforce Center at UCSF. IHPS is an interdisciplinary collection of con- cerned researchers who share a mission - to improve health and transform health care in the United States by working across competing interests, collecting evidence, informing policy, and improving practice. About the Foundation The California Health Care Foundation (CHCF) is dedicated to advancing meaning- ful, measurable improvements in the way the health care delivery system provides Understanding California's Community Health care to the people of California, particularly Worker/Promotor Workforce: The Series those with low incomes and those whose Despite being a critical part of California's health needs are not well served by the status quo. workforce, there are relatively little comprehensive We work to ensure that people have access data on community health workers and promotores to the care they need, when they need it, at (CHW/Ps) in California. With funding from CHCF, a price they can afford. Healthforce Center at UCSF fielded surveys of CHW/Ps, the institutions that train them, and the CHCF informs policymakers and industry organizations that employ them. The survey data, leaders, invests in ideas and innovations, published in a series of reports, paint a more complete picture of the current CHW/P workforce and connects with changemakers to create as well as challenges and opportunities related to a more responsive, patient-centered health training and employment. This picture can inform care system. policy decisions as the state looks to support and expand this important workforce. To learn more, visit www.chcf.org/collection/ understanding-californias-community-health-worker- DESIGN BY DANA KAY HERRICK promotor-workforce. Executive Summary In California, one of the most culturally diverse states some programs were unable to provide responses in the country, health care must bridge cultural and for all requested information, limiting conclusions linguistic divides to serve all communities equitably. that can be drawn across all programs. Missing data As trusted community members with lived experi- were particularly apparent in the following fields: ence, community health workers and promotores program completion rates, job placement rates, (CHW/Ps) have a long history of connecting those and student demographic information. not well served by the traditional health care system with culturally competent health and social services. There may be additional training programs that are not identified in this report, particularly given the There is increasing recognition in California that number of community-based, grassroots organiza- CHW/Ps are a critical part of the health care tions that deploy CHW/Ps in their communities. If workforce. In 2019, the California Future Health you would like your program's information to be Workforce Commission recommended scaling the included in report updates, contact Carlina Hansen, CHW/P workforce to broaden access to preventive senior program officer at the California Health Care and social support services as well as team-based, Foundation. integrated primary and behavioral health care. Key findings from the collected data include the Currently, there are no standardized training curri- following: cula or requirements for CHW/Ps in California, and $ While California has a diversity of CHW/P little is known about the number and scope of the training programs administered in different training programs that are offered in the state. The settings, they are relatively limited in certain purpose of this report is to describe CHW/P educa- regions. We identified and collected information tion and training programs in California, including from 40 CHW/P education/training programs in details about program location(s), delivery mode, the state. length and more. $ Twenty-fiveof these 40 programs were active Healthforce Center at UCSF identified programs as of December 2021. through established connections from previous $ Among active programs, 14 were college/ projects and by searching the web. All identified university-based (across 11 schools), 10 were programs were asked the same set of questions; organization-based (across 10 organizations), some provided information via email, and others and one was high school-based. provided it via Zoom. See Methodology for more details. $ Most active training programs (17) are concen- trated in the Bay Area and Greater Los Angeles While this report captures a majority of the CHW/P area. While a few training programs offer state- education and training programs in California, it is wide training (e.g., Vision y Compromiso, El Sol not a comprehensive description of all programs Neighborhood Education Center, and Transitions in the state.1 Some programs may have been Clinic Network), opportunities for training are missed, and some programs did not respond to limited in some parts of the state (see Figure 1, our requests for program information. Additionally, page 4). Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs 3 Figure 1. CHW/P Training Programs in California Future Active Inactive Launch Santa Rosa Sacramento Santa Rosa Junior College Futuro Health at Mercy College of Health Sciences Center for Well-Being Sacramento City College San Francisco Valley High School Transitions Clinic Network Homeless Prenatal Program Berkeley City College, Berkeley City College of San Francisco Cañada College, Redwood City Mission College, Santa Clara (1 active, 1 inactive) Bakersfield Foothill College, Los Altos Hills Evergreen Valley College, San Jose Cabrillo College, Aptos Bakersfield College Promotoras con Alma Monterey Peninsula College, Monterey San Bernardino Los Angeles El Sol Neighborhood Educational Center Loma Linda University Health, Los Angeles County Department of Public Health San Manuel Gateway College Visión y Compromiso Worker Education & Resource Center, Inc Esperanza Community Housing University of California Riverside Extension, Riverside AltaMed Latino Health Access, College of the Desert, Palm Desert Charles R. Drew University of Medicine and Science Santa Ana San Diego City College, San Diego Chula Vista Community Collaborative, Chula Vista Public Health Institute (Northern Adverse Childhood Experiences Collaborative of the Population Health Innovation Lab), Online Note: The map represents the locations where these programs are based and does not reflect additional training locations, if additional locations are offered. Source: Author analysis of CHW/P training programs in California. $ There is a mix of well-established and newer $ A majority of active programs (18) offered programs. Of all the active programs (exclud- general, rather than specialized, CHW/P ing the high school-based program), nearly half training. General training consists of building (11, 46%) had been in existence for more than core skills, such as health communication and 10 years, and nearly half (11, 46%) launched in education, motivational interviewing, and advo- the last 5 years. Two (8%) were between 5 and cacy. Specialized training involves building 10 years old. specialty skills related to specific clinical condi- tions (e.g., diabetes or asthma) or populations (e.g., people who were formerly incarcerated or young children). California Health Care Foundation www.chcf.org 4 $ There is little consistency in program length. The 14 active college/university-based programs Program length and duration varied considerably were offered across 11 unique schools. One uni- between college/university-based programs and versity offered multiple CHW/P training programs, organization-based programs. or "tracks." Half of these active programs were for credit, while the other half were not for credit. The $ College/university-based programs ranged one high school-based program was offered at one from 8 weeks to 3 semesters in length and campus. averaged 283 didactic hours/program (range: 80 to 816 hours). We identified 10 active organization-based pro- $ Organization-based programs ranged from 1 grams across 10 unique organizations. Several of to 12 weeks in length and averaged 87 didac- these organizations offered multiple specialty train- tic hours/program (range: 10 to 400 hours). ings in addition to the general CHW/P trainings described in this report. Summary of Training Details about these active CHW/P training programs are provided in Tables A1 to A8 in Appendix A. Program Characteristics Different tables reflect different sections of the We identified 40 active and inactive education/ survey that probed on details such as program training programs for CHW/P work in California, location, program duration and length, program 24 of which were college/university-based,2 15 of specialty, instructor qualifications, prerequisites for which were organization-based,3 and one of which enrollment, completion/graduation requirements, was high school-based. program completion rate, and more. Appendix C provides more details about program content and Among the 40 total programs identified, 25 were curriculum. active. Fourteen of the active programs were col- lege/university-based, one was high school-based, Tables 1 through 4 in the body of this report syn- and 10 were organization-based. The inactive thesize key takeaways or highlights that emerged programs include programs that had ended, had from each section of the survey, when looking paused, or were newly developing.4 This narra- across all 25 active programs, as well as specifically tive summarizes information only about the active at active college/university-based and organization- programs, although the tables in Appendix A based programs. Readers should refer to the tables include information on active and future programs in Appendix A for further details about any given together. Information about inactive programs that active program. have ended or have been paused can be found in Appendix B. Programs that commented on the rea- sons for their pause or closure indicated a lack of funding, lack of student demand, and/or lack of a CHW/P job market for future program graduates. Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs 5 Table 1. K ey Takeaways about General Program Information among Active Programs (See Tables A1 and A2 in Appendix A for more details.) LOCATION(S) All Active Programs $ Most active programs were located in either the San Francisco Bay Area (8) or the Greater Los Angeles area (9). $ Only 5 active programs took place outside of these areas, in Sacramento, Monterey, Chula Vista and Bakersfield (2). $ Two active programs were offered completely online. $ One program was high school based (Sacramento). $ While some programs based in the Bay Area or Los Angeles provided training in other parts of the state, training opportunities remained limited in large swaths of the state, including the far north and the Central Valley, where no programs were located. College/University-based Programs $ The Bay Area and Greater Los Angeles area both have 5 programs. $ The 5 Bay Area programs were offered across 5 colleges/universities. $ The 5 LA programs were offered across 2 colleges/universities (one university offered 4 programs). $ Three college-based programs were offered outside of the Bay Area and Greater Los Angeles area: in Bakersfield, Monterey, and Sacramento. $ One online-only program was conducted through a college located outside of California, but the program was offered only to California residents, regardless of where they lived in the state. Organization-based Programs $ While a few organization-based training programs offer statewide training (e.g. Vision y Compromiso, El Sol Neighborhood Education Center, and Transitions Clinic Network), opportunities for training are limited in some parts of the state. $ The Bay Area offered 3 programs across 3 organizations. Two of the programs were population-specific (e.g., formerly incarcerated with complex conditions, families with minor children), and one was an apprenticeship program. $ The Greater Los Angeles area offered 4 programs across 4 organizations. Three of these organizations offered general/ basic CHW/P training, although they also offered additional population- and disease-specific trainings. $ Among the 3 programs offered outside of the Bay Area and Greater Los Angeles area, one was based in Bakersfield and served the Central Valley, one was located in Chula Vista, and one was located in Santa Rosa. FREQUENCY OF OFFERING AND CREDIT All Active Programs $ Most college/university-based programs offered trainings every semester, and most organization-based programs offered trainings on an as-needed basis. $ Only college/university-based programs offered credit for classes, although one organization-based program's training was provided by a local college (Homeless Prenatal Program education provided by City College of San Francisco). College/University-based Programs $ Most programs (11) were offered each semester; others were offered annually. $ Seven programs were for credit; 7 programs were not for credit. Organization-based Programs $ Frequency of program offerings (6) varied significantly and depended on funding and demand. $ One program offered a one-time training for existing staff. $ One program was considered for credit because it contracted with a college to provide didactic/lecture training. California Health Care Foundation www.chcf.org 6 Table 1. Key Takeaways about General Program Information among Active Programs, continued PROGRAM INITIATION AND END DATES All Active Programs $ Of all the active programs (excluding the high school-based program), nearly half (11, 46%) had been in existence for more than 10 years, and nearly half (11, 46%) launched in the last 5 years. Two (8%) were between 5 and 10 years old. $ The high school-based program was a little under 10 years old. $ More organization-based programs were established earlier compared with college/university-based programs. College/University-based Programs $ The earliest offered program was established in 1992 (City College of San Francisco). $ The majority of programs (9) originated in the 2010s. Organization-based Programs $ The earliest offered program began in 1989 (Homeless Prenatal Program). $ Several programs (4) originated in the early 2000s. PROGRAM LENGTH AND DURATION All Active Programs $ Generally, college/university-based programs were longer in length than organization-based programs. College/University-based Programs $ Program duration varied greatly, ranging from a minimum of 8 weeks to a maximum of 3 semesters. $ Program length ranged from 80 to 816 didactic or lecture hours and averaged 283 hours/program. One program reported that program length depended on market demand. $ Among the 12 programs that had a mandatory internship/externship/practicum component, the length of the intern- ship/externship/practicum ranged from 54 to 840 hours and averaged 204 hours per program. Organization-based Programs $ With the exception of the apprenticeship program (which lasted 16 months), program length ranged from 1 to 12 weeks. $ Several programs (4) reported that the length of the training varied depending on the type of training being provided. $ Among the 9 programs that reported a defined length, program length ranged from 10 to 400 didactic or lecture hours and averaged 87 hours/program. $ Only one program had a mandatory internship/externship/practicum component, which was the apprenticeship. Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs 7 Table 2. K ey Takeaways about Instructional Details Among Active Programs (See Tables A3 and A4 in Appendix A for more details.) PROGRAM SPECIALTY All Active Programs $ Among all active programs, the majority (18) offered only general training. The remaining 6 programs were specialty- focused or offered specialty trainings in addition to their general training program. $ Specialties included population-specific foci, including families with small children and people recently released from incarceration. Several programs also have health-specific foci, including behavioral health, chronic disease prevention and management, and nutrition. College/University-based Programs $ Almost all (13) were general programs; the other was behavioral health specific. Organization-based Programs $ Half were general and half either were specialty-focused or offered specialty trainings in addition to general training. STUDENTS PER COHORT All Active Programs $ College/university-based programs averaged more students per class/cohort than organization-based programs. College/University-based Programs $ Among schools that reported this information, the average number of students per class/cohort ranged from 7 to 74, for an overall average of 25 students. Organization-based Programs $ Among organizations that reported this information, the average number of students per class/cohort ranged from 3 to 30, for an overall average of 18 students. $ Two programs trained existing staff, one of which included non-CHW/P staff. INSTRUCTOR CREDENTIALS All Active Programs $ Instructors in both the college/university and organizational settings had a wide range of qualifications and experience. Examples of these instructors' credentials included master's-trained professionals (e.g., MPHs, MSWs), doctoral-trained professionals (e.g., PhDs, DrPHs), nursing faculty, medical assisting faculty, experienced CHW/Ps, and executives. $ Organization-based programs did not rely on master's- or doctoral-trained professionals as much as college/university- based programs. College/University-based Programs $ Most programs' (8) instructors were master's- or doctoral-trained. Organization-based Programs $ Instructors in organization-based programs had varied qualifications, such as master's training, experience as a CHW/P or public health worker, and employment at a particular organization. California Health Care Foundation www.chcf.org 8 Table 2. Key Takeaways about Instructional Details Among Active Programs, continued DELIVERY MODE AND LANGUAGES OFFERED All Active Programs $ Prior to the COVID-19 pandemic, many programs (6) operated using a hybrid model and maintained the hybrid model throughout the pandemic. $ Prior to COVID, several programs (5) operated using a remote model and maintained the remote model throughout the pandemic. $ A majority of programs (13) adapted their delivery mode during the pandemic, with most opting for an entirely remote model. $ Half of all programs were taught only in English. The other half included complete Spanish instruction or incorporated a Spanish instruction component into the program. $ Organization-based programs offered more instruction options in Spanish compared to college/university-based programs. College/University-based Programs $ Most programs (8) indicated that delivery mode changed during COVID. Among these programs, prior to COVID, programs either were held entirely in-person (2) or used a hybrid model (6). Post-COVID, programs shifted to either a hybrid model (1) or an entirely remote model (7). $ The remaining 6 programs indicated no change in their delivery mode during COVID. Four of these programs maintained a hybrid model, and 2 programs maintained an entirely remote model. $ Most programs (9) offered instruction only in English, with one also providing ESL (English as a second language) instructors. The remaining 5 programs offered trainings in Spanish or incorporated Spanish into certain components of the training (e.g., written materials only, role-playing). Organization-based Programs $ Half of programs indicated that delivery mode changed during COVID. Among these programs, prior to COVID, 4 programs were held in-person only (the other was an online-only course). These 4 programs shifted to either a hybrid (2) or completely virtual model (2). The other half maintained either a hybrid (2) or entirely virtual model (3). $ Three programs were taught only in English, and one program was taught only in Spanish. The remaining 6 programs provided some form of Spanish instruction if needed/desired. Note: The terms online or virtual could refer to either synchronous or asynchronous training. Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs 9 Table 3. K ey Takeaways about Program Requirements and Costs Among Active Programs (See Tables A5 and A6 in Appendix A for more details.) PROGRAM PREREQUISITES/REQUIREMENTS AND GRADUATION REQUIREMENTS All Active Programs $ Nearly half of programs (10) did not have any program prerequisites/requirements. For those programs that did, examples of prerequisites/requirements included taking a test to demonstrate proficiency in English, completing an introductory/foundational course, and having prior work experience in a community or health care setting. $ Across all programs, graduation requirements mostly consisted of completing the necessary coursework (sometimes with a grade of C or above) or attending all/most of the didactic sessions. College/University-based Programs $ Many programs (6) did not have any program prerequisites/requirements beyond having a high school diploma and having been accepted into the college/university. $ For programs that had prerequisites, they included taking a test to demonstrate proficiency in English, completing an introductory/foundational course, and having prior work experience in a community or health care setting. One program listed several recommended courses covering subjects such as Microsoft Office and medical coding. $ For all programs but one, graduation requirements consisted of completing the necessary coursework and internship/ externship/practicum, if this was a component of the program. Some programs required that students achieve a grade of C or higher to pass each class. Organization-based Programs $ Many programs (4) did not have any program prerequisites/requirements. Several programs (3) were offered only to staff at specific organizations, where current employment at that organization was required for program eligibility. With the exception of the apprenticeship program, other programs required that students demonstrate passion for, commit- ment to, and previous involvement in the community. $ Graduation requirements for all programs included attending all or most of the didactic sessions. INTERNSHIP/EXTERNSHIP REQUIREMENTS AND PARTNERS All Active Programs $ While almost all college/university-based programs required an internship/externship, almost none of the organization- based programs did. College/University-based Programs $ Nearly all programs (12) required an internship or externship. Sometimes, the required length of the internship/extern- ship depended on whether it was paid. Among these 6 programs, 5 of them required 120 hours of an unpaid internship or 150 hours of a paid internship. $ Internship/externship partners included community-based organizations, local clinical settings (e.g., community clinics, hospitals), health plans, and the public health department. Organization-based Programs $ With the exception of the apprenticeship program, none of the programs required an internship or externship. One program allowed for an optional internship/externship of up to 240 hours, paid or unpaid. California Health Care Foundation www.chcf.org 10 Table 3. Key Takeaways about Program Requirements and Costs Among Active Programs, continued STUDENT PROGRAM COSTS All Active Programs $ Costs for students varied considerably among programs. College/university-based programs were more expensive than organization-based programs, most of which offered their programs for free. College/University-based Programs $ Tuition ranged from $538 total to $6,450 total among programs that did not have separate costs for residents versus nonresidents. $ A few programs (3) offered their programs for free, one of which had a residential requirement for free tuition. Organization-based Programs $ Most programs (6) were offered at no cost to participants. The cost of 3 programs varied depending on the type and format of training and whether the course was taught individually or in a group. One program required only that students purchase their own textbook for $90. Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs 11 Table 4. K ey Takeaways about Student Information from Active Programs (See Tables A7 and A8 in Appendix A for more information.) PROGRAM COMPLETION RATE AND JOB PLACEMENT All Active Programs $ Among programs with available data (14) and excluding the high school program, all but one reported a program completion rate of 90% or above. $ Among programs with available data (7) and excluding the high school program, reported job placement rates ranged from 50% to 100%, with most reported rates at 90% or above. College/University-based Programs $ Among programs with available data, all but one reported a program completion rate of 90% or above. $ Most programs did not collect data on whether graduates received jobs soon after graduation. Those that did reported high rates of job placement. Organization-based Programs $ Among programs with available data, all reported a program completion rate of 90% or above. $ Among programs with available data, placement rates range from 67% to 92%. STUDENT FOLLOW-UP POST-COMPLETION All Active Programs $ Most programs (16) kept in touch with former program participants through informal means, such as via LinkedIn, Listservs/email, newsletters, Google Groups and Facebook. Some organization-based programs held regular meetings that could be attended by graduates as desired. College/University-based Programs $ Most programs (9) had some form of communication with graduates, although most of it was informal through the use of LinkedIn, Listservs, Google Groups and Facebook. Organization-based Programs $ Most programs (7) had some form of communication with graduates, with several holding regular meetings that could be attended by graduates. Other programs kept in touch with students via email, monthly newsletters, and Facebook. STUDENT DEMOGRAPHIC INFORMATION All Active Programs $ Half of programs did not report student demographic information. $ Among those that did report information, the student population was overwhelmingly female. College/University-based Programs $ Many programs (6) did not report student demographic data. Several programs that did provide data did not systemati- cally collect these data; as such, many programs provided anecdotal information. $ Colleges and universities that did report these data reported significantly more female than male students. $ With the exception of gender, programs reported having diverse student populations in categories such as race/ethnic- ity (although many had high Latinx enrollment), age, and educational background. Organization-based Programs $ Most programs (6) did not report student demographic data. Those that did mostly reported anecdotal information. $ Most participants identified as female and as Latinx, and many were fluent in Spanish. California Health Care Foundation www.chcf.org 12 Methodology For this analysis, we classified CHW/P education To collect information from each program, we and training programs as either college/university- started by emailing representatives from each based or organization-based, with the exception of school or organization with a list of questions. one program that was high school-based. College/ Because we had already established contacts at university-based programs - both public and some of these schools and organizations, we knew private - were offered at postsecondary institu- the correct people to email in most cases. For the tions. Organization-based programs were offered university/college-based programs identified by at community-based organizations, such as non- HWI, we had email introductions facilitated by their profits (including health centers) and county health staff members. For the college/university-based departments.5 programs identified by our systematic scan, we reached out to the most appropriate faculty and/ Programs were identified using multiple methods. or staff personnel that we could identify based on Initially, programs were identified based on the col- the information provided on their website. Several lective knowledge of the research team, which had programs responded to our email request. Some completed prior research about the CHW/P profes- preferred to provide information to us over the sion. We then used a snowball sampling method, phone, and we arranged Zoom calls and took notes asking faculty and/or program staff from those pro- during those calls when that was the case. grams that were interviewed first if they knew of other education or training programs in the state. After program information was collected, we reviewed each response. Later, we followed up with For college/university-based programs, we worked the programs that did not answer our questions closely with representatives from the Health completely, forgot to answer certain questions, Workforce Initiative (HWI), who helped identify and/or required clarification about what we were programs across the state. We also conducted a asking. We confirmed program responses we felt systematic scan of each college in the state, broken were ambiguous. down by county. Once we identified all colleges, we checked their websites for information about CHW/P education/training. If the website indicated that they had a CHW/P program, we included them. For organization-based programs, we mostly relied on previous knowledge and snowball sampling. We also conducted several thorough web searches in an effort to identify additional programs. Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs 13 Appendix A. Active and Future Programs Table A1. General Program Information: Active and Future College/University-Based Programs HOW OFTEN YEAR FOR SCHOOL/PROGRAM(S) LOCATION(S) OFFERED BEGAN PROGRAM DURATION/LENGTH CREDIT Bakersfield College Bakersfield Every 2017 2 semesters Yes Health Navigator Certificate semester 378 lecture hours and of Achievement 180 to 225 internship hours* (depending on whether it's paid or unpaid) Berkeley City College Berkeley Fall and 2018 1 semester No Community Health spring 105 hours Worker Degree and Certificate Program Cabrillo College Aptos, Every 2019 2 semesters Yes Community Health Worker Watsonville semester 816 lecture hours and Certificate of Achievement 120 internship hours Note: Cabrillo College also offers a non-credit program. Comprehensive data on this non-credit option were not collected, but the program's tuition is free, and earning the non-credit certificate requires the completion of 2 courses. City College of San Francisco San Francisco Once a year, 1992 2 to 3 semesters Yes Community Health beginning 306 to 324 lecture hours and Worker Program in the fall 128 to 150 internship hours College of the Desert Palm Desert N/A Expected 2 semesters Yes Community Health Worker: (expected to to start in 252 lecture hours and be offered fall 2023 Children and Families year-round) 162 lab hours Certificate of Achievement Evergreen Valley College San Jose Every 2014 1 to 2 semesters Yes Patient Community Navigator semester 180 lecture hours and 120 to Certificate 150 work experience hours Foothill College Los Altos Hills Once a year TBD 1 year TBD Community Health Worker length TBD Certificate Program Futuro Health Online Twice a year 2021 9 months (3 quarters) N/A (education provided by Mercy College ~720 hours* of Health Sciences) Community Health Worker: Behavioral Health Program (certificate) Note: Credits at Futuro Health's program are transferrable to Bachelor's in Public Health or Healthcare Administration at Mercy College of Health Sciences. California Health Care Foundation www.chcf.org 14 Table A1. General Program Information: Active and Future College/University-Based Programs, continued HOW OFTEN YEAR FOR SCHOOL/PROGRAM(S) LOCATION(S) OFFERED BEGAN PROGRAM DURATION/LENGTH CREDIT Loma Linda University Health San Bernardino Fall, winter, 2011 Traditional: No San Manuel Gateway College spring 6 months over 2 quarters Clinic-Based Community Health 80 didactic training hours and Worker Training 200 practical experience hours $ "Traditional" track Intensive: $ "Intensive" track 9 weeks scheduled indepen- dent of academic schedules 150 didactic and skills lab hours and 250 practicum hours Community Health Worker 6 months over 2 quarters Foundations Training 100 didactic training hours and 100 practical experience hours School-Based Community Based on market demand, Health and Education usually contractual with school Worker Training districts 80 didactic and skills lab hours and 100 practicum hours Mission College Santa Clara Once a year, 2020 8 weeks No Community Health Worker beginning in 108 lecture hours and Certificate the summer 54 externship hours Note: Mission College also had a for-credit community health program with a behavioral health focus that ended ~8 years ago. It averaged 5 to 6 students per cohort. Monterey Peninsula College Monterey, Spring, fall 2020 2 semesters Yes Community Health Marina 300 lecture hours and Worker Certificate 120 to 150 internship hours Providence and Charles R. Los Angeles Twice a year 2021 6 months No Drew University of Medicine County 200 core training hours and and Science (CDU) 840 internship hours Providence-CDU Community Health Worker Academy (certificate) Sacramento City College – Sacramento Once a year 2019 3 semesters Yes Los Rios 423 lecture hours and Community Health Care Worker 120 to 150 internship hours Certificate Valley High School Sacramento N/A 2013 6 semesters Yes Health Tech Academy's 342 to 513 lecture hours and Community Health 50 fieldwork hours* Worker Certification Note: This is a high school-based program. *Program length is estimated based on the number of units required to complete the program and the number of hours that make up a unit. Notes: N/A is not applicable; TBD is to be determined. All survey data are available for download in Excel at www.chcf.org/chwpworkforce. Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs 15 Table A2. General Program Information: Active Organization-Based Programs HOW OFTEN YEAR FOR ORGANIZATION/PROGRAM LOCATION(S) OFFERED BEGAN PROGRAM DURATION/LENGTH CREDIT AltaMed Los Angeles, One-time training 2020 4 weeks: 2 weeks with Penn N/A (Penn Center for Community Orange County for existing staff trainer and 2 weeks of orient- Health Workers) ing CHWs to new systems and Community Health Worker technologies Program Full days for all 4 weeks (~160 hours) Center for Well-Being Sonoma County Varies depending 2008 5 weeks N/A Community Health Workers on funding; (program 15 hours as frequently as revamped in (certificate) 2019) 4 times a year Chula Vista Community Chula Vista On demand, 2008 Varies N/A Collaborative mostly on a (paused and CVCC Promotores Program monthly basis, for restarted in core competencies 2020) training only El Sol Neighborhood San Bernardino, Year-round, as 2004 Varies depending on training: N/A Educational Center Riverside (and requested $ El Sol has 211 training Community Health Worker/ offers trainings modules Promotor Training Center across the state $ 40 hours average (certificate) and nationally) Homeless Prenatal San Francisco Twice a year, in the 1989 16 months Yes Program spring and fall CCSF courses: ~400 hours (training provided by City College of San Francisco) Apprenticeship: ~1,160 hours Community Health Worker Internship: last 6 months of Training Program program (hours vary) (certificate) Latino Health Access Orange County As requested 1998 Varies depending on training: N/A The Promotor Training $ Basic promotor training completed over 4 full days $ ~32 hours average Note: Training offered to new staff when they are hired, and once a year to volunteers/interns. Latino Health Access also provided training and capacity- building support to outside groups for a fee and on a requested basis. Northern ACEs Online Year-round 2021 1 to 2 weeks N/A Collaborative/Population 60 hours for core coursework Health Innovation Lab, plus any additional courses a program of the Public Health Institute North State Community Health Worker Training and Resource Hub (certificate) Note: ACEs are adverse childhood experiences. California Health Care Foundation www.chcf.org 16 Table A2. General Program Information: Active Organization-Based Programs, continued HOW OFTEN YEAR FOR ORGANIZATION/PROGRAM LOCATION(S) OFFERED BEGAN PROGRAM DURATION/LENGTH CREDIT Promotoras con Alma Central Valley As needed 2019 Varies depending on training; N/A Promotoras con Alma core competency training is: (certificate) $ Completed over 9 weeks $ 20 hours Transitions Clinic Network San Francisco; 3 times per year 2012 12 weeks N/A (TCN) trainings offered 10 lecture hours TCN CHW Online Training nationally Course (certificate) Note: Training is only for CHW/Ps at a TCN-affiliated clinic and does not teach CHW/P core competencies. Visión y Compromiso Los Angeles; 10 to 17 trainings 2007 6 weeks N/A Promotoras Transformando trainings offered per year 48 classroom hours Familias y Comunidades nationally and (certificate) internationally Note: N/A is not applicable. Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs 17 Table A3. Instructional Details: Active and Future College/University-Based Programs AVERAGE # OF PROGRAM STUDENTS PER LANGUAGES SCHOOL/PROGRAM(S) SPECIALTY CLASS/COHORT INSTRUCTORS DELIVERY MODE OFFERED Bakersfield College General 15 to 25 Public Health Science Hybrid English Health Navigator Certificate faculty of Achievement Berkeley City College General 34 Master's-trained Pre-COVID: English Community Health Worker instructors Hybrid Degree and Certificate (MPHs, MSWs) During COVID: Program Remote Cabrillo College General 7 MPH instructors, Pre-COVID: English Community Health Worker ESL instructor In-person (courses have an ESL instructor to Certificate of Achievement During COVID: facilitate language Hybrid acquisition City College of San Francisco General 20 to 25 Working professionals Pre-COVID: English Community Health Worker in the public health In-person Program field classroom learn- ing and online assignments During COVID: Remote with core classes held synchronously and asynchronous work completed online Note Students can select courses to customize their certificate and receive training in different areas of emphasis, such as working with older adults or youth, supporting people coming home from incarceration (re-entry), or supporting people living with HIV or hepatitis diseases. College of the Desert Children 15 Nursing faculty; N/A English Community Health Worker: and their faculty with Master's (expected to start families in Public Health or offering program Children and Families in fall 2023) Certificate of Achievement additional degree Evergreen Valley College General Not Community college Hybrid English Patient Community Navigator available faculty Certificate Foothill College TBD TBD TBD N/A English, other Community Health Worker languages Certificate Program TBD Futuro Health Behavioral 74 BAs with experience Remote English; some (education provided by Mercy health in community health, materials College of Health Sciences) social work, and offered in Community Health Worker: behavioral health Spanish Behavioral Health Program (certificate) California Health Care Foundation www.chcf.org 18 Table A3. Instructional Details: Active and Future College/University-Based Programs, continued AVERAGE # OF PROGRAM STUDENTS PER LANGUAGES SCHOOL/PROGRAM(S) SPECIALTY CLASS/COHORT INSTRUCTORS DELIVERY MODE OFFERED Loma Linda University Health General CHW/Ps, MPHs, Pre-COVID: English and San Manuel Gateway College DrPHs, physicians In-person Spanish Clinic-Based Community and behavioral and hybrid Health Worker Training health specialists During COVID: $ "Traditional" track 11 Remote $ "Intensive" track 25 Community Health Worker General 11 See above See above English and Foundations Training Spanish School-Based Community General Not See above See above English Health and Education available Worker Training Mission College General 13 to 21 One instructor (RN, Remote English Community Health Worker PHN) with background Certificate in community health and nursing administration Note: Mission College also had a for-credit community health program with a behavioral health focus that ended ~8 years ago. It averaged 5 to 6 students per cohort. Monterey Peninsula College General Not Medical Assisting Hybrid English Community Health Worker available faculty Certificate Providence and Charles R. General 11 to 16 Trainers with master's Hybrid English with Drew University of Medicine degrees, experienced trainings and Science (CDU) CHW/Ps, guest speakers (e.g., role- Providence-CDU Community within the community playing) in Health Worker Academy health and research field Spanish (certificate) Sacramento City College – General 25 Adjunct instructors Pre-COVID: English Los Rios with Master's in Public In-person Community Health Care Health degrees During COVID: Worker Certificate Remote Valley High School High 70 Credentialed Health Pre-COVID: English Health Tech Academy's school / Science Career In-person Community Health Worker under- Technical Education During COVID: Certification served (CTE) teacher Remote (2020-21), students in-person (2021-22) Note: This is a high school-based program. Note: ESL is English as a second language; HIV is human immunodeficiency virus; hybrid delivery is in-person and remote; N/A is not applicable; TBD is to be determined. Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs 19 Table A4. Instructional Details: Active Organization-Based Programs AVERAGE # OF ORGANIZATION/ PROGRAM STUDENTS PER LANGUAGES PROGRAM SPECIALTY CLASS/COHORT INSTRUCTORS DELIVERY MODE OFFERED AltaMed Chronic disease 11 CHWs, Penn Center Remote Mostly English, (Penn Center for Community prevention and 1 coordinator, employees but trainer Health Workers) management 3 managers, was somewhat Community Health 1 director bilingual in Worker Program (one-time training Spanish.* for existing staff) *Instruction/training was in English; manuals were translated into Spanish; and students were able to ask questions, make comments, and receive responses in Spanish during the training. Center for Well-Being General (with a 12 to 30 Master's-trained, Pre-COVID: English Community Health focus on issues in experienced CHWs In-person Workers (certificate) Sonoma County) During COVID: Remote Chula Vista Community General 12 San Diego Futures Pre-COVID: English and Collaborative (existing staff) Foundation staff In-person Spanish CVCC Promotores During COVID: Program Virtual until mid-2021, then back to in-person El Sol Neighborhood General; offers 15 to 20 CHWs and public Hybrid English and Educational Center several culturally health experts Spanish Community Health sensitive curricula Worker/Promotor Training Center (certificate) Homeless Prenatal Families with 3 to 10 Homeless Prenatal Pre-COVID: English Program minor children Program coordinators In-person (training provided by City During COVID: College of San Francisco) Hybrid Community Health Worker Training Program (certificate) Latino Health Access General 10 to 25 CEO and founder Hybrid English and The Promotor Training of LHA (MPH, MD Spanish in Venezuela), chief program officer (MPH, MSW), senior program directors, senior coordinators and senior promo- tores with a collective combination of lived and technical experience California Health Care Foundation www.chcf.org 20 Table A4. Instructional Details: Active Organization-Based Programs, continued AVERAGE # OF ORGANIZATION/ PROGRAM STUDENTS PER LANGUAGES PROGRAM SPECIALTY CLASS/COHORT INSTRUCTORS DELIVERY MODE OFFERED Northern ACEs General; N/A N/A Pre-COVID: English; Collaborative/Population additional train- (Courses are asynchronous Online some courses Health Innovation Lab, ings available for and not led by instructors.) offered in During COVID: a program of the Public chronic illnesses Online and Spanish Health Institute and healthy in-person if North State Community lifestyles needed Health Worker Training and Resource Hub (certificate) Notes: ACEs are adverse childhood experiences; Chronic illness trainings are available for diabetes/prediabetes and oral health disparities. Healthy lifestyles trainings are available for behavioral health care, depression, anxiety, promoting healthy lifestyles, substance use, and supporting tobacco cessation. Online work is distinguished from remote work when coursework is completed asynchronously. Promotoras con Alma General; 10 to 11 Executive director, Remote Spanish Promotoras con Alma additional train- managing director (certificate) ings available for chronic illnesses, working in groups, and families with children with special needs Transitions Clinic Patients with 6 to 8 Senior CHWs Remote English Network (TCN) complex, chronic TCN CHW Online physical and Training Course behavioral health (certificate) needs who are recently released from incarceration Note: Training is only for CHW/Ps at a TCN-affiliated clinic and does not teach CHW/P core competencies. Visión y Compromiso General 25 to 30 Approved and Pre-COVID: English and Promotoras experienced In-person Spanish Transformando Familias y facilitators During COVID: Comunidades (certificate) Hybrid Note: Hybrid delivery is in-person and remote; N/A is not applicable. Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs 21 Table A5. Program Requirements and Costs: Active and Future College/University-Based Programs PROGRAM INTERNSHIP/ PREREQUISITES/ GRADUATION EXTERNSHIP SCHOOL/PROGRAM(S) REQUIREMENTS REQUIREMENTS REQUIREMENTS COST Bakersfield College None 18 units of core Unpaid: Residents: ~$1,104 Health Navigator courses 180 hours (plus additional student fees) Certificate of 3 elective units Paid: 225 hours Nonresidents: ~$6,792 Achievement 3 units of internship (estimated) (plus additional student fees) or alternative 3-unit course Each course requires a grade of C or above INTERNSHIP/EXTERNSHIP PARTNERS: Community partners, including Kern Family Health, Adventist Health, Central Valley Tobacco Control Policy, and others Berkeley City College None 2 courses None No cost to students Community Health Worker Degree and Certificate Program Cabrillo College IBEST English language 11 units of Unpaid: <$900 Community Health assessment core courses 120 hours $40 to $80 for textbook Worker Certificate of 3 elective units Paid: 150 hours used in core courses plus Achievement 2 units of additional costs for other internship required books INTERNSHIP/EXTERNSHIP PARTNERS: Second Harvest Foodbank, Peer Ambassadors at Cabrillo College, Salud Para La Gente, Center for Community Action, Monarch Services Note: IBEST is Integrated Basic Education and Skills Training. City College of Enrollment in college 14 units of Unpaid: San Francisco residents: San Francisco Intro to CHW course core courses 120 hours free Community Health (1 unit) 3 to 4 units Paid: 150 hours California residents living Worker Program (sometimes waived for of electives outside of San Francisco: CHW/Ps already working $782 to $828 ($46/credit) in the field) 2 units of (plus one-time fees each semes- internship ter ranging between $23 and $26) A final performance- $50 to $90 for textbook based exam (PBE) used in core courses plus additional costs for other required books INTERNSHIP/EXTERNSHIP PARTNERS: Local employers, such as health center, hospital, public health department, or community-based nonprofit agency College of the Desert None 17 units of courses None $255 (excluding books and supplies) Community Health Worker: Children and Families Certificate of Achievement California Health Care Foundation www.chcf.org 22 Table A5. Program Requirements and Costs: Active and Future College/University-Based Programs, continued PROGRAM INTERNSHIP/ PREREQUISITES/ GRADUATION EXTERNSHIP SCHOOL/PROGRAM(S) REQUIREMENTS REQUIREMENTS REQUIREMENTS COST Evergreen Valley 6 recommended courses 10 units of Unpaid: $538 College that can be completed coursework 120 hours Patient Community either before starting 2 units of work Paid: 150 hours Navigator Certificate the required courses or experience concurrently: $ Microsoft Office $ Medical Coding $ Blueprint for Success $ Introduction to Ethnic Studies $ Life Management $ Personal Growth and Adjustment INTERNSHIP/EXTERNSHIP PARTNERS: Information not available. Foothill College TBD TBD TBD TBD (program not yet offered) Community Health Worker Certificate Program Futuro Health 18 years of age or older 3 courses None Tuition waived during (education provided High school diploma/ COVID-19 pandemic; $100 by Mercy College of nonrefundable registra- GED Health Sciences) tion fee and $20/month Interest in: membership for education Community Health Worker: Behavioral $ Working with patients and training as part of the Health Program $ Community work application process. (certificate) Nonaffiliated students: English proficiency $3,200 Legally allowed to work (includes textbooks in the US and simulation) Computer and internet proficiency Reliable internet access Own a computer and webcam <7 years old Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs 23 Table A5. Program Requirements and Costs: Active and Future College/University-Based Programs, continued PROGRAM INTERNSHIP/ PREREQUISITES/ GRADUATION EXTERNSHIP SCHOOL/PROGRAM(S) REQUIREMENTS REQUIREMENTS REQUIREMENTS COST Loma Linda University High school diploma/ Successful Internship is Traditional: Health San Manuel GED; successful completion of required. $6,450 Gateway College completion of the both didactic Traditional: (all-inclusive, except regalia for Foundations* training competencies graduation) Clinic-Based It is not always Community Health *Included in intensive track. and practicum paid, but some Intensive: Worker Training components employers Varies by contract with have paid off sponsors depending on $ "Traditional" track students' tuition deliverables $ "Intensive" track balance as compensation for work done during their practicum. Intensive: Students are employed, and employers pay for their time at the training and practicum at their own clini- cal sites. Community Health High school diploma/ Internship is $3,750 Worker Foundations GED required. It (all-inclusive, except regalia for Training is not always graduation) paid, but some School-Based High school diploma/ employers No information available Community Health GED; successful have paid off and Education Worker completion of the students' tuition Training Foundations training balance as compensation for work done during their practicum. INTERNSHIP/EXTERNSHIP PARTNERS: Inland Empire Health Plan, L.A. Care, Goodwill, Chaffey Joint Union High School District, San Bernardino City Unified School District, San Bernardino County, Loma Linda University School of Behavioral Health, Congregations Organized for Prophetic Engagement, San Bernardino County Workforce Development Board, Cathedral City, El Sol Neighborhood Educational Center, Riverside County Workforce Development Board, Sickle Cell Disease Foundation Mission College None 2 courses 54 unpaid No cost to students Community Health Externship externship Worker Certificate hours* *Usually completed at students' workplace INTERNSHIP/EXTERNSHIP PARTNERS: Local organizations, including MayView Community Health, Gardner Health, AACI, School Health Centers of Santa Clara County, Planned Parenthood Mar Monte, Community Health Partnerships, Santa Clara County Clinics Note: Mission College also had a for-credit community health program with a behavioral health focus that ended ~8 years ago. It averaged 5 to 6 students per cohort. California Health Care Foundation www.chcf.org 24 Table A5. Program Requirements and Costs: Active and Future College/University-Based Programs, continued PROGRAM INTERNSHIP/ PREREQUISITES/ GRADUATION EXTERNSHIP SCHOOL/PROGRAM(S) REQUIREMENTS REQUIREMENTS REQUIREMENTS COST Monterey Peninsula None 16 units of courses Unpaid: <$2,000 College 2 units of internship 120 hours Community Health Paid: 150 hours Worker Certificate INTERNSHIP/EXTERNSHIP PARTNERS: Students are responsible for identifying their own internships, but Monterey Peninsula College is seeking to establish partnerships. Providence and 18 years or older Completion of 80% 6-month paid No cost to students Charles R. Drew High school diploma/ of the program internship University of Medicine GED requirements and Science (CDU) Some prior experience Providence-CDU in a community and/or Community Health health care setting Worker Academy (certificate) Fluency in Spanish is highly preferred Computer program proficiency INTERNSHIP/EXTERNSHIP PARTNERS: Cedars-Sinai Medical Center, Dignity Health Northridge Hospital Medical Center, Harbor Community Health Center, San Fernando Community Health Center, Behavioral Health Services, Inc., Torrance Memorial Medical Center, Westside Family Health Center, Venice Family Clinic, and multiple sites across Providence Sacramento City None 23.5 units of courses Unpaid: $1,697.50 College – Los Rios 2 units of work 120 hours (includes tuition, books, and various fees) Community Health experience Paid: 150 hours Care Worker Certificate INTERNSHIP/EXTERNSHIP PARTNERS: Internship partners are largely in the Sacramento region, but the program will work with any student to find an intern- ship outside of the region. Valley High School None 4 courses 50 hours of No cost to students Health Tech Academy's CHW exams paid fieldwork Community Health Fieldwork Worker Certification INTERNSHIP/EXTERNSHIP PARTNERS: Central Valley Health Network/UC San Francisco (AHEC Scholars), Common Ground Church, La Familia Counseling Center, WellSpace Health, One Community Health, Health Education Council Notes: This is a high school-based program. AHEC is Area Health Education Center. Note: GED is general equivalency diploma; N/A is not applicable; TBD is to be determined. Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs 25 Table A6. Program Requirements and Costs: Active Organization-Based Programs INTERNSHIP/ PROGRAM PREREQUISITES/ GRADUATION EXTERNSHIP ORGANIZATION/PROGRAM REQUIREMENTS REQUIREMENTS REQUIREMENTS COST AltaMed Employed as CHW at N/A N/A No cost to students (Penn Center for Community AltaMed in Health Education Health Workers) department Community Health Worker Program Center for Well-Being None Attend at least None No cost to students Community Health Workers 4 of 5 sessions (certificate) Chula Vista Community Employed at CVCC None N/A No cost to students Collaborative CVCC Promotores Program El Sol Neighborhood Possess the qualities Completion of None Varies depending on Educational Center (e.g., passion, community trainings training Community Health Worker/ involvement, leadership) and Promotor Training Center the heart to serve others (certificate) Homeless Prenatal $ Updated résumé Complete course- Internship No cost to students Program $ Recommendation from work to receive required for (training provided by City College HPP case manager certificate last 6 months of San Francisco [CCSF]) of program (or other written recommenda- Apprenticeship Community Health Worker tion if not a former HPP client) Training Program $ Minimum of 1 year in (certificate) stable housing $ Clean and sober for a minimum of 2 years $ Stable childcare $ Looking to pursue or currently pursuing an AA degree or GED certificate (old program); must be able to enroll in CHW Certificate Program at CCSF $ Fluent in English (to attend CCSF courses) $ Looking to find employ- ment in an entry-level position in the social service sector $ Former HPP client or be a member of the community (i.e., demonstrate passion) INTERNSHIP/EXTERNSHIP PARTNERS: Arriba Juntos, HealthRIGHT 360, City and County of Alameda, City and County of San Francisco, Compass Family Services, Center for Young Women's Development, Larkin Street Youth, La Casa de las Madres California Health Care Foundation www.chcf.org 26 Table A6. Program Requirements and Costs: Active Organization-Based Programs, continued INTERNSHIP/ PROGRAM PREREQUISITES/ GRADUATION EXTERNSHIP ORGANIZATION/PROGRAM REQUIREMENTS REQUIREMENTS REQUIREMENTS COST Latino Health Access None Completion of None Varies depending on The Promotor Training training(s) training and format (in-person vs. remote) Northern ACEs None None None Individual courses: Collaborative/Population $175 each Health Innovation Lab, Core Group (10 courses): a program of the Public $1,500 Health Institute (Reduced rate is available North State Community for 2+ individuals from the Health Worker Training and same agency registering at the same time.) Resource Hub (certificate) Note: ACEs are adverse childhood experiences. Promotoras con Alma None Completion of None No cost to students Promotoras con Alma trainings (certificate) Transitions Clinic Network Employment as a CHW at a Participate in None $90 for textbook (TCN) TCN-affiliated clinic live sessions TCN CHW Online Training Personal history of Complete: Course (certificate) incarceration $ 12 self-paced online modules $ 2 written assignments Note: Training is only for CHW/Ps at a TCN-affiliated clinic and does not teach CHW/P core competencies. Visión y Compromiso Interest in becoming a Completion of None No cost to students Promotoras Transformando promotora comunitaria trainings Familias y Comunidades Practice of educa- (certificate) tional presentation Note: N/A is not applicable. Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs 27 Table A7. Student Information: Active and Future College/University-Based Programs PROGRAM FOLLOW-UP/ COMPLETION CONTACT WITH SCHOOL/PROGRAM RATE GRADUATES STUDENT DEMOGRAPHICS Bakersfield College Not No Not available Health Navigator Certificate available of Achievement Berkeley City College 90% to 100% No $ 30% n ew immigrants, some of whom have health Community Health Worker care backgrounds Degree and Certificate $ 30% e mployed but looking for additional training Program $ 30% r eturning adult learners who have not been in workforce for 10 years, do not have a high school diploma, and are mostly female $ 30% non-English speakers $ Languages spoken: Arabic, Spanish, Eritrean, Tagalog, Chinese* *Reported demographic information is anecdotal. Cabrillo College Not Yes Not available Community Health Worker available (via Listserv and LinkedIn) Certificate of Achievement City College of San Francisco 91% Yes GENDER NON-ENGLISH LANGUAGES Community Health (via LinkedIn and $ Female . . . . . . . 30 $ Cantonese. . . . . . 2 Google Groups) Worker Program $ Male. . . . . . . . . 11 $ Italian/French. . . . 1 RACE/ETHNICITY $ Japanese/Korean. . 1 $ Asian . . . . . . . . 8 $ Samoan . . . . . . . 1 $ Black . . . . . . . . 7 $ South Asian. . . . . 1 $ Latinx . . . . . . . . 13 $ Spanish . . . . . . .10 $ Pacific Islander . . . 1 $ Tagalog . . . . . . . 1 $ White (non-Hispanic). 12 OTHER AGE GROUPS $ LGBTQ . . . . . . . 9* *3 identify as nonbinary $ 20 to 34. . . . . . .22 $ Bachelor's degree $ 35 to 44. . . . . . . 9 or higher . . . . . . 13 $ 45 to 59. . . . . . . 8 $ 60+. . . . . . . . . 2 Note: Completion and demographic data are from June 2021 graduating class. Foothill College N/A N/A N/A (program not Community Health Worker yet offered) Certificate Program Evergreen Valley College Not Not Not available Patient Community available available Navigator Certificate California Health Care Foundation www.chcf.org 28 Table A7. Student Information: Active and Future College/University-Based Programs, continued PROGRAM FOLLOW-UP/ COMPLETION CONTACT WITH SCHOOL/PROGRAM RATE GRADUATES STUDENT DEMOGRAPHICS College of the Desert N/A N/A N/A (program Community Health Worker: expected to Children and Families start in fall 2023) Certificate of Achievement Futuro Health Not Not available Not available (education provided by Mercy available College of Health Sciences) Community Health Worker: Behavioral Health Program (certificate) Loma Linda University Health 98% Yes $ Mostly female (8:2) San Manuel Gateway College $ High school diploma/GED Clinic-Based Community $ Experience ranges from none to 20+ years Health Worker Training $ All ethnic and racial backgrounds $ "Traditional" track (predominantly Latinx, then Black, Asian, $ "Intensive" track and Native American) Community Health Worker Foundations Training School-Based Community Health and Education Worker Training Notes: There was a 99% job placement rate within 6 to 9 months of the training, where 90% of students are employed in clinical-, community-, and school- based settings. No systematic follow-up, but the program stays in contact via Facebook, email events blasts, job announcements, trainings/webinars, policy information, etc. Direct contacts are done with specific students as needed and per their request. The program also has a CHW leadership council with CHWs leading the group. Mission College 100% No RACE/ETHNICITY AGE GROUPS Community Health Worker $ Asian . . . . . . . . . 3 $ 20 to 34. . . . . . . 14 Certificate $ Black . . . . . . . . . 1 $ 35 to 44. . . . . . . 3 $ Latinx . . . . . . . . 14 $ 45 to 60. . . . . . . 4 $ White (non-Hispanic) . . 3 EDUCATION GENDER $ Did not graduate $ Female . . . . . . . 18 from / enroll in high school . . . . . 1 $ Male. . . . . . . . . 2 $ High school $ Nonbinary. . . . . . 1 diploma/GED. . . . 9 $ Associate's degree . 3 $ Bachelor's degree or higher . . . . . . . 8 Notes: Completion and demographic data are from the first cohort (2020). Mission College also had a for-credit community health program with a behavioral health focus that ended ~8 years ago. It averaged 5 to 6 students per cohort. Information about the percentage of graduates with jobs upon program completion was not available – most were already employed. Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs 29 Table A7. Student Information: Active and Future College/University-Based Programs, continued PROGRAM FOLLOW-UP/ COMPLETION CONTACT WITH SCHOOL/PROGRAM RATE GRADUATES STUDENT DEMOGRAPHICS Monterey Peninsula College Not Yes Not available Community Health Worker available (via email) Certificate Providence and Charles R. Not Yes Cohort 1 Cohort 2 Drew University of Medicine available (virtual check-in GENDER GENDER and Science (CDU) meetings as requested by $ Female . . . . . . . 10 $ Female . . . . . . . 15 Providence-CDU Community graduates; Health Worker Academy $ Male. . . . . . . . . 1 $ Male. . . . . . . . . 1 outcome (certificate of completion) evaluation forms RACE/ETHNICITY RACE/ETHNICITY will be regularly $ Latinx . . . . . . . . 9 $ Latinx . . . . . . . . 16 administered) $ Other . . . . . . . . 2 LANGUAGE LANGUAGE $ Fluent in Spanish . . 16 $ Fluent in Spanish . . 7 EDUCATION EDUCATION $ Bachelor's degree. . 5 $ Bachelor's degree. . 1 $ Some college. . . . 11 $ Some college. . . .10 Note: The percentage of graduates with jobs upon program completion was 100%. Sacramento City College – 22% to 53% Yes Not available Los Rios (via a graduate survey) Community Health Care Worker Certificate Valley High School 25% Yes $ 80% Female (sporadic emails Health Tech Academy's $ 50% L atinx and phone calls, Community Health Worker surveys as needed) (all of whom speak Spanish) Certification $ 35% A sian (mostly Hmong, some Vietnamese, Chinese, East Indian, Pacific Islander) Notes: This is a high school-based program. Most students enroll in college upon program completion; some enlist in the military. Note: LGBTQ is lesbian, gay, bisexual, transgender and questioning and/or queer; N/A is not applicable. California Health Care Foundation www.chcf.org 30 Table A8. Student Information: Active Organization-Based Programs PROGRAM FOLLOW-UP OR COMPLETION CONTACT WITH ORGANIZATION/PROGRAM RATE GRADUATES STUDENT DEMOGRAPHICS AltaMed 100% N/A $ All from Latin America/Spanish-speaking (Penn Center for Community countries Health Workers) $ All female Community Health $ CHWs had an average of 11 years of experience Worker Program Center for Well-Being 90% Yes Not available (via monthly meetings Community Health Workers and newsletters) (certificate) Note: Information about the percentage of graduates with jobs upon program completion was not available – most were already employed. Chula Vista Community 100% N/A Not available Collaborative CVCC Promotores Program El Sol Neighborhood 95% Yes Not available Educational Center (data from (via email) last 2 years) Community Health Worker/ Promotor Training Center (certificate) Note: The percentage of graduates with jobs upon program completion was 67% (data from last 2 years). Homeless Prenatal Program Not Yes GENDER CITY OF RESIDENCE (training provided by City College of available (most work at HPP $ Female . . . . . 100% $ San Francisco. . . 47% San Francisco) after program completion) RACE/ETHNICITY $ Richmond. . . . . 13% Community Health Worker $ Latinx . . . . . . .40% $ Vallejo. . . . . . . 7% Training Program (certificate) $ White . . . . . . . 7% $ San Mateo. . . . . 7% $ Asian . . . . . . 7% $ Orinda. . . . . . . 7% $ Black . . . . . . . 47% $ Pacifica. . . . . . . 7% PRIMARY LANGUAGE $ Tracy . . . . . . . . 7% $ English . . . . . . 80% $ Antioch . . . . . . 7% $ Spanish . . . . . .20% OTHER EDUCATION $ Average $ High school/GED. 7% household size . . . . 3 $ Some college* . . 86% $ Associate's degree.7% *13% of those who attended some college were first- generation college students. Notes: The percentage of graduates with jobs upon program completion was 92%. Demographic data for FY 2020–21 and FY 2021–22. Segments may not sum to 100% due to rounding. Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs 31 Table A8. Student Information: Active Organization-Based Programs, continued PROGRAM FOLLOW-UP OR COMPLETION CONTACT WITH ORGANIZATION/PROGRAM RATE GRADUATES STUDENT DEMOGRAPHICS Latino Health Access 90% to 100% No Not available The Promotor Training Northern ACEs Not Yes Not available Collaborative/Population available (monthly Health Innovation Lab, a peer convening) program of the Public Health Institute North State Community Health Worker Training and Resource Hub (certificate) Promotoras con Alma 90% Yes $ All Spanish speakers (via a coalition that Promotoras con Alma $ 99% women regularly meets) (certificate) $ Ages range from 39 to 55 Transitions Clinic Network Not Yes $ Majority of CHWs who complete the training (TCN) available (ongoing mentoring are older (50+); Black, Latinx or other people of from senior CHWs, color; and English-speaking TCN CHW Online Training biweekly fireside chats, Course (certificate) one-on-one mentoring $ Slightly more males than females and a smaller as needed) percentage of trans women Notes: Training is only for CHW/Ps at a TCN-affiliated clinic and does not teach CHW/P core competencies. Visión y Compromiso 90% No Not available Promotoras Transformando Familias y Comunidades (certificate) Notes: ACEs are adverse childhood experiences; N/A is not applicable. California Health Care Foundation www.chcf.org 32 Appendix B. Inactive Programs (Paused or Ended) Table B1. General Program Information: Paused or Ended College/University-Based Programs YEAR HOW OFTEN YEAR ENDED/ PROGRAM FOR SCHOOL/PROGRAM(S) LOCATION OFFERED BEGAN PAUSED DURATION/LENGTH CREDIT Cañada College Redwood City N/A 2008 2018 252 lecture hours and 180 Yes Community Health Worker to 225 internship hours* Certificate of Achievement (depending on whether it's paid or unpaid) Promotor Education and 288 lecture hours and 60 Employment Project to 75 internship hours* Certificate of Achievement (depending on whether it's paid or unpaid) Mission College Santa Clara N/A 2018 2018 2 to 3 semesters Yes (not started Associate in Science in 1,044 lecture hours and due to Community Health Worker low interest) 100 internship hours* Note: Mission College also had a for-credit community health program with a behavioral health focus that ended ~8 years ago. It averaged 5 to 6 students per cohort. San Diego City College San Diego N/A 2007 2018 2 to 4 semesters No Community Health Work 162 lecture hours and Certificate of Performance 40 to 70 volunteer hours Community Health Work N/A 2019 2019 306 lecture hours and Yes Certificate of Achievement (minimal 40 to 70 volunteer hours* enrollment never met) Santa Rosa Junior College Santa Rosa Once 1997 2019 3 semesters Yes Community Health Worker a year to 1998 400 to 423.5 lecture hours (beginning in Certificate of Achievement and 240 internship hours the summer) Program Community Health Worker Not Not ~440 to 468 lecture hours* Associate Degree available available UC Riverside University Riverside Twice 2017 2019 5 weeks Yes Extension a year 60 classroom-based Community Health Worker instruction hours and (professional achievement 120 online-based award/certificate) instruction hours Note: N/A is not applicable. *Program length is estimated based on the number of units required to complete the program and the number of hours that made up a unit. Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs 33 Table B2. General Program Information: Paused or Ended Organization-Based Programs YEAR HOW OFTEN YEAR ENDED/ PROGRAM FOR ORGANIZATION/PROGRAM(S) LOCATION OFFERED BEGAN PAUSED DURATION/LENGTH CREDIT County of Los Angeles Los Angeles Once 2000 2020 3 months N/A Public Health County a year 18 to 24 hours Promotores Training Program (certificate) Esperanza Community South Central Once 1996 Paused in 6 months N/A Housing Corporation Los Angeles a year 2021 216 to 240 training hours and (new cohort Community Health 250 optional internship hours expected in Promotores Training 2022) after program completion Program (certificate) Note: Participants can earn two certificates: one for completing the actual training program and another after they finish the internship. Worker Education and Los Angeles Not 2008 2010 2 weeks N/A Resource Center (WERC) County available CHW Program with Esperanza Community Housing Corporation Care Navigator 2016 2019 4 to 6 weeks Apprenticeship Program ~160 hours of classroom instruction and 2,000 hours of on-the-job work experience SUCCEED Program 2013 2015 3 weeks 90 hours Note: N/A is not applicable. California Health Care Foundation www.chcf.org 34 Table B3. Instructional Details: Paused or Ended College/University-Based Programs AVERAGE # OF PROGRAM STUDENTS PER LANGUAGES SCHOOL/PROGRAM SPECIALTY CLASS/COHORT INSTRUCTORS DELIVERY MODE OFFERED Cañada College Not available Not available Not available Not available English Community Health Worker Certificate of Achievement Promotor Education and Employment Project Certificate of Achievement Mission College* General N/A N/A N/A English (not started due Associate in Science in to low interest) Community Health Worker San Diego City College General 12 MPH, MSW, PhD In-person English, Spanish Community Health Work Certificate of Performance Community Health Work Certificate of Achievement Santa Rosa Junior College† General 18 to 22 Master's-trained In-person English Community Health Worker Certificate of Achievement Program Community Health Worker Not available Not available Not available Not available Not available Associate Degree UC Riverside University General 13 Instructor #1: Hybrid English Extension PhD, RN, LNC Community Health Worker Instructor #2: (professional achievement EdD, MS, BCPC award/certificate) *Mission College also had a for-credit community health program with a behavioral health focus that ended ~8 years ago. It averaged 5 to 6 students per cohort. Students could choose one of the following areas of emphasis: geriatric care, cognitive disability – mental illness, or cognitive disability – developmental disability. † Specialties included prevention of acute and chronic disease, substance use, and mental health; focus was on Sonoma County health disparities and epidemiology. Note: Hybrid delivery is in-person and remote. N/A is not applicable. Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs 35 Table B4. Instructional Details: Paused or Ended Organization-Based Programs AVERAGE # OF ORGANIZATION/ PROGRAM STUDENTS PER DELIVERY LANGUAGES PROGRAM(S) SPECIALTY CLASS/COHORT INSTRUCTORS MODE OFFERED County of Los Angeles Nutrition 10 to 40 Health Education In-person Primarily Spanish; Public Health Assistant some trainings Promotores Training offered in English Program (certificate) Esperanza Community Low-income 20 to 25 Agency staff and Pre-COVID: English and Housing Corporation South Central promotores In-person Spanish Community Health Los Angeles During COVID: Promotores Training residents Hybrid Program (certificate) Worker Education and General 30 WERC instructors Not available English Resource Center (WERC) and instructors from (Spanish assistance) CHW Program with Esperanza Esperanza Community Housing Corporation Care Navigator Primary care 10 to 15 Classroom: English Apprenticeship Program and social WERC instructors and determinants guest instructors of health Worksite: professional mentor SUCCEED Program Post-stroke 8 WERC instructors, English patients medical staff from (Spanish assistance) Rancho Los Amigos National Rehabilitation Center Note: Hybrid delivery is in-person and remote. California Health Care Foundation www.chcf.org 36 Table B5. Program Requirements and Costs: Paused or Ended College/University-Based Programs PROGRAM INTERNSHIP/ PREREQUISITES/ EXTERNSHIP SCHOOL/PROGRAM(S) REQUIREMENTS GRADUATION REQUIREMENTS REQUIREMENTS COST Cañada College Not available 4 units of core courses Unpaid: 180 hours Not Community Health 10 units of selective courses Paid: 225 hours* available Worker Certificate 3 units of internship of Achievement Promotor Education 10 units of core courses Unpaid: 60 hours and Employment 6 units of selective courses Paid: 75 hours* Project Certificate of Achievement 1 unit of internship Mission College† Enrollment in college 25 units of core courses None Not Associate in Science 1 to 10 units of electives depend- available (not started in Community Health ing on area of emphasis due to low Worker Associate in Science degree interest) Students must maintain a grade of C or above in all core classes and program electives San Diego City None 9 units of courses 40 to 70 volunteer $414 College Volunteering hours (excluding books and Community Health supplies) Work Certificate of Performance Community Health 17 units of courses Work Certificate of 1 to 4 units of work experience Achievement Santa Rosa Junior English 1A or proficiency 26.5 units from Community Unpaid: 240 hours $1,300 College Health Worker Internship (offered through several (in 2019) nonprofits and County Community Health Public Health) Worker Certificate of Achievement Program Community Health Not available 27.5 units from Community Not available Not Worker Associate Health Worker requirements and available Degree Information Learning Resources Associate's degree UC Riverside High school diploma/GED 10 units of courses None $2,800 University Extension Proficient in English reading, (excluding textbooks) Community Health writing and comprehension Worker (professional Passion for helping people achievement award/ certificate) Access to a computer and the internet Application includes a writing assignment to determine readiness for the program *Hours are based on estimations. † Mission College also had a for-credit community health program with a behavioral health focus that ended ~8 years ago. It averaged 5 to 6 students per cohort. Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs Note: N/A is not applicable. 37 Table B6. Program Requirements and Costs: Paused or Ended Organization-Based Programs PROGRAM ORGANIZATION/ PREREQUISITES/ INTERNSHIP/EXTERNSHIP PROGRAM(S) REQUIREMENTS GRADUATION REQUIREMENTS REQUIREMENTS COST County of Los Angeles None Attend at least 11 of 12 None No cost to Public Health sessions students Promotores Training Program (certificate) Esperanza Community Application and 6 months of training Paid: 240 hours No cost to Housing Corporation interview with an Unpaid: optional students Community Health alumna Promotores Training Program (certificate) INTERNSHIP/EXTERNSHIP PARTNERS: Susan G. Komen, Food Education Access Support Together (FEAST), and Strategic Actions for a Just Economy (SAJE). Worker Education and None None None No cost to Resource Center (WERC) students CHW Program with Esperanza Community Housing Corporation Care Navigator Cultural alignment Evaluation by professional N/A Apprenticeship Program with and lived mentor after 1,000 hours and experience in the 2,000 hours on the job community where Issuance of State/Federal they will serve Apprenticeship credential upon completing the program and receiving offer of perma- nent employment SUCCEED Program None None Internship required, but length/duration of internship not available INTERNSHIP/EXTERNSHIP PARTNER: Rancho Los Amigos National Rehabilitation Center. Note: N/A is not applicable. California Health Care Foundation www.chcf.org 38 Table B7. Student Information: Paused or Ended College/University-Based Programs PROGRAM FOLLOW-UP OR CONTACT SCHOOL/PROGRAM(S) COMPLETION RATE WITH GRADUATES STUDENT DEMOGRAPHICS Cañada College Not available Not available Not available Community Health Worker Certificate of Achievement Promotor Education and Employment Project Certificate of Achievement Mission College* Not available Not available Not available (not started due to low interest) Associate in Science in Community Health Worker San Diego City College Not available No Not available Community Health Work Certificate of Performance Community Health Work Certificate of Achievement Santa Rosa Junior College Nearly 100% each year † Yes $ ~75% were female graduates are emailed Community Health Worker $ ~80% were Latinx job opportunities Certificate of Achievement (~50% of whom spoke Spanish in Program their home) $ Ages ranged from 20 to 50‡ Community Health Worker Not available Not available Associate Degree UC Riverside University Not available No Not available Extension Community Health Worker (professional achievement award/ certificate) *Mission College also had a for-credit community health program with a behavioral health focus that ended ~8 years ago. It averaged 5 to 6 students per cohort. † The percentage of graduates with jobs upon program completion was more than 50%. These data were not available for the other schools. ‡ Reported demographic information is anecdotal. Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs 39 Table B8. Student Information: Paused or Ended Organization-Based Programs PROGRAM % OF GRADUATES FOLLOW-UP ORGANIZATION/ COMPLETION WITH JOBS UPON OR CONTACT PROGRAM(S) RATE COMPLETION WITH GRADUATES STUDENT DEMOGRAPHICS County of Los Angeles Not available Not available No $ 100% Latinx Public Health $ Majority were 40 years and older Promotores Training $ Most are bilingual: 70% reported Program (certificate) speaking both Spanish and English $ Over 70% of respondents reported having at least a high school diploma or GED, with half of respondents reporting some college or graduate school education Esperanza Community 90% to 95% 80% Yes Mostly women* Housing Corporation (in 2020) (via email and Facebook) Community Health Promotores Training Program (certificate) Worker Education and 94% Not available No GENDER AGE GROUPS Resource Center (WERC) $ Female . . 92% $ 18 to 29. . 18% CHW Program with $ Male. . . . . 8% $ 30 to 39. . 30% Esperanza Community $ 40 to 49. . 28% RACE/ETHNICITY Housing Corporation $ Latinx . . . 78% $ 50 to 59. . 24% $ Black . . . 17% $ White . . . . 5% Care Navigator 67% 50%† Yes ‡ GENDER RACE/ETHNICITY Apprenticeship Program $ Female . . 78% $ Latinx . . . 83% $ Male. . . . 22% $ Black . . . 17% SUCCEED Program 88% Not available No GENDER RACE/ETHNICITY $ Female . . 100% $ Latinx . . . 60% $ White . . . 40% *Reported demographic information is anecdotal. † Participants who did not receive a job either did not complete the program, accepted similar (but not CHW positions) upon graduation, or were let go due to performance issues. ‡ Occasional contact with graduates, including preparing and applying for promotional positions as on-the-job experts to provide feedback in workgroups and as guest speakers in training Notes: GED is general equivalency diploma. California Health Care Foundation www.chcf.org 40 Appendix C. Program Content and Curriculum for All Programs COLLEGE/UNIVERSITY-BASED PROGRAMS Bakersfield College Cabrillo College LEARNING OUTCOMES LEARNING OUTCOMES $ Practice within the code of ethics required in the $ Identify basic health needs and evaluate health education field. health and human service resources within the community. $ Use communication strategies that are respon- sive to the social determinants of health for an $ Demonstrate CHW professional skills and job individual and/or community. Social determi- readiness in the core competencies identified nants include conditions in the environments in by the Community Health Care Worker Core which people are born, live, learn, work, play, Consensus Project (C3) and the needs of the worship, and age that affect a wide range of local community. health, functioning, and quality-of-life outcomes and risks. Cañada College (both programs) $ Implement health education plans to promote LEARNING OUTCOMES healthy behaviors, address health risks, and reduce harm. $ View the client as a whole person in the context of family and community in assessing the client's $ Work with clients to facilitate access to resources strengths and needs. and increase their ability to navigate the health care system. $ Demonstrate a working knowledge of emer- gency and nonemergency services available in San Mateo County. Berkeley City College $ Demonstrate an understanding of the qualities LEARNING OUTCOMES and characteristics of effective human service $ Explainthe career opportunities as a community professionals. health worker. $ Demonstrate skills for entry-level placement in City College of San Francisco volunteer or internship opportunities. LEARNING OUTCOMES $ Determine a successful pathway to reach career $ Analyze and evaluate public health concepts and goals as a community health worker. information for health promotion. $ Assessand integrate professional skills necessary for employment in the CHW field. $ Evaluate and implement entry-level proficiency in CHW core competencies for working effec- tively with diverse individuals, groups, and communities. Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs 41 College of the Desert Futuro Health (education provided by Mercy College of Health Sciences) LEARNING OUTCOMES LEARNING OUTCOMES $ Demonstrate the ability to deliver basic compo- nents of safe, effective health care and screening $ Describe the role of community health workers in tests for children and families. addressing the needs of vulnerable populations and health disparities, and explain the impact of $ Explain the concepts of ethics and confidential- racial and ethnic disparities in health diagnoses ity, including techniques of communication and and treatment of diseases. mandated reporting process and protocols. $ With cultural humility and an understanding of $ Research and critically evaluate sources of health behavior change, engage and communicate with information that promote health for children and individuals about their physical or behavioral families. health to recognize conditions, access care, and $ Identify community resources and strategies participate fully in prevention and care plans. that support children and families while creating $ Identify and effectively connect with available an action plan to confront aggression, bullying, community resources to make referrals that child abuse and neglect. support the patient care plan, address social determinants of health, and inform the inte- Evergreen Valley College grated or collaborative team of the availability of such resources and make recommendations. LEARNING OUTCOMES $ Understand the impact of trauma on the individ- $ Demonstrate effective written and oral communi- ual, oneself, and community; the health system cation necessary for patient navigation. response; adverse childhood experiences (ACEs); $ Interpret and explain medical forms to assist and the role of the CHW in preventing, treating, patients with understanding the forms. and healing trauma and ACEs. $ Interpret and clarify health care issues to help $ Describe how individual health is shaped by fam- patients make informed decisions. ily, community, neighborhood, and wider social conditions (such as education, poverty, housing, $ Assist patients with challenging health care safety, transportation, and environmental qual- processes. ity), and the impact CHWs can have. $ Apply the practices of a patient community navi- $ Participateeffectively on a collaborative or gator in a health care environment. integrated health team for better patient care, including learning how to work with licensed Foothill College providers and other team members of varied backgrounds and training levels. TBD – program has not yet been offered. $ Listen reflectively and practice motivational interviewing to more effectively work with both patients and colleagues on collaborative teams. California Health Care Foundation www.chcf.org 42 $ Effectively manage their time in many different Loma Linda University Health San Manuel environments, including those that are fast-paced Gateway College and/or require multitasking. Community Health Worker Foundations Training $ Professionally and effectively represent employ- TOPICS ers in all internal and external communications in fulfilling their duties as a CHW. $ Public health fundamentals $ Describe ethical and legal issues (e.g., confidenti- $ Popular education ality, informed consent, boundaries, competence) $ Cultural humility that are unique to behavioral health, unlicensed care provision, and collaborative practice. $ Emotional intelligence $ Learnhow to use 4 basic screens/assessments $ Leadership with patients, including 2 for behavioral health. $ Health education and promotion $ Describethe role of data in their work as a CHW $ Home visitation and in-patient care and team practice, and know how to track, report, share, and use data. $ Harm reduction $ Identifybehavioral health diagnosis and treat- $ Mental health aid ment issues for specific populations, and explain $ Foundations of behavior change the etiology, signs and symptoms, complications, medications, and treatment modalities for physi- $ Interdisciplinary team approach cal and mental health conditions. $ Assisting communities in using resources in $ Describe the basic organization of health care physical and behavioral health services and public health systems (including specifically behavioral health care); describe issues of access, Clinic-Based Community Health Worker Training quality, and cost in the health care system, espe- ("traditional" and "intensive" tracks) cially behavioral health; and understand the role TOPICS of the CHW within that system. $ Organizational culture $ Identifythe basic payment mechanisms for providing health services, the basic insurance $ Health Insurance Portability and Accountability mechanisms for paying for health services, and Act (HIPPA) the disparate impact on different populations. $ Basic medical terminology $ Manage their own individual stress, including $ Home visitation workplace stress, and be able to teach self-aware- ness and stress prevention and management to $ Patient navigation patients. $ Service/care coordination $ Transitions of care $ Medication review $ Behavior change (including motivational interviewing and goal setting) Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs 43 School-Based Community Health and Education Monterey Peninsula College Worker Training LEARNING OUTCOMES TOPICS $ Identifybasic health needs and assist in access- $ Family engagement ing resources for at-risk individuals and groups in the local community. $ Navigating educational resources $ Home visitation Providence and Charles R. Drew University of $ Confidentiality and safety issues Medicine and Science (CDU) CHW ACADEMY OBJECTIVES Mission College $ Provide jobsite training in Providence hospitals Community Health Worker Certificate or clinics or with a partner Internship Host health care organization. LEARNING OUTCOMES $ Increase employment opportunities for interns $ Students will describe public health concepts who complete the CHW Academy. and information for health promotion. $ Obtain long-term employment with the employer $ Students will assess and integrate professional that provided them with the internship. skills necessary for employment in the CHW field. $ Improve interns' ability to navigate services that $ Students will evaluate and implement entry-level advance economic and physical well-being for proficiency in CHW core competencies for work- patients and their families. ing effectively with diverse individuals' groups and communities. $ Improve access to preventive and medical care services in communities served. Associate in Science in Community Health Worker LEARNING OUTCOMES $ Students will be able to identify the personal qualities and core competencies related to work- setting skills, knowledge base, health promotion/ education, service coordination, researching and health coaching. $ Students will know the current community health care issues and community agencies and resources available for consumers today. $ Students will be able to effectively advocate for environmental safety issues while working with clients of diverse ages, cultural backgrounds, and intellectual and emotional abilities. California Health Care Foundation www.chcf.org 44 Sacramento City College – Los Rios $ Incorporate professional and ethical boundaries, conflict resolution, self-care, time management, LEARNING OUTCOMES and skills for providing and receiving constructive $ Clarifyroles, responsibilities, and scope of prac- feedback to assist in working within a profes- tice of community health workers. sional setting. $ Investigate complex service delivery systems $ Collect and synthesize information to understand within the U.S. health care system and key legal the needs, strengths, and resources of the indi- responsibilities within the context of health ser- viduals and communities that community health vice delivery systems. workers serve. $ Use accepted terminology to describe findings, $ Use information collected to help plan and carry patterns, habits, and behaviors that prevent out effective programs, services, and advocacy the development and progression of common for individuals and communities. physical, mental, and behavioral conditions and $ Provide culturally competent care by applying recommend strategies that reduce high utiliza- knowledge of cultural beliefs, values, customs, tion of unnecessary health care services. and social behavior shared by different groups of $ Demonstrate the ability to accurately report and people with a common identity. document client assessments, interventions, $ Educate and promote healthy behavior change changes in status, and outcomes in the written by providing people with information, tools, and and electronic medical record (EMR). encouragement. $ Use a variety of outreach methods to engage $ Understand how to bridge cultural, linguistic, with individuals, groups, organizations, and the knowledge and literacy differences among indi- community, and help them learn about and use viduals, families, communities, and providers resources to improve their health and well-being. in order to tell them how to use the services of $ Identify conditions in which people are born, health providers and other service organizations. grow, work, live, and age, as well as the wider set $ Assess,analyze, and apply sociological and com- of forces and systems shaping the conditions of munity development theory, research methods, daily life. and practice. $ Evaluate and inventory available community resources, including health and social services. $ Demonstrate knowledge and proficiency with technology, including web-based applications, Microsoft Office, and EMR systems. $ Communicate effectively and purposefully with clients, community members, colleagues and other professionals as demonstrated by listening carefully and communicating respectfully. $ Demonstrate the ability to advocate and build capacity for individual and community health. Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs 45 San Diego City College (both programs) UC Riverside University Extension LEARNING OUTCOMES TOPICS $ Recognize, identify, assess, and address key con- $ Care management concepts and client customer cepts in aging (e.g., physical and mental health, service skills exercise, nutrition, the normal aging process, $ Principles of the continuum of care management etc.) affecting optimal aging and older adult- hood functioning. $ Ethics, fiduciary responsibilities $ Identifyand compare the various public benefits $ Legal aspects of care management available through local, state, and federal public $ Communication skills and effective listening assistance programs. $ Insurancemodels: HMOs, PPOs, long-term care, $ Identify and make referral to appropriate services. Medicare, Workers' Compensation, disability, $ Recognize and identify risk of caregiver stress, Medi-Cal, etc. particularly in caring for individuals suffering from $ Levels of care, including acute hospital and simi- Alzheimer's and other forms of dementia. lar, hospice, skilled nursing facilities, custodial $ Make a report of an incident or suspected inci- care, home health care, assisted living, residential dent of abuse/neglect of dependent adults and programs, day care and return-to-work programs elders. (e.g., outpatient services) $ Career options for community health workers Santa Rosa Junior College (both programs) LEARNING OUTCOMES $ Demonstrate a variety of community health outreach strategies and techniques, such as examining common disease and health prob- lems, motivating health behavior changes, preventing disease and injury, identifying and using community health resources, respecting cultural diversity, translating and interpreting (cultural, linguistic and/or medical), establishing networks within communities, and improving cli- ent access to medical care. $ Work effectively as a member of a health care team, and implement effective case man- agement, communication, interpersonal and professional skills. California Health Care Foundation www.chcf.org 46 Valley High School ORGANIZATION-BASED PROGRAMS TOPICS AltaMed (Penn Center for Community Health Workers) $ The role of the CHW TOPICS $ Health care careers $ Code of ethics $ Nutrition $ Patient privacy $ CPR/first aid $ Mandated reporting $ Mental health $ Safety in the field $ Tobacco, alcohol, and drugs $ The Arc (model for engaging and working $ Family life with patients) $ Noninfectious diseases $ Patient-centered goal setting $ Introduction to public health $ Patient profiles $ Infectious diseases $ Interviewing and understanding patients $ Community outreach $ Listening skills $ Building presentation and interpersonal skills $ Summarizing your patient effectively $ Motivational interviewing $ Working toward patients' goals $ Health care navigation $ Developing strong road maps $ Communityadvocacy and solving $ Bringing a do-it-now mindset to your work community problems $ Engaging and meeting patients for the first time $ Case management $ IMPaCT manual step-by-step $ Public health infrastructure and $ Organizational systems for community health disease response specialists (CHSs) $ Careers in behavioral health $ Interviewing patients and identifying root causes $ Brain anatomy and physiology $ Planning and addressing the tricky parts of $ Introduction to psychology home visits; home visit safety $ Adverse childhood experiences $ Core tasks for a safe discharge; clinical team members and their roles in discharge; practice $ Abnormal psychology reading discharge summaries $ Social psychology $ Sharing information with the care team $ The wellness and recovery model $ Primary care clinic team members Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs 47 $ How to help patients get the most out of their $ Ensuring good outcomes for patients and appointments; guiding patients through the for CHSs clinic appointment $ Strategies for ending the patient relationship $ Talking to doctors $ Connecting to other sources of support $ Coaching patients to prepare for appointments; supporting, advocating, and giving space dur- Center for Well-Being ing appointments Training based on the Community Health Worker $ Getting to know your patient Core Consensus (C3) Project $ Identifying root causes $ Creating snapshots Chula Vista Community Collaborative $ Medical,psychiatric, substance use, and Information not available. domestic violence crises $ How to respond to and resolve crises County of Los Angeles Public Health $ Safety protocol TOPICS $ Understanding motivational interviewing (MI) $ MyPlate and the stages of change $ Basic nutrition concepts $ Key interviewing skills to use as a CHS $ Portion distortion $ Helping patients access community and $ Label reading local resources $ Rethink your drink $ How trauma affects patients $ Breakfast made easy $ Skills CHSs can use to be trauma informed $ Children and weight $ Preparation for the standardized patient $ All you need to know about fats $ Substance use and addiction challenges patients face $ Physical activity concepts $ Skills CHSs can use to support patients with $ Surviving lunch the healthy way substance use concerns $ Steps in community education $ Responding to and resolving conflict as a CHS, including de-escalation techniques $ Mental health challenges patients face; skills to support patients with mental health concerns $ Understanding and responding to stress (both good and bad); stress management techniques California Health Care Foundation www.chcf.org 48 El Sol Neighborhood Educational Center $ Neuroscience trauma COMPETENCIES $ Healthy homes/lead poison prevention $ Communication $ Oil drilling in South Los Angeles $ Service coordination and navigation $ HIV and other sexually transmitted infections (STIs) $ Advocacy $ Green cleaning and personal care products $ Individual and community assessment $ Understanding coercive control and its role in $ Professional skills and conduct domestic violence $ Knowledge base $ Home-visiting protocols $ Interpersonal relationship building $ Capacity building Homeless Prenatal Program (training provided by City College of San Francisco) $ Education facilitation TOPICS $ Outreach $ Microsoft and Google software programs $ Evaluation and research $ Communication and active listening Esperanza Community Housing Corporation $ Time management TOPICS $ Group facilitation $ Trauma yoga $ Domestic violence training $ Community social media $ Vicarious trauma $ CPR/first aid $ Motivational interviewing $ Nutrition education and leadership training $ De-escalation $ Healing art $ Community resources and navigation $ Breast cancer $ Harm reduction and substance use $ Poison control $ Asthma $ Asthma medications $ Transgender health $ Navigating special needs systems $ Racial equity $ Childbirth justice Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs 49 Latino Health Access Transitions Clinic Network (TCN) TRAINING OBJECTIVE TCN provides specialized training that is designed to supplement core competency training. Train people in the promotor model, which is cen- tered on community-driven public health programs, MODULES so that they understand public health concepts and gain skills to become agents of change in their $ Incarceration in the United States community. $ Social determinants and collateral consequences CORE CONCEPTS $ Incarceration's impact on physical health $ What is a promotor/a? $ Incarceration's impact on behavioral health $ Health equity $ Cultural humility and marginalized populations $ Social determinants of health $ Therole of community health workers in team- $ What is the dominant discourse paradigm, based care and why is it important to acknowledge and challenge it by unlearning harmful practices $ Overcoming institutionalization and prejudices? $ Outreach, intake, follow-up, and graduation $ Principles of practice $ Service coordination and navigation $ Effective communication $ Advocacy in the clinic and in the community $ How to accompany adults in behavior change $ Mentorship, professionalism, and ethics $ What is outreach and engagement, and how is $ Stress and burnout it done effectively as a promotor? Visión y Compromiso Northern ACEs Collaborative/Population Health Innovation Lab, a program of the TOPICS Public Health Institute $ Thepromotor model and the role of the CORE COMPETENCY TRAINING promotor in community transformation $ Advocacy skills $ Communication and group formation $ Care coordination and system navigation $ Emotional intelligence and conflict resolution $ Communication skills $ Popular education, behavior change and adult learning $ Community outreach and engagement $ Adult learning styles and community $ Cultural competency participation $ The ethics of community work Promotoras con Alma Information not available. California Health Care Foundation www.chcf.org 50 Worker Education and Resource Center $ Gather and analyze quantitative and qualitative (WERC) data to assess community assets and barriers. CHW Program with Esperanza Community Housing $ Create an inventory of community assets Corporation and issues. Information not available. $ Understand and practice active listening and open-ended questions. Care Navigator Apprenticeship Program $ Understand and practice open-ended PROGRAM GOAL questions. Prepare care navigators (CNs) to be integrated into $ Practice techniques to establish rapport and patient-centered medical home teams to work with build trust. complex care patients to improve health outcomes. $ Simplify medical terminology for patients. LEARNING OBJECTIVES $ Learn and practice motivational interviewing $ Understandthe emerging roles and history (MI). of promotores. $ Understand and demonstrate health literacy $ Understandthe Triple Aim and the role of and teach-back. CNs with complex care patients. $ Practice basic computer skills for electronic $ Understand the value of a patient peer health records. perspective on the medical team. $ Learn appropriate communication between $ Identify the core competencies necessary patient and medical team. for CNs. $ Learn and practice professional etiquette, $ Define health and wellness, integrated care, including telephone and email communication. community, social determinants of health, $ Practice writing case notes. culture identity, and competency and humility $ Understand the concept of "the simple seven." $ Analyze local targeted patient communities. $ Understand complex care patients. $ Understand integrated care and system navigation. $ Understand behavioral/mental health. $ Understand the patient-centered medical model $ Help patients understand the care team's and managed care. advice, discuss how the patient feels about the advice, and work with patients to use that $ Identifylocal resources to manage chronic/ advice to improve their health social conditions. $ Understand professionalism and working $ Establish a broad-based network of local in teams. resources that will culminate in a final project. $ Respect confidentiality and observe boundaries $ Understand the communities in which the with patients. clinic patients reside. Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs 51 $ Learn to identify unsafe work-related situations and coping skills. COMPETENCIES $ Team member effectiveness $ Navigation $ Professionalism $ Advocacy $ Health literacy $ Cultural competency $ IT skills $ Communication skills $ Motivational Interviewing (MI) SUCCEED Program Information not available. California Health Care Foundation www.chcf.org 52 Endnotes 1.We did not collect information about short-term or one- time trainings conducted by employers for their CHW/P employees as part of continuing education or to add additional specialized skills. 2.College/university-based programs - both public and private – were offered at postsecondary institutions. 3.Organization-based programs were offered at community- based organizations, such as nonprofits (including health centers), community-based organizations, and county health departments. 4.This analysis identified 15 inactive programs. Twelve of these programs had ended or were paused, 2 programs were slated to launch in 2022, and one program was expected to relaunch in 2022. Note that information from 3 additional programs from 3 unique colleges was not collected. Two did not respond to information requests, and one did not have information available for its program, which had been inactive for several years. 5.There are numerous training programs that are employer- based and that focus on training staff to deploy in their organizations. This report is not inclusive of all these training programs. Understanding California's Community Health Worker/Promotor Workforce: CHW/P Training Programs 53