In 2017, the United Methodist Health Ministry Fund Board of Directors voted to honor the organization’s founding president with the establishment of the Kim Moore Award for Visionary Leadership. Each year, the Fund solicits nominations in a chosen strategic field of work and honors one individual whose leadership has had a positive effect on the health of a specific group of persons. For 2023, the Health Fund is inviting nominations for a leader who has previously or is currently serving in the strategic area of access to care in Kansas.
The winner of the award will be honored at a ceremony in May 2024. The individual will receive a cash award of $500, and if associated with an organization, that agency will receive an additional $2,000 to use as it deems.
Please direct any questions about this award to Katie Schoenhoff, Director of Programs. To nominate a candidate, please complete the online form below or include the same information in an email or letter to Katie (katie@healthfund.org / United Methodist Health Ministry Fund, PO Box 1384, Hutchinson, KS 67504-1384).
Nominations need to be received in the Health Fund office by November 17. If you previously nominated an individual who was not selected, you are welcome to renominate that person for the 2023 award.
The relationships that infants and toddlers form with their caregivers are foundational. Through strong attachment and nurturance, children are better prepared for school and to hit developmental milestones on time.
The second phase of the pilot is underway and focuses on creating healthier futures for toddlers. Our evaluation will measure executive functioning and child well-being, which are both related to school readiness.
“Investing early is an opportunity to help have a profound impact on the health and economic well-being of children and families,” said David Jordan, Health Fund president. “For every $1 invested you see a $7 return. Ultimately, we all share the goal of having healthier kids and families. ABC helps us get there for some of the most vulnerable Kansans. The results are promising, and the future is bright.”
This guest blog post was authored by Joyea Marshall-Crowley, CBS, Wichita Black Breastfeeding Coalition.
In the Wichita area, we have heard from Black and brown mothers that they are not even being asked about breastfeeding as an initial feeding choice, and that their healthcare providers assume they are formula-feeding their babies. This makes it difficult for Black and brown mothers to obtain breastfeeding resources, support, or information during pregnancy and upon delivery. It is imperative to have these supports for a woman’s breastfeeding journey, and it should be accessible to all mothers no matter their decision to breastfeed or not.
The need for the Wichita Black Breastfeeding Coalition is clear.
Who is the Wichita Black Breastfeeding Coalition?
The Wichita Black Breastfeeding Coalition (WBBC) was formed in October 2020 under the non-profit organization Kansas Breastfeeding Coalition. The foundational vision for this local breastfeeding coalition is to help increase breastfeeding rates in the Black and brown communities of the Wichita Metropolitan Area.
The coalition currently houses six members. The outstanding members of the WBBC hold many titles, such as Certified Breastfeeding Specialist (currently on track to obtain their IBCLC), Certified Trained Doulas, Registered Nurse, Chocolate Milk Certified Trainer, Chiropractor, and Midwife, to name a few.
All WBBC members share the same passion for helping women of color gain the support, resources, and tools needed to reach their breastfeeding goals. We want mothers of color to have a safe space just for them to receive the breastfeeding support they need—and that is what they will get from the Wichita Black Breastfeeding Coalition.
“I Breastfed; This is My Legacy”
Representation of Black women is so important when it comes to normalizing breastfeeding. This group is underrepresented, and there is already a stigma in the Black and brown community that breastfeeding is a “white” thing. When they see pictures and videos of breastfeeding mothers that heavily display white mothers as the focus it just reinforces the same message as the stigma and creates barriers.
To dispel this myth, the Wichita Black Breastfeeding Coalition created a project called “Latched Legacy.” This project highlights and normalizes that Black women do indeed breastfeed. The campaign video shows Black mothers confidently sharing the statement “I Breastfed; This is My Legacy” while capturing them with their children and partners. The project’s goal is not only to increase breastfeeding initiation rates in the Wichita Metro Area but also to increase media representation for Black mothers regarding breastfeeding.
“Latched Legacy” campaign video
In conjunction with representation, this project has also allowed us to provide breastfeeding kits for pregnant and breastfeeding mothers of color. These kits include supplies and information to encourage them to initiate breastfeeding as their first choice upon delivery. As a result, we have a success rate of 95% of mothers who have received a kit while pregnant initiating breastfeeding as their first choice of feeding after delivery.
Breastfeeding is for mothers of all backgrounds. We are changing the Black breastfeeding narrative one family at a time in the Wichita area. Every Kansas family should receive the resources and support they need to reach their breastfeeding goals. You can support new or expecting parents in your area by referring them to a local breastfeeding coalition or to an organization that provides breastfeeding resources.
About the series
This is the final post in a series on breastfeeding in Kansas. Prior posts include:
This guest blog post was authored by Heather Peterson RDN, LD, CLC, Reno County WIC Coordinator.
Every day, I look forward to going to work in WIC: we truly are the Happy, Healthy Baby People!
WIC is a supplemental food program that serves pregnant, breastfeeding, and postpartum women, infants, and children to age 5. Nearly half of all babies born in the United States are eligible for the WIC program. In Kansas, 40% of babies participate in WIC. This program has evolved over the past two decades from a formula handout to a reliable source of breastfeeding support. WIC promotes breastfeeding as the optimal way to nourish a newborn. All WIC staff encourage a pregnant woman’s decision to breastfeed.
A vast majority of women express a high desire to breastfeed their babies. Unfortunately, many of the women WIC serves return to work within two weeks of delivery. This can sabotage a woman’s desire to breastfeed. WIC offers several sources of support for breastfeeding moms.
The WIC food package for an exclusively breastfeeding woman is larger than any other food package and contains additional protein foods, including canned salmon or tuna. These fishes are higher in Omega-3 fatty acids that are important for infant brain development and overall health for the mom. Exclusively breastfeeding women enjoy a $47 per month fruit and vegetable benefit that allows them to purchase fresh fruits and vegetables. Women who are exclusively breastfeeding qualify for WIC foods until they are one year postpartum. Exclusively breastfed infants receive a large food package starting at 6 months of age to support their continued growth and development.
One major benefit of the program is that many local WIC agencies participate in the Breastfeeding Peer Counselor (BFPC) program. BFPCs are exactly what their name implies, women that have recently participated in the WIC program and breastfed their children. The BFPC usually communicates with women via text message, phone calls, and social media, and are even available to support breastfeeding parents outside of regular office hours.
Peer counselors will reach out to women during their pregnancy and offer reliable information about preparing to breastfeed, surrounding themselves with breastfeeding advocates, how to obtain a breast pump from their insurance, and what to expect the first days after delivery. Peer counselors can be a “social event director,” connecting pregnant and breastfeeding women in their community. Peer counselors will seek activities that are free of charge, such as playing at the splash pad, attending library time, gift-wrapping parties, and moms’ movie night out. One of our most popular events was a cooking class hosted by a local church. The foods were donated and each family took home a chicken noodle casserole they learned to prepare. This social time allows pregnant women to see how normal breastfeeding happens out and about whether the breastfeeding mom chooses to be discreet or open.
Photos from Breastfeeding Peer Counselorevents.
In the near future, families will have another trusted breastfeeding resource. Soon, each WIC agency will be required to have a Designated Breastfeeding Expert. This person handles more challenging breastfeeding issues. Breastfeeding is a learned skill. For some families, this comes easily and for others, there are more bumps in the road. Many physician’s offices will refer patients to WIC because they know there is reliable breastfeeding help available.
Sharing information about supports like WIC is something we can all do to support parents. It’s easy to determine WIC eligibility. Potential participants can find their local WIC office by visiting signupWIC.com and entering their ZIP code. To participate in the Kansas WIC program, families must reside in Kansas and meet income guidelines, which can be found at kdhe.ks.gov.
As a community, we can help families to meet their breastfeeding goals. Supporting paid maternity leave legislation, creating breastfeeding-friendly work environments, designating a private space for a woman to breastfeed if that is her preference, and learning about the amazing benefits of breastfeeding are all things we can do to create an environment that encourages breastfeeding success.
About the series
This is the fourth post in a series on breastfeeding in Kansas. Other posts include:
“I think it’s time for mommy milk!” said my 5-year-old to my 2-year-old as their 1-month-old baby brother began to fuss. “Mommy milk” has always been the term for breast milk in our house, coined by our eldest when her sister was born.
While celebrating National Breastfeeding Month, I remember my own breastfeeding experience. I was fortunate to successfully breastfeed all three of my children. I even had enough stored milk with my oldest two children that I was able to donate to a human milk bank.
My breastfeeding journey was relatively “painless” compared to others – if you don’t count the predicted engorgement, leaking, sore nipples, thrush for both me and my infant, and associated frustrations with finding appropriate times to pump while at work. (Thankfully, I had a very understanding employer.)
As a pediatrician and International Board Certified Lactation Consultant, I also have the privilege of being part of the breastfeeding/chestfeeding journey with many of my patients and their caregivers as they work to provide nutrition for their infants. Not all of their journeys were as “painless” as mine. One case in particular stands out – a mother who came to me with her 2-month-old infant. The case was referred to me due to the infant’s poor weight gain. I worked with the mother and child over the course of about 2 years. We tried different techniques to support weight gain including different ways to give expressed breast milk, different feeding routines, elimination diets for mom, creative ways to introduce solid foods, and so many other things. We involved specialists in different fields to help support the child and mother. Ultimately, the baby did well and was growing and thriving the last time that I saw her. Her mother worked tirelessly to provide the nutrition that she needed to ensure adequate growth, even though it was not the breastfeeding journey the mother would have imagined for herself.
Why breastfeed? The importance of human milk (in brief)
Physiological Benefits to the Infant
Human milk has been proven to be the optimal source of nutrition for infants.
There are multiple aspects in the dynamic properties of breast milk including antimicrobial, anti-inflammatory, and immunoregulatory agents which contribute to the developing immune system of the infant and help prevent infection.
Breastfeeding can reduce the risk of Sudden Infant Death Syndrome (SIDS), certain types of autoimmune disease (inflammatory bowel disease, diabetes mellitus, asthma, atopic dermatitis), leukemia, and obesity.
Physiological Benefits to the Mother
The act of breastfeeding can be beneficial to maternal health in helping mothers recover more quickly from childbirth, assisting with postpartum weight loss, reducing the risk of ovarian and breast cancer, reducing the risk of hypertension, and reducing risk of type 2 diabetes.
Intangible Benefits
Breastfeeding or chestfeeding facilitates maternal and infant bonding.
Breastfeeding can ultimately lead to a closer and more responsive infant/mother dyad.
It’s shown to reduce maternal stress and decrease cognitive and behavioral problems later in childhood.
What does the American Academy of Pediatrics say about breastfeeding and how do we promote and support breastfeeding mothers and their babies?
Exclusive breastfeeding for the first 6 months of life (consistent with guidelines provided by World Health Organization, American College of Obstetricians and Gynecologists, American Academy of Family Physicians, and Canadian Pediatric Society)
Continued breastfeeding along with appropriate complementary foods introduced at 6 months for as long as desired, 2+ years
Recognize that medical contraindications to breastfeeding are rare
Birth hospitals and centers should implement maternity care practices shown to improve breastfeeding initiation, duration, and exclusivity
National tracking of breastfeeding rates through age 2 years
Policies should be in place to protect breastfeeding
Universal paid maternity leave
Right to breastfeed in public
Insurance coverage for necessary items and care in breastfeeding
On-site child care in the workplace
Universal break time and adequate accommodations for human milk expression at work
Recognize that pediatricians (and all those caring for infants) play a critical role in breastfeeding success
Providing evidence-based information on feeding choices
Supporting early skin-to-skin contact and skilled lactation support while in the hospital
Using current resources to give guidance and minimize disruptions in breastfeeding when questions arise due to maternal medications, medical conditions, or vaccinations
Acquiring up-to-date information on the benefits of breastfeeding and how to provide breastfeeding care in the office and the community
Advocating for culturally sensitive and appropriate policies to promote breastfeeding
Assisting parents with preterm infants on establishing milk supply when infant is unable to feed at the breast and the use of pasteurized donor human milk
The graph above shows 2018 national breastfeeding rates for the infants in the breastfeeding dyad exclusively at 3 and 6 months of life, 6 and 12 months of life, and any breastfeeding at all throughout 0-12 months of life. Each age range is broken down into race and ethnicity at that stage. As evidenced above, we are making progress in supporting our lactating mothers and breastfeeding infants but there is always room for improvement. The education is ongoing as we strive to advocate for the breastfeeding dyad.
There are two excellent local upcoming opportunities for education as we welcome Dr. Joan Younger Meek to Grand Rounds at Wesley Medical Center in Wichita, KS, on September 15, and at the Kansas Chapter of the AAP Fall CME Meeting at Hyatt Regency Hotel in Wichita, KS, on September 16. Dr. Meek is the lead author of the new policy statement published July 2022 on “Breastfeeding and the Use of Human Milk” in the Journal of Pediatrics and a leading expert on breastfeeding and lactation. Please attend her presentations if you have the chance. In the meantime, Happy National Breastfeeding Month!
About the series
This is the third post in a series on breastfeeding in Kansas. Other posts include:
This guest blog post was authored by Brenda Bandy, IBCLC, and Jennie Toland, BSN, RN, CLC, Co-Executive Directors of the Kansas Breastfeeding Coalition.
“[…] exclusive breastfeeding goes a long way toward canceling out the health difference between being born into poverty and being born into affluence…It is almost as if breastfeeding takes the infant out of poverty for those first few months in order to give the child a fairer start in life […]”
– James P. Grant, former UNICEF executive director
We are thrilled to report the state of breastfeeding in Kansas is strong! According to data from the Centers for Disease Control and Prevention (CDC) released on August 1, Kansas exceeds the national rates of breastfeeding in all measures. Kansas ranks 14th in the nation in the percent of infants exclusively breastfeeding at 6 months of age for babies born in 2019. This is up from 27th place only five years ago.
The data show nearly 90% of families in Kansas choose to breastfeed. However, the choice to breastfeed is negatively influenced by lack of support in the workplace, lack of access to clinical and peer lactation support, and often lack of family support. Without the right support, the choice to breastfeed isn’t a choice at all.
Consider this map above of breastfeeding initiation rates by county. The counties in pink exceed the state average in breastfeeding initiation rates. The counties in white have the lowest rates of breastfeeding initiation. Social determinants of health can greatly impact breastfeeding rates. We must carefully consider what factors are making it difficult for families to be able to choose to breastfeed.
The graph above illustrates the gaps in breastfeeding rates. These disparities result from structural barriers and historical trauma that make it more difficult for Black, Indigenous and Latina mothers to engage in a traditional practice that has sustained their cultures over generations. While Black and Indigenous families do breastfeed, they do so despite bias and inequities.
The KBC has taken the following action to address racial disparities in breastfeeding rates with support from our partners at the Kansas Department of Health and Environment (KDHE) and the United Methodist Health Ministry Fund (Health Fund):
Compiled research and resources on our Equity pages for racial & ethnic, geographical and LGTBQIA+ equity
How can we make impactful and sustainable improvements to breastfeeding? The answer lies within the community. It is our responsibility to support communities and ensure they have needed resources. While we celebrate increased breastfeeding rates in Kansas, a “rising tide” of breastfeeding support is not enough when some families in Kansas are not even in a boat.
The American Academy of Pediatrics’ (AAP) new Position Statement: Breastfeeding and the Use of Human Milk highlights the importance of supportive policies and systems. The AAP statement recommends “Policies that protect breastfeeding, including universal paid maternity leave, the right of a woman to breastfeed in public, insurance coverage for lactation support and breast pumps, on-site child care; universal workplace break time with a clean, private location for expressing milk, the right to feed expressed milk, and the right to breastfeed in child care centers and lactation rooms in schools are all essential to supporting families in sustaining breastfeeding.”
The KBC and our partners, including the Health Fund and KDHE, are working on improving policies, systems and environments to be more supportive of breastfeeding families.
A recent policy “win” for families in Kansas was the extension of Medicaid postpartum coverage for mothers from a mere 60 days to a full year. This extension of access to coverage will increase access to breastfeeding support in addition to essential physical and mental health services during the first year after giving birth.
If you are curious what breastfeeding support looks like in your county, visit the KBC’s Breastfeeding Support by Kansas County. This document allows you to easily see not only breastfeeding rates but also peer, clinical, and systems-level support for breastfeeding.
We invite you to join the Kansas Breastfeeding Coalition to build on this momentum and continue to improve policies, systems and environments to support Kansas families to breastfeed.
Please consider taking the following actions to support breastfeeding in your community.
As we celebrate National Breastfeeding Month, we are reminded of the gains achieved and the work ahead in helping ensure that breastfeeding’s numerous health benefits are available to all mothers and children.
At the United Methodist Health Ministry Fund, we have worked to support breastfeeding for more than 15 years. In early years, we supported breastfeeding as a proven way to help prevent early childhood obesity. Since 2010, breastfeeding support has been a cornerstone of our strategic work, and the more we’ve gained understanding about the physical, emotional, and relational benefits that breastfeeding has for both a child’s and mother’s well-being, the more importance we’ve placed on this work.
A 2007 breastfeeding support grant to United Methodist Mexican-American Ministries (now Genesis Family Health) in western Kansas was a success in its own right, but also highlighted several challenges and opportunities that have guided our subsequent work.
One early learning was that mothers often face challenges which make it difficult to continue breastfeeding when returning to work. In 2010, we began supporting the Kansas Breastfeeding Coalition’s Business Case for Breastfeeding program, which illustrates the bottom-line benefits of supporting breastfeeding employees and simple, low-cost ways to do so.
We learned that supportive maternity facility policies and procedures, trained health care providers, and post-delivery/postpartum access to lactation support make a huge difference in initiating and maintaining successful breastfeeding. We also learned the importance and value of collaboration across the national, state, and local levels.
The Health Fund worked with the Kansas Breastfeeding Workgroup to develop the High 5 for Mom and Baby program that started in 2011. This program provides training, resources, and a framework to help Kansas hospitals and birth facilities implement five or more evidence-based practices proven to support successful breastfeeding, improving maternal and infant health outcomes while also reducing racial and ethnic health disparities.
To obtain High 5 for Mom & Baby recognition, facilities complete a voluntary, self-reported evaluation and follow five or more of the evidence-based High 5 for Mom & Baby practices.
In 2014, we co-sponsored the Kansas Health Summit on Breastfeeding with the Kansas Health Foundation (KHF). From there, we and KHF used the summit to inform a grant initiative where we co-funded 10 projects to work on physician education, lactation support services, regional coalition development, and more.
We’ve continued to work in partnership with the Kansas Breastfeeding Coalition and have long funded the organization’s leadership as well as various projects providing a continuum of care for women prenatally and throughout their breastfeeding journey.
Gaining experience through these projects, we have continued to adapt and modify our breastfeeding work as we saw more Kansas hospitals taking on maternity care best practices each year. Starting in 2016, we provided funding for five hospitals to work toward the rigorous Baby-Friendly designation, which all five have now achieved. We then partnered with Kansas Department of Health and Environment (KDHE) to co-fund another five hospitals. At this time, 10 Kansas hospitals maintain the Baby-Friendly designation, covering nearly 50% of births in our state.
While Baby-Friendly designation is the “gold standard” for supporting breastfeeding in maternity care settings, we recognized that many other hospitals are working to improve their goals and may not have the staffing or financial means to achieve the designation.
In 2020, we launched the High 5 for Mom and Baby Premier program. These facilities follow all 10 of the evidence-based High 5 for Mom & Baby practices. This spring we announced that 22 facilities had achieved premier recognition, which is the largest number of hospitals to earn the premier recognition since it was introduced.
Since we’ve entered the breastfeeding field, we have seen significant increases in breastfeeding initiation and duration rates for the state. In 2021, Kansas reached the top 15 states for all measures for the first time.
This is in part because multiple funding partners have worked together to support the field, including KDHE and KHF. So much traction has been gained and we have valuable leadership from the Kansas Breastfeeding Coalition and local coalitions across the state that have helped Kansas see significant gains in lactation support and policies within hospitals and communities. This work has led to more women receiving supports in various settings—local businesses, workplaces, places of worship, health departments, and more. All of us working together has made a significant difference for women and children across our state.
While there is much to celebrate, there is much left to do. Although the overall breastfeeding rates are improving, rates for Black and brown women–as was the case in 2007 and unfortunately remains true today–are not seeing as many improvements and these gaps need to be narrowed. In recent years, our work with the Kansas Breastfeeding Coalition has focused on working with coalitions led by women of color to support their communities. We continue to proudly support the work that the coalition is doing to amplify all voices.
During National Breastfeeding Month we should celebrate the work that has been accomplished, but we still must all come together and continue to help every Kansas family achieve their infant feeding goals to create the best outcomes for mothers and babies.
About the series
This is the first in a multipart series on the state of breastfeeding in Kansas. Next week we’ll learn more from the Kansas Breastfeeding Coalition on how our state ranks in breastfeeding and how individuals and businesses can support breastfeeding mothers.
The ten High 5 for Mom & Baby practices are based on the WHO/UNICEF Ten Steps to Successful Breastfeeding – evidence-based practices proven to increase breastfeeding success and reduce racial and ethnic disparities.
1. Facility will have a written maternity care and infant feeding policy that addresses all ten High 5 for Mom & Baby practices supporting breastfeeding
2. Facility will maintain staff competency in lactation support
3. All pregnant women will receive information and instruction on breastfeeding
4. Assure immediate and sustained skin-to-skin contact between mother and baby after birth
5. All families will receive individualized infant feeding counseling
6. Give newborn infants no food or drink other than breastmilk unless medically indicated
7. Practice “rooming in” – allow mothers and infants to remain together 24 hours a day
8. Families will be encouraged to feed their babies when the baby exhibits feeding cues, regardless of feeding methods
9. Give no pacifiers or artificial nipples to breastfeeding infants
10. Provide mothers options for breastfeeding support in the community (such as a telephone number, walk-in clinic information, support groups, etc.) upon discharge
This piece originally appeared in the Kansas Child summer 2022 issue.David Jordan is president and CEO of the United Methodist Health Ministry Fund.
It’s true what they say: children don’t come with an instruction manual. These days, many families are struggling to feel successful raising their children while also coping with the many demands and challenges of modern life.
Toxic stress and adverse childhood experiences (ACEs) are major influences on a child’s overall development — affecting school readiness, student success, physical and mental health, and other factors, including the ability to exercise self-control. ACEs include abuse, neglect, witnessing violence, mental health or substance use problems in the household, and instability in the household, such as separated parents, among other experiences.
ACEs are incredibly common. According to the CDC, approximately 61% of adults surveyed across 25 states reported that they had experienced at least one ACE, while 1 in 6 had experienced at least four. In Kansas, 39% of children have experienced an ACE, and 20% have experienced two or more ACEs.
The first step toward addressing toxic stress and supporting children’s physical health and social-emotional development is to screen early and regularly. Performing a developmental screening when a child first enrolls in early care and education can identify potential risk factors or barriers to success. In many cases, when these concerns are identified and addressed early, the interventions are less intrusive, and children reach developmental milestones more quickly.
Programs and Interventions
Caring and responsive relationships are critical for every child’s healthy development. A number of programs and interventions, including evidence-based home visiting models within the state, nurture caring relationships and positive childhood experiences.
For example, evidence-based early literacy programs promote stronger caregiver-child relationships. Programs like Reach Out and Read (ROR) engage parents, children, and health care providers. ROR’s Perry Klass notes that by reading to young children, parents and educators are teaching responsiveness and cultivating routines and structures that will help children feel safe. These relationships and routines will stimulate healthy brain development and foster a love of reading, leading to improved language skills and health outcomes.
For kids with significant needs, caring and responsive relationships mitigate the effects of toxic stress. Research shows that infants and toddlers who have experienced adversity can benefit from early intervention that focuses on building supportive adult relationships.
One strategy to counteract early adversity is the evidence-based Attachment and Biobehavioral Catch-up (ABC) program. Over the course of the 10-week program, parents increase their knowledge and skills in order to create secure attachments and help their children have better outcomes. While babies cannot verbalize their needs, parents can learn to recognize and respond to their child’s cues, which leads to strong and healthy relationships.
Through support for evidence‐based early childhood development programs, we can ensure that the youngest Kansans enjoy nurturing family environments that prepare them for healthy lives and academic success. Investing in proven early childhood interventions as a state will result in a more capable workforce, reduced health care and mortality costs, and reduced demand for public services. Kansas’ future depends on the children we invest in today.
Child Care Providers & Infant Mental Health
No one can say that caring for infants is simple work. Understanding infants and toddlers and making sure they receive appropriate behavioral health support is difficult.
According to the American Academy of Pediatrics, as many as 1 in 10 preschoolers are affected by emotional, relationship, and behavioral problems. A young child’s misbehavior may be due to mental health concerns. Ensuring that children receive age-appropriate support as early as possible is important for their future health and school readiness.
How can child care providers promote good mental health?
• Connect parents to local resources, such as early childhood development centers that specialize in home visiting and building parents’ caregiving confidence and skills. • Provide age-appropriate screenings for children in your care. If you are not currently using screenings, you can attend ASQ trainings through the Kansas Technical Assistance System Network (TASN). • Advocate for statewide policy changes that would benefit infant mental health, such as increased consultation services and the use of the DC: 0-5 diagnostic classification tool.
We often wish someone could walk us through insurance applications or help us understand doctor’s orders. The challenges can be amplified for uninsured patients and patients whose primary language isn’t English.
Thankfully, there is growing interest in Kansas and beyond in establishing the widespread practice of community health workers to help patients navigate our complicated health system.
A community health worker (CHW) is a member of the health care team who serves as a bridge between patients and providers. They translate doctor jargon. They fill out paperwork and connect patients to needed resources. CHWs help patients overcome obstacles to seeking care, such as transportation or language barriers.
CHWs make the system work better for patients and providers, which is why the United Methodist Health Ministry Fund has invested in supporting the use of CHWs in health care settings throughout Kansas and is partnering with the Kansas Department of Health and Environment, the Health Forward Foundation and over 20 health care and community stakeholders to create certification and payment policies to establish and sustain the profession in Kansas.
CHWs Impact: Lucy’s first patient
Lucy Watie of Bob Wilson Hospital is one of approximately 500 CHWs practicing in Kansas today. As a resident of Ulysses who works at her local hospital, she is passionate about improving the health of her neighbors and community.
“One of my first referrals was a 23-year-old, obstetric patient, mother of two,” said Watie. “The client had no insurance and was considering canceling her ultrasound appointment.”
This patient’s health was impacted by more than what happened at her doctor’s office. All of us are affected by the social determinants of health—the conditions where we live, learn, work and play. This patient lived in a deteriorating apartment with two small children and very little money.
She couldn’t afford to pay for a safe place to live. Paying for an ultrasound was out of the question. Watie helped her apply for Medicaid, SNAP, and WIC. During their time working together, the patient moved from an unsafe apartment to subsidized housing, obtained a library card for internet access, enrolled in the adult learning center to work on her diploma, and established care with a dentist.
“This young lady has endured trauma in her life and been diagnosed with mental illness,” said Watie. “It’s so rewarding to see how well this client is doing since her discharge. She is happier, healthier and has become very self-sufficient.”
Working with a CHW was a lifechanging experience.
Community health workers are becoming more common in Kansas as health care organizations realize their value as part of the care team. Although CHWs improve access to services while reducing disparities and the cost of care, there are challenges to implementing them.
A 2021 study commissioned by the United Methodist Health Ministry Fund identified opportunities to expand the use of CHWs in Kansas, including standardizing education and training, and exploring alternative funding sources because most CHW positions are largely dependent on grant funding. Until now, there has been no baseline education and training to becoming a CHW in Kansas.
Certification program announced
Kansas is one of a growing number of states that are recognizing the community health worker profession by formalizing the certification process. This week, the Kansas Department of Health and Environment (KDHE) and the Kansas Community Health Worker Coalition announced the certification process, which has two pathways. Interested individuals can become a CHW by completing a KDHE-approved CHW training program or through a combination of work experience and letters of recommendation.
The decision to move forward with the state certification process is the result of workgroup recommendations made by a group of health care professionals including providers, payers, community health advocates, and community health workers, convened by KDHE and the United Methodist Health Ministry Fund, with support from the Health Forward Foundation, that explored the role of community health workers in Kansas, a certification process and sustainability issues—including Medicaid payment policy. The group continues to work collaboratively to explore sustainability issues.
As momentum and support for the profession grows in Kansas and nationally, the state of Kansas has recently received two grants to support the use and deployment of nearly 100 community health workers to help Kansans navigate the health care system and challenges resulting from the COVID-19 pandemic.
Through return on investment, community health workers actually pay for themselves. They reduce reliance on emergency care and increase primary care use. A 2020 study at Penn Medicine found each dollar invested in their CHW program would have a $2.47 return on investment to an average Medicaid payer within the fiscal year.
To become a sustainable part of patient-centered health care, the next challenge to overcome will be creating sustainable funding for CHW positions. The 2021 research study found that more sustainable funding options could include Medicaid, service reimbursement strategies, and other innovative and unique payment ideas. Integrating CHWs into a care team can also create new possibilities for funding.
What’s clear is that CHWs can improve health and bring down costs. Recognizing the profession through a certification process is an important step forward. Establishing sustainable financing will ensure better patient care and reduce costs for providers and payers, like state Medicaid programs.
Dr. Sharla Smith of the Kansas Birth Equity Network joined Health Fund CEO David Jordan for a conversation on the Black maternal health crisis.
Conversation with Dr. Sharla Smith of the Kansas Birth Equity Network
“Black women are two to three times more likely to die of childbirth-related issues than white women,” said Dr. Smith. “We’re seeing that crisis happen in the absence of the social determinants of health. So, Black women from the wealthiest communities still have worse outcomes. Black educated women still have worse outcomes than all other women.”
