Community Health Teams Newsletter
March 2021
Building Community-Clinical Linkages
CTC-RI is excited to advance Community Health Team (CHT) sustainability efforts by supporting a 3-part miniseries entitled Community-Clinical Linkages as a Critical Component of Comprehensive Primary Care. Over 40 stakeholders, including health plans, hospitals, state agencies and community based organizations, are involved in providing feedback and direction to a multi- payer strategy to utilize CHTs as a vehicle for addressing key priorities in RI to reduce health disparities and achieve population health goals. We have brought in national consultants (Soma Saha, MD, Founder, Well Bing and Equity (WE) in the World and Well Being in the Nation (WIN) Network and Craig Jones, MD, Capitol Health Associates; former Executive Director of the Vermont Blueprint for Health) to share national best practices around payment design to support population health level initiatives. Through monthly meetings in December, January and February, our goal was to develop a consensus on a sustainable multi-payer/sector funding model for CHTs that leverages Medicaid benefits for Community Health Workers and Behavioral Health services and a statewide learning community to promote innovation and share best practices. Ongoing work continues to support these efforts.
HIGHLIGHT ON CHT WORK WITH MLPB
Strengthening CHT Capacity to Partner with People on Complex Health-Related Social Needs
Through CTC-RI's partnership with MLPB (operating in RI, MA, and nationally), we are:

  • Strengthening CHT's ability to detect and meet complex health-related social needs in strengths-based, person-centered ways; and
  • Improving population-level social determinants of health by identifying trends/barriers that can be mapped to legal problem-solving strategies.

The work of our Community Health Teams can be big, challenging, and complex -- sometimes team members need support from a legal partner! Check out Samantha Morton's new blog about our innovative telementoring partnership on MLPB's blog platform, Bridging Divides! 
Recent Training Topics
Through its Unlocking Access training series, MLPB has educated CHTs about complex systems and decision-makers, how people's legal risks/rights/remedies can make a difference, and scope-of-practice-aligned problem-solving strategies.

Topics included:

  • New Public Charge Rule: Best Practices for Partnering with Immigrant Households
  • Legal Protections for People with Disabilities and their Caregivers
  • Family Law 101: Custody, Visitation, Child Support
  • Navigating DCYF in General- and as a Family Impacted by OUD
What CHT Consults with MLPB Reveal About Trends in Community Need
Our shared goal is increased health equity for the people and populations our community health teams serve.
CTC-RI Community Health Teams Benefit from COVID-19 Relief Funds
"Rhode to Equity" Applications Now Open
The Rhode to Equity is an innovative funding opportunity made available through EOHHS Health Systems Transformation Project. The intent of this 12-month learning and action collaborative is to provide up to 6 cross-sector teams with the opportunity to test and evaluate strategies that will build leadership and operational capacity for clinical-community linkages, resulting in place-based communities that improve both health and social outcomes. This work will be guided by Somava Saha, MD, MS, Well Being and Equity in the World and Well Being in the Nation Network. Using the Pathways to Population Health tools developed through 100 Million Healthier Lives, the Rhode to Equity will bring together teams from:  

  1. Health Equity Zones (backbone agencies, CBO partners)
  2. Accountable Entities (at both the leadership- and clinic-level)
  3. Community Health Teams
  4. Persons with lived experience of inequity (PLE)

Important dates to remember:

  • Application opened: February 5 (questions accepted on rolling basis to deliverables@ctc-ri.org)
  • Webinar information sessions: March 26 (2-3:30pm) and April 13, 2021 (11:30am-1pm)
  • Office hours (Q&A consultation): April 1, April 22, May 12 (10-11am)
  • Applications due: May 21 (click for application)
  • Teams notified: June 4
  • Participative Agreement due back with W-9: June 18
  • Teams complete Compass Assessment: June 18
  • Team participation in kickoff meeting: July 14 (1-5pm)
March 19 Webinar for CHWs and Patient Navigators on Supporting Clients to Use Technology
The next webinar in the 'Advancing Team Based Telehealth in Rhode Island' series is coming up on March 19, from 9:00am-10:30am. The webinar, Strategies for Community Health Workers (CHW) & Patient Navigators to Help Clients Overcome Technology Barriers, will give CHWs and Patient Navigators the opportunity to practice techniques and strategies to support their clients in the use of technology. Participants will break into groups to role play different scenarios with the support of URI student interns from Age Friendly RI's Cyber Seniors program. Participants in this webinar are eligible for educational hours toward earning the CCHW certification for RI. Registration for the webinar can be found here. This webinar series is funded by UnitedHealthcare.
Care Transformation Collaborative of RI | ctc-ri@ctc-ri.org | ctc-ri.org