question about community health workers

Good afternoon. What is the level of training/education that is needed for community health workers to be able to successfully educate and manage the asthma issues that come up during a home visit. Does the community worker refer back to the provider? Thank you.

Jerry Goldstein MD

St. Christopher's Hospital for Children

Philadelphia, PA

Our Safe at Home program, funded by HUD Healthy Homes Demonstration and Production grants, requires the environmental health educators to be Certified Asthma Educators or working towards certification. The educators act as case coordinators by reporting the findings of the home inspection and the interventions performed to mitigate known health hazards (dust/allergen removal, removal of soiled carpets, mold remediation, pests, etc). They also manage the collection of pre/post health surveys to monitor asthma control as well as follow-up education and case management. In our organization they serve as the point of contact for both the provider and the family.

If you have any questions please feel free to contact me at

Brendan Wade Brown

Program Evaluation and Data Management Associate

Coaliton to End Childhood Lead Poisoning

Green & Healthy Homes Initiative

The WIN for Asthma program does not have specific education or certification requirements for community health workers (CHWs) but, once hired, the CHWs do participate in an intensive training program that we developed.   The CHWs, who represent the local community, use a peer-based approach to support participants and do not provide clinical guidance/information.  Instead, they encourage the participants to communicate regularly with their provider.  In addition, our medical director, a pediatrician, offers monthly community-based asthma workshops during which participants  have the opportunity to ask questions about medications, side effects, etc.  

To give you a sense of the type of training the CHWs receive, upon hire they participate in a 2-week core competency training that is followed by additional training in key areas such as case management, disease management, home visiting, motivational interviewing, integrated pest management strategies, among others.   The initial and on-going trainings are delivered by community partners, faculty, and senior CHWs.   I would be happy to share our training protocol with you and/or to discuss this topic in more detail.


Patricia Peretz

Manager, Community Health and Evaluation

NewYork Presbyterian Hospital


Where can I find more resources and research supporting allen-proff pillows and mattress covers actually decrease asthma triggers in children?

Thank, Tracy and participants---great job.


My questions include the following:

many of the "best" CHW I know who have the cultural and linguistically competency for our target population do not have the computer literacy skills to "chart" effectively in the patient centered medical home.  Part of the idea of CHW is to take the burden off the busy provider and give it to someone who is from the community and understands realities and resources.   But those folks often have other barriers to being part of today's team---proficiency in English and computer skills.

-Lois Wessel, CFNP

Association of Clinicians for the  Underserved


Second question---


How do community based CHW who are not in the PCMH (pt centered medical home) effectively communicate with the PCMH if the CHW is based at the health department or outside the clinic?

-Lois Wessel


What ICD 9 codes are programs currrently using for home visit reimbursement for AE-C's?

Robin Costley, CRT, AE-C

Marion County Public Health Department, AE-C

Asthma Alliance of Indianapolis, Coalition Manager



This is for smelton's question.  The best evidence on asthma home interventions can be found at the CDC's community guide:  The research seems to conclude that multi-trigger interventions are most effective, instead of trigger-specific interventions.



For LAWessel's question on computer skills and English proficiency.  This is a tough one because you are also hiring for their cultural competency and abililty to connect with hard to reach populations.  I think they can be trained and systems can be set up to facilitate communcation.  You might need to rethink communcation systems for this workforce.  For example, at Boston Medical Center the CHW and RN meets then the RN Case Manager reviews and posts in the EMR.


LAWessel's question 2.  Communcation back to provider is key.  However, Boston Public Helath Commission has a good web-based system called Breathe Easy at Home that provides feedback to providers after referral.  We are studying this sytem to take it statewide.  If you can't find that website, please let me know.


Here's the Breathe Easy website:

@smelton, check the 2000 IOM Clearing the Air Report which supported dust mite encasings and the NHLBI EPR-3 Guidelines also recommend to encase the mattess and pillow in an allergy encasing  (or wash the pillow weekly which is not practical), and wash bedding weekly (page 188).

By the way, washing bedding in 130 degrees F is not necessary if the bedding will also be placed in a dryer. Just washing in cold water is 90% effective and the dryer will do the rest. Household water temp should be between 115 and 120 to reduce burn injuries.  

P Bouton

Columbus Public Health, Healthy Homes Program

The community health workers should be educated well about the asthma isues that they would have to face during home visit. They all should be given short term courses on how to manage these situations by experienced clinical practitioners.

Community workers don't need any special courses or skills when they enroll to this program. They will be told what to do and shall learn the knowledge they need. Anyone may join the bijuterii argint program.

Yes we do refer back. I think before doing this me must have to see the ration and according to market research reports we need to improve our education.