RWJF Graduation

FOR IMMEDIATE RELEASE—

Pilot project provides health improvement model
for those living in subsidized and public housing

New toolkit shows how trained community health workers

working with community nurses and a dedicated support team

can help fill healthcare gaps, avoid costlier crisis care

Asheville, N.C. Oct. 24, 2022 — A team of Asheville healthcare providers who began a project called HELP three years ago now is sharing their findings as a guide for others nationally and widening the outreach locally as well.

The methods and findings of the grant-funded pilot Health Engagement Leading to Prevention are being made available nationally in Toolkit for Training and Utilization of Community Health Workers in Subsidized Housing.  And the HELP team, through a spinoff nonprofit, IFPHA, has already expanded the outreach from one pilot residence location to five others in the city.

The team was among eight selected nationwide in 2019 by the Robert Wood Johnson Foundation's (RWJF) Clinical Scholars program to receive $315,000 for their project as well as leadership development and support. HELP’s work focuses on addressing health challenges faced in subsidized housing through providing Community Health Worker training, resident education, and regular clinical support.

“We know we can improve quality of life and prevent premature death, and even save money doing it, with tools that currently exist,” said Dr. Shuchin Shukla, one of HELP’s  scholars. “We just need to implement them.”

HELP undertook implementing them at Arrowhead Apartments in Asheville to determine the most effective ways to do so. The HELP team was led by community nurse Kathey Avery, RN, BSN, and founder of IFPHA, the Institute for Preventive Healthcare & Advocacy, along with  Frank Castelblanco, RN, DNP, and Dr. Shukla, MD, MPH, both of Mountain Area Health Education Center.

They were also supported by Angelique Scott, LPN and CHW supervisor; Kevin Rumley, M.S.W.,  of Veterans Treatment Court; Professor Ameena Batada of UNC Asheville Health and Wellness Department; Stephanie Swepson Twitty, president and CEO of Eagle Market Streets Development Corporation; ABIPA (Asheville Buncombe Institute Parity Achievement); MAHEC (Mountain Area Health Education Center) as well as Arrowhead’s residence manager Ladonna Eubanks and service coordinator, Shana Roberts.

THE HELP MODEL utilizes supported community health worker services, first providing direct services and health education to the residents and, for sustainability, training of embedded community health workers who are actually part of the facility community. Arrowhead residents trained as CHWs were Ava Roberts and Robin Miller. The CHWs, overseen by a community nurse, are supported by an interdisciplinary team including medical providers, social workers, and housing managers.

All are working to achieve a safe, healthy environment where seniors, disabled, and formerly unhoused individuals can live and work together in community in a safe, respectful way that allows everyone’s mental and physical health issues to be effectively addressed and managed.

“Our model results in better outcomes for people who often fall through cracks of our current healthcare system such as people who are older, disabled, or formerly homeless,” Avery said. “Instead of utilizing costly emergency medical services, or people being evicted for uncontrolled physical and mental health issues, these community residents are supported with help quickly and regularly.”

The emphasis is on preventive healthcare that considers the social determinants of health as well as effective management of chronic ailments and other assessed health needs improving the likelihood of aging in place and other housing stability. Because of the pandemic, the work focused on crisis care and infection prevention as well.

DURING THE COURSE OF THE PILOT, all 116 Arrowhead residents participated in at least one outreach besides the monthly healthy food and COVID-19 PPE distributions for all residents and other identified resource needs. About a quarter of them were consistent participants in all HELP outreaches. A food pantry and a community garden were begun. And 11 residents successfully completed smoking cessation to avoid eviction since Arrowhead is a smoke-free, independent living faciltiy.  Eight others got support dealing with hoarding behaviors and cleaning infractions.

And though the COVID pandemic impacted planned activities and methodology, HELP being in place allowed for quick pivoting to help residents, many dealing with multiple health issues, keep safe and protected.

Timely education information as well as bags with immunity-building fresh fruit and vegetables, cleaning supplies, and personal protective supplies (masks, hand sanitizer, wipes) were hung on residents’ doors. Once vaccines became available, vaccine clinics were arranged at Arrowhead in addition to transportation services to other clinics.

“Since HELP has been coming to my home, the quality of life for me and my fellow residents has improved a great deal,” Robin Miller noted, “particularly because of their dedicated service and concern throughout the pandemic.”

HELP activities, now called HELP2Day under an initiative from IFPHA, continue at Arrowhead and Klondyke Apartments, a public housing location where the model was replicated. IFPHA evolved as a nonprofit, founded by Avery, in May 2020 to assure that that successful work continues and expands. The HELP2Day initiative is currently actively engaging residents in five housing communities and taking initial steps in several others.

To view or download the toolkit, visit: clinicalscholarsnli.org/community-impact/help

Clinical Scholars is a national leadership program for experienced health care providers supported by the Robert Wood Johnson Foundation. Working in teams from diverse disciplines, Clinical Scholars Fellows receive three years of funding for projects addressing complex health problems, and equity-centered leadership training to extend their influence and impact. Since 2016, Clinical Scholars has supported 162 Fellows with 44 projects across 28 U.S. states and territories.

Asheville’s HELP team was among those honored at Clinical Scholars graduation presentations in Vermont in late September.