HURON — Kelly Engebretson was excited to get a prosthetic leg after having part of her leg amputated. But he didn’t know how he would make it to the appointment.
Nah Thu Thu Win’s twin sons needed vaccinations before they could start kindergarten. But she spoke little English, and the boys had no health insurance.
William Arce and Wanda Serrano were recovering from recent surgeries. But the couple needed help sorting out their insurance and understanding their bills.
Engebretson, Wynn, Arce and Serrano were lucky to have someone to help them.
They’re all paired with community health workers in Huron, a city of 14,000 people known for its state fair and home to the world’s largest pheasant sculpture.
The three employees employed at Huron Regional Medical Center help patients navigate the health care system and address barriers to accessing care, such as poverty and unstable housing. Community health workers can also provide basic education on managing chronic health problems such as diabetes and high cholesterol.
Community health worker programs are expanding across the United States, including rural areas and small cities as health care providers. state and federal government Governments are increasingly investing in them. These efforts have attracted attention during the new coronavirus pandemic. Found Improve people’s access to health and preventive care while reducing costly hospital visits.
“Expansion of the medical system”
Community health worker programs can address common barriers people face in rural areas. rising poverty rate and specific health problemssaid Gabriela Boscan Fauquier, who oversees community health worker efforts at the National Rural Health Association.
Workers are “an extension of the health care system,” she said, and serve as a “bridge between the formal part of this health care system and the community.”
Programs are often based in hospital systems or community health centers. The median hourly wage for workers is $23, according to the federal Bureau of Labor Statistics. Patients are typically referred to the program by a clinician who notices a personal conflict or frequent visits to a hospital emergency department.
south dakota It is among the states that recently funded community health worker programs, developed training requirements for health care workers, and approved Medicaid reimbursement for health care services. The state’s certification program requires 200 hours of coursework and 40 hours of job shadowing.
Huron Regional Medical Center began the initiative in fall 2022 after receiving a $228,000 federal grant. The program is currently funded by nonprofit hospitals and Medicaid reimbursement.
Serving Huron’s Minority Communities
Huron is a small city surrounded by countryside, populated mostly by white people. However, there are thousands of Karen ethnic groups from the Southeast Asian country of Myanmar. Began to arrive in 2006. Many are refugees. The city also has a large Hispanic population from the Caribbean, Mexico, and Central and South America.
Mickey Scheibe, one of Huron’s community health workers, recently stopped by the home of his client, Kelly Engebretson. The 61-year-old has been unable to work since having part of his leg amputated due to complications from diabetes.
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Engebretson said Scheibe will help him with “the hurdles he has to overcome,” such as applying for Medicaid.
He told Scheibe he didn’t know how he would get his prosthetic limb installed in Sioux Falls, a two-hour drive from his home. Scheibe, 54, said she would help him ride safely.
She also invited Engebretson to participate in a diabetes education program.
“Absolutely, absolutely, please drop me off,” he replied, adding that he would invite his mother to go with him.
The same day, Scheibe’s colleague Saumay Ramos visited the apartment where William Arce and Wanda Serrano lived. Arce was recovering from heart surgery, and Serrano was recovering from knee and shoulder surgery.
The couple, both 61, moved from Puerto Rico three years ago to be closer to their children in Huron. Ramos, also from Puerto Rico, arranged their appointments, answered questions about claims and helped Arce find a walker and additional insurance.
Ramos, 29, handed Arce a pamphlet on heart health and asked him to read the section on angina, the pain that occurs when the heart doesn’t have enough blood flowing to it.
“Que entiende?” she said, asking Arce what he understood about her condition. Arce answered in Spanish that she knew what angina was and what symptoms to look out for.
Later that day, Paw Wa Tha, the town’s third community health worker, met with her client, Nah Thu Thu Win, who moved to Huron from Myanmar in February with her husband and six-year-old twins. did. The Wynn family, like Sa, are members of the local Karen community, whose people were persecuted under the military regime in Myanmar, formerly known as Burma.
Wynn, 29, thought her children would qualify for Medicaid. But unlike most other states, South Dakota not provide compensation immediately For children who immigrated to the United States legally, the boys’ father hopes to eventually enroll them in the insurance his job provides.
Sa didn’t want her children to wait for medical treatment. The 24-year-old previously took his twins to a free mobile dental clinic in Huron. It turns out I need more advanced dental care, which is only available free of charge in Sioux Falls. Mr. Sa helped me make the arrangements.
According to Sa and Ramos, many Karen people and people from rural areas in Central and South America had little access to health care before immigrating to the United States. They said a major part of their job is to explain what types of care are available and when it’s important to seek help.
The three community health workers sometimes take customers grocery shopping and teach them how to read labels and identify healthy foods.
Boscan Fauquier, president of the National Rural Health Association, said community health workers are familiar with the cultures they serve and can offer affordable meals that customers are familiar with.
Changing needs in rural America
The total population of rural America is decreasing, but the 2020 Census shows that the population is decreasing. become more diverse This is because people representing ethnic minorities are attracted to jobs in industries such as agriculture, meat processing, and mining. Some people are attracted to rural areas because of their low crime rates and cheap housing.
Boscan-Fauquier said many rural health worker programs serve minority populations. highly likely They are more likely to face medical barriers than white people.
She pointed to programs that provide services native american reservationthe southern Black Belt region, and Spanish-speaking communities where workers are called promoter. But community health workers also serve rural white communities, such as areas of Appalachia affected by the opioid crisis.
Medicare, the federal health care program for adults age 65 and older, reimburses the services of community health workers. since January. Boscan-Fauquier said advocates want to expand the state’s Medicaid program. private insurance company Refunds will also be possible.
Engebretson said he is happy to see local health care workers not only in large cities, but throughout South Dakota.
The more they can “reach out to people, the better it will be,” he says.
