Community Health Workers
In the ED, our Community Health Workers and Peer Recovery Specialists serve as an important bridge between the hospital and the community. They are uniquely positioned and equipped to assist our most marginalized and at-risk patient populations in improving their health and well-being
People
Community health workers (CHWs) are frontline public health professionals who are representative of the patient population they serve.
Peer recovery specialists (PRSs) are in long-term recovery and are experts in supporting patients with co-occurring substance use disorders and mental health conditions.
Programs
There are four programs throughout the hospital that employ CHWs and PRSs. In the Center for Primary Care, there are CHWs in the Transitions and Recovery Clinic. In the Emergency Department, there are two groups of CHWs and PRSs: the Substance Misuse Assistance Response Team (SMART) and the Emergency Department to Community Connections and Re-Engagement (ED-CCARE) team.
ED-CCARE addresses the underlying social needs of patients with high ED utilization and connects them to outpatient care
SMART connects ED patients with substance use concerns to outpatient care and provides individualized counseling
The Recovery Clinic supports patients in recovery and prevents hospitalizations related to opioid use
The Transitions Clinic provides primary care for patients released from incarceration who have multiple chronic conditions
What do they do?
CHWs and PRSs provide extensive support to patients, including:
- Assessing the patient's social determinants of health
- Connecting patients to medical and behavioral health support
- Informing successful hospital discharge plans and translating hospital plans
- Providing peer support to ensure the safety and comfort of patients
- Crisis intervention, safety planning, and harm reduction health practices
- Advocating for patients in court and with probation/parole officers
- Identifying housing and sober living environments for patients
- Obtaining vital documents and applying for employment and benefits
- Collaborating with other community agencies who also provide support
Why are they integral to Rhode Island Hospital?
Acting as a bridge between the hospital and community, CHWs and PRSs are uniquely equipped to assist vulnerable patients in improving their health. CHWs and PRSs ensure access to quality and comprehensive care by directly working with providers and providing health education, social support, and care coordination. They can often be found throughout the hospital providing necessary support to their patients; feel free to say hello and ask them about their important work!
How to contact Community Health Workers
- Patients presenting with overdose: continue to place a Recovery Coach consult– during the weekdays from 8am-5pm this consult will go to the ED CHW/PRS. At off hours it will continue to be Anchor.
- Patients currently working with a CHW: see the Care Plan in Epic with their contact information. Please call the CHW (during the weekdays 8a—5pm) or secure chat them to let them know the patient is in the ED
- If you have a patient that you think may benefit from CHW/PRS services, please secure chat the patient’s info to “RIH ED CHWs” (you can expect a timely response during the weekday from 8am-5pm)
- Any substance use disorder
- Homelessness or housing instability
- Management of chronic medical conditions resulting in frequent ED visits
- Other social determinants of health: immigration issues, court advocacy, identification, transportation, government or social services
Contact
For more information about the Community Health Workers Program, contact Rebecca Karb, MD, PhD