Improved healthcare access through the healthcare workforce

When MAPP2Health participants discussed improving healthcare access in locality-specific workgroups, the focus often turned to community health workers and other peer health advocates as trusted resources in their communities. Community health workers reflect the diversity of the communities they serve, acting as educators, liaisons, and healthcare navigators for their clients, improving both the quality and continuity of care.

In the same vein, cultural humility and empathy, equity, and inclusion were identified as core competencies necessary but underrepresented in the healthcare workforce. Participants discussed the lack of diversity in medical school clinical training curricula and clinical providers, and how this was a disservice to patients. Research on the healthcare workforce aligns with MAPP2Health participants’ assumptions: The effects of diversifying the healthcare workforce are that patients are more satisfied, more likely to make healthy behavior changes, and more likely to have improved health when their provider is “in racial and ethnic concordance” (Harvard Medical School; US Department of Health and Human Services (HHS) Office of Minority Health).

Taking this into account, the CHIP objectives aim to improve healthcare access not only by expanding services to where they’re needed most, but by ensuring that those services are delivered by diverse, trusted, and community-conscious providers.

Workgroup Partners: Albemarle County Public Schools, Blue Ridge Medical Center, Clinical Skills Center in the UVA School of Medicine, Sentara Martha Jefferson Hospital, BRHD, Charlottesville Free Clinic, Community Mental Health and Wellness Coalition, Move2Health Equity, Network2Work@PVCC, Starr Hill Pathways, UVA’s Division for Diversity, Equity, and Inclusion, UVA Health’s Latino Health Initiative, UVA Health’s Office of Diversity and Community Engagement, WellAWARE.

Workgroup Partners for Community Paramedicine Objective: Charlottesville Fire Department, Albemarle County Fire & Rescue Community Risk & Resilience, Charlottesville Area Rescue Squad (CARS), Wintergreen Fire & Rescue, UVA Health’s Community Paramedicine Program

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CHIP Goals + Objectives |2023-2025 CHIP Report (PDF)

 

GOAL	Objective	Sub-Objective	Convener	Contributors	Target Date	Indicator	Target	Status
1. Ensure providers and staff reflect the diverse patient population	1.1 Clinicians (including behavioral health clinicians) reflect the diverse patient population				12/31/2025	As of December 31, 2025 – % clinicians who are people of color – % behavioral health clinicians who are people of color – % clinicians who are multi-lingual – % behavioral health clinicians who are multi-lingual	>=15% >=15% >=20% >=20%	1st Progress update will be 12/31/2024
		1.1.1 Increase the number of people of color and multi-language speakers who participate in local trainings and classes to join the clinical workforce	Blue Ridge Health District	Charlottesville Free Clinic Sentara Martha Jefferson Hospital, UVA Health Office of Diversity and Community Engagement	12/31/2025	# people of color and multi-language speakers who take local trainings or classes encouraging clinical workforce entry during 2024	baseline + 20%	Sentara MJH’s CNA course graduated June and 10 in December 2023. UVA Health’s RMA course traied 20 RMAs and 15 are working as RMAs as of November 2023. Both CNA + RMA courses were offered in Charlottesville neighborhoods with accommodations for working students. Enrollees were majority BIPOC students from local communities.
		1.1.2 Improve simulations and scenarios at UVA Med School to include “Standardized Patients ”that are diverse in race, age, gender identity, and socio-economic status	UVA Clinical Skills Center	Latino Health Initiative Move2Health Equity UVA Health Office of Diversity and Community Engagement	12/31/2025	As of December 2025, % of Standardized patients who are – younger than 60 – identify as LGBTQIA+– – are non-native English speakers	>=10% >=30% >=5% >=15%	30% complete Recruitment video and promotional materials under development as of 07/31/2023. 50 Standardized Patients attend 1st DEI presentation (in series of 5) hosted by Director of Diversity Education, Sly Mata. 10/03/2023
		1.1.3 Bolster and expand the clinical workforce pipeline	UVA Health Office of Diversity and Community Engagement	Albemarle County Public Schools Pipelines & Pathways at UVA, Sentara Martha Jefferson Hospital, Starr Hill Pathways	12/31/2025	# clinical workforce pipeline paths that support people of color and multi-lingual speakers	baseline + 10%	Starr Hill Pathways graduated its summer cohort and hosted a career fair in Charlottesville, June 27, 2023.
	1.2 CHWs (and similar outreach worker positions) reflect the diverse patient population				12/31/2025	As of 12/31/2025, % CHWs and similar districtwide who are – people of color – multi-lingual	>=10% >=5%	CHW or similar position baseline = 28. Established 06/1/2023 via BRHD Outreach Network survey.
		1.2.1 Increase the number of people of color, LGBTQ+, and multi-language speakers who participate in local trainings and classes to become CHWs and similar outreach positions	Blue Ridge Health District	Latino Health Initiative, Sentara Martha Jefferson Hospital, WellAware	12/31/2025	# people of color, LGBTQIA+, and multi-language speakers who take local CHW or similar outreach trainings or classes between September 1, 2023–December 31, 2025	30 [baseline is 0]	PVCC CHW certification course launched August 21. 13 students enrolled; 69% of students are people of color; all participants on scholarship.
		1.2.2 Increase paid opportunities for multilingual and local CHWs as patient supporters and navigators	TBD	Latino Health Initiative WellAware	12/31/2025	# paid multi-lingual or local CHWs providing patient support between 2024-2025	baseline + 10%	Two new CHWs hired to BRHD team, October 2023 (serving Greene and Albemarle). Open position at SMJH to be filled fall 2023.
		1.2.3 Create a network that will provide an opportunity for training, collaboration, and networking for the district’s CHWs and similar positions	Blue Ridge Health District		12/31/2024	# CHWs or people in similar positions referred via the network hub to trainings during 2024	30	BRHD Outreach Network Coordinator hired and onboarded as of July 2023. CHW Network Kickoff 10/18/2023 at SMJH hosted by BRHD.
	1.3 Medical interpreters are working in sufficient variety to serve a diverse patient population				12/31/2025	# high quality trained medical interpreters working in the District by 12/31/2025	baseline + 10%	No progress updates as of 10/15/2023
		1.3.1 IRC and UVA Health collaborate for training and staffing of medical interpreters	Blue Ridge Health District	International Rescue Committee Charlottesville (IRC) UVA Health Special Services	12/31/2025	TBD	TBD	Second meeting of IRC and UVA to discuss collaboration in August 2023.
		1.3.2 Expand medical interpreter paid positions beyond UVA Hospital	Blue Ridge Health District	TBD	12/31/2025	# new medical interpreter paid positions outside UVA Hospital from 01/01/2023- 12/31/2025	10	Medical interpreter reimbursement (paid by Medicaid) information distributed to Medicaid Dentists in District 10/15/2023.

 

 

GOAL	Objective	Sub-Objective	Convener	Contributors	Target Date	Indicator	Target	Status
2. Expand the provision of health services in rural and underserved communities	2.1 Work with county and city governments to include incentives for healthcare practices in rural or underserved communities in comprehensive plans or zoning		Blue Ridge Health District	Albemarle County AC44, Nelson County Department of Planning & Zoning	12/31/2025	# comprehensive plans including CHIP recommedations or incentivize healthcare practices in rural or underserved communities	3	Community Crossroads concept included in both AC44 and Nelson County plan drafts as of July 31, 2023.
	2.2 Expand the provision of Medicaid health services				12/31/2025	TBD	TBD
		2.2.1 Advocate at the legislative level for increased Medicaid reimbursement rates, particularly for dentistry and mental and behavioral health services	TBD	TBD	12/31/2025	# meetings with legislators to discuss increasing Medicaid reimbursement rates by 12/31/2025	3	No progress updates as of 10/15/2023
		2.2.2 Assess the proportion of Medicaid-eligible patients in each locality to determine the ideal benchmark for enrollment numbers	Blue Ridge Health District	Move2Health Equity	12/31/2023	#assessments completed by 12/31/2023	1	First pass of assessment completed by July 2023. Followup meetings to determine grant funding possibilities for more in-depth evaluation.
		2.2.3 Characterize the providers (including dentists) who do not accept Medicaid	Blue Ridge Health District	Free Clinic Charlottesville	12/31/2023	# reports on characteristics of provider who do not accept Medicaid completed by 12/31/2023	1	30% complete. Meeting with DMAS Smiles for Children Medicaid dental program September 12 and October 13.
	2.3 Assess the need for more integrated or broader Community Paramedicine (CP) services through Charlottesville, Albemarle, Nelson Fire Departments and volunteer EMS providers		Blue Ridge Health District	Albemarle County Fire & Rescue, Charlottesville Albemarle Rescue Squad, Charlottesville Fire Department, Greene County EMS, UVA Population Health’s CP Program, Wintergreen Fire & Rescue	12/31/2023	#meetings held by 12/31/2023 that include at least three Community Paramedicine partners to determine levels of collaboration and cooperation	2	50% complete: First meeting of entire CP cohort August 3, 2023. Collaboration with UVA SCOPES program for convening of CP Group, October 2023.

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