Abstracts

Rationale: Evidence supports use of nontraditional health providers (NTHP), (e.g., community health workers [CHW], navigators, health educators/coaches) for delivery of coordinated care, self-management, and for reducing disparities.1 NTHP share experiences with the population served, and link patients, providers, and community services. Engaging NTHP is an evidence-based public health practice.1 The Centers for Medicare and Medicaid Services expanded payment for services provided by non-licensed providers.2 States are mobilizing partners to integrate NTHP into healthcare teams.1 The Institute of Medicine notes that NTHP are a valuable asset in epilepsy care.3 Scant research exists in the use of NTHP in epilepsy,4 but their use in other diseases offer promise for epilepsy. This study examined how NTHP can be integrated into epilepsy care.Methods: Reports from federal and state agencies, and other groups were reviewed to assess NTHP scope of practice. The IOM report was used to identify gaps in epilepsy care. NTHP roles, competencies, models of care, and care gaps were cross-walked.Results: NTHP definitions, roles, and certification vary by state. Core competencies for NTHP functioning as CHW exist (Table 1). Models of care have been identified (Table 2). Forty states are working to integrate NTHP into healthcare systems.5 Community colleges, state agencies, nonprofits, and health systems offer NTHP training in many states.6 Cost savings for NTHP services are reported.7 Medicaid reimburses for NTHP services in AK, MN, and NM.1,5 Trained NTHP can meet gaps in epilepsy care (Table 2). Epilepsy content is being developed in TX to employ CHW for delivery of epilepsy self-management.Conclusions: NTHP play a key role in healthcare teams. Epilepsy stakeholders can partner with existing groups to develop and evaluate efforts to integrate NTHP into epilepsy care. REFERENCES 1. CDC. (2015). Addressing chronic disease through community health workers: a policy and systems-level approach. http://www.cdc.gov/dhdsp/docs/chw_brief.pdf. 2. CMS. (2103). Update on preventive services initiatives. www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-11-27-2013-Prevention.pdf. 3. IOM (2012). Epilepsy across the spectrum: promoting health and understanding. Washington, DC: The National Academies Press. 4. Kelley S. et al. (2012). Evaluation of the Florida integrated case management intervention program on treatment outcomes and quality of life of medically indigent adults with epilepsy, final report. Tampa: Univ. So. FL. 5. Nat. Acad. State Health Policy. 2015. State community health worker models. http://www.nashp.org/state-community-health-worker-models/. 6. ASTHO. (2015). Community health workers (CHW) training/certification standards. http://www.astho.org/Public-Policy/Public-Health-Law/Scope-of-Practice/CHW-Certification-Standards/. 7. Nat. Diabetes Educ. Prog. (2015, February 11). Community health workers: their role in Preventing and Controlling Chronic Conditions [Webinar]. In NDEP Webinar Series. https://cc.readytalk.com/cc/s/meetingArchive?eventId=codjxak0riu7.