| Community Health Advisors |
In late 1994 and early 1995, the Border Health Office/Public Health Division of the New Mexico Department of Health began providing funding to a local Community Health Center (La Clinica de Familia) in Doña Ana County to expand the one existing Community Health Advisor (CHA) Program in Southern New Mexico. A few dedicated women began to fulfill a critical need in Southern Doña Ana County by making referrals to health care and other social service agencies, accessing locally available resources for their customers, providing information and education to individuals, families, and groups, and conducting culturally sensitive home visits to provide emotional support and assess the living situations of their clientele.
The Border Health Office recognized the important role that these promotoras had in their communities, and as a result, sent out two more Request for Proposals (RFPs) in early 1995 to expand these services out to Luna and Grant Counties. By mid-1995, word was getting out about the Promotoras in Southern New Mexico, and their programs were getting inundated with requests for assistance. By late 1995, the Border Health Office responded to these requests by providing funding to implement yet another Promotora Project in Hidalgo County, and now funds at least one project in all four of the border counties in New Mexico. A fifth project was funded in Northern Doña Ana County in early 1996, and the Border Health Office presently has more than $250,000 invested in Community Health Advisor Programs throughout Southwestern New Mexico.
Each of the Promotora Projects work at a different level in their communities, as they are all affiliated with organizations whose needs vary from county to county. With the exception of the CHA Project in Luna County, all four of the other contracts are with healthcare facilities. The Border Health Office works closely with each of these organizations to ensure that the Promotoras are meeting the needs of the healthcare facilities while also addressing other community needs outside of the healthcare arena. While the challenges are immense and the needs overwhelming, the Border Health Office believes strongly in the concept of Community Health Advisors, and feels that the amount of funding invested in these projects is extremely beneficial to the communities in which they are involved.
The Border Health Office in Las Cruces, New Mexico has funded and supported Border Area Community Health Programs, (Promotoras), for approximately six years and has provided $1,375,405 to Columbus, Gila, Southern Dona Ana county as well as in the Hatch areas. Largely due to funding, we expanded services to colonias and other areas of need, and expanded on training and orientation for the promotoras.
Here is a snapshot of what wonderful work is being done in the southern part of the state and how resourceful the Promotoras or Community Health Workers are in leveraging dollars for their community.
In southern Dona Ana County, La Clinica de Familia has a total of 15 Promotoras that provide educational services such as substance abuse, parenting classes, TB education, environmental assessments of the home, prenatal care education, diabetes, breast and cervical education and screening through the Avon grant. Promotoras also enroll children and their families to the Medicaid enrollment program. Some of their greatest success for the 1999 to 2000 year was the increase in self sufficiency of many of their clients, 275 cases were inactivated due to families ability to perform their own case management. Also the number of Medicaid enrollment increased considerably, as well as an increase in providing clinical services to 753 prenatal patients and 2,631 well child patients. There was also an increase in individual's awareness of environmental factors through surveys and assessments that were administered with the Promotora's help.
In Hatch at Ben Archer Clinic, the Promotora is actively involved with her community by involving them in organizing a Milagro and Las Uvas walking program, a Fiesta for diabetes prevention and collaboration, assisted in various Health Fairs as well as organized a toy drive for Christmas. The Promotora are very involved with the Maternal Child Health Council in its efforts to help reduce racial disparities among women of childbearing years by assisting in organizing their focus groups around prenatal issues. She also provides a wide range of educational services- the topics are endless.
In Columbus, the Promotora Project has been very involved in leveraging dollars for their community. In fiscal year 1999 to 2000 they received a $12,000 grant, from the New Mexico Community Foundation, a mini-grant from the March of Dimes for the Maternal and Child Health Program which totaled $2,000. This particular grant was used to help pay for the purchase of bathtubs and baby supplies as well as to provide a series of workshop emphasizing the need for early and adequate prenatal care, post- partum care and care of the newborn. This particular project also assists the Border Health Mobile
Clinic making appointments and following up with clients that may need immediate medical attention. This particular project also provides services to their Senior Population such as assisting in annual income tax preparation, household management teaching them to fill out money orders and making their own appointments. The Promotora Project also assists in recognizing the needs of their community and bringing it back to the attention of the Village. Particular barriers include the lack of meal services for the homebound seniors and mental health services for seniors as well citizens of their community.
In Lordsburg, at Hidalgo Medical Services, the Promotora's assisted in developing and implementing outreach clinics in very remote rural communities in Hidalgo and Southern Grant County. They have also provided local outreach clinics at the local grocery store, bank and Senior Citizens Center. The outreach clinics benefit the communities by improving access to care and screenings brings awareness to the public around health issues. The Promotora project has also found a need to assist the community in finding pharmaceuticals free and or at a reduced cost. This they feel helps reduce the spread of chronic disease.
In Silver City, at Gila Regional Medical Center the First Born Project provides home visits as well as educational services to all first time parents despite income. This service has been an existence for two years. They have also given families training on infant massage, Basic Pediatric Life Support, the NM NOW car seat training's and toddler play groups. For fiscal year 2000 they were unable to service a total of 111 clients which concerned many of the service providers. The First Born Program has worked very diligently to leverage dollars into their community. Recently they were awarded a grant a $133,000.00 from Behavioral Health Services-Substance Abuse Prevention Initiative to increase their potential to see more clients. So this, of course, has enabled them to hire more staff to meet the demand of their community. This grant will require the Project to provide culturally relevant and age appropriate ATODA prevention activities. For fiscal year 2000 the total number of home visits as well as hospital visits were 1569 and they were able to provide services to 60 families.
As you can see, the Promotora Projects are an invaluable service to the community. They certainly know the pulse of their community! Our hats go off to all these people that make it possible.
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New Mexico Border Health Office
District III, Public Health Division 1170 N. Solano, Ste. L Las Cruces, NM 88001 Phone: (505) 528-5156 Fax: (505) 528-6045 Toll free: 1-800-784-0394 bho@nmsu.edu |
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New Mexico's motto is Crescit Eundo (It Grows As It Goes)
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