Kim had a realization after being suddenly laid off from her corporate job of 10 years.
“I had this feeling [about] the next job I walked into,” she said. “I wanted to really love it and feel like I’m giving back to people from what I do.”
One of her former colleagues suggested that Kim would be a great community health worker since she was a trusted member and leader of her church and broader community. Kim applied for an open CHW position at Sinai Urban Health Institute (SUHI), and they immediately offered it to her.
As part of a small team, Kim started out as a CHW educating families on how to manage symptoms of pediatric asthma in young patients at Mount Sinai Hospital. However, the team saw children return to the hospital with the same symptoms and conditions. They realized that a lot would happen after the children left the hospital that did not have to do with not following the doctor’s orders.
“It was really about life beating people up,” Kim shared. “People had to make choices—do I buy groceries? Or, do I get medicine? And if I have multiple children, we can’t afford all of the medicines.”
“We were dealing with the social determinants [of health].”
SUHI soon adapted the community health worker model from being in-house to a more hands-on, community-based approach, a way that acknowledged the complexity and intersectionality of social and structural issues affecting health. With this change, the CHWs’ outreach also changed as they now added education on chronic conditions like diabetes, cancer, and COPD.
The shift also expanded the role of the CHW to one that viewed them as local connectors to needed services and resources, such as food access and financial assistance.
“It was like putting together the pieces of the puzzle—to paint the picture of what was happening with the patient [and their caregivers].”
As a result, Kim’s role quickly evolved as she gained experience helping with new CHW trainings and found a unique purpose in that role. She took training seriously, especially after her early experiences when doing in-home visits.
“I was hell-bent on sharing a real boots-on-the-ground perspective to potential new community health workers because of the shock I experienced when I first got hired,” Kim said. “I didn’t want that to happen to anybody else or cause them to lose their joy for the work for unexpected situations that could occur.”
SUHI allowed Kim to adapt the CHW trainings to include case studies and role-playing activities designed from lessons learned through experiences in the field, which allowed her to advance several of her skills as a trainer, consultant, and community health worker. Kim pioneered this new role as a trainer and educator of CHWs, a newly created career pathway for the field of work at SUHI. Since the COVID pandemic began, Kim has trained over 2000 individuals and prepared them to work for large initiatives with the City of Chicago, Cook County Department of Public Health, and more, emphasizing the importance of such a role.
“Kim has been a big influence on my career development as a CHW. Her expertise has shown me new ways to approach certain aspects of working with people, but the biggest influence that she has had on me is her positive attitude and always uplifting the people around her. I have tried to make that a part of my management style because it does have a big impact on the team, especially when dealing with some really challenging work.”
Zac Catrambone, CHW Supervisor at BEDS Plus.
“You have to be committed to the purpose of people first before you decide to this work,” Kim said. “At the core of it is, how do you help change a life?”
Kim has experienced this firsthand, connecting with individuals who need help but have lost hope that it is available. As important as it is for CHWs to create deep connections and recognize the humanity of others in their interactions, according to Kim, it is equally as important to care for the wellness of the CHWs themselves as they can deal with sensitive issues or situations in the community as well as issues of their own, like burnout.
“It’s constant how we care for our CHWs,” she said. “I always ask, ‘What’s going on with you? How can we make this better.’ We really help them navigate that as a group.”
Kim is referring to the CHW Initiative, which offers CHWs an opportunity to network and learn new skills or ways to deal with issues through group interactions and learning.
In 2018, Community Memorial Foundation and Healthy Communities Foundation partnered with Health & Medicine Policy Research Group and Sinai Urban Health Institute (SUHI) to develop a pilot Community Health Worker Initiative. Now in its sixth year, the project continues to improve access to culturally competent care within the rapidly diversifying western suburbs of Chicago and strengthen the interpersonal networks and skillsets of CHWs working in the area. The SUHI team, led by Kim, began by facilitating a learning collaborative for CHWs at the five original pilot organizations, and in 2022, with support from the Coleman Foundation, the collaborative expanded to include any CHW working in the Western Suburbs. At the West Suburban CHW Learning Lab’s quarterly meetings, CHWs and their supervisors engage with one another and with content experts to strengthen their skills, referral networks, and knowledge.
“[What] has been so beautiful with this initiative…with the western suburbs is that [the CHWs] didn’t know about one another. They didn’t know the depth, and the breadth of what they could do, and how they could support each other. They like knowing that there is a network that they can depend on. And so as we see the evolution…it’s not a siloed approach, but it’s more of a collective effort to make sure that communities are supported, and that they know about services, and that they understand what the community health worker role is, and how it can be impactful in organizations and communities that they serve,” Kim said.
The success of the initiative is demonstrated both quantitatively and qualitatively. Between Year 1 and Year 4, the total number of referrals made by the five pilot organizations increased more than 133x (from 40 to 5,380) and closed-loop referrals resulting in accessed services grew 250% (from 26% in Year 1 to 92% in Year 4). CHW Learning Lab participants report increased knowledge, confidence, and understanding of the changing health landscape, including MPox virus prevention and Medicaid Redetermination. Three CHWs have been promoted within their agencies and cite Kim’s leadership as instrumental in their career development.
“It’s more than just a job,” echoes Kim. “It’s heart work…. You have to be committed to the purpose of people.”
“Being a part of the CHW collaborative trained under Kim Jay, has cultivated my career growth within my agency Beds-Plus, serving the homeless population. Kim’s leadership empowered me as in individual to be an advocate for the people by motivating me with her training. Her teaching method will give any individual a powerful perspective on how to be a positive professional and to keep going!”
Miriam Martinez, former CHW, Beds Plus
Looking forward, Kim is enthusiastic to advance CHW work in the community. The West Suburban Initiative has made great progress in addressing the disconnect between service providers in the area. For this work to continue to grow, the initiative must address key challenges, including the long-term sustainability of CHW work. Kim emphasizes the need to develop a cohesive, nationwide approach to the CHW role, including a certification process with the State of Illinois.
“I think about the opportunities that we have to really empower communities to be self-reliant and motivated, to take care of one another, and to be champions of what their health and their mental health looks like,” Kim said.
Regarding the future of CHW certification, Kim emphasized that certification must be inclusive of the backgrounds CHWs come from, including both higher education and field experience. Requiring all CHWs to obtain a degree would exclude many health workers already working in the community, some for years. It could also create a financial barrier for prospective CHWs, including people with lived experiences of poverty and racism.
In addition to the issue of certification, financial sustainability is another significant concern for the field. In Kim’s mind, the solution is simple: insurance companies should reimburse community health work.
Kim cited the financial benefits of CHW services, “With our asthma intervention, you know, we would reduce ED visits by 86%. And we know that for every dollar spent, we saved eight. As long as we stay on target with what reimbursements could look like for CHWs, that will take care of that sustainability component.”
Kim has been actively involved in conversations with senators and representatives, speaking at hearings to advocate for CHW reimbursement through insurance companies. She pointed out that funding CHWs would be a win-win, as it would save insurance companies money from fewer hospital visits and preventable procedures.
“We’ve seen some movement, and we’re hoping that it doesn’t become stagnant because of all the bureaucracy wrapped up in it,” Kim said. “Because we know community health workers work. […] Why can’t [insurance] just pay for that?”
Kim is eager to continue building the momentum of the CHW movement both locally and through her advocacy for policies that support this critical work.
“Evolution is imminent, I know that it is,” Kim said. “[The CHW movement] must evolve. It cannot stay stagnant because of what impact it has made so far.”