Paige Menking is a graduate student at the LBJ School of Public Affairs who joined our team last year to work as a GRA on our Community Health Worker (CHW) Institute. As a health policy student and a certified CHW and CHW Instructor, Paige has proven herself invaluable when it comes to looking at ways to empower this workforce and enhance their presence as part of a holistic health team. She has been selected as our Staff Highlight and shared some of her history and vision for better health care delivery.

Q: What made you decide to go back to school for a master’s degree in Public Affairs?
A: After working for years at non-profits and state agencies, I wanted to get a bird’s eye view of our health care delivery systems to increase my impact. LBJ offers a great combination of thinking big picture but also getting into the weeds. I hope that combination will help me make better decisions at a system level and make positive changes in terms of health care delivery and policy.

Q: What kinds of changes do you feel are the most needed in health care policy and delivery
A: What’s become most clear to me is that there is no silver bullet. Health care is huge, it’s an economic engine and it has so many moving parts. I think the conversation is starting to focus around the intersections of access, quality and patient experience but we can do more to humanize systems of care and CHWs are a big part of that. We need physicians and hospital administrators to center decisions around population health and the social determinants like poverty, housing, trauma, etc. And on a national scale, payment models need to incorporate a realistic view of what affects people’s health and the healthcare system at large. We can’t just think about paying doctors for one specific thing; we need to be thinking about how to have payment models that allow medical providers to address social determinants of health.

Q: What has your experience been like working with TCRSS?
A: Well, besides the healthy snacks that are always available, I feel fortunate to have found a way to continue my work with Community Health Workers while I’m in school. This was the luckiest situation I could have come across, because the CHWs model of providing culturally competent, access to health and social services is something that is really important to me. Dr. Kim and the TCRSS team are focused on innovative and collaborative ways to address health disparities and so my knowledge and skill set just fit right in with the team’s mission and the work they were already doing. I also appreciate the support and guidance from Dr. Kim and the TCRSS team, who value and foster excellent scholarship. They really empower and support me in developing strong skills in the scientific method, including survey development and implementation, delivering presentations and writing for publication.

Q: Where do you see the Community Health Workers fitting in to a new more holistic model of health care delivery?
A: I think CHWs are key to bridging the gap between the health care system and communities who have been traditionally isolated from and mistrustful of that delivery system. There is still no silver bullet, and we need some large structural changes to really ensure health equity, but CHWs are uniquely qualified to address patients’ real issues today. They can help people navigate this really complicated system; they do the hard work of getting people access, and they inject compassion into a sometimes scary situation for a lot of folks.

Q: What kind of policy changes do you think could empower the movement of this work force?
A: Well, we need to figure out how to pay them sustainable and living wages. We need to also figure out how to have career ladders for folks who are doing this work and how to have them grow in their work, so that they don’t have to stay in the same position for 30 years without movement. Figuring out the payment model is the biggest challenge we face now, so when we think of how we are designing a health care system and how Medicaid, Medicare and other insurance plans compensate physicians and hospitals – CHWs and other folks who address population health and social determinants need to be a part of that conversation.