Connecting care where it's needed

There they were: a half-dozen women — one using a walker — talking and laughing and marching in place in the living room of the Epworth Towers retirement community in Hays.

In a calming, steady tone, Karissa Frasier — a community health worker from Kansas State University's local extension office — kept the group in cadence.

"Okay, let's get warmed up," she says. "Let's march in place to get those muscles ready to walk."

The morning's session is something of a routine for the group, which normally numbers twice the size of this day's gathering. For the past six weeks, they've participated in K-State Extension's Walk with Ease program, which helps people with arthritis or other chronic diseases increase their physical activity.

The warm-up is followed by 15 minutes of walking through the retirement home's halls.

Walk with Ease is one of numerous K-State Extension programs that Frasier has implemented as a certified Kansas Community Health Worker.

The initiative, established in 2017, empowers local community members to serve as public health workers, acting as a link and intermediary between the community and health and social services.

"As a community health worker," Frasier said, "I get to help people navigate the health world. For some, that could be health care or health insurance — like Medicare or Medicaid — or helping them find an assistance program to pay for medications.

"I also help people one-on-one, guiding them through their individual health journey with chronic disease and managing health."

K‑State empowers community health workers to bridge local wellness gaps

Elaine Johannes, the Kansas Health Foundation's Distinguished Professor of Community Health in K‑State's School of Human Sciences, said nearly half of U.S. states and territories have certification programs, and Kansas was among the first.

Since 2017, the state's program has been administered by the Kansas Division of Public Health within the Kansas Department of Health and Environment.

K-State got involved in 2023 through a university initiative that led to six extension offices that have had, or currently have, a community health worker.

"K-State Extension is the first extension system to employ community health workers in local extension offices to assist with rural health care coordination, identify service gaps and connect clients to health care providers for care and local health care access," she said.

To become certified, community health workers complete 160 hours of training, including 60 hours in the field, or they can provide documentation of prior community health work.

Monique Koerner, a family and community wellness expert with K-State Extension, works closely with Frasier to serve the region around Hays.

"One of K-State Extension's core missions is health and family well-being," Koerner said. "I truly believe that the community health worker position helps to extend the work that family and community wellness agents are already doing. I love the fact that they more often work one-on-one with clients."

Recently, a local woman who was attending K-State Extension's Stay Strong, Stay Healthy class found herself in a dilemma.

Just before the second class, the woman had to call the extension office to apologize for not being able to make it, Koerner said. Her husband had dementia, and after a really bad night, she wasn't sure what life would look like moving forward.

"Karissa works a lot with the local dementia support groups and respite care, so I was able to hand that client's name to Karissa, who was able to make contact, hear her story and provide her with the resources she's going to need during this time," Koerner said.

Frasier said her role is simple.

"I sit back and listen," she said. "I do a lot of listening and get to know someone and understand what they're struggling with."

From there, Frasier helps her neighbors navigate their health challenges, first by understanding how they can approach and overcome any barriers.

"For example, I might ask, 'How can we change your behavior to make the lifestyle changes needed to achieve better health?'" Frasier said. "We also talk about their doctor's recommendations and how we can incorporate those into our daily lives."

One woman, Frasier remembers, could not afford the medication she needed to treat a chronic condition.

But after a bit of looking, Frasier helped the woman find a grant she could apply for and receive.

"She now has thousands of dollars of funding for that medication. With that barrier out of the way, we were able to look holistically at her lifestyle and determine how we can better manage her disease in the future."

Community health workers cover communities from 'all walks of life'

Koerner and Frasier tend to heap praise on the relationship between health workers and extension professionals.

They've seen it work successfully, and they believe it's a model that will lead to healthier communities.

By covering community health holistically — Koerner does maternal and child health work, while Frasier handles the adult development and aging side — Extension staff like them take a "womb to tomb" approach to serving their local communities, Koerner said.

"I see people of all different ages and all walks of life. I may have an older person come to me looking for help signing up for Medicare. I may have a middle-aged person who has a disability, and they need help navigating their benefits. Or, I may have a young entrepreneur come through my door asking for help signing up for marketplace insurance."

Through the program, K‑State Extension community health workers are carrying out the university's land-grant mission of service and education.

"Extension already is a great resource," Frasier said. "If our communities are able to implement a health worker in a community-based setting like K-State Extension offers, we'll be able to reach more people and serve them in multiple ways."

More information on community health and wellness programs is available at Kansans' local K‑State Extension offices.

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