“I was a nursing facility transition specialist. So it was my job to help patients leave the nursing home and get back to their home,” says Lenny Avery, Executive Director at the Alcona County Commission on Aging. He is also a Master Community Health Worker (CHW) and Training Consultant at Everyday Life Consulting.
“I’ll never forget my first client. Her name was Bertha. She was about as direct as a sledgehammer to the face. She swore constantly, but was a very nice lady,” Avery explains.
“She had terminal cancer. And she said to me, ‘Lenny, I don’t want to die in here. All I want to do is be able to drink coffee on my own porch.’ I said, ‘Let’s see what we can do.’ I got her transitioned home with nursing help.”
Here, Avery chokes up. “She was so happy just to be on her porch, drinking her coffee. She died three weeks later. She got exactly what she wanted.”
The beginning of a career
This is just one of many impactful moments in Avery’s career as a CHW. But Avery doesn’t have a traditional CHW career path. At 17 years old, Avery had a bad experience with the legal system. “From that moment, I wanted to be an advocate.” He decided to pursue a bachelor’s degree in pre-law and had every intention of becoming a lawyer.
This aspiration changed when he started his first “real” job after college, a position in which he helped people with disabilities and mental health issues access resources to live well. He quickly fell in love with direct client care and realized that he could be an advocate for clients outside of the courtroom.
“We have a voice; we have a right to have our services on our own terms and have our voices heard.”
After his 17 years of direct care work, Avery began working for the Disability Network. His role was undefined, but he and his colleagues were CHWs before the term even came to their organization. When the network’s program changed and began using Medicaid dollars, the state decided that people in Avery’s position had to have formal education in social work. This cut down about 75% of the network’s workforce.
Avery began to research other options and roles. This is when he learned about Community Health Workers and their training and certification. Avery and his colleagues petitioned the state to change the formal education requirement to encompass CHWs – and the state approved this recommendation. That’s how Avery and his team ended up in CHW certification training.
Recognizing the CHW role
In community health work, there are more than 150 recognized job titles that fall under the CHW umbrella. This can make it difficult for those with other titles – like asthma peer, recovery coach, care coordinator, outreach specialist, etc. – to recognize that they actually are CHWs.
To Avery, the definition of a CHW is simple. “I am a tool that bridges the gap between a person’s needs and a person’s resources,” he says. “I believe CHWs are born. They’re born because they have that extra dose of empathy and passion and a whole lot of crazy.”
Avery’s empathy and passion is clear as he explains another impactful CHW moment. “I met a 32-year-old woman who had ALS. She was quadriplegic. She couldn’t communicate. And she had this beautiful, amazing life with her husband and 2 kids before ALS took her body,” Avery says.
“Her husband showed me all these pictures. Her husband is just broken because she’s spending 24 hours a day in the nursing home. ‘I just want her to go home.’ But at the time, no one did 24-hour home care.”
So Avery took the fight all the way to the Medicaid court, relying on his pre-law degree and his lived experience. “I acted as her advocate. I read over 1,700 pages of Medicaid information. I was able to get her a machine that she could look at with her eyes and the machine would talk,” he says, again tearing up. His client was able to move back home with her family while still maintaining the level of care she received in the nursing home. “She cried because she had a voice – because she could communicate.”
For those considering a career as a CHW
Avery encourages people considering a career in social work or patient care to reflect on community health work. Community health work is unique in that some CHWs have a high school diploma, while others have bachelor's degrees and even doctoral degrees. The emphasis in community health work is on the CHW's lived experience. “Having a degree doesn't give you the lived experience, and not having a degree doesn't invalidate you from the CHW role. You partner lived experience with an actual curriculum that grows with [the students]. It’s flexible.”
Ultimately, the most important part of being a CHW is having the passion. “This is a career and a calling. Community health work isn’t for everyone. It’s for that select few that have the empathy, the passion, for those who think outside the box.”