Washington State Human Rights Commission

DSHS developing a Navigator program to help minority communities access health care

OLYMPIA -- The Department of Social and Health Services (DSHS) is developing a "Patient Navigator" program that will help members of minority communities find their way into the health-care system to get the treatments and information they need.

The Navigator program, to be headed by Vazaskia Caldwell, was funded by the 2007 Legislature, which appropriated $1.5 million for the project. DSHS plans to use the funds to support a one-year, 1,000-patient pilot beginning early next year.

"We are realizing today that the policies of health care organizations may not be adapted to the needs and cultural values of all those they treat," said Doug Porter, Assistant Secretary of DSHS and Sate Medicaid Director.

"That's where patient navigators come in. They can bridge these gaps as well as improve care and lower costs in the process."

The idea grew out of a study five years ago that showed African-American urban Medicaid recipients in Washington state were measurably more likely to have late-stage diagnosis of breast and cervical cancers with much lower odds of survival. The patient navigator idea surfaced in the Medicaid program's search for interventions that might help eliminate that disparity – one of many health-care differences that can show up between cultures and ethnic minorities.

The pilot navigator program was developed at Harlem Hospital in New York City, which trained area residents about the health-care system and began using those volunteers to advise patients. The navigators combine the roles of case manager and advocate. They coordinate services among medical providers, schedule appointments, arrange interpreter services, assist patients in obtaining financial coverage for their care, and facilitate transportation and child care for medical appointments.

Navigators also work with providers. While they educate patients about finding a doctor, preventive strategies for chronic conditions and keeping track of treatment plans, they counsel health professionals about how they can effectively address individual patients’ needs, especially when they must reach across to other cultures or communities.

In order to achieve the goal of reducing health disparities, the patient navigator must be:

DSHS is not the first to get involved with navigators. The Northwest Indian Health Board has received federal funds from the National Cancer Institute to participate in a cancer navigation initiative. Meanwhile, the anti-cancer Komen Foundation of Puget Sound is also funding two health navigation programs in the state – a Breast Cancer Care project with the University of Washington, Harborview Medical Center and the Seattle Cancer Care Alliance, and a Breast Cancer Patient Navigation Project with the Franciscan Health System in Pierce and South King counties.

Caldwell, the Medicaid Navigator program manager, took over the project this fall. She is new to state service but not to community education and public policy issues. She spent the past five years as director of community education and public policy for the Pierce County YWCA. Prior to that, she spent five years as program manager and national trainer for the American Cancer Society, where she worked on outreach and cancer education.

Today, patient navigators are used across the country in a variety of settings, including several in Washington State. Patient navigators work to make the health-care system more "user friendly" and culturally competent, not just for their own clients but for all members of the target community.

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