The patients referred to San Juan
Basin Public Health (SJBPH) face many other barriers in this remote part of
Colorado as well, including income, age, disability, insurance coverage, mental
health and health literacy. Health navigators refer patients to doctors,
dentists, mental health professionals, senior centers, and social services that
provide food and housing assistance. SJBPH care coordinators provide home
visits, help people sign up for Medicaid, coordinate with families and empower
their clients to learn how to take care of their own health.
In 2016, the six SJBPH programs that
make up its Care Coordination services - the Regional Care Collaborative(RCCO),
Temporary Assistance for Needy Families (TANF), Healthy Communities, B4 Babies,
Maternal Child Health (MCH) and dental navigation - served around 2,000
clients.
“Health care is hard to navigate and
critical to our community,” said Kalisha Crossland, Care Coordination Services Program
Manager, “You can see the ripples we make in our small communities.”
Crossland
oversees navigation needs for SJBPH’s five health navigators, who respond each
day to a variety of challenges. Access to health care providers, especially
those who take Medicaid, is limited. Pediatric and dental providers are few and
not always conveniently located. And specialty
services at major hospitals are a day’s drive away, into Denver or Albuquerque.
Transportation from the small towns
in these rural and frontier counties to health care providers is perhaps the
area’s biggest obstacle. SJBPH navigators often have to get creative in
arranging rides to necessary medical appointments. The agency uses two transit
companies and enlists the help of a local raft company whose drivers bus
patients to health care facilities off-season.
“That’s why we love our jobs,” says
Care Coordinator Karen Evans. “Every day is different.”
Evans tells of a woman from Archuleta
County that the care coordination team had worked with who had complex medical
problems. She had little income, no insurance, and mental health challenges
that kept her from understanding the care she needed or how to get it. Care
Coordinators arranged for her transportation to surgery in Denver, helped her
make follow-up medical appointments and access numerous community resources and
services, eventually showing her how to manage her ongoing health needs. This
isolated woman had a breakthrough, Evans said, from being dependent on others
for her care to taking care of her own health care needs.
“It changed her quality of life,”
said Evans. “We’re empowering people to take care of themselves.”
But it’s not easy. Health navigators,
Crossland says, have to have the skills to succeed, including critical thinking,
problem solving, public health and services knowledge, cultural sensitivity and
communication - sometimes in more than one language. Education is important as
well, she says, especially a background in nursing, social work or health
navigator training. But the most important attribute for a successful health
navigator, she says, is a caring attitude.
“If you don’t care,” says Crossland, “This is
probably not a good job for you.”
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