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The Path to Patient Navigators

This document explores the evolution of patient navigation programs in Texas between 2006 and 2012. It highlights the roles of client and peer advocates, doulas, and promotoras, as well as the impact of federally funded programs. Insights from surveys and focus groups emphasize the needs and challenges faced by individuals navigating the healthcare system. The document discusses financial allocations, revised standards of care, and the integration of feedback into the patient navigator responsibilities, showcasing the progress and ongoing challenges within Texas's healthcare landscape.

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The Path to Patient Navigators

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  1. The Path to Patient Navigators One Texas Experience

  2. 2006 and Before • Client / Peer Advocates • Outreach • Volunteer Coordinators • Federally Funded Programs • Doulas • Promotoras • Mid Wifery

  3. 2007 • 75% Core / 25% Non Core • Positive Voices Input groups • “Who is your case manager?” • “What do you wish you had been told when you first came into ‘The System’?” • “How do you really get what you need?” • UTA School of Social Work study • “How Much is Enough”

  4. 2007 • Chart Audit – what are the services we are providing under “Case Management” • Case Management Funding • The “ideal scenario” • The reality • A possible contingency plan for changes in funding? • …patient navigation – what are others doing?

  5. 2008 • “The Gorilla System” vs. “The Guerrilla Model”

  6. 2009 • Client, Agency Social Workers, Agency Supervisors, Administrative Agency meetings • Texas Department of State Health Services Medical (and non-medical) Case Manager Working Group • First allocations for Patient Navigators • $161,000 (Fort Worth), $20, 000 Abilene • Which model? • Who are they? Peers vs. Others • What will they do? • How do they document it? • How is it different?

  7. 2010 • DSHS / NCT joint work plan • Initial Standards • Client Input • Needs Assessment • JPS Hospital applies for and receives non-Ryan White funding for Patient Navigator – ED / Healing Wings (HIV clinic) linkage

  8. 2011 • DSHS Case Management Program • HRSA funding debauchery • 4 sets of allocations • Loss of $500,000 in first cut • By final award = loss of $22,00 • Set contingency plan in action • Increased PN allocations $240,000 Fort Worth • Incorporated Needs Assessment recommendations into PN responsibilities

  9. 2012 • Revised Standards of Care • Trainings • Minimum FTE funding = .5 • Part D funds to target specific pops • DIS • Youth • Minority AIDS Initiative • Impacts • Less Non-Medical Case Managers • Without the fear of loss of jobs • Increased PN’s • Reduction in allocations to Case Management programs • Increased input for Planning Council

  10. Future • Increasing scope of PN network - • Prevention linkages • Consumer evaluation of PNs • ACA and other funding opportunities

  11. Thank you to the PN Stars • Ana Colin-Hernandez • 8 volunteer Patient Navigators • Claudia Jacquez • Felicia Young • Jeff Hamilton • Melissa Androtti

  12. Jamie Schield jlschield@tarrantcounty.comGil Flores gaflores@tarrantcounty.com

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