1. Public Health Foundations in Health Navigator Education
The League for Innovation in the Community College
Innovations Conference
San Francisco, California
Public Health Foundations in Health Navigator Education
March 13, 2017
3:15pm-4:15pm
Kaysie Schmidt
Health Navigator Faculty

2. Projected Demand for Public Health Workforce
Public health workers are in demand. The Affordable Care Act (ACA) and its focus on prevention has reinvigorated interest in a qualified workforce to provide essential public health functions and fill existing and emerging occupations.
The law authorized the Prevention and Public Health Fund, increased funding for the National Health Service Corps and established the National Health Care Workforce Commission to facilitate workforce planning. The ACA highlights the need to better enumerate the PH Workforce but to also address the increased need for growth.
Source: CDPHE Patient Navigator Workforce Development Initiative, Public Health Workforce Factsheet Outline at

3. Projected Demand for Public Health Workforce
As demand for a qualified public health workforce increases, workforce shortages must be urgently addressed.
The ratio of the public health workforce in US population has decreased drastically:
220/100,000 in 1980
158/100,000 in 2000
220/100,000 estimated projected need by 2020
Estimates suggest that 225,000 additional public health workers will be need to be added by 2020 due to population growth and a substantial portion of the current workforce retiring over the next few years.
Source: CDPHE Patient Navigator Workforce Development Initiative, Public Health Workforce Factsheet Outline at

4. Current State of Public Health Workforce
The ACA highlights the need to better enumerate the public health workforce in addition to the need for a growing workforce.
The public health workforce in the US is recognized but it is difficult to quantity. The public health workforce includes those with various different backgrounds and areas of expertise including:
public health, physicians and nurses, first responders, social workers, community organizers, advocates, laboratory workers, health educators, nutritionists, epidemiologists, and environmental health workers
Source: CDPHE Patient Navigator Workforce Development Initiative, Public Health Workforce Factsheet Outline at

5. Current State of Public Health Workforce
More workplace studies are critical and necessary to better understand the current composition of the public health workforce to identify strengths, shortages, needs, and opportunities.
Robust data from quality workforce studies is needed to inform plans for development, recruitment and retention.
Source: CDPHE Patient Navigator Workforce Development Initiative, Public Health Workforce Factsheet Outline at

6. Current Composition of Public Health Workforce
The average public health worker is 47 years old.
The turnover rate was at 10% in 2002 and has increased over time to 11.5% in 2011.
More than 40% of US public health workers in state agencies either plan to retire or leave their organization within a year.
There are more women then men in the PH workforce; women represent 72% of the workforce.
Source: CDPHE Patient Navigator Workforce Development Initiative, Public Health Workforce Factsheet Outline at

7. Current Composition of Public Health Workforce
Latinos and African Americans are underrepresented in the workforce.
Entry into the public health workforce can either require years of advanced education and board certification or just a high school diploma and a willingness to learn.
There is no single degree, degree path or certification that characterizes the public health workforce.
The most common baccalaureate majors include:
Business, Nursing, Biological Sciences, Psychology/Sociology.
Master’s of Public Health degrees are the most common master’s degree trailed by business degrees at 11%.
The most common PHDs are held in Public Health or Law or with a portion holding MDs.
Source: CDPHE Patient Navigator Workforce Development Initiative, Public Health Workforce Factsheet Outline at

12. Disclaimer
This project is supported by Grant Number 1C1CMS from the Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. The research presented here was conducted by the awardee. Findings might or might not be consistent with or confirmed by the independent evaluation contractor.

13. In 2012, Southeast Health Group stepped outside its traditional role as a behavioral health provider to develop an innovative Health Navigator program in collaboration with the local community college, hospital, FQHC and health department.
The program enhances cross-systems care coordination to improve population health in Prowers County, Colorado.

14. Landscape Southeast Health Group serves a six county rural area
Population
46,559 Southeast Region
12,034 Prowers County
High Poverty
Person below poverty
23.3% Prowers County
13.2% Colorado
Median household income
$34,391 Prowers County
$58,433 Colorado
Poor health outcomes and health factors
Overall Prowers County ranked 49 of out 60 counties in Colorado by Robert Wood Johnson Foundation

15. PROBLEM:
Prowers county
Nationally

16. QUESTION:
How can we get patients to show up for their routine and preventative care appointments?

17. ANSWER:

18. MORE INFO ON HOT-SPOTTING

19. STRATEGY:

20. INNOVATION:

21. Services Provided

22. Results

23. Original FY11 High Utilizers Who Remained in Data Set Over Time
TOTAL N
TOTAL SAVINGS
AGAINST BASELINE
FY 11
$3,440,487
120
Baseline
FY 12
$3,021,724
116
-$418,763
FY 13
$2,197,215
108
-$1,243,272
FY 14
$2,140,399 99
-$1,300,088
FY 15*
$1,972,546 90
-$1,049,178*
TOTAL:
-$4,011,301*
*Claims data is not finalized

24. INNOVATION:

25. INNOVATION:

26. INNOVATION:
CAREER LADDER

27. Next Steps
Leverage funding to expand program from Prowers County to six county region with 4 Health Navigators
Utilize Peer Specialists to assist with transportation needs

28. Colorado Department of Public Health & Environment Cancer, Cardiovascular, and Pulmonary Disease (CCPD)
3-Year grant from the Colorado Department of Public Health and Environment
Adopt and implement approved standardized curriculum, incorporating minimum basic core competencies
Increase enrollment
Increase completion rate
Increase job placement rate
Expand Advisory Committee
Graduate first cohort of two-year degree
Develop evaluation and sustainability plans

29. Community Health Worker Certificate
Year One
Course
Title
Credits
PBH 100
Intro to Health Navigation 2
PBH 101
HN Principles & Practices 1 3
HWE 111
Health and Wellness
ENG 121
English Composition I
CIS 118
Intro to PC Applications
HWE 103
Community First Aid and CPR 1
PBH 102
HN Principles & Practices 2
PBH 103
HN Principles & Practices 3
PSY 101
General Psychology I
COM 125 or
COM 115
Interpersonal Communication
Public Speaking
HWE 100
Human Nutrition
CSL 250
Motivational Interviewing I
1.5
PBH 180
CHW Practicum
Total Credits
32.5

30. Health Navigator Associate of Applied Science
Year Two
Course
Title
Credits
PBH 200
Health Systems Navigation 5
PBH 210
Community Health Focus on Prevention 2
BIO 106
Basic Anatomy & Physiology 4
HPR 178
Medical Terminology
Health Communications 3
PBH 212
HN Transition to Practice
PBH 280
HN Internship
PSY 102
General Psychology II
MAT 120 or
MAT 135 or
SPA 115
Math for Liberals Arts or
Intro to Statistics
Spanish for the Professional I
Total Credits
60.5 or 61.5

31. Foundational Competencies – Knowledge and Awareness of:
Domain
Ethical, legal, and professional issues
Health beliefs and behaviors
Psychology of illness
Disease-specific knowledge
Healthcare system structure and function
Resource and referral mechanisms and sources
Functional Competencies – Demonstrating Skills and Understanding Process of:
Domain
Patient/client assessment
Client interaction and communication skills
Work within health patient/client care team and community
Health care team-patient/client communication
Appropriate referral for behavioral health or emergency medical care
Care coordination
Client activation, education and support
Developmental Competencies
– Display Integrative Capacity of All Knowledge and Skills:
Domain
Professionalism and development
System change
Program development and management
Cross-walk curriculum with CDPHE Patient Navigator Entry-Level Competencies
Revise courses in Colorado Community College System’s (CCCS) Common Course Numbering System (CCNS)

32. & Department of Social Services Department of Human Services
Our Partners
Bent County
& Department of Social Services
Arkansas Valley Regional Medical Center (2 HN)
Southeast Health Group – hiring FT HN for Lamar office
Arkansas Valley Hospice – inquired about getting training for new HN staff hire
High Plains Community Health Center – Patient Facilitator (FT) opening
Colorado Coalition for the Homeless – Peer Mentor (FT), Education Health Navigator (PT)
Health Department &
Department of Human Services