Resource Navigators learn valuable lessons about factors that influence health

Anu and Hannah head shots

When Wisconsin HealthCorps Volunteer Hannah Fleischman was placed as a coordinator with CPP’s Community Resource Navigator Program, she didn’t know what to expect. Now, after a year with the program, Fleischman says the lessons will follow her into medical school and throughout her career as a provider.

The Community Resource Navigator Program, a partnership between CPP and three clinics within UW Health, trains undergraduate students to assist primary care patients in securing resources in the community, such as transportation, housing, utility assistance, and food security, that can influence their health outcomes. Throughout the U.S., health professional training programs have sought ways to build both relational and leadership skills among future health care providers, while trying to expose them to the broader systems and socioeconomic factors that influence population health outcomes.

“I learned just how challenging it can be to access community resources,” says Fleischman. “I’m Marshfield, Wisconsin. I wasn’t expecting people in Madison, where there are so many resources, would have so many challenges.” Fleischman says she never expected, for example, that so many clients would need access scanners, copy machines, and fax equipment to duplicate or send sensitive information to qualify for housing, services, or to meet employment requirements. “Now, during COVID, while the navigators aren’t in the clinics, I’m not sure where people will get this kind of help.”

Anupama Bhalla, trained as a dentist in India, also served as an Americorps/Vista volunteer coordinator with the program. “The uniqueness of this program is that students are in the clinic,” she says. “They learn how to talk with people in that setting. When students come in the beginning, many are afraid of touching the phone to contact patients. We sit with them during the first call and ask them to follow our lead.” After two to three weeks of experience, Bhalla says students knew what to do. “I have seen the progress. By the end of the term, they don’t want to leave. One student, who started when I did, was very shaky during her first intake. By the end, she was finding a lot of resources online and gained a lot of confidence in her communication skills.” 

Fleischman says the students learned the value of advocacy in helping patients secure needed assistance. “One patient had an energy bill due that she couldn’t pay for, and she had called the company multiple times but was repeatedly told she could not get energy assistance,” she says. “Then, we called energy assistance together, and we asked to talk with the representative’s supervisor. When we said, ‘I’m a navigator with this organization and I am working with this patient,’ she got the assistance she needed. She says that happened multiple times and taught her and the students the value of advocacy. 

Fleischman split her time between CPP and UW Health’s Office of Population Health, where she learned more about using data to inform policy. “As a biology major, I didn’t realize how much the social determinants of health–food, transit, health insurance, employment–matter in medicine,” says Fleischman. “All of these have a huge impact on patients, their everyday life and wellbeing. It was an eye-opener. If someone is homeless, it makes total sense that it will lead to other health issues down the line.”

Bhalla agrees. “I never thought housing would be such a huge issue in Dane County, but it is,” she says. Bhalla also observed that patients in this area know about the plentiful network of food pantries but face transportation barriers in reaching them. “Most pantries serve people once a month. If patients use the bus, they cannot carry this amount of food on the bus. Although many health care providers in Dane County offer taxi services, no food pantry does. We give them the list of pantries, but they cannot get there.”

Now, special measures remain in place because of COVID-19. “The metro now runs free on the Saturday schedule, but it won’t last long and people will be back to square one,” says Bhalla. “They will really need help with transportation and housing, especially as the pandemic goes on,” and as economic conditions worsen.

Fleischman, who was accepted into the UW School of Medicine and Public Health WARM program, plans to return to northern wisconsin after her medical training. “I have already thought about how this kind of resource could be used in rural areas.”