New Haven Community Health Worker (CHW) Katia Astudillo helps dozens of her clients navigate the logistics of getting vaccinated and connects them with other health services. She even helps them find rental assistance. In and around New London, CHW Lizbeth Polo-Smith hands out flyers about COVID-19 safety and vaccinations at churches, laundromats, stores, warming centers for the homeless—anywhere she can. As COVID-19 laid bare Connecticut’s health care deserts, it now highlights the efforts of CHWs who labored in forgotten neighborhoods for years. In many ways, they have become a key factor in the state’s public health response for marginalized communities during the pandemic.
A few years ago, patient navigators at Project Access-New Haven set out to see if they could change the course of health care treatment for some Medicaid patients who frequently used emergency rooms.
They contacted emergency departments at Yale New Haven Hospital and its Saint Raphael campus and enrolled 100 patients in their study in 2013. Those selected had visited emergency rooms four to 18 times in the past year for chest pain, abdominal pain or chronic migraines, among other ailments. The navigators at Project Access coordinated health care for the patients. They scheduled appointments with primary care physicians, provided reminders, accompanied patients to physician visits and followed up to ensure compliance with the prescribed treatment. The preliminary results were eye-opening: “We saw an average cost reduction of $153 per member per month,” said Dr. Roberta Capp, assistant professor, Department of Emergency Medicine at the University of Colorado Denver, and lead investigator of the study.
In 2015, the Rev. Nancy Butler, the charismatic founder of Glastonbury’s Riverfront Family Church who died earlier this month, was diagnosed with ALS, or Lou Gehrig’s disease. Neither the advanced degrees she and her husband, Gregory B. Butler, earned nor his experience as a corporate lawyer prepared them for the complexities of the health care system. “My wife gets sick and I don’t have a clue how to navigate,” Greg Butler said. “This stuff is enormously complicated. What does your insurance cover?