Patient navigators help citizens tackle healthcare barriers.
At 29 years old, Liliana Herrera received news that would change her life: She’d been diagnosed with breast cancer.
In search of accessible treatment, Herrera moved to West Palm Beach, FL — where she began her personal journey from cancer patient to a patient navigator, helping women facing similar health challenges.
Four years after undergoing a lumpectomy and radiation treatments, she was rocked by a recurrence of breast cancer. Her job didn’t provide health insurance, but her income exceeded the federal limits for government-subsidized coverage.
“I really had one option: Either I do nothing or choose to resign from my position and lose my job, my home and my transportation,” Herrera said. “A friend allowed me to move into a warehouse where I slept on a lawn chair for a number of weeks until I qualified for medical assistance.”
After undergoing chemotherapy and a mastectomy, Herrera was able to take charge of her life again.
“It made me realize that there are women in my community in the same situation,” she said. That’s when she realized she wanted to improve their lives, too. “Humanity is my passion,” she said.
Herrera teamed up with a physician to provide primary care services for women in her Palm Beach community, first by going door-to-door in low-income neighborhoods and working out of tents in parking lots or wherever they could find available space. After hearing about their work, the Department of Health in Tallahassee gave Herrera grant funding to provide breast and cervical cancer screenings to women in Palm Beach County, Florida, which she did for 15 years.
Eventually, Herrera transitioned to Area Agency on Aging in Palm Beach, where she connected seniors and their caregivers with programs that support needs such as nutrition assistance and diabetes care. Then Herrera’s extensive experience in helping underserved patients made her an ideal candidate for her latest lifesaving role: patient navigator.
Navigating barriers to healthcare
Now as a patient navigator at MorseLife Health System, Herrera partners with patients to tackle barriers in accessing healthcare.
Navigators are a crucial bridge between patients and medical teams. They receive patient referrals from a wide range of sources, such as community centers, social services agencies, churches, soup kitchens, hospitals and walk-ins at outpatient healthcare facilities. They help patients by coordinating many aspects of care, including booking medical appointments, arranging transportation, explaining health screenings, providing translations, managing follow-up treatments and scheduling annual Well Woman visits.
Patient navigators are particularly significant in medical deserts, which are generally found in low-income neighborhoods where residents experience hurdles to receiving healthcare – including preventive care. These obstacles include having no insurance, lacking affordable and stable housing, suffering from poor access to healthy foods and not having reliable transportation. Medical deserts are also more likely to impact people of color.
Herrera is one of a dozen patient navigators working to reduce these healthcare disparities for women across Palm Beach County – thanks to an innovative, nationally celebrated partnership between the nonprofit organization Promise Fund of Florida, the global medical technology and women’s health leader Hologic, and a network of community healthcare centers including MorseLife.
Promise Fund receives grants from Hologic’s Project Health Equality initiative and other donors, then channels that money toward supporting the salaries of the dozen patient navigators. The alliance focuses on 3D mammography, cervical cancer screening, uterine fibroids, abnormal uterine bleeding (heavy periods) and other women’s health conditions.
First Lady Jill Biden, federal health leaders and other White House officials lauded Herrera and the Promise Fund-Hologic partnership during a visit on June 23, 2022 to FoundCare, another clinic in the network of patient navigators.
Preventive care made personal
FoundCare is a federally qualified health clinic that provides primary care and women’s health services.
Nurse practitioner Rose Philius, the women’s health director at FoundCare, has made it her mission to educate her community on the importance of preventive care. Originally from Haiti, Philius never planned to pursue a career in healthcare. But after her mother passed away at 54 from a heart attack, Philius realized that if she’d been educated on the warning signs, she may have recognized the critical care her mother needed. In that moment, Philius decided to pursue a career in preventive care.
“In my culture, people think that you only go to the doctor whenever you’re sick. A lot of them don’t go for a mammogram or for a screening, so I educate them,” Philius said. “I say, ‘It’s important for you to get your mammogram in case there’s something wrong. Then we can see it early and not wait until it’s too late.’”
It’s common for Philius’ patients to lack access to transportation or experience language barriers. On an average day, she sees 25 patients who’ve taken two or three buses to see her. Philius and her team always take time to stress the importance of regular screenings and explain — in the patients’ native languages — what care they’ll receive and why.
“When I came here, I didn’t speak English and didn’t have anyone to help me navigate the system,” Philius said. “Now that I’m a healthcare provider, I feel like it’s important to take the extra step to educate the patient so they will be more likely to come back.”
Traveling far for treatment
For patient navigators like Herrera, serving as a trusted source of guidance means establishing friendships with the women they support. One patient who has formed a particularly close relationship with Herrera is Brenda Martinez Garcia.
Originally from Mexico, Martinez Garcia now lives in Florida with her husband and two children. After being diagnosed with breast cancer at 40, she underwent a mastectomy and radiation.
As part of her care, Martinez Garcia had to receive radiation treatments in Tampa, several hours away from her home in Palm Beach. With Herrera by her side, Martinez Garcia spent a month in Tampa for the daily treatments.
Herrera said when a patient doesn’t qualify for health insurance based on income, patient navigators work together to find sources of charitable care for that person. In Martinez Garcia’s case, Herrera was able to connect her with available treatment in Tampa.
“Having gone through breast cancer myself, I can always empathize with the emotional struggles a woman goes through during diagnosis and treatment. At the same time, I can encourage her and say, ‘No matter what you’re facing, we’re going to do it together. You are not alone, and I will not walk away from you. That is a promise I have to make to each woman I work with,” Herrera said.
Through the support of organizations like Promise Fund and Hologic, Herrera and other patient navigators are able to do more to keep these promises to women in their communities. Their reward comes when patients recognize the importance of preventive care.
“I wish that women would get their annual screenings and not be fearful about receiving a diagnosis because there are organizations and people that are there to help,” Martinez Garcia said. “Sometimes, women don’t know where to go or who to connect with to get the help that they may need.”Martinez Garcia, Herrera and Philius urge people facing financial or other healthcare hurdles to seek out free or discounted care in their communities. For a quick, easy-to-understand guide to preventive care by different age categories, visit screeningsforher.com.
