July 21, 2014 Standard Occupational Classification Policy Committee
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July 21, 2014 Standard Occupational Classification Policy Committee U.S. Bureau of Labor Statistics, Suite 2135 2 Massachusetts Avenue NE., Washington, DC 20212 To Whom It May Concern: The George Washington University Cancer Institute, in conjunction with the Academy of Oncology Nurse & Patient Navigators (AONN+), the Colorado Department of Public Health and Environment, the Patient Navigator Training Collaborative, the Cancer Patient Navigators of Georgia (CPNG), the Georgia Center for Oncology Research and Education, Inc., the `Imi Hale Native Hawaiian Cancer Network, the Virginia Cancer Patient Navigator Network, the Florida Coalition of Oncology Nurse Navigators (FCONN), the Cancer Community Network, the Social Work Program at the University of Houston-Downtown and Nueva Vida, are writing to request that the SOC Policy Committee (SOCPC) adopt the proposed definition of Patient Navigation as reviewed and supported by the American College of Surgeons’ Commission on Cancer for inclusion in the 2018 Standard Occupational Classification (SOC) system. A patient navigator is a healthcare expert who reduces and eliminates barriers to accessing care, empowers patients and their families and facilitates timely access to high-quality medical care across the healthcare continuum. Patient navigators work with medically underserved individuals, populations and communities to reduce disparities in health care. A growing amount of literature and research demonstrates the impact of patient navigation on at-risk individuals dealing with medically and culturally complex cases. Research has also shown cost savings to programs utilizing patient navigators. Furthermore, recent changes in national policy and accreditation standards have made clear that the field of patient navigation will continue to grow. Given these changes and the growing body of research to support the field, we feel it is critical that patient navigation be included in the 2018 SOC system. We strongly encourage the SOCPC to adopt the proposed definition of Patient Navigators for inclusion in the 2018 SOC system. Sincerely, Mandi Pratt-Chapman, MA Director, The George Washington University Cancer Institute Lillie Shockney, RN, BS, MAS Program Director, Academy of Oncology Nurse & Patient Navigators Elizabeth Whitley, PhD, RN Director, Prevention Services Division Colorado Department of Public Health and Environment Patricia Alvarez Valverde PhD, MPH Director, Patient Navigator Training Collaborative Angela Patterson Vice President, Georgia Center for Oncology Research and Education, Inc. & Cancer Patient Navigators of Georgia (CPNG) JoAnn Tsark Project Director, `Imi Hale Native Hawaiian Cancer Network, a program of Papa Ola Lokahi Christina Sheffield Director, Cancer Network at the University of Virginia Virginia Cancer Patient Navigator Network Delmarie Newman Butler, RN, CBHN, BSHSA President, Florida Coalition of Oncology Nurse Navigators (FCONN) Terri Salter, RN, MSN, MBA UAB Administrative Director, Cancer Community Network Dr. Stephen Wernet Director, Social Work Program, College of Public Service University of Houston-Downtown (UHD) Dr. Health Goltz, PhD, LMSW, Med Assistant Professor of Social Work, Social Work Program, College of Public Service University of Houston-Downtown (UHD) Margaret Darling Chief Evaluation and Advocacy Officer, Nueva Vida Organizations in Support of this Submission: American Cancer Society Cancer Action Network American College of Surgeon’s Commission on Cancer Avon Foundation Breast Cancer Crusade Capital City Area Health Education Center Carmella Rose Health Foundation Pacific Cancer Foundation Via Christi Health Systems (VCHS) Oncology Service Line The Wisconsin Cancer Council Wisconsin Comprehensive Cancer Control Program Individuals in Support of this Submission: Amy Arnold Fort Walton Beach Medical Center Cancer Registrar Coordinator Fort Walton Beach, FL Onslow Memorial Hospital Jacksonville, NC Charlene Forcier, RN, MS, CHPN Oncology Nurse Navigator Karli Bergheer, MBA Norris Cotton Cancer Center Integrative Oncology Patient Navigator Manchester, NH Pacific Cancer Foundation Wailuku, HI Lorena Gayton Patient Navigator, Support Screen Jennie Boyer, BSN, RN Department of Supportive Care Medicine Oncology Nurse Navigator Sheri & Les Biller Patient and Family Saint Agnes Cancer Institute Resource Center, City of Hope Baltimore, MD Duarte, CA Delmarie Newman Butler, RN, CBHN, Marc Hulbert, Ph.D. BSHSA Executive Director Breast Health Navigator Avon Foundation Breast Cancer Crusade Bethesda Women’s Health Center Boynton Beach, FL Debra Jones, RN, BSN, MPH Oncology Patient Navigator Angie Carr, LSCSW, ACSW, MBA Sentara Leigh Cancer Services Patient Navigator Norfolk, VA KU Wichita Center for Breast Cancer Survivorship Susan Krivacic Wichita, KA Patient Advocate Darlene deManicor, PhD Judy McCree Carrington, B.A. Patient Advocate Psychology, Certificate in Gerontology Women’s Cancer Resource Center Community Clinical Linkages Coordinator Oakland, CA Prevention Services Division Colorado Department of Public Health Christine Economos, BS, BPS, and Environment Patient Navigator Los Angeles Center for Women’s Health Melissa Mealy California Hospital Medical Center Patient Resource Navigator Los Angeles, CA South Atlantic Division, American Cancer Society Ginamarie Farino, MPH, PA-C Wheeling, WV Cancer Program Administrator Methodist Hospital of Southern California Susan T. Scott, RN, BSN, OCN Arcadia, CA Oncology Nurse Navigator Roy and Patricia Disney Family Cancer Susan Ferdon Center Oncology Patient Navigator Burbank, CA Robin Supinger Patient Navigator Dayton Physicians Network Dayton, OH Sarony Young Health Systems Policy Coordinator, Prevention Services Division Health Systems Unit Policy, Systems, and Analytics Branch Colorado Department of Public Health and Environment Maggie Ward, MSN, APRN Oncology Nurse Navigator Via Christi Health Systems (VCHS) Wichita, KS Jeanne Strickland Associate Researcher UW Carbone Cancer Center Wisconsin Comprehensive Cancer Control Proram Deborah Szabo, RN, MSN Nurse Manager, Site Disease Group University of Miami Sylvester Cancer Center Standard Occupation Classification (SOC) System Patient Navigation Input Requested by the SOC Policy Committee The healthcare system has become increasingly complex and difficult to navigate, particularly for poor, minority and other medically underserved populations. Fragmented care systems and barriers to accessing care such as reliable transportation, lack of childcare, language barriers and a lack of insurance often prevent people that need healthcare from receiving it. The growing field of patient navigation has developed out of a need to help patients with medically and culturally complex cases access timely, high-quality care across the healthcare continuum. Patient navigators are a new occupation developed as part of the transformation of care responsive to patient needs. Patient navigators reduce and eliminate barriers to accessing care, empower patients and their families and facilitate timely access to high-quality medical care across the healthcare continuum. Patient navigators work with medically underserved individuals, populations and communities to reduce disparities in health care. An increasing amount of literature and research demonstrates the impact of patient navigation on at-risk individuals dealing with medically and culturally complex cases. Research has also shown cost savings to programs utilizing patient navigators, making the field attractive for a variety of employers. Furthermore, recent changes in national policy and accreditation standards have made clear that the field of patient navigation will continue to grow. Given these changes and the growing body of research to support the field, we feel it is critical that patient navigation be included in the 2018 SOC system. Proposed definition: 21-109X Patient Navigators Reduce and eliminate barriers to access to care. May perform clinical duties as allowed under applicable licensure. Includes Nurse Navigators who primarily support adherence to treatment by eliminating barriers to accessing care. Excludes “Health Educators” (21-1091), “Social and Human Service Assistants” (21-1093) and “Community Health Workers” (21-1094). Illustrative Examples: Oncology Patient Navigator, Resource Navigator. 1. Nature of the work performed. *Addressing the nature of the work performed is the most important type of information the SOCPC will use when considering comments. • What duties do the workers in the occupation perform? According to the Patient Navigator Outreach and Chronic Disease Prevention Act of 2005, duties of patient navigators include: (1) acting as contacts by assisting in the coordination of health care services; (2) facilitating the involvement of community organizations in helping 1 individuals who are at risk for or who have cancer or other chronic diseases; (3) notifying patients of clinical trials and, upon request, aiding in enrollment of eligible individuals; (4) anticipating, identifying and helping patients overcome barriers within the health care system; (5) coordinating with the relevant health insurance ombudsman programs to provide information to individuals who are at risk for or who have cancer or other chronic diseases; and (6) conducting ongoing outreach to health disparity populations.1 In 2013 the Oncology Nursing Society identified competencies for Oncology Nurse Navigators.2 The George Washington University Cancer Institute has conducted research to better define the