This guest post was written by Kristina Pinto from Fishing Partnership Support Services.
As a program evaluator for Fishing Partnership Support Services (FPSS), I’ve discovered that our Navigators’ work with commercial fishermen does not punch a clock. They’ve talked to harvesters on the Cape Cod clam flats and explained affordable care to an uninsured plow driver clearing a driveway. One Navigator even spoke with fishermen about coverage that could allow for urgently needed services following the funeral of a fisherman friend who died far too young.
FPSS is a non-profit that meets the health and wellness needs of the New England fishing industry by providing safety trainings, health interventions, and Navigator services. Assisting fishermen with their health is a lifestyle, not a job, so Navigators come from fishing families; one of our Navigators actually is a fisherman. Since our last Enroll America blog post, our team has grown to 8 Navigators working with the fishermen of Massachusetts and now with lobstermen in Maine. Because fishermen are independent, hard-to-reach, and often skeptical of the government, we’ve also expanded outreach to include email blasts and social networking with strategic messaging that promotes self-sufficiency. Plus, we now perform direct outreach when helping fishermen with groundfish disaster relief claims. Finally, we’ve redoubled our effort to help with finding primary care once consumers are enrolled.
But our top strategy for keeping people healthy when they aren’t on dry land during business hours has been this: go where they are. Navigators do outreach at birthday parties and funerals, grocery stores and bars, industry meetings and trainings. With a group that is skeptical of any government regulation, email blasts and postcards aren’t enough. The Navigators routinely perform 1:1 outreach on the docks and at fishing events, talking to workers who are offloading fish or visiting a health screening van we schedule.
Because Navigators are immersed in the fishing community, they know their values and norms. They build trusting relationships with fishermen over time by reaching out to them with respect for the industry’s culture. The fishermen know our Navigators like friends, not bureaucrats, and they enroll in coverage because they see them everywhere in the community and trust the Navigators’ expertise.
Applications and even enrollments were achieved with attendees at several safety trainings we hosted this year. For instance, a young uninsured fisherman came to the class with an awful toothache and no insurance. By the end of the day, he’d become certified in basic safety and left with health care coverage and a dentist appointment, thanks to one of our New Bedford Navigators.
Because our Navigators become trusted friends with consumers, FPSS attributes much of our success to a system of shared leadership. Navigators’ knowledge of community needs directs our program design and enrollment strategies. Rather than a top-down approach, FPSS works from the ground up — listening to the Navigators who know their clients. For example, we scheduled several enrollment workshops but found that attendance was poor for any event that was not related to fishing. The Navigators suggested that they focus on outreach at fishing events, such as safety trainings, where they made presentations and logged hundreds of 1:1 outreach conversations. Though the insurance workshops didn’t reach many fishermen, the fishing events result in follow-up calls to attendees who tell us they’re uninsured or interested in help — and these calls lead to enrollment appointments.
By knowing our population, going where they are, and closely involving Navigators in program design, FPSS helps our population do what they love: work. “Without health insurance, I can’t work,” an oyster farmer shared with me. “And without Shannon, I wouldn’t have insurance.”
After enrolling with the help of FPSS’s Kennebunk-based Navigator April, a lobsterman and his wife from midcoast Maine saved $850/month when they qualified for subsidies on the Silver plan they selected on the Marketplace.