What is a Professional Healthcare Advocate?

Professional health care advocates are a new and growing profession in the elder care world, especially given how dispersed many families are. I recently reached out to Nancy Ruffner, President of Navigate NC, a local advocacy agency based in Raleigh to help answer common questions about this profession.

We help clients and their families navigate the challenges that come with aging or chronic conditions. We assist with everything from navigating a complex healthcare system, to locating the correct physician or specialist, to interpreting or untangling medical bills, as well as pressing for insurance coverage. We educate, inform our clients of options, identify payment resources and legal needs, and stand by your side in the hospital when you may not have a strong voice, or when you may be transitioning from home-to hospital-to rehab- to home.

What is your training?

I earned a Bachelors of Science in Social Work, BSW, from Western Carolina University (WCU) and a Graduate Certificate in Counselor Education, GCCE, from NC State University. I am a Baby Boomer and was a member of the Sandwich Generation. Personal experience led me down this path.

What value do you bring to your clients?

We work for the client and their family only - not for hospitals, not for insurance. We pay attention to the details. We get it done right the first time, so clients realize a time and cost-savings. Many of us once experienced that overwhelm that comes with an acute situation, high emotion, no information and little hope. We can bring savvy and hope, guidance and peace of mind.

Are there credentials? If so, what kind of credentials should we look for when selecting a Professional Healthcare Advocate?

Our emerging industry has developed a formal accreditation process including formal exam and an internationally recognized certification as BCPA (Board Certified Patient Advocate). There are two professional organizations, APHA (Alliance of Professional Advocates) and NAHAC (National Association of Healthcare Advocacy Consultants). Since 2009 a number of organizations and universities have developed courses and programs for Professional Patient Advocacy. Among our ranks are Nurses, Social Workers, Attorneys, Paralegals, Physicians, Case Managers, and more. Ask us what our experience has been handling a situation like yours.

What are the three most common reasons people contact you?

People contact us to tap into our expertise when navigating change or a healthcare system that's not showing any signs of getting any easier. We have personal and professional experience to bring you education and savvy which results in your ability to make good decisions for best outcomes.

Tell me one story about how you have helped a client.

Jill, an Adult Child of a mother now in rehab, called us for assistance. Jill lives in California and her brother Jack in New York. Mother fell, fractured her leg requiring surgery and hospitalization followed by a transfer to skilled rehab. All are unsure if Mother can return home, where she had been living independently in a multi-level home. Additional medical problems include arthritis and a long-standing seizure disorder. Mom, daughter, and son were all confused about care, how long Mother could stay, what insurance (both private and Medicare) would cover, and what to do next. The family had talked about moving Mother to a senior community but they didn't know how to find one or how to pay for it. Some financial records had been gathered by the mother but she had long been private about her affairs. The family home was her only asset, but how could they begin to attempt to liquidate it from out of state? There were no powers of attorney documents in place, nor will, Living Will or DNR. In this case a Professional Advocate gathered legal, housing, and medical information, as well as information that may qualify Mother for other resources. They stepped in to supervise Mother's immediate rehab care and participated in discharge planning. The advocate became the local eyes, ears and expertise to coordinate the care and keep children at a distance informed, while also putting a plan in place for the next phase.

How do I find a Professional Healthcare Advocate if I don’t live in this region? Is there a database or association I should search?

Search-by-zip-code directories from our two professional organizations, APHA and NAHAC.

What can I expect to pay for these services?

Services for Professional Advocates across the US are ranging from $75 to $250 per hour depending upon where services are sought. In North Carolina we see a range of $90 to $175 per hour. Because we only work for the individual (not for Insurance, hospitals or medical groups), nor do we sign any contracts with housing communities “to move you in” we are Fee-for-service, or private pay.

What are names of other individuals/agencies working in this region in this space?

Joan Moss Health Clear For You and Liisa Ogburn, Aging Advisors NC in Raleigh; in the Triangle: Everybody Needs a Nurse, Diane Halloran, and Sheryl Scharoun, Baby Boom Health.

Any additional advice?

Take advantage of our complimentary initial conversation. We will discuss your concerns and you will learn ways we can provide remedy and have handled situations like yours. We feel strongly about educating our clients so they make informed decisions.