Three in 10 Miami-Dade County citizens lack health insurance of any kind – the highest rate in Florida – and many people experience a range of frustrations trying to arrange for health care for themselves, their children and loved ones. Community health workers play a pivotal role in linking underserved populations to the health-care services they seek and need.

“These workers truly are saving lives out there. They’re connecting folks, people on the verge of serious [health] problems. In many cases, a community health worker reached out and now the people are healthy and taking care of themselves,” said Victor Jose Santana, Community Health Worker Coordinator for the Collins Center for Public Policy, Miami office.

In an effort to provide a seamless system of care for Miami-Dade County children, prenatal through adolescence and beyond, The Children’s Trust launched HealthConnect in 2006. This comprehensive quality-driven health initiative is comprised of three components – HealthConnect In Our Community, HealthConnect In Our Schools and HealthConnect The Early Years.

Through HealthConnect In Our Community, 20 Community Health Workers and 25 Navigators (requires additional professional training) are identified by local agencies and strategically placed around the county.

These outreach coordinators and health paraprofessionals understand the health-care system; they are outgoing and intimately familiar with the neighborhoods they serve. They pound the sidewalks of their neighborhoods, frequenting cafeterias, bodegas, day-care centers – wherever they can – seeking to engage residents in conversation and help them resolve problems and better access the health-care system.

Coordinator Santana offers the example of Tracy Britten, a 23-year-old single mother and community health worker with the Overtown Human Services Coalition, as a successful prototype. Britten, Santana says, lacked experience when she started, but was very familiar with the Overtown community and its residents. With the support of other more experienced workers, Britten grew more confident and competent. “Now she turns in lots of data and has placed a lot of people in care,” Santana said.

Community health workers are a bridge between providers of health, social and community services and underserved, hard-to-reach populations of the community. They facilitate access to health insurance and to primary-care providers and health services, educate on health awareness, and, by providing for earlier access, decrease the need for emergency-room care and associated high costs.

Superior communication skills are essential. Community health workers are generally bilingual and trilingual as language is critical to generate trust and to communicate effectively.

To earn a Level I certificate, a prospective community health worker completes a 30-hour training program, then 15 hours of field-work practicum, shadowed by an instructor. The curriculum emphasizes cultural competency, confidentiality and legal issues, and potential ethical dilemmas. Students learn to recognize early warning signs for substance abuse, domestic violence, mental health, illegal activities, abuse and neglect. They are versed on making presentations, on establishing rapports and strengthening verbal and non-verbal communication skills.

On completion of the course and fieldwork, the candidate must pass an exam, administered two weeks after the training. The Children’s Trust assumes payment for the course.

Of the 58 graduates in this the first year, most were placed in jobs either through assistance from HealthConnect In Our Community, Santana said, or with the aid of a Community Access Program (HIRSA) grant.

Miami-Dade College is considering adding a Community Health Worker certificate program to their Community Education program, and Community Voices Miami is currently developing curricula and criteria for Level II and III training.

A community health worker can expect to earn $27,000/year on average. Some agencies provide a benefits package.

In addition to connecting people to services, these outreach specialists play an advocacy role, Santana said. New security regulations have left many immigrants fearful, and hesitant to visit a clinic for fear of a raid. Community health workers counsel immigrants on their rights and in other many other areas – such as domestic violence and substance abuse – as well. .

Through the expanding efforts of HealthConnect In Our Community and other initiatives, community health workers provide an essential service that promotes healthier living and unifies the fragmented health services in the community.



The Foreign Educated Physician to Nursing (FEPN) program, a revolutionary education initiative pioneered by Florida International University College of Nursing & Health Sciences (FIU CN&HS) in Miami, Florida, expanded to Tampa, Florida with the beginning of Spring semester classes on January 8, 2007.

The FEPN is the nation’s first-ever education program to transform foreign-educated physicians into nurses through a fast-track, specialized curriculum. Financial support from Palm Harbor-based Hospital Corporation of America (HCA) West Florida will provide funding for local faculty, full scholarships for up to 15 students (recruited from the Tampa Bay area), and long-distance technology equipment for real-time videoconferencing delivery of the program from Miami to students in Tampa.

This latest cohort of students in FEPN is comprised of 48 Miami and 15 Tampa-area candidates, with the program based at the Biscayne Bay Campus (BBC) in North Miami. Both Miami and Tampa students will participate in the program by taking classroom courses together via real-time, interactive videoconferencing between FIU BBC and Largo Medical Center (LMC). LMC will be equipped with long-distance technology through the HCA funds. However, clinical activities for the Tampa student will take place locally at LMC and fellow HCA West Florida facilities Edward White Hospital, Northside Hospital & Heart Institute, and St. Petersburg General Hospital, all located in St. Petersburg.

Upon graduation and professional nursing certification, graduates of the FEPN program will enter into multi-year work commitments with the four participating HCA West Florida hospitals. In South Florida, where the program was developed, the majority of the program’s 165 graduates are employed as working RNs in local health care facilities through Miami-Dade and Broward counties since the program launched in May 2002.



Keiser University has launched a new venture into higher education with a Graduate School. In conjunction with the first graduate degree offered by the university, Keiser changed from a college to a university, a transformation which accurately reflects the stature of the school. And what graduate degree would be more natural for the university to start with than the MBA, a natural extension of the mission of the university.

The MBA program is offered by Keiser University Graduate School in an accelerated format to working professionals and college graduates who wish to advance their career opportunities through a highly marketable graduate degree. Students who enroll in the Graduate School can complete their MBA in as little as twelve months. Also, Keiser University has a strong history of job placement, with over 90% of its undergraduate students placed in field. The strong placement history tells graduates and employers that KU students graduate with the skills and knowledge required for professional success and advancement.

Keiser University graduate students are currently enrolled in one of three concentrations, international business, leadership for managers, or marketing. Are other concentrations possible in the future? “Absolutely”, says Graduate Dean Sara Malmstrom. “Keiser University is known for its ability, no its passion, to partner with the community to provide needed education. Our model of higher education is successful because we listen to the needs of our students, our advisors, and the community we live in.”

Keiser University brings professors to the classroom experience that have academic credentials and real world experience. Dr. Catherine Klinger, leadership professor, worked in the corporate world for fifteen years. She transformed herself, through her MBA, from the world of art to the corporate boardroom, eventually working as an in house consultant to CEO’s. “The reason why I work at Keiser University is because our student’s first philosophy is not just lip service, it is what we do. I make a personal commitment to work with each student, mentoring them and modeling the behaviors which they need to be successful in the business world.” Dr. Klinger’s passion for student success is not unique at Keiser University. A visitor to the university recently stated that if she didn’t already have an MBA, this is where she would earn hers.

Keiser University is further distinguished by technology needed for MBA graduates, library services available 24/7, extended hours of campus operation, and an open door policy starting with the campus leadership. Students are issued laptop computers with up to date software and programs allowing them to work in the classroom or at home on their school work. Graduate classrooms are networked with wireless internet connections, making information access up to the second. The KU library, accessible any time and any where from a computer, has a nearly overwhelming number of resources for students to use. “This is an exciting time in Keiser University’s history. I told the first class of graduate students when I met them that they were trailblazers. Some day they would be able to look back and say ‘look at what I started’,” says Dr. Malmstrom. Keiser University is truly moving into the 21st Century by providing what South Florida needs for a stronger future.



The growing nursing shortage is posing a real threat to the U.S. health care system, one that can be alleviated in part through new approaches to nursing education.

The number of RNs in the workforce is expected to peak this year and then decline, due to the aging workforce, despite the fact that RNs top the list of the 10 occupations with the highest projected job growth.

The shortage is even taking a toll on the level of care today’s nurses are able to provide. According to a study by the University of Pennsylvania School of Nursing (as quoted by the American Nurses Association) an estimated 20,000 people die each year because they checked into a hospital with overworked nurses.

While the cause of the nursing shortage has long been linked to an aging and disaffected nursing population leaving the practice, we believe a more fundamental cause is the lack of nurse educators, who are unable to serve the growing waitlists of qualified nursing student applicants. In 2005, schools of nursing, colleges and universities across the country turned away nearly 180,000 qualified applicants, due in large measure to the shortage of nursing educators.

Given the growing need, we need to find more creative ways to educate the next generation of nurses, whether it’s LPN to RN or RN to a bachelor’s level nurse. Many of these individuals lack the time and financial resources for traditional campus degree programs and are looking for more flexible programs that are better suited to their lives.

Recognizing these needs, alternatives like distance learning programs and online degrees are helping to unburden the university system and ultimately will help alleviate the nursing shortage. Enrollment in college level distance education courses continues to grow: the most recent studies on distance learning published by the U.S. Department of Education found that student enrollment nearly doubled from 1994-95 to 1997-98, and then more than doubled again in 2000-01 when 2.9 million students were enrolled in college level distance education courses.

However, educating adult learners is not without its own set of challenges. The first 120 days are critical to an adult learner’s success. For many, they must learn how to learn again. Once they get over this initial hurdle and get a taste of accomplishment, their chances for completing their degree increase dramatically.

With an eye toward retention, student-centric approaches and new technology for distance learning are being developed.

A flexible learning process, which can be found at Career Learning Centers in Fort Lauderdale for instance, offers a mix of face-to-face tutoring, along with self-paced study materials and online tutoring to ensure success on examinations, all in a format that fits with the busy schedule of an adult learner.

These face-to-face sessions meet once a week for four hours and conclude after three to twelve weeks (depending on the course). They are designed to overcome the scheduling obstacles customary in traditional programs with morning, afternoon and evening options, Monday through Saturday.

Career Learning Centers doesn’t require students to purchase additional study guides, tutorials or modules and will help students regardless of the distance learning system they may have already purchased.

Perhaps the biggest advancement in distance education is in the realm of technology. Career Learning Centers offers a full academic experience that incorporates online tutors as part of a new Learning Management System (LMS).

The online component provides interactive quizzes, multi-media lectures, valuable hyperlinks to web resources and other activities to reinforce the classroom learning. All of these supplemental tools serve to reinforce the classroom experience, engage the various learning styles, allow students to review difficult lecture material or catch up if they missed class and simulate testing they will face for the high stakes exams.

“The goal is to hold the students’ hands and help them through courses with a mix of face-to-face assistance and independent tools that are right for them,” said Judy Mainzinger, Director of Career Learning Centers.

Pressure to educate the next generation of nurses will undoubtedly continue. In fact, the National Advisory Council on Nurse Education and Practice and the American Nurses Association recommend that, by 2010, the majority of nurses should have a bachelor’s degree in order to meet patient needs most effectively. In addition, a University of Pennsylvania study found that nurses with a higher level of education were able to deliver a higher degree of patient care.

The integration of dynamic online learning tools available 24/7 coupled with the personalized education of face-to-face tutoring centers like CLC, are able to accommodate the life demands and learning style of each individual interested in advancing his or her nursing career. The flexible learning approach also helps nurse educators serve the maximum number of students with high quality education tailored to the students’ needs, rather than the students conforming to the traditional program format.



Deb Lewandowski, director of oncology services at Martin Memorial Health Systems, has seen much of her nursing staff change faster than Superman in a phone booth.

In the past four years, the turnover rate on the oncology unit at Martin Memorial has ranged from 18 to 39 percent. But Martin Memorial isn’t the only provider that’s feeling the effects of high turnover in oncology nursing. Research indicates turnover rates on a national level average 22 percent on acute-care oncology floors.

Part of the problem, Lewandowski said, is that nurses aren’t trained specifically for oncology care.

“New nurses entering the workforce don’t have the experience or skills to deliver strong cancer care,” Lewandowski said. “And because there are high turnover rates, that leaves new nurses and those nurses who do have experience to care for more patients. That leads to compassion fatigue, burnout and higher turnover.”

To combat that trend, Lewandowski partnered with Martin Memorial’s education department to develop an oncology residency program. It is designed to develop, support and enhance the knowledge base of oncology nurses in an acute-care setting.

The year-long program, which started in January 2008, is facilitated by George Anderson, who has been a nurse for more than 25 years. The initial program will be provided for 10 of the 25 oncology nurses on staff, targeting those who are within their first year of hire.

A skills assessment is performed prior to the program, followed by classroom sessions, interactive Web-based programs, rounding and visits by guest speakers. The material is designed to improve the nurses’ knowledge of oncology care, as well as processes specific to Martin Memorial.

Eventually, nurses in the program will have an opportunity to visit the Moffitt Cancer Center – which Martin Memorial is affiliated with – to learn specialized aspects of oncology care.

“Our goal is to grow and retain our own oncology nurses,” Lewandowski said. “Cancer is growing in the United States. More people are going to get cancer and we need people who are going to be able to take care of them.”