News

UMass Amherst Nursing Alum Nominated for Rosoff Award

Date: 
Sep 6, 2018
Debra Wojnarowski

Debra Wojnarowski ‘76, was nominated for a Rosoff Award for her work as a Nurse Case Manager at Harvard Pilgrim Healthcare (HPHC), by the Ad Club in May. The Rosoff Awards celebrate individuals and organizations “breaking new ground in inclusion and diversity.” 

Wojnarowski has worked for Harvard Pilgrim Healthcare for 18 years, but has been assisting transgender members in understanding and accessing their Transgender Medical Benefits. She has helped over 500 members access these benefits and has received praise from both her company and members for her dedication. 

A member nominated her for the Rosoff award. HPHC won an award in the “Companies” category. 

Learn more about Wojnarowski, in her own words, in the Question & Answer below. 

Q: How do you feel your work contributes to equality and social justice?

A: In Jan 2014 I was approached by HPHC leadership to take on the role of developing a Program and Network to meet the needs of our transgender members. I couldn’t say YES fast enough. Many things were happening in the media, the press, television, healthcare, legislation to bring awareness to the transgender community.

In June of 2014, The Department of Insurance issued a bulletin that prohibited all health plans in Massachusetts that provided coverage to fully insured from discriminating based on gender identity or gender dysphoria including medically necessary transgender surgery and related healthcare services. Because I had been in the role for 6 months (thanks to incredible foresight of the leadership), I was prepared to start assisting members to access the care they needed. In the first year, I assisted 60 members, the second year 150 members, and it grows yearly. If members are self-insured and are not covered by the state mandate, their employers are given the option of purchasing a rider to cover the benefits. Many companies have stepped forward and done the right thing by doing that. At HPHC we have 1.2+M members. They are primarily in New England, but many throughout the country if their employer is based in Massachusetts. This has allowed me to reach out to providers in many states to learn their programs, resources, specialties to be able to direct and advocate for our members getting care outside of New England. In fact, all nurses at HPHC must be licensed in the 8 states we do business in. Transgender people are the most grateful members to work with. They are so appreciative that you acknowledge their true gender, address them with the correct pronouns and name. As a nurse, I am able to discuss in detail with them the medical and surgical procedures which many lay people are uncomfortable discussing. My nursing career has been working with adults. This role has given me the opportunity to work with children and adolescents and assist their parents with resources and guidance on how best provide for their child.

I had the opportunity to be part of a panel at First Event several years back, with Jeremi Carswell M.D. the Director of the Gender Management Clinic at Boston’s Children’s Hospital and K.T. Crossman Esq. at Transformative Law . We discussed our work and answered questions from parents of trans kids on how to get care and advocate for care. In New England, only Massachusetts, Rhode Island, and Connecticut are mandate states.  In the U.S., there are only 15 states and Washington D.C. that prohibit transgender insurance exclusions.

Q: How do you feel your education at the UMass Amherst College of Nursing prepared you for your work and what did it teach you about social justice and reaching the underserved?

42 Years ago I graduated from UMass Amherst!! When I entered UMass as a freshman, I thought you were entering a 4-year baccalaureate nursing program. After two years of courses, you needed to apply to the School of Nursing (I and most others in 1972 must have missed that bulletin). This was devastating to hear. I had already formed a bond with many “Peer Nursing Students,” we had taken courses together, and we talked about passions and desires for a career.

We were informed that there were a limited number of slots for the junior class. I got in. My roommate didn’t. How devastating for her. How devastating for me. There did not appear to be any rhyme or reason for the decision. Other “nursing majors” on my floor did get in and others did not get in. They were told they could reapply the following year.  This was Injustice.  My roommate was a trooper, she did the 5 year plan, using that year between sophomore and junior years to take courses and remain enrolled. She applied and got in, and graduated a year after me. We remain friends and frequently vacation together. I realized this is not what you wanted to hear. That experience will never leave me. I don’t know if it still continues, hopefully not (Editor's Note: Nursing Majors are currently accepted into the nursing program upon being admitted to UMass). I have always loved the underdog and always wanted to even the playing field.

Equity was very important to me. There were plenty of situations during my 4 years at UMass in my clinical rotations that I encountered marginalized people. I recall driving to Springfield and told during a community health rotation, "Just walk into the Elderly housing Complex and befriend someone sitting on a bench. Tell them who you are and that you are studying at UMass Amherst, and ask them their story, and about their life and healthcare and ask if you could come back the next week and talk to them again."

In another rotation, I was at Northampton State Hospital, taking with a resident on an inpatient ward about what deemed them a threat to the community and themselves. I was 20 yrs old, listening to someone with Mental Health issues peaked my curiosity. Their life was in/out of facilities, lost relationships, and delusions.

I did have some experiences prior to coming to UMass helping the underserved. In high school, I spent a month in Honduras working with local people on a coffee plantation. I think my UMass years cemented in me that my passion and satisfaction was helping those who needed help. I had no desire to be the nurse that worked on a cutting-edge transplant team or become a nurse administrator removed from patient interaction. I was happy in the trenches. I can speak for those who can’t. I can be an ally to the underprivileged. I can be a haunt to make something happen. I can listen, I can hear you, and I can make change happen.

 

Q: What does it mean to you to work for an organization valuing social justice?

HPHC has long been a company that strengthened the workplace by embracing diversity & inclusion. To have the opportunity to be a leader and role model for them in working with the transgender members is such an honor. At Harvard Pilgrim, we define inclusion as valuing difference and creating value through difference each day – among our employees, with our customers, business partners, suppliers and vendors, and in the communities where we live and work. Inclusion is a Harvard Pilgrim core value as well as a critical business strategy.

Q: What would you say to other nurses about how they can incorporate practices of inclusion and justice into their work? 

Thinking about the trans patient, there are many barriers to getting care. One of the biggest is fear. Many have had horrendous experiences with the healthcare system. They can sense the uncomfortableness in providers. One thing this has led to is a high incidence of not getting treatment for SDT & HIV, depression, suicide thoughts, trauma, and sexual assault.

Providers must avoid assumptions based on their natal sex and gender presentation. Using preferred words, i.e. transgender or trans patient, transman / transmale, F2M or FTM, transwoman/transfemale, M2F or MTF, gender non-conforming /gender queer. Ask them their preferred pronouns and use their surnames in the office. Many times their first name on the record is not the name they use.

Acknowledge previous healthcare experiences with respect and advocacy. Treat the anatomy that is present. Treat the risk that is present. If needed refer the patient to providers who are trans competent. Acknowledge your mistakes in addressing them or making assumptions, apologize, ask the patient to teach you. Listen, listen, listen. 

Apology builds trust. Many of the people I work with have been rejected by their family/ friends/neighbors/employers. Their desire to affirm their gender identity can supersede most other things in their life. For years many have lived as society has mandated. And now with the transgender tipping point/awakening/acknowledgement many can start the process or continue to live in their true gender. It is NOT easy. Some do not have insurance for gender conforming surgeries. Some do not have prescription coverage for cross-gender hormones and are using the underground to access medications. No one who I have worked with that is in their 20’s or older has had a cake walk. Everyone’s transition is different. Today, because of pediatric endocrinologist and gender management services for adolescents, the future generations hopefully will have an easier time. The earlier you transition, both socially and medically affords you a better future.

 

Q: What does the Rosoff nomination mean to you?

Being nominated as an Individual with greats such as Drew Faust, President of Harvard University, Andrew Dreyfus the C.E.O. of B.C.B.S. of Massachusetts, Boston police officers, as well as nominees who are doing amazing work in Silicon Valley, Washington D.C. and other parts of the country. It was the pinnacle of my nursing career to be one of the nominees who’s committed to serving the needs of a diverse population.

Read more about the nominees: 

http://theadclub.org/rosoff2018/nominees-2/

http://theadclub.org/rosoff2018/2018/05/10/wojnarowski-debra/

 

Q: How do you hope to inspire other nurses, particularly UMass nurses? 

Follow your passion, whatever is it. Nursing can take you anywhere and everywhere. I would never have thought that in 1976, upon graduating, that I would be sitting in my home office 27 years later, working at a position I loved, for a company that realized, 120 nurses were much happier, more productive, healthier had better life/work balance, because they could telecommute. There are so many exciting opportunities. Our members love to communicate electronically; we have apps for them, secure email servers. live chat. We have many tools on our website including a digital exercise program tailored for diabetics, a tele-behavioral health program, a digital holistic health management program that members can send direct messages securely and privately to their primary nurse right from their smartphone, and get the care and support they need to manage their conditions, navigate the healthcare system, and achieve their health goals. 

When you graduate, the opportunities available to you are so varied. I have never regretted getting my nursing degree at Umass Amherst. No one can take that away from you.

I can’t even imagine what the graduating class of 2018 will be doing in 10, 20, or 30 years.  The future is yours to make. Embrace it.

 

Debra can be reached at Debra_Wojnarowski@harvardpilgrim.org by any UMass nurses with questions.