April Success Stories

Highlighting some of the great work Titanium Healthcare Lead Care Managers, Care Coordinators, and Housing Navigators achieved in April 2024 for the California Enhanced Care Management Program, Community Supports Program, and Washington Health Homes.

“Path to stability”

LCM/CC/HN/RES/Nurse: Erika

Conditions: Diabetes, Hypertension, Kidney Disease

Situation: My 68-year-old member was facing financial difficulties and she informed me she was behind on rent, owed her current landlord over $10,000, and was not sure how she would be able to pay it back. She was actively looking for resources and reached out to The People’s Project which were able to assist her. She was informed they would cover part of her past due rent and is currently receiving rent relief. She was also looking for food resources and TAP resources as she mentioned the bus is her primary mode of transportation.

Outcome: I provided her with The Commodity Supplemental Food Program resource and assisted her with applying during an in-person visit. I also helped her apply for the TAP LIFE Program for her transportation as she had mentioned she was not sure she was enrolled in the program anymore. I will continue to provide resources and support to her and will follow up on the outcomes of the applications submitted.

Health Plan: LA Care

“Cleaning Up”

LCM/CC/HN/RES/Nurse: Rebecca

Conditions: Arthritis COPD, High Cholesterol, Hypertension, Physical Disability, Diabetes

Situation: My 62-year-old member stated his bedroom ceiling collapsed and fell onto his bed in Jan 2024. Although he received repairs for the ceiling, there was debris left in his room, and it was unsafe to sleep there. Therefore, he has not been sleeping in his bedroom, which has been causing more aches and pains for him with mobility and pain issues. My member was distressed due to property management not providing clean-up of his room and also being unable to reach his case manager at Section 8.

Outcome: Since he provided his Section 8 case manager’s phone number and email, I called and emailed, receiving a call back within 2 days. I confirmed an urgent inspection would be done and received a call from the inspector when it was getting done. After it was conducted, I got this text message from my member:

“Thank you so much! I just got off the phone with her. I don’t know how you did it but I really appreciate it. Thanks again Rebecca.”

Health Plan: LA Care

Cute illustration of an apartment complex.

“Insurance Workaround”

LCM/CC/HN/RES/Nurse: Ana

Conditions: Hypertension, Depression, Anxiety, PTSD, Brain Aneurysm

Situation: My 54-year-old member has TMJ and suffers from pain in his jaw as a result. He needs oral Maxillofacial surgery as a result. He’d been referred to an oral Maxillofacial surgeon at UCLA, but the surgeon’s office told us that they do not accept LA Care.

Outcome: We spoke to UCLA Quality Management and LA Care to remedy this situation since my member was not able to be referred outside the UCLA system and the UCLA surgeon couldn’t see him. After a bit of back and forth, I called Medi-Cal to see what the options were, being told to try Denti-Cal and if that does not work to have my member change from LA Care to another insurance that the surgeon will take. LCM called Denti-Cal and was able to make changes that will not only allow him to have his surgery but will also allow him to go to any oral maxillofacial surgeon in her area!

Health Plan: LA Care

“Updating the Record”

LCM/CC/HN/RES/Nurse: Robin

Conditions: Arthritis, HIV/AIDS, Vision Loss, Anxiety, bipolar disorder, Major Depression Disorder, Chronic Liver Disease, Diabetes, Fibromyalgia

Situation: My 60-year-old member has been having a hard time with getting in contact with her specialist’s office to check the status on her upcoming hernia repair surgery. She told me she’s called several times, left several voice mail messages with no luck.

Outcome: I called the office and left a voicemail message for a return call back. I got a call back and added my member for a three-way call where we learned my member would need a CT scan before the surgery—her last scan was done in 2021 and an updated scan was needed. We were told that she’d receive a call back by the end of the day with a referral to get the scan, which was scheduled for 4/8/24.

I scheduled her transportation to her appointment and she informed me that she would need barium sulfate before the scan which I hunted down for her. She was grateful for my help and we’re both looking forward to her feeling better after her repair surgery.

Health Plan: LA Care

“Supporting A Caregiver”

LCM/CC/HN/RES/Nurse: Giovani

Conditions: Asthma, Chronic Kidney Disease, Chronic Liver Disease, Diabetes, Hypertension, Major Depression Disorder, Anxiety, Chronic Pain, Sleep Apnea, Sciatica, GERD, Fatty Liver

Situation: My 31-year-old member has several conditions that make them eligible to apply for Mom’s Meals through Health Net. My member’s mother is also their IHSS care worker. Their mother asked about policies regarding their tax statements. They have been told that they owe the IRS money because they take care of both my member and their father. Both are disabled and live in the same home. This places a financial burden on the entire family because of the high amount of money that they owe.

Outcome: I was able to coordinate and create a plan. I called my member and was able to complete a Mom’s Meals application in order to help them obtain medically tailored meals. I told their mother that because they are a caregiver who lives in the same place with their care recipients they are tax exempt and should not owe money and I provided them with links to this information online for further evidence. With this they will be able to file a claim so that they do not have to pay their tax fees. They instead will receive a tax return and will actually receive money back.

Health Plan: Health Net

“Project Angel”

LCM/CC/HN/RES/Nurse: Nancy

Conditions: Diabetes Type I, Thyroid Issues, Depression

Situation: My 28-year-old member expressed her concern on her previous subscription to Project Angel ending. Member stated that she did not know the next steps to renewing her access to the medically tailored meals. Due to a busy schedule, she was unable to find time and motivation to figure out more details on the steps to extend her membership.

Outcome: I contacted Project Angel and left voicemails until a representative responded to me. Next I’ll be working with her PCP to get the proper forms signed on her behalf. After that, she’ll have her medically tailored meals and will continue to save money through Project Angel.

Health Plan: LA Care

“A1c Win!”

LCM/CC/HN/RES/Nurse: Robin

Conditions: Coronary Artery Disease, Diabetes, Hypertension, High Cholesterol

Situation: I recently received my 63-year-old member onto my caseload and upon completing a review of her chart I noted her SMART goal was to lose 10 lbs to help improve her diabetes. I scheduled an in-person visit to introduce myself and was able to obtain more information and found that she has been consistently meeting her 3-4 times per week walk with her children that lasts 45 minutes.

Outcome: She reported she was feeling good and on a recent visit to her provider’s office, she was informed her A1c level is at 6.9, almost a whole point from her previous visit at 7.6! Previous LCMs have helped keep her accountable and were able to help schedule her appointments for bloodwork and transportation to her medical appointments. I’ll be doing the same for her and hoping to improve her diabetes and independently manage her care soon.

Health Plan: Health Net

“Transplant Talk”

LCM/CC/HN/RES/Nurse: Kevin

Conditions: Arthritis, Hypertension, Diabetes, Chronic Kidney Disease

Situation: My 53-year-old member attends dialysis treatment at least 3 times a week and has been managing her kidney disease for over 5 years. During our first in-person encounter, I explored her interest in obtaining a kidney transplant. The member and her daughter stated that they would be more than willing to consider the possibility of a transplant so we collaborated to come up with a plan.

Outcome: I coordinated with one of the Social Workers who provides services at my member’s dialysis center. With the Social Worker’s assistance, we were able to obtain an authorization from the member’s health plan for the member to be evaluated for a kidney transplant. The member has the appointment for evaluation scheduled. In our most recent meeting, the member expressed joy as she shared that she is now “hopeful” about her future.

Health Plan: LA Care

“Benefits Reinstated”

LCM/CC/HN/RES/Nurse:Marie

Conditions: Traumatic Brain Injury, Seizures/Epilepsy, Anemia, Vertigo, Fibromyalgia, Dissociative Identity Disorder, PTSD, ADHD, Constipation, Heart Palpitations, Panic Attacks, Weak Muscles, Nerve damage (back of neck), Acid Reflux, Nausea, Fatigue, Insomnia, Dyslexia, Auto Brewery Syndrome

Situation: My 27-year-old member was reassigned to me in February with very high needs. He had expired authorizations for both rhinology and voice therapy and was needing to see providers ASAP due to extreme pain and discomfort. His CalFresh and general relief were both discontinued before being reassigned to me. He was stressed out and in a lot of pain which caused him to be impatient with me.

Outcome: I prioritized his requests, staying on hold with EBT services for over an hour and a half at minimum to get his benefits reinstated and I’m continually working on getting the required authorizations and CPT codes for him to see the specialists he needs. We’re scheduled to call general relief together on the 25th, but this has truly been a long, difficult process for us to get his benefits back but it will all be worth it in the end. One goal accomplished, 3 more to go!

Health Plan: Anthem

“Rental Relief”

LCM/CC/HN/RES/Nurse: David

Conditions: Asthma, Bronchitis, Diabetes, Heart Problems, High Cholesterol, Hypertension

Situation: My 56-year-old member informed me that he is backed-up with his rent due to an injury that he sustained on his right arm which made him unable to work for a while. He also indicated that his wife was recently laid off from her job. He said that he even received an eviction notice from the landlord stating that if he does not pay this month’s rent, he will be evicted.

Outcome: I asked him if he was available for a conference call, to call the HOPICS program which we did. We found out he qualified for the program and we signed him up. He expressed his gratitude for helping with the rental assistance program.

Health Plan: Health Net

“It Takes A Village”

LCM/CC/HN/RES/Nurse: Eric

Conditions: Diabetes Type II, Diabetic Neuropathy, Hypertension, Heart Murmur, Hearing Impairment, Visual Impairment, Chronic Pain, Depression, Forgetfulness, Legs Wounds

Situation: My 64-year-old member has been in and out of the hospital due to high blood sugar, poor circulation in lower extremities, and open wounds. He was recommended to be discharged to a Skilled Nursing Facility following hospitalization but he refused.

Outcome: I’ve conducted face-to-face encounters, following up with him closely to ensure he followed recommendations. With the help of his PCP, a social worker, the Hospital Case Manager, and hospital nurse, the member consented to be transferred to a Skilled Nursing Facility for continued care. I asked each provider to educate the member on the risks and safety of taking care of open wounds at home and I called my member to coach him through what questions he should ask each person on his care team so he had no second guessing or missing information. He’s currently there and he informed me that he understands why he has to be there and the value it brings to him in his recovery.

Health Plan: Molina Healthcare of California

“Success Across the Board”

LCM/CC/HN/RES/Nurse: Stella

Conditions: Diabetes Type II, Shortness of breath post COVID, Pre-excitation Syndrome, Fatty Liver, Unspecified Convulsions, Cyst of Kidney, History of Pneumonia, Hypertension, History of low testosterone

Situation: My 64-year-old member is currently homeless and living in his truck. He says his only problem at the moment is the fact that his truck can’t reverse anymore, so he has to push it manually if he needs to move it backwards. He’s been having trouble with social security and disability, being taken off disability which left him responsible for his co-pays for a while which wasn’t feasible for him. He also noted the weather lately has been making it difficult to sleep in his truck, with one of his sons adding that if he could purchase an RV, he would be able to park it on his land. He has a cousin who lets him sleep in her “she shed.” He thinks he has a possible Lipoma which causes him pain to the touch. He completed a chest X-Ray that revealed plaque in his arteries and needs to see a Pulmonologist.

Outcome: Since helping him, and with the assistance of his daughter, he has been placed back on disability and Medicaid which covers all costs of his medical appointments. He stated that he’s now more at ease and attends his appointments in comfort. I’ve scheduled appointments for him at the pulmonologist and an ultrasound. I also helped him get backdated checks for the social security he missed which allowed him to fix his truck and will allow him to purchase an RV! I gave him some educational materials on diabetes friendly meals to help him lower his A1c; he’s been doing really well managing his weight by limiting carbohydrates and cutting down meal size, having gone from 310 to 285 since our last meeting and is now in the prediabetic range!.

Health Plan: Coordinated Care of Washington

“Transportation Sorted”

LCM/CC/HN/RES/Nurse: Karla

Conditions: Aneurysm, Craniotomy surgery

Situation: My member resides in a remote area far from the city and informed me about her transportation challenges, particularly regarding her difficulty in obtaining Uber rides to her location. She expressed concerns about attending medical appointments, noting that her previous roommate used to provide transportation but is no longer available. Consequently, she’s anxious about how she’ll manage to get to her appointments in the absence of reliable transportation.

Outcome: I informed her that Santa Clara Family Health Plan offers transportation services for her medical appointments and provided her with the contact number to call whenever she needs assistance. I also assured her that she can ask me for help in setting up transportation whenever she needs to which she expressed deep gratitude and relief.

Health Plan: Santa Clara Family Health Plan

“Good Optics”

LCM/CC/HN/RES/Nurse: Jasmine

Conditions: Primary Biliary Cirrhosis, Hypertension, Asthma, PTSD, Depression, Anxiety, High Blood Pressure, High Cholesterol, Emphysema

Situation: My member had reported that she had difficulty with her vision, and had not been able to wear glasses since 2016. I contacted Anthem for optometry providers near her and narrowed down the options to a list for her.

Outcome: She then contacted the office of the provider she chose, scheduled an appointment, and I helped her with scheduling transportation to the appointment. She will soon have the proper resources to help her vision.

Health Plan: Anthem San Francisco County

“Scheduling Success”

LCM/CC/HN/RES/Nurse: Karina

Conditions: Chronic Kidney Disease, Chronic Liver Disease, Depression, Osteoporosis

Situation: My 59-year-old member informed me that she’d received 3 authorizations for a vascular surgeon office visit, physical therapy, and gastroenterologist appointment. She also stated she needed to make an appointment for a mammogram and lab work.

Outcome: I went to her home and we scheduled the appointments together; she tearfully told me that she always forgets her appointments and after she missed them, they would be rescheduled months later. She said this was frustrating and she felt helpless. I taught her how to put the appointments on her phone calendar and ring an alarm two hours in advance. I also assured her that I’d call her the morning of her appointments to remind her. She also told me she didn’t have reliable transportation and did not like to bother her friends and family for rides so I assisted her in arranging transportation through Anthem.

Health Plan: Anthem

Cute illustration of a calendar

“Making it Her Own”

LCM/CC/HN/RES/Nurse: Marissa

Conditions: Pre-diabetic, Hypotension

Situation: My 31-year-old has 4 children and has been staying in a shelter recently. We worked together to find her and her family an apartment.

Outcome: She was able to graduate from the Community Supports program as I connected her to resources that assist with housing. As of 4 days ago (4/20/2024), she moved into a 2-bedroom apartment in Downey with her children. We are both excited for the move and are working to furnish the apartment and make it her own.

Health Plan: LA Care

“New Home, New Me””

LCM/CC/HN/RES/Nurse: Kristina

Conditions: Multiple diagnosis of 7 of her body organs are not working together

Situation: My member is a 60-year-old female with multiple health conditions that have plagued her since childhood, worsening with age. Many of her organs are not working in unison. She’s been living with a very emotionally and mentally abusive roommate for several years with her Section 8 Voucher. She was too afraid to tell anyone that her roommate was abusing her, which caused her medical conditions to worsen. She signed up for the Community Supports program in hopes that we could help her find another place to live.

Outcome: We’ve worked tenaciously together, resulting in her moving into her new house by herself on 5/1/2024!

Health Plan: Central California Alliance for Health

Cute illustration of a blood pressure machine.“Blood Pressure Double-Take”

LCM/CC/HN/RES/Nurse: Denise

Conditions: Hypertension, Congestive Heart Failure, COPD, Arthritis, Vision Loss, Bronchitis, Chronic Liver Disease

Situation: My 70-year-old member had an in-person visit where her blood pressure was at 165/125 with 75 for pulse. I tried to check the blood pressure again, but the blood pressure monitor read an error when trying to verify the reading was correct.

Outcome: Clinical Consultant Hannah assisted me with following up with her and making sure her blood pressure was checked again to ensure it was not continuing to stay high. I completed a clinical case conference and obtained guidance on how to handle the situation with my member. I called her back to follow up and obtain new reading. After multiple calls and interventions, I confirmed the readings which were 133/79 for the right arm, 76 heart rate and left arm of 118/73. I collaborated with my member’s care team and addressed the emergent issue.

Health Plan: Health Net

Care Management

ECM California Helpline
Tel: (310) 280-5203

Washington Health Homes
Tel: (206) 926-3890

Locations

Garden Grove
Tel: (714) 897-1071 | Fax: (714) 373-4696

Lakewood
Tel: (562) 925-7401 | Fax: ( 562) 925-8898

Downey
Tel: (562) 928-9700 | Fax: (562) 928 8300

Downtown Los Angeles
(Virtual visits only)
Tel: (213) 765-8123 | Fax: (213) 336-3032

Titanium Healthcare Logo White

12566 Valley View Street
Garden Grove, CA 92845
Tel: (714) 897-1071

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Titanium Healthcare® Inc.
All Rights Reserved.