December Success Stories

Highlighting some of the great work Titanium Healthcare Lead Care Managers, Care Coordinators, and Housing Navigators achieved in December 2023 for the California Enhanced Care Management Program, Community Supports Program, and Washington Health Homes.

“A New Home”

LCM/CC/HN/RES/Nurse: Esmeralda

Conditions: Memory loss, Arthritis, Chronic Pain , Diabetes, High Cholesterol, Hypertension, Vision Loss, Osteopenia, Fatty Liver

Situation: My 67-year-old member recently acquired long-term housing after living in a shelter for the past 5 years. I’ve been assisting her with the process which has not been easy for her—her furniture was delayed, and she had to sleep on a blow-up mattress for 2 months. She finally received her bed this month, but continues to wait for a refrigerator. She has felt stressed having to deal with chronic pain and even stomach issues due to the delay in getting everything she needs.

Outcome: I have assisted her following up on the programs helping her with the furniture, low-income utility applications/bills, and medical appointments. She is able to schedule her own transportation but requested reminders as she navigates through all of this. We found that meeting face to face was the best way I could fully support her as she settles in.

Health Plan: LA Care, CA

“Referral Request Rodeo”

LCM/CC/HN/RES/Nurse: Megan

Conditions: Diabetes Type II, Hypertension, Congestive Heart Failure

Situation: My 47-year-old member told me that he had been experiencing on-going ear problems for several months, saying that he had an ear infection that connected to his sinus and throat and was also having pain and a dizzy, vertigo-like feeling. He’d already had blood work done and an X-Ray on his ear, and was told by his ENT that the next available appointment was 5 months away. I called his PCP, who had referred him to an ENT to ask for an expedited referral to a different ENT that had availability. A week later my member called me to say that he’d received a new referral but that it was to the same ENT! So, I asked him to send me the referral and upon further discussion with the PCP’s office, I figured out that the dates weren’t matching up and my member had been sent the original referral again. After figuring that out, I asked about the status of his new referral to a new ENT and was told my member could expect it within 7-10 business days.

Outcome: My member contacted me to reschedule our upcoming in-person appointment and told me he had received a new referral and had the appointment set! I was also able to schedule transportation for him to this new ENT appointment. All is well.

Health Plan: LA Care, CA

“Rental Red Flag”

LCM/CC/HN/RES/Nurse: Ana

Conditions: Hypertension, Chronic Kidney Disease, Chronic Liver Disease

Situation: My 64-year-old member contacted me because he was notified that his rent, which is $1,000 a month, would probably be increased to $1,500 per month which he doesn’t have the means to pay for. He was concerned because he had been renting at that location for almost 20 years and has not had such a steep rent increase. I told him that Huntington Park has rent control and it could only be raised a certain percentage per month and he asked me to verify with the city to see if anything could be done.

Outcome: I called the City of Huntington Park and asked for assistance from the housing division and was then connected to the Fair Housing Foundation who corroborated that between City guidelines and state law rent can only be raised 8.8% percentage in a 12 month period. This increase must be done in writing and presented to him with a notice. My member was relieved to hear the information and thanked me for following up, telling me he would speak to his Landlord and come to an agreement. I also forwarded him the number to the Fair Housing Foundation since they do offer legal help for tenants who are being evicted or have their rent increased.

Health Plan: LA Care, CA

“Lost and Found”

LCM/CC/HN/RES/Nurse: Amy

Conditions: Gallstones, Asthma, Depression, Physical Injury, Migraines

Situation: My 30-year-old member has been experiencing a series of hardships with her health and personal life, struggling to manage her health on top of having financial hardships. Due to her financial situation, her phone service was discontinued and she was unable to reach me. I was not able to reach her or her emergency contact, but with some persistence, I eventually obtained another contact for her and was successfully able to follow up. Member was supposed to get surgery and follow up with a health concern but due to losing her phone service, she never received correspondence back from her health providers.

Outcome: Once I was able to get in touch with her, I began assisting her again to get back on track with her care plan. I notified her providers of her new contact information and set her up with her surgery provider—she’s now finding her way back on track with her
health and other resources she was unable to obtain
on her own.

Health Plan: Anthem, CA

“Quick Fix”

LCM/CC/HN/RES/Nurse name: Elizabeth

Situation: My 37-year-old member who struggles with mental illness contacted me to ask for assistance because he lost his insurance card. He did not want to create an online portal with LA Care so I called on his behalf.

Outcome: Within the span of less than 20 minutes we spoke with an agent who was able to process the request for a new insurance card which will arrive at the member’s home address within 7 to 10 business days; he is still able to see his specialists by providing his CIN number in the meantime. He expressed his gratitude for my help.

Health Plan: LA Care, CA

“SMART Goal Success”

LCM/CC/HN/RES/Nurse: Dana

Conditions: Diabetes Type II, Hypertension, Cataracts, Chronic Kidney Disease (stage 3B), Elevated Cholesterol, Glaucoma, Diabetic Macular Edema.

Situation: My member is a 64-year-old who deals with multiple chronic conditions and expressed her concern of losing weight and wanting a healthy BMI to improve her health and overall condition. We discussed a SMART Goal (Specific, Measurable, Achievable, Relevant, and Time-Bound) that would fit her lifestyle including more daily walks with her dog and watching her carb intake.

Outcome: When we talked in October, her goal was to lose 14 pounds and when I asked about her weight in December, she told me she’s down to 166 from 172! 6 pounds in just about 2 months is great progress for her and she was extremely happy with it. We’ll continue to work together and I’ll continue to monitor her progress to reach her weight loss goal!

Health Plan: LA Care, CA

“Language Barrier Leap”

LCM/CC/HN/RES/Nurse name: Lizette

Conditions: Hypertension, Chronic Liver Disease, Chronic Kidney Disease, Coronary Artery Disease, Cholesterol, Osteoporosis

Situation: I contacted my 72-year-old member for a monthly check-in. She stated she was unable to schedule an appointment for a thyroid ultrasound due to language barriers and had issues figuring out what test she needed to get.

Outcome: I went over the authorization with the member and was able to see the test she needed which I confirmed when she contacted Radnet. I obtained the contact information and scheduled an appointment for her because she stated she has issues scheduling. I also reminded her that I can assist her whenever needed and she thanked me for the help.

Health Plan: LA Care, CA

“A Pain Free Future”

LCM/CC/HN/RES/Nurse name: Jessica

Conditions: Obesity

Situation: My 41-year-old member has been diagnosed with morbid obesity; she has health problems with her knees and back due to her condition and has been frequently visiting the orthopedic specialist due to pain. The member is taking medication to lose weight and, after that, will have her bariatric surgery. The member feels tired, and she is anxious to improve her mobility.

Outcome: I’ve been working with her to reduce some of her anxiety and worry surrounding her condition and future procedure, assisting with her appointments, and filling out medical forms as her primary language is Spanish. We’re happy with her effort in losing weight and are excited to see her improve even more after her surgery!

Health Plan: Community Health Group, CA

“Warmth on the Way”

LCM/CC/HN/RES/Nurse name: Karla

Situation: My member is a 60-year-old male, temporarily staying at a friend’s house. He asked me for help getting clothes for the colder winter months, so I did some research and found a clothing donation service called Sharia’s Closet.

Outcome: I filled out an application for him online and within 3 days they responded, saying they had a bag of clothes ready for my member. We figured out the best time I could drop off the new bag of clothes for him and now he’s ready for the cold!

Health Plan: Community Health Group, CA

A cute illustration of a parka, a warm hat and scarf.

“Asthma Advocacy”

LCM/CC/HN/RES/Nurse: David

Conditions: Asthma

Situation: My 8-year-old member was in need of a nebulizer for her asthma, so I called her PCP’s office to ask for a referral for one, informing the receptionist of the member’s condition.

Outcome: She told me the referral was authorized and I let the member’s mother know—she was thankful for my help and I confirmed with her that the nebulizer was covered by her health plan.

Health Plan: LA Care, CA

A cute illustration of a nebulizer.

“A Sweet Family”

LCM/CC/HN/RES/Nurse: Samantha

Conditions: High cholesterol, Diabetes, Heart condition, Asthma, Depression, Anxiety, Nerve pain due to injury

Situation: I’ve been working with my 56-year-old member to try to get him help with past due rent. I was able to get him approved with HOPICS.

Outcome: It took some time, but we were able to get him approved for the past due rent, plus 1 month. I was also able to get his application completed for CalFresh. We also had him set up for some job applications and interviews. Our next goal is to get him hired with better benefits. He mentioned to me that his wife needs work too, so I sent her some job links, and they hired her 1 week after submitting her application. They are such a sweet family and I’m so happy to help them out.

Health Plan: Health Net, CA

“Toddler’s Talking Trouble”

LCM/CC/HN/RES/Nurse: Jeniffer

Age: 61
Conditions: Hypertension, High Cholesterol, Major Depression Disorder, Diverticulitis, Diabetes.

Situation: My member is a 23 month old toddler. When speaking to his mom she was concerned about his speech delay. He had a recent doctor’s appointment and he was checked for his vision and hearing. His mom told me that everything was great but one of her goals for him was to get him started in speech therapy.

Outcome: I contacted Tri-Counties regional center and submitted a referral for him to start speech therapy services and explained to his mom that a service coordinator from Tri-Counties will be reaching out to her to get the process started. I will follow up with her to make sure her son gets the therapy he needs because it’s important to start speech therapy sooner than later.

Health Plan: Central California Alliance for Health, CA

“Wintertime Win”

LCM/CC/HN/RES/Nurse: Jeniffer

Conditions: Autism

Situation: My member is a 12-year-old boy with autism who lives with his mom who is his primary caretaker. This month, they needed help with rental assistance. His mom’s work had slowed down lately as it’s winter and is dependent on tourism. She was having a hard time keeping up with their expenses.

Outcome: I assisted her in filling out an application with catholic charities and we made sure she had everything she needed to provide. I also made sure someone would be able to assist her in Spanish at the catholic charities office. Additionally, I helped her navigate the SSI website so she could update her employment pay stubs. We are hoping she will receive the funds she needs to pay their rent and I will be following up to make sure everything goes as planned.
Health Plan: Central California Alliance for Health, CA

“A Step Towards Mobility”

LCM/CC/HN/RES/Nurse: Nancy

Conditions: Diabetes, Hypertension, Traumatic Brain Injury, Major Depression Disorder, Physical disability, Vision Loss, Gout

Situation: My 41-year-old member has trouble walking for long periods of time and one of his SMART goals is receiving physical therapy for his knees. His previous physical therapy clinic did not allow him to continue because he missed an appointment because he had to go to the hospital—which is ridiculous.

Outcome: I was able to help him find a new clinic and he finally has a consultation appointment for 1/25/24.

Health Plan: LA Care, CA

“Supportive Conversation”

LCM/CC/HN/RES/Nurse: Joan

Conditions: SUD, Major Depressive Disorder, Sciatica

Situation: My member is 57-years old. When we met, the first thing he said was “I blew up my whole life.” He described how he “fell off the wagon” after 2 years of sobriety, lost the money he saved to move out of his family home, and was not even sure if he had completed the paperwork necessary to start higher education later in the month. He felt all the progress he made in the last few years was gone. He was starting over, and while he knew what he needed to do, he was too depressed and overwhelmed to do anything.

Outcome: We were able to have an honest, empathetic, conversation. This revealed that while he had lost some progress (losing the new housing opportunity), fortunately he still was signed-up with other housing associations to continue the search. We also agreed that he would also check in with his higher education administration regarding his paperwork.

He starting the meeting crying and feeling overwhelmed, but by the end he was motivated and hopeful.

UnitedHealthcare, WA

“Time Trial”

LCM/CC/HN/RES/Nurse: Karina

Conditions: COPD, Asthma, Diabetes Type 2, Ovarian cancer in 2010, Stroke (2019), Bipolar, Depression, Hypertension

Situation: My 51-year-old member contacted me and told me she had tried to reach her pharmacy multiple times because she needed a prescription refill for her transmitters for her Omnipod and Dexcom—two tools essential for diabetes management. She stated she was going out of town for the holidays tomorrow and desperately needed her refill to be able to safely go on the trip.

Outcome: I called her pharmacy and was able to arrange a prescription refill within the hour. When I called to tell her she was relieved and expressed her gratitude.

Health Plan: LA Care, CA

“Road to Recovery”

LCM/CC/HN/RES/Nurse name: Eric

Situation: My 27-year-old member was enrolled with Titanium Healthcare at the end of September 2023 and after multiple non-mail and mail attempts of engagement, I was finally able to get hold of him at the beginning of November 2023. I learned that he was experiencing homelessness, SUD, food and funding insecurity, depression, and had not seen his PCP in months. We scheduled to begin working on all concerns the following week, but he did not answer when I called; I later found out he had been incarcerated for 2 weeks.

Outcome: Once I got back in contact with him in December, we immediately picked up where we had left off. Together, we submitted a referral for Community Supports Housing Navigation, applied for CalFresh, scheduled a PCP appointment for 12/29/2023, contacted Behavioral/Mental Health to get connected to a provider, and discussed starting outpatient SUD treatment. He seems willing and open to work on getting his health back in order and I will continue to follow up to ensure there are no gaps in care and all concerns have been fully addressed.

Health Plan: Molina, CA

“In a Good Place”

LCM/CC/HN/RES/Nurse name: Nyovi

Situation: My 41-year-old member was struggling to keep up with medical care due to daily dialysis. He recently used resources I provided him to find new PCP with more availability and currently he has an appointment scheduled with this new PCP.

Outcome: I was also able to get him started on MTM by CCAH through the website and also provided him with dental provider contacts so he can find a dentist that he likes. While completing an in-person appointment last week with him at his new home with his girlfriend, he told me that he’s very satisfied with care, feels more trust towards healthcare in general, and most importantly that he’s motivated to continue to heal. He mentioned that he’s also excited because his siblings are potential matches for a kidney transplant so he doesn’t have to keep doing daily dialysis. He’s in a very good place right now and I feel like we’re a good team together.

Health Plan: Central California Alliance for Health, CA

“Delivering Solutions”

LCM/CC/HN/RES/Nurse name: Suzanne

Conditions: Benign Prostatic Hyperplasia, Type II Diabetes, Hypertension, Nocturia

Situation: My 69-year-old member told me his Meals on Wheels had been stopped because he was not home to accept the meals because he has lots of appointments and cannot wait daily from 10 am to 2 pm for the meal to arrive.

Outcome: I called Meals on Wheels and was able to speak with Julio, a staff member, and made arrangements for the meals to be left at the front desk of his apartment— my member is happy with this new arrangement and thanked me for reaching out to them.

Health Plan: Central California Alliance for Health, CA

“Pharmacy Odyssey”

LCM/CC/HN/RES/Nurse name: Antone

Conditions: Fibromyalgia, Spinal Stenosis, Depression, PTSD, Bipolar, Traumatic Brian Injury, Gastric Issues, has metal plate on L4, L5, Hepatitis C

Situation: In April, 2023 my 50-year-old member received a diagnosis of Hepatitis C, which she suspected she contracted from her partner. Determined to seek immediate treatment, she asked for my help to find an appropriate specialist to treat her condition. Initially faced with the challenge of her original Gastroenterologist Specialist being reassigned, we encountered further obstacles during the appointment scheduling process and were recommended lab work to assess the status of her Hepatitis C. She was reluctant to go to numerous appointments and other lab work with different specialists, so I obtained many of her previous lab tests which the GI specialist approved; during her appointment with the specialist he told her that she would actually in fact need new, up to date tests which caused her some frustration.

Outcome: Nonetheless, she agreed to undergo new lab tests, which I set up transportation for. These tests lead to the prescription of a 30-day course of medication, Epclusa, but we encountered another hiccup when it was submitted to the wrong department at the pharmacy. Despite numerous exchanges with the Pharmacy Specialty department, she faced delays in acquiring her medication until she finally received it at the beginning of December 2023. Through perseverance and guidance, she is now on the path to full recovery from Hepatitis C.

Health Plan: Anthem, CA

a cute illustration of a prescription.

“Prescription Persistence”

LCM/CC/HN/RES/Nurse: Sandra

Conditions: Hypertension, Chronic Arthritis, Pre-Diabetes,
High Cholesterol, Erythema Nodosum

Situation: My 60-year-old member had expressed to me this month during our check in that she was stressing about her medication. It’s a new medication that helps with her pre-diabetes and assists her in losing weight which she told me was her insecurity. She alerted me that the medication was on back order at her pharmacy and was hoping to begin taking it soon, so I made an appointment with her PCP to tell her doctor that her pharmacy did not have that medication available.

Outcome: After the appointment, she was given three medications as options instead of the original medication prescribed. I called her pharmacy and inquired about all three and the representative was able to confirm that one of the three listed was available. I then contacted the prescription department at her PCP and ordered her the new medication that was available for her to begin to take. I followed up with her this week and she let me know that she has now begun the new medication and she already feels relieved. She thanked me for advocating for her to get a new medication that helped her both physically and mentally.

Health Plan: LA Care, CA

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

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

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All Rights Reserved.