January Success Stories

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

“Unseen Battle”

LCM/CC/HN/RES/Nurse: Megan

Conditions: Hypertension, Arthritis (foot pain), Surgical history: Tumor removal, behind the eye–noncancerous

Situation: My 51 year-old member needed a follow up with her spine and brain neurosurgery provider because she was having ongoing problems after a procedure where she had a non-cancerous tumor behind her eye removed. She’d been having trouble speaking to a “live person” at the doctor’s office and was directed to use an online system to make a request for an appointment, but she was never contacted by the office to schedule. She’d attempted to call and use the online system on several occasions. I called the office and also had a hard time speaking to someone so I left a detailed voicemail on her behalf. The provider returned my call and I was able to get answers about the situation, then relaying the info to my member about how she could set an appointment—which she did.

Outcome: She was told at her new appointment that she would need additional surgery to extract the remaining pieces of the tumor as well as plastic surgery to repair the skin tissue damage in the area around her eye. Though it took some perseverance, she was happy that she was able to get the appointment and is moving along in her healing process.

Health Plan: LA Care, CA

“Planning Progress”

LCM/CC/HN/RES/Nurse: Vanessa

Conditions: Diabetes,Hypertension, PTSD, Schizophrenia, Memory Loss, Arthritis, Vision Loss, Anxiety, Chronic Pain, Traumatic Brain Injury

Situation: My 56-year-old member was having a difficult time keeping track of and remembering medical appointments and follow ups with specialists and was not able to create transportation appointments though she had a planner where she would write down all appointments.

Outcome: I worked with her to demonstrate how she could make transportation appointments and after some practice she was able to make them, as well as doctor’s appointments, by herself. I suggested to her to include the pickup and drop off times in her planner and to highlight the important information about each appointment so it stands out to her. She noted that highlighting really helps her and how happy she is with the progress we made together.

Health Plan: LA Care, CA

“Weight Loss Within Reach”

LCM/CC/HN/RES/Nurse: Keeah

Conditions: Asthma, Major Depressive Disorder

Situation: I was able to contact my member’s weight loss surgery office, who informed me that the member had to complete a one-time assessment with a psychiatrist for them to move forward with the surgery. They would also need to complete a set of documents that were given to them upon initial assessment. Once the documents are on file with the office and the assessment is complete with the psychiatrist, my member will be able to move forward with the surgery. I called the member to inform them of this and they were ecstatic. They stated they would call and set up their appointment as well as bring in the required documents.

Outcome: I was able to contact my member’s weight loss surgery office, who informed me that the member had to complete a one-time assessment with a psychiatrist for them to move forward with the surgery. They would also need to complete a set of documents that were given to them upon initial assessment. Once the documents are on file with the office and the assessment is complete with the psychiatrist, my member will be able to move forward with the surgery. I called the member to inform them of this and they were ecstatic. They stated they would call and set up their appointment as well as bring in the required documents.

Health Plan: LA Care, CA

Illustration of a scale to weight a person.

“Remission Renewal”

LCM/CC/HN/RES/Nurse: Stephanie

Conditions: B-Cell Acute Lymphoblastic Leukemia, Asthma, Hypertension

Situation: My 8 year-old member and her mother have been maintaining her health status over the past two years. My member had been recently informed that her cancer was in remission and would need further check-ups and blood work to evaluate and monitor it. Her mother informed me that her hypertension has decreased and is now within normal limits, but that she’s developed asthma from Leukemia. She also noted that she had recently attended a parent-teacher conference and that her daughter needed some reading support.

Outcome: I encouraged my member’s mother to speak with the school about enrollment to after or during school programs that can assist in tutoring and increase reading opportunities at home. After a few check-ins, I learned she was enrolled in an after school tutoring and an in-school support program where she is pulled from class for reading support. Currently we have met all of their care goals; I reviewed her asthma status, helped refill some medications, and went over the importance of continuing with the medical appointments. I’m happy to report that she’s graduated from the program and is doing well.

Health Plan: Anthem, CA

“Easy Switch”

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

Situation: My 47 year-old member called me frantically in December 2023 because they had switched her insurance from Health Net to Molina and could not schedule her January 2024 appointment with her specialist. She’s been seeing her specialist for some time due to her conditions, and she did not want to have to change all her doctors since she has been seeing most of them for a long time. I reassured her that we’d make the call to member services together to switch her back.

Outcome: We were able to switch her back to Health Net effective 1/1/2024 and she was able to schedule all of her January appointments and exams, which she expressed her gratitude for.

Health Plan: Health Net, CA

“Housing Hope”

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

Conditions: At risk of homelessness

Situation: My 41 year-old member is facing the imminent risk of homelessness and reached out for assistance. She explained that her housing contract had expired on 12/31/2023 but had received a 30-day extension, adding urgency to her situation.

Outcome: In response, I proactively reached out to her to ask about updates from the Merced Community Action Agency. Learning that she had not received any updates, I extended my apologies for the delay, offering comfort and encouragement and assured her that I would stay engaged and informed her of any developments on my end. I contacted MCAA to check the status of her referrals. The outcome was positive—she qualified for assistance! I told her the news, providing her with a renewed sense of hope and she is now scheduled to apply and complete the necessary steps on 01/18/24.

Health Plan: Central California Alliance for Health, CA

“Extra IHSS hours”

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

Conditions: Quadriplegic, Diabetic
Member’s age: 54

Situation: My 54-year-old member was in need of having IHSS (In-Home Supportive Services) hours expanded to full coverage. Together, we attended a PCP visit along with his IHSS caregiver – where I was able to offer my support. My member’s PCP took into account the experiences and observations I had made over time about my member’s needs.

Outcome: The member’s PCP then wrote a letter to the IHSS caseworker to max out the member’s hours. The PCP also completed the IHSS application for additional hours and for Adult Protective Services for the member to obtain round the clock care in the member’s home.

Health Plan: Inland Empire Health Plan, CA

 “Reaching Out”

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

Conditions: End-Stage Renal Disease, Gout, Arthritis, Asthma, Controlled High Cholesterol, Diabetes, Hypertension, Dialysis

Situation: I had been unable to reach my 65 year-old member for a follow up and to complete an updated COMP assessment. However, I continued to call at different times on different days and was finally able to reach my member.

Outcome: The COMP assessment was successfully completed. I was able to follow up on the health plan and checked in on how they’re doing. I encouraged them to continue following up with their providers and to complete needed assessments. My member was thankful to have me still checking in on them and providing the support they needed.

Health Plan: Blue Shield Promise, CA

“Finding Rent Relief”

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

Conditions: Diabetes, Hypertension, Kidney Disease

Situation: My 68-year-old member was facing financial difficulties and she informed me she was behind on rent and 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 who were able to assist her with rental assistance. 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. 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, CA

“Prescription Predicament Overcome”

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

Conditions: Renal Failure (Dialysis), Diabetes Type II, Congestive Heart Failure, Arthritis

Situation: My 82 year-old member was grappling with uncontrolled glucose levels, posing challenges for both her and her daughter who is also her caregiver. The prescribed solution, Freestyle Libre 2, was not covered by insurance, creating additional hurdles. In response to the insurance restrictions I suggested a proactive approach—having the PCP revise the member’s prescription and insulin dosage which aimed to address the glucose management issue while working within the constraints of insurance coverage.

Outcome: Acting on the advice her daughter conveyed the information to her mother’s doctor who modified the dosage of insulin, resulting in almost three weeks of near-normal glucose readings. This positive outcome marked a significant improvement in the member’s health and quality of life. Her daughter expressed heartfelt gratitude for my support and advocacy.

Health Plan: Central California Alliance for Health, CA

“Basic needs”

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

Condition: Type II Diabetes

Situation: My 19 year-old member and her family were facing financial difficulties, particularly in meeting their basic needs for food and diapers.

Outcome: I provided her and her family with information on local food resources, specifically recommending the Second Harvest Food Bank in Watsonville and Fishes and Loaves on 2nd Street, which also provides assistance with diapers and formula when available. Furthermore, I knew she had trouble with transportation so I gave her the number for Central California Alliance for Health’s transportation services and I told her she could contact me whenever she needed assistance.

Health Plan: Central California Alliance for Health, CA

Cute illustration of a box containing food.

“Building a Base”

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

Conditions: Diabetes, Hypertension, Meningitis, L-5
Compression Fracture, Depression

Situation: My 31 year-old member was grappling with financial challenges, having been out of work since 2021 due to ongoing health conditions and treatments. Disability payments had recently paused, adding to the financial strain. Despite living with parents, he aspired to contribute more financially to the household. Upon introduction, I initiated a call to the member to understand his current situation. He shared details about his health conditions, care team, and financial struggles.

Outcome: Together, we completed the Central California Alliance for Health Community Supports Housing Navigation Services Form for rental assistance and the Central California Alliance for Health Medically Tailored Meals Forms for 12 weeks of meals and groceries. These efforts were aimed at easing the financial burden promptly. He continually expressed his gratitude as we filled out the forms together during our initial call. Additionally, I will follow up on the status of SSI payments, ensuring that he receives the financial support essential for his situation.

Health Plan: Central California Alliance for Health, CA

“Weight Loss Incoming”

LCM/CC/HN/RES/Nurse: Ana

Conditions: Asthma, Hypertension, Anxiety, Major Depression Disorder, Hyperlipidemia, Arthritis, PTSD

Situation: My 51-year-old member asked me for help with scheduling a primary care appointment. She wanted to reconnect with her PCP and consult with the office’s nutritionist for weight loss, emphasizing her goal of becoming a candidate for weight loss surgery. Despite missing the initially scheduled appointment she contacted me again, requesting assistance in rescheduling.

Outcome: I promptly contacted the PCP’s office and successfully secured an appointment during her specified time frame for the following week.

Health Plan: Central California Alliance for Health, CA

“Coordinated Care”

LCM/CC/HN/RES/Nurse: Karla

Conditions: Primary Biliary Cirrhosis, Hypertension, Asthma, PTSD, Arthritis, Torn Meniscus

Situation: My 53-year-old member, who faces the difficulties of arthritis and a torn meniscus, relies solely on crutches for mobility, making meal preparation a challenging task. Furthermore, she was terminated from the tailored meal program, and transportation to medical appointments became a significant concern as she doesn’t drive. In response to my member’s needs, I took immediate action. I submitted a referral to Blue Cross for tailored meals.

Outcome: She’s now approved for Performance Kitchen, ensuring she receives the necessary meals at home. I also coordinated and set up transportation services to facilitate her attendance at medical appointments. I will continue to work with her to come up with solutions along her path to wellness.

Health Plan: Anthem, CA

“Behavioral Breakthrough”

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

Conditions: ADHD, Anxiety

Situation: My 6 year-old member’s mother told me she has been having behavioral problems at school. She needs more time to complete assignments and is disruptive during class which affects other students. The school hasn’t done much to address the behavior, and the mother is seeking assistance with their behavioral health.

Outcome: I provided guidance and contact information to the member’s mother about how to address the situation. The mother contacted her daughter’s PCP and the behavioral health department to schedule an appointment. She’s currently having two therapy sessions per week with a specialist; my member’s mother informed me that the member has undergone behavioral assessments and is progressing positively.

Health Plan: Community Health Group, CA

“From Stress to Success”

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

Conditions: Hypertension, Diverticulitis, Hearing Loss

Situation: My 55 year-old member has been working full-time lately because she found a new job after having been laid off and does not have time to follow up on her health conditions which is causing her stress. She’s been doing a lot of overtime lately and is unable to plan out or address her health goals.

Outcome: I had previously assisted her with getting a new PCP whom she was never able to see due to her busy schedule. I was able to assist her with scheduling an appointment that fit her schedule and she was able to be seen. She was very happy with the service she received and even wanted to switch her daughter to this new PCP because of her positive experience and was able to get several follow up referrals and will be able to get back into managing her health.

Health Plan: LA Care, CA

“A Weight Lifted”

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

Conditions: Type II Diabetes, Fatty Liver, Chronic Liver Disease (borderline)

Situation: My member is a 15-year-old pediatric patient. Her mother was very concerned about her not losing as much weight as expected after she incorporated daily exercise and was on a clean diet. I spoke to my member and encouraged her to discuss other medication options with an endocrinologist to obtain better results.

Outcome: My member’s mother obtained an Ozempic prescription for her from her specialist and has lost 7 pounds so far and her liver markers have lowered. Her health is improving overall, and the member is feeling more confident. We will continue to keep monitoring her overall health and weight loss journey.

Health Plan: LA Care, CA

“Bright Smiles and Happy Eyes”

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

Conditions: Asthma, Poor Eyesight

Situation: My 9 year-old member faced challenges in finding suitable optometry and dental providers. Their difficulties included proximity to their home, acceptance of their insurance, and a positive treatment experience during visits. The previous experiences they had at dental and optometry offices were negative, with poor treatment and inconclusive eye assessments despite the member experiencing headaches and vision difficulties. To help them, I conducted a home visit and engaged in multiple phone calls with her mother with the goal of identifying healthcare providers in the Citrus Heights area that met their specific criteria.

Outcome: After diligent efforts, Western Dental on Elkhorn Blvd and Peach Tree Health on Rosin Court were identified as suitable options and appointments were booked for both my member and her siblings. Additionally, I’m in the process of reinstating the family in the Mom’s Meals food delivery service and I’ll be communicating updates to my member’s mother.

Health Plan: Health Net, CA

“TMJ Triumph”

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

Conditions: Asthma, Bipolar, Seizures

Situation: Member is a 47-year-old female and was having a hard time scheduling and coordinating her appointments. In addition, member needed to see a specialist for TMJ caused by her seizures.

Outcome: I was able to assist her by locating oral surgeons through the Medi-Cal dental website and sent over dental clinics that were accepting new patients. She was able to schedule an appointment and get seen for her TMJ, and is now in the process of getting a night guard to avoid additional damage. She expressed to me that she is very appreciative of my help.

Health Plan: LA Care, CA

“Sleeping on the Floor no More”

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

Conditions: Diabetes, High Cholesterol, Hypertension, Fatty Liver, Anxiety, Chronic Pain

Situation: My 67-year-old member recently acquired long-term housing and needed help with getting situated in her new home. This involved getting furniture, a refrigerator, and setting up utilities. My member was feeling overwhelmed with managing everything because not having a refrigerator and a bed was taking a physical toll on her. My member was already working with HACLA (Housing Authority of the City of Los Angeles) to obtain the furniture and refrigerator, but it was taking too long.

Outcome: I met with my member at her new apartment to help her get organized. We scheduled follow up appointments with her specialists. I also helped her navigate her email on her phone to track bills and applications. We paid the gas bill over the phone together and switched to paper statements in the mail because the phone and online system was confusing her. She also needed to figure out her account for the Department of Water and Power and sign up for low income programs. I also provided her with information on low-cost internet services for seniors which she applied to. My member has received her furniture and is no longer sleeping on the floor. I’m continuing to assist her with trying to get a refrigerator.

Health Plan: LA Care, CA

Illustration of a woman sleeping in a bed.

“Ride Resolution”

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

Conditions: Hypertension, Asthma, Vision Loss, Hernia in abdomen, Prostate issues, High Cholesterol

Situation: My 74 year-old member was concerned that he no longer qualified for ECM due to a change in his Medicare. He had tried to book transportation for an appointment, but he’d been denied by LA Care transportation. The member was upset that he had to find other ways to transport because he had already learned how to book his own transportation appointments and asked me to help him. I checked his eligibility and verified that he was still eligible with LA Care and suggested that we call LA Care transportation together to book an appointment

Outcome: We called LA Care transportation and booked his transportation for 1/31/2024.

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.