Charleston, W.Va.: The West Virginia Association of Health Plans (WVAHP) announced the winners of its sixth annual iCare Awards on December 9th at the University of Charleston. WVAHP is a trade association made up of the managed care organizations (MCOs) that service West Virginia’s Medicaid program – Aetna Better Health of WV, Highmark Health Options, The Health Plan, and UniCare Health Plan of WV. The iCare Awards are given to employees of WVAHP member-MCOs who have demonstrated exemplary care and service to West Virginia Medicaid members in helping them achieve positive outcomes in their healthcare delivery.
“This event continues to grow each year, and we look forward to celebrating the good work these employees do for their members every day,” said Ben Beakes, executive director of the WVAHP. “Some may not know that our employees are healthcare professionals, nurses, social workers, and case managers. The dedication to each of their members is evident in the stories they share. We are proud to recognize the 2024 iCARE Award winners.”
GRAND PRIZE WINNER
Hannah Kinsey – Aetna Better Health of WV- “Hope for a Future”
Debbie is an 18-year-old member who sadly tried to commit suicide the day before Christmas. Debbie’s grandmother found her lifeless in the woods, called 911 and tried holding her up until help came. The paramedics were able to revive Debbie before taking her to the hospital. On December 27th Debbie woke up but was still not breathing on her own. She was able to be extubated and taken off the breathing machine a few days later. She started with physical therapy, occupational therapy, and speech therapy. Debbie’s grandmother stayed with her as much as possible but also had her mom in the hospital and was going back and forth between the two. Debbie was left alone when her grandmother had to go check on her mom. The CSED wrap facilitator was able to go to the hospital to sit with Debbie while her grandmother was away. Debbie continued to make progress at the hospital and was able to go to a local rehabilitation facility to complete the therapy needed to get back home. On January 16th, Debbie was able to complete her goals at the rehabilitation facility and was able to go home with her grandmother. She successfully graduated from high school this past spring and is now working part time and maintaining her therapy. She has the hope she needs to keep moving forward. Debbie’s grandmother was also given hope through the support she received while going through this difficult time and is grateful for the CSED team.
Runner-Up Winners
Kayla Burnett – Aetna Better Health of WV – “Care Packages”
Story submitted by Greg Carpenter: Aetna Better Health WV provides various “Incentives” and “Extra Benefits” to our Foster Care Children. We deliver roughly 100 of these packages each week. One of the most appreciated items is the Duffel Bag Care Package for children entering foster care for the first time. These most vulnerable children receive toiletries, a blanket, books, crayons, teddy bear, and a couple of small toys. And since most carry their belongings in a trash bag, we include a duffel bag for those items. Kayla Burnett, administrative assistant, in addition to all of her other administrative duties, has stepped outside of those responsibilities to take ownership of this program. She maintains and has organized the storage of the inventory of items and prepares the various packages for shipping. Kayla has received several “Thank-You” cards from children, expressing their appreciation for what they received. Kayla assumed full responsibility for this Aetna program when many of our employees were assigned to work at home. She demonstrates great care and compassion for the members receiving these items from the plan. To some, this effort may seem insignificant in the full scope of the care Medicaid MCO’s provide their members. But Kayla has brought a reminder to all of us of the importance to truly reach the member in a caring, personal, and compassionate way through those various care packages.
Sandra Cline – UniCare Health Plan of WV – “Journey of Hope & Recovery”
So, my story begins a year before I started working for Unicare but has now come full circle. I was the Peer Recovery Support Specialist for CAMC’s Drug-Free Mother Baby Program and became close to a patient I’ll call Sam. Sam struggled with quitting opioids. After completing treatment, she returned home and did well for a few years, got her kids back, earned her CNA certification, and was working and taking care of herself and her children. Coming home from work one evening, she was involved in a terrible car accident and in the hospital for months, receiving significant amounts of pain medication. Unfortunately, this led her to start using again and became pregnant with her fourth child. I grew very close to Sam. I would offer encouragement and let her know someone genuinely cared. She was accepted into Project Hope in Huntington where she and the baby stayed for nine months. I visited monthly, took her to lunch, and interacted with her daughter. Sam eventually moved to Keyser which made visiting too difficult. Fast forward a year, and my story comes full circle. A familiar name showed up on my member spreadsheet. I almost started crying when I made the call. When the young lady answered, I recognized her voice immediately. It was my Sam. When I said, "Hello stranger, do you know who this is?" she replied, "I know this voice,". We were both overwhelmed with joy. She is working as a CNA and has her own apartment. I signed her up with Jobs and Hope to further her education and help her return to school to earn her RN degree. Since reconnecting, we text every week. I think it’s time for a road trip to Keyser and I cannot wait to give Sam and Addy a big hug.
Michelle Tracy – The Health Plan – “Persistence Paid Off”
I had a member with severe medical issues - developmental delays, she could not read or write, her speech was hard to follow at times, she did not know her address, the year she was born or how old she was. She asked me to contact her friend to help fill out an assessment, so I did. She had no idea what medications she was on but stated she “took them” but was “out of some right now”. She lived by herself, and I was worried about people taking advantage of her. I talked to a social worker at The Health Plan and reached out to several different agencies for help. I called the member’s cardiologist with my concerns and about her meds, as well as her PCP about home health and other assistances. I did find out that the member had Medicare as her primary insurance with Medicaid as secondary coverage! Progress was made - I spoke to the member and her friend frequently and explained care needs, processes, and services to them as well as facilitating appointments when needed. She received two and a half hours of aid services five days a week. I was thankful for these hours and for caring eyes and helping hands on the member. She is being followed closely and now has two volunteers from the local church who help with scheduling and transportation to appointments. She has been ordered a lift chair, understands she has dental coverage, and started physical therapy. It may have taken me months to get this member the help she needed but I feel confident now that she is safe, supported, has resources, has assistance, and knows who to call to ask for help.
HONORABLE MENTIONS:
Shelley Bashnett – Highmark Health Options – “A Story of Collaboration & Compassion”
A member with a history of PTSD, Bipolar Disorder, and multiple suicide attempts, was recently discharged from a psychiatric hospital. The member was waiting for a bed to open at a treatment facility, but his current living situation was unstable. A combination of factors presented a significant risk of further harm. Unable to conduct a face-to-face assessment, I immediately contacted the member’s local non-emergency phone line and requested a well-check. I kept the member on the phone while the dispatch team sent EMS and law enforcement to his location. The member, despite initially resisting, ultimately agreed to be evaluated at the Emergency Room. We did receive an alert that he had a mental hygiene hearing, so we can see that he is getting help. This situation underscores the importance of "when in doubt, call out!" Swift action and collaboration with external resources saved valuable time and potentially prevented further harm to the member.
Alexandra Martin – Aetna Better Health of WV – “A Simple Request with a Large Reward”
Cody, a 13-year-old male, recently came into care after being removed from his biological mother and father when the conditions of the home were found to be unsafe. Cody had never lived with anyone other than his parents so being placed within a foster home was upsetting and not ideal. It eventually became discouraging when multiple foster homes put in notice after notice for removal, which eventually resulted in shelter placement for Cody. Cody learned that what happened in his life was not his fault, and that despite being in care he is a worthy member of society and deserving of having his needs met. Cody voiced to the shelter staff that he could really use a new pair of shoes. Understanding that being in care also means being provided with limited funding for apparel, it was not likely that Cody would be able to get the pair of shoes of his choosing, especially the brand-new pair of Nike Air Jordan’s he had his eyes on. The shelter reached out to Aetna staff in hopes of locating a resource to assist with funding a pair of shoes for Cody. The Aetna staff immediately connected with a resource that is known to help children and families in need to present the need for a new pair of shoes for the member. Without hesitation, the representative immediately replied, indicating that the request could be fulfilled, and requested an estimate for any pair of shoes that Cody desired. After speaking with Cody, the exact shoe-make, color and size was identified – a pair of yellow and black Nike Air Jordan’s in a size 9.5. Aetna staff received an email containing a picture of Cody wearing his brand-new Nike Air Jordan shoes, accompanied by a smile on his face, cheek to cheek. While his verbal “thank you” was relayed, the smile on his face in the picture said it all.
Christina Sparr – The Health Plan – “Putting Your Health First”
I had a member who was stressed and overwhelmed by all of her responsibilities. The care of her elderly parents, the loss of a child, and the day-to-day stresses of life. She had not put her health first. I reminded her that you cannot fully care of someone else without taking care of yourself first. She agreed to participate in our case management program. She had a goal of losing some weight, lowering her A1C and completing our diabetes education. She had not been taking her diabetes medication as prescribed for over a month due to an issue with obtaining the medication. I reached out to both the PBM and provider and was finally able to resolve the issue. We completed the diabetic education, and she is now up to date on all of her health screenings and follow-up appointments. She has been exercising and improving her diet and as a result she has lost over 40lbs and lowered her A1C. She is truly happy with how far she has come in prioritizing her health.
Cassandra Whaling – UniCare Health Plan of WV – “Community, Compassion, and Perseverance”
John was a previously healthy, vibrant, carefree 23-year-old whose journey was abruptly altered in May of 2023 when he was struck by a reckless drunk driver while walking to work one day. This tragic incident resulted in him becoming quadriplegic. For the next several months he had to face life from the confinement of a hospital bed. The discharge planning coordination began between our nurse, UniCare case manager, our medical director, and the facility. The goal was to get our member to a specialized rehab facility for spinal cord injuries in Georgia. He developed extensive wounds warranting a transfer to an LTAC where he spent 107 days. Once his wound was stable and he was ready to transfer, we hit another wall. How do we get him there? Emails started and ultimately landed in the inbox of plan president Tadd Haynes; with a request to pay for a flight. He gave his stamp of approval within the hour, and we were able to get a single case agreement and arrange the flight. Our member went to Georgia to participate in a spinal cord injury program and is now able to feed himself, navigate his own power wheelchair with a joystick, and increased his strength and coordination.
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