Daylyn Presley

15

Oct2015
A Bodfish, CA resident gave Coach Ida a run for her care transition money. In his 60s with multiple chronic conditions and recovering from addiction, he needed post‐discharge food, transportation and legal aid. The Bakersfield meals on wheels program didn’t cover his area, so Ida had to find another non‐profit organization that delivers meals to the homebound to serve him. Rides to his medical appointments in town were arranged with All American Transportation, in cooperation with his Kern Family Medi-Cal plan and physician. ... Read More
October 15, 2015Daylyn Presley
margarite2

15

Oct2015
Margarite was grateful for the visit from her coach, Adrine, and her encouragement and guidance on following up with the doctor. She had not planned to do so, but because Adrine helped her identify some medication red flags, she realized the wisdom of an educated discussion with her primary care physician.
October 15, 2015Daylyn Presley

15

Oct2015
Before hospitalization, Mabel had been in charge of her own medications. But after discharge, her escalating confusion concerned her family, so they concentrated the coaching session on medication reconciliation. In that process, Mabel’s daughter realized that she had many duplicate prescriptions issued by her primary care physician before and after her hospital stay. Narine, Mabel’s transitions coach, showed the family how to make medication notes on Mabel’s Personal Health Record, and draft questions for the follow-up appointment with the doctor. ... Read More
October 15, 2015Daylyn Presley
mother-daughter2

15

Oct2015
Maria’s mom was released from the hospital following treatment for an infection on her leg caused by a dog bite. Her mom was also showing signs of memory problems that made it difficult for her to get to doctor appointments without assistance. Unfortunately, Maria’s full-time job meant that she didn’t have the flexibility to be able to ... Read More
October 15, 2015Daylyn Presley

15

Oct2015
After being released from the hospital, Wayne was prescribed medication for his condition. The problem was that the medication had a co-pay of $120, too much for Wayne and his wife to pay on their fixed income. Wayne’s transitions coach advised him to contact his doctor and request medication with a lower co-pay. Wayne and his wife were surprised to learn that this was an option. They called the doctor who prescribed Wayne a different medication with a co-pay of only $20. ... Read More
October 15, 2015Daylyn Presley
pouletpatient2

15

Oct2015
— CCTP Patient Partners’ Community Care Transitions Coaches are trained to help you get the most out of the health care system, and community programs and services. They understand how hard it can be to manage doctor appointments, remember which medications to take, or just do simple tasks when you’re feeling less than your best. Your transitions coach can help you in the transfer from hospital to home. And they can help lower your chances of going back to the hospital. ... Read More
October 15, 2015Daylyn Presley
SWHAimage

14

Oct2015
Partners CEO, June Simmons, and Sandy Atkins, Vice-President, Strategic Initiatives, have contributed a chapter to The Oxford Handbook of Social Work in Health and Aging, 2nd edition, the first social work reference book to combine the fields of health care and aging. The chapter was also co-authored by Janice Lynch Schuster, who specializes in aging and end of life issues, and is a frequent contributor to the Washington Post. Their co-authored chapter, “Health Maintenance Organizations, Managed Care, and the Affordable Care Act” considers the question, ‘How can we better care for ... Read More
October 14, 2015Daylyn Presley

23

Sep2015
Yale School of Medicine has received grant funding to implement HomeMeds, an evidence-based, in-home, medication review and intervention program developed and licensed by Partners in Care Foundation. The implementation of HomeMeds is part of a three year research project being carried out at Yale aimed at reducing healthcare utilization, particularly falls prevention. Yale will work with the University of Connecticut School of Pharmacy to conduct the medication reviews.
September 23, 2015Daylyn Presley

17

Sep2015
HomeMeds, an evidence-based, in-home, medication review and intervention program developed and licensed by Partners in Care Foundation is being offered by Texas-based Tejas Behavioral Health in collaboration with Cigna/Health Spring to members with acute psychological needs. Medication-related problems endanger the lives of a high percentage of elders living at home, leaving them at risk for falls, dizziness, cardiac symptoms, confusion and other side effects that frequently result in unnecessary ER visits and hospitalization. ... Read More
September 17, 2015Daylyn Presley

14

Sep2015
The success of Partners Community-Based Care Transitions Program in West LA, which has seen a change in readmission reduction rates among those served of 28.1%, has resulted in a private contract with UCLA Medical Group to serve their members. Utilizing Partners Care Transitions/HomeMeds Plus 30 program, UCLA began referring high-risk patients from Santa Monica UCLA Medical Center in early May 2015. “The strength of our partnerships at UCLA is reflected in the degree to which we have become involved in their other readmission initiatives,” commented Anwar Zoueihid, Vice-President, Health Services at ... Read More
September 14, 2015Daylyn Presley
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