Care Manager solves a Member’s loss of services

Malaika was in a day hab program at Mount Sinai West, but when the pandemic hit, her program was shut down, and her family was at a loss on how to get her back into the program.

“We didn’t appreciate all the documentation they were doing for Malaika,” said her stepfather, Raymond. “So now it was on us to do.”

On her own

This left Malaika’s parents on their own to connect Malaika to the services she needed. On top of this, there was a disconnection in Malaika’s funding. Everything her parents tried to submit for her care was rejected. “This was when we resigned ourselves to the fact that Malaika would not be in a program. We almost gave up,” Raymond said.

Then Jessica was assigned to Malaika’s case. According to the family, Jessica was like a detective. She combed through every detail while doing the research necessary to solve the problem of why Malaika seemed to be falling through the cracks.

“That’s why we love Jess so much,” commented Raymond. “She held our hand through the process and got us the right information.”

Finding the solution

Jessica looked into Malaika’s records and noticed that her Medicaid wasn’t processed for services such as day hab. She was able to help Malaika’s parents submit the correct information to Medicaid, which led to Malaika being approved again for her day hab.

Now that Malaika is back in her program, she smiles and lights up when she sees Jessica. Jessica communicates with Malaika through sign language, allowing Malaika the freedom to communicate her needs directly.

“Malaika is getting to express herself again, and now that she is on her regular schedule, she’s gotten her life back,” said Jessica. “Working with Malaika has been one of the greatest experiences I’ve had working at ACANY.”