Care Manager solves a Member’s loss of services

Jessica Lewis is helping Malaika Foy with Core Competencies: Comprehensive Care Management and Person and Family Supports.

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 in how to support her.

“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 the moment we resigned ourselves to the fact that Malaika would not be in a program at all. We almost gave up,” Raymond said.

Then Jessica was assigned to Malaika’s case through ACA/NY. 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 whole process and got us to the right information.”

Finding the solution

Jessica looked into Malaika’s records and noticed that her Medicaid wasn’t processed for services like the 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, overcoming another barrier Malaika has had in her life.

“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 ACA/NY.”