Paul Szmal: FLX Morning continues at 8.15, and my guest at this time is the Director of Care Management for Finger Lakes Community Health, Tiffany Mantegna, joining us on Zoom this morning. Tiffany, good morning. How are you this morning?
Tiffany Mantegna: Good morning. I'm doing well. I'm glad it's Friday. How are you all?
Paul Szmal: Glad it's Friday as well, definitely. Before we get into talking about care management, which is kind of the core focus of the conversation this morning, I wanted to get a little bit about your background, how you came to be a member of the Finger Lakes Community Health family.
Tiffany Mantegna: Yeah, absolutely. So I've been here at Finger Lakes Community Health for a little over six years, but prior to that, I did get my teaching degree from SUNY Brockport, and I was teaching for about six years at the Happiness House here in Geneva, working with our universal pre-K program, which was a blended classroom. Did that for, like I said, for about six years or so, and then I just realized I needed more involvement in the community that I live in. There was only so much I could do within the classroom walls, so I ventured into casework or to care management, which I call it now. I needed to get into the homes of individuals who needed the support, so I dabbled around a little bit with other agencies here in Ontario County, and then I led my way over to Finger Lakes Community Health, where I actually get the best of the best, because we have all different services. We're not just focusing on addiction, or we're not focusing on mental health, we're focusing on the true individual who is in need of full support. And that's what really care management is all about, because visiting your doctor and getting prescriptions and stuff, that's one thing, but care management actually involves a lot of the non-medical factors that come with a healthcare system and working within that system.
Paul Szmal: Correct. Correct. So, we find that many individuals struggle with the social barriers to care. They call them the social determinants of care. It's all that stuff that happens outside of the healthcare centre. Even trying to get up in the morning to go to your appointment may be difficult. Getting to your appointment because you have lack of transportation is difficult. Even remembering that appointment is difficult, so that's where a care manager can assist an individual with either going to meet the individual at the home to make sure they're up for their appointment, taking them to their appointment, and then while at the appointment, they can advocate alongside the patient to get the patient's needs met.
Now, I wanted to go through some of the individual things that are part of the care management program. And one of these, I have to say, I am guilty of this, and it just happened the other day, is that care management people can help you stay ahead on getting your prescriptions refilled when you need to call in and get refills from your provider.
Tiffany Mantegna: Absolutely. I'm guilty of it as well. With that, the nice thing is that within our care management program, we do focus solely on our patients of care here at Finger Lakes Community Health, and we are able to get into the patient's chart, figure out what kind of prescriptions they have, when their medication refills are, and then actually, if we do get a message from our patient stating, oh my goodness, I forgot to refill my prescription, we have that one-to-one direct conversation or contact with the providers, the nursing staff, to say, you know, we need some extra support getting this prescription filled, especially when it comes to our controlled substances, because those technically take longer, because the providers have to make sure that individuals are not abusing their medications. So we want to make sure that we're refilling those prescriptions, you know, at the 30-day mark or whatever the prescription may be, because also insurance might not cover those if the prescription is trying to be refilled too soon. So what we can do is we also encourage our individuals or our patients to set reminders when their medication is due. We can do that by helping them create a calendar at their home, setting reminders within their cell phones, but even sending up, signing up for text messaging, depending on where they refill their medication, for example, like Walmart, they send out text reminders to refill the prescription when it's coming low. So it all depends on where the individual gets their prescription filled. We can work with them, and some facilities even offer delivery for medication. So that's something that we definitely look into if transportation is a barrier when an individual needs to get their medication refilled.
Paul Szmal: And one of the things you already mentioned was, for some people, transportation to and from medical appointments is a challenge.
Tiffany Mantegna: It is a huge challenge. We find that it's one of the biggest barriers for our individuals. So what our care management program does is we actually do have, if a patient is not connected with care management, we first determine, you know, do they need extra support? And if so, then they can get connected with us. If a person needs a ride and they just don't have the ability, we do have a transportation department at Finger Lakes Community Health that we can help arrange transportation and bring that person to their appointment, as long as we have ample time and knowledge of that prior to the appointment. And sometimes we don't. Sometimes we get a message or I'll get a message and say, Tiffany, do you have somebody on your team who can go grab somebody quickly for this appointment? They don't have transportation. And I can send out a message and boom, we're able to pick somebody up. We definitely want to encourage individuals and teach individuals what availability they do have for transportation. There is Medicaid transportation available for medical appointments if the individual has New York State Medicaid. We also have a very great bus transit system here in Ontario County and many other counties have them as well. But it's also learning how to navigate that bus route to ensure that you're going to get on the right route, get to your appointment on time, but whatever it is. So we definitely encourage, you know, and teach individuals how to be self-sufficient if we are not available for transportation. But we do have that as a backup.
Paul Szmal: And sometimes people find themselves in difficult situations, either with finances, even food and housing and a care management team member. It can be a critical asset in those kind of situations.
Tiffany Mantegna: Absolutely. And again, this is something that New York State is focusing on is these social barriers. People are not going to worry about whether or not they're going to make their doctor's appointment. They want to make sure that they have food on the table. They have somewhere to sit or excuse me, sleep at night. You know, are they fully clothed? Do they have utilities on? Whatever it may be. So we work with individuals to ensure that, you know, do you have the benefits accessible to you that you're that you're qualified for? Many individuals, sometimes they feel that they almost feel some sort of like I should I shouldn't go down there and I shouldn't ask for help to when they go to social services. You know, I can't do that. I'm embarrassed to do that. And our motto is, if it's there and you're able to receive those services, let's go with you to help get you those services that you need. There's also many different supports within the community that are able to help individuals with financial hardships. It's just finding those resources and then being able to ask for help. And that's sometimes the hardest part is asking for help. Once we know that an individual is in need of help, and sometimes they don't even have to ask us, we're able to identify it. But for them to receive the help, that's what is most important. Once they're able to accept that they need help, receive the help, then we're there to help coordinate any type of hardship that they might have with other local agencies within the area.
Paul Szmal: And one of the other things that care management people can help with is navigating something that can be sometimes extremely difficult to understand, and that's health insurance enrollment.
Tiffany Mantegna: Oh, absolutely. So we did see a huge decline of individuals who didn't have health insurance after the COVID pandemic ended. Everyone's health insurance remained active during the COVID pandemic. And then once that stopped, once the pandemic ended, people forgot to renew their insurance. So we actually have financial enrollers here at Finger Lakes Community Health that work individually with those to see what types of insurance do you qualify for. And all I can do is say, as this team is active, they will come out and they will meet you where they're at, ensure that you have all the proper documentation to get the insurance activated. Many people don't even know where to go to get insurance. They'll say, well, get on the web and go to the New York State website and get on and apply for insurance that way. That's very overwhelming in itself. So whenever I know of individuals who need health insurance, I connect them with our financial enrollers to get Medicaid or other insurance that they may qualify for.
Paul Szmal: And the different means that you can help even extend out beyond that to things like help with finding help with job training, resumes, preparing for interviews, even finding appropriate daycare.
Tiffany Mantegna: Yes, absolutely, because, again, these are the things that we consider barriers. If individuals don't know how to access life or even what's available out there, we're going to walk alongside them. I love to use the analogy of the driver's ed teacher. I'm not sure if anybody took that, but that was one thing that always resonates with me when I think about this role is that I was the one driving the car, but my driver's ed teacher was right there beside me to pump his brake or grab the wheel if needed. And that's how we look at it. We look at it as the individual has to lead. So whatever it is that they want, whether or not they want to go back to school, right? How do I even access that? Where do I start? You know, maybe they need to get their GED. How can we prep to get the individual ready for their GED? If they want to find a job, great. What is it? What are you best? What are you good at? Where's your interest? How do we get resumes, right? We can connect them with New York State Department of Labor. They have resume workshop writing down there. And now if I work, who's going to watch my, who's going to watch my kids? So we can go through and we can, and if the individual qualifies, then there is assistance through Department of Social Services that individuals can apply for daycare assistance to be able to, you know, afford daycare and work because many times people won't work because of the cost of daycare expenses. So there are those things out there. It's just trying, it's actually identifying where they are and how to access them.
Paul Szmal: Tiffany, I appreciate the information this morning. Thank you very much for joining us. Hope you have a great weekend.
Tiffany Mantegna: Thank you. I appreciate it. Have a great weekend as well. It's 826 on FLX Morning.
