Reaching Out To New Members and Those with Disabilities

"HOW ARE YOU FEELING?" is not a casual question for Robert Qualls and Shirley Boothe. On any day, the answer can involve a dizzying array of medical, emotional and logistical issues that, for Qualls, literally are a matter of life and death.

Qualls, 44, of Houston, is an AMERIGROUP member who participates in an innovative program that the State of Texas offers people who are enrolled in Medicaid and have long-term physical or psychological disabilities. Boothe is Qualls' AMERIGROUP care manager, the one person he can turn to for help in addressing virtually all his health needs. And as Qualls observes, "I deal with a very full plate of physical and emotional issues."

Qualls was born with hydrocephalus, a buildup of fluid in the brain that he estimates has required "somewhere between 20 and 30 brain surgeries" to date. Complications from that condition have left him with cerebral palsy. He is legally blind, he walks with a cane for balance and he struggles with chronic pain, anxiety and depression. At any one time, he says, he is being treated with about 10 to 12 different medications.

"Robert has his good days and his bad days," says Boothe, who helps him work through both. Boothe and AMERIGROUP's long-term care program, AMERIPLUS, see that there are as many good days as possible. Qualls lives independently in an apartment complex called Independence Hall, which is built to accommodate physical disabilities. A part-time home care attendant helps him keep his place in order. He has access to all the medications he needs; previous programs limited him to no more than three. He spends his good days at an adult activity center, where he participates in a scouting program. "I dreamed of being a scout when I was a boy," he says. "I was 40 years old when it happened."

The AMERIPLUS program coordinates these services along with Qualls' numerous physicians and prescriptions, with Boothe serving as the central link. She visits him periodically, keeps abreast of his medical records and is never more than a phone call away. "My goal is to offer Robert encouragement and keep him participating in his activities," Boothe says. Says Qualls, "Shirley, God bless her, she does great."

AMERIGROUP is one of the few companies that has developed and deployed a comprehensive long-term care program like AMERIPLUS. Qualls and Boothe know that long-term care is literally a never-ending challenge; the right help and support for urgent individual needs can never come soon enough. But for Boothe, the task is more than worthwhile. "It's a hard thing to do," Boothe says. "It can be frustrating. But if you do it well, it's very rewarding. When you have someone look you in the eye and say, 'You¹re an angel sent from heaven,' well, you'd have to be tougher than an old boot not to feel that."

"Shirley, God bless her, she does great."

ROBERT QUALLS
AMERIGROUP Member on his Case Manager, Shirley Boothe