John Finds His Independence


From John’s 8th floor apartment, he’s got a clear view of the Rhode Island State House. That view includes the iconic statue on top of the dome – a statue with whom John now has something in common.

“I’m independent,” John exclaims. “Got my independence back, fully!”

This newly-independent man came to Neighborhood Health Plan of Rhode Island about two years ago. At that point, his mobility issues prevented him from leaving his own home.

“[I] was very depressed,” John explained. “[I] couldn’t get nowhere; it was like a dungeon to me.  No life, nothing, until Janet came in my life, from Neighborhood.”

He’s talking about Janet Miller, a Medical Case Manager at Neighborhood, who had just started working for the non-profit health insurer when she met John.

“John was actually my first member, my first CFNA [Comprehensive Functional Needs Assessment], my first home visit,” Janet says. Immediately, Janet began to figure out how she could help.

“He was living in an apartment that really didn’t meet his needs; he was depressed because he couldn’t get out of his apartment,” Janet remembers. “He had said to me that he felt like a prisoner in home because he couldn’t get outside.”

In no time, Janet helped John get his motorized wheelchair. It was a vital first step in helping him reclaim his independence. That turned out to be a process that required a team, which is exactly where Neighborhood excels.

Janet explains: “We needed to find [John] suitable housing; we needed to address his depression. He had a lack of socialization because he was stuck in his apartment.  I actually called his primary care provider and suggested physical therapy and occupational therapy. The doctor did order that. [John] received that in-home and he received all the equipment that he needed.  And he saw a counselor. Eventually we were able to get him into subsidized housing.”

Neighborhood even helped John get much-needed dentures – giving him yet another reason to smile.

“It’s the truth: They actually gave me my life back,” John says when asked what Neighborhood has done for him. “I’m a new man now. I go places I’d never gone before, with a chair!  Think about that!”

And in his early 6os, John has plenty of places to see.

“I referred him for waiver services so he can receive long-term support in his home, which enables him to stay in the community,” Janet offers. “And it gives him freedom, independence, and just a better, healthier way of living.”

That’s where Susan comes in.

“Once John had all the ammunition he needed to be self-sufficient, it made sense for him to go into the Personal Choice program,” says Susan Von Villas, a Medical Case Manager with Neighborhood’s Personal Choice program.

Personal Choice is a self-directed program that allows certain Neighborhood’s members (specifically, people with disabilities over the age of 18, or people age 65 or older) to decide who will provide their care and when. It is a voluntary program designed to provide a home and community-based program where individuals who are eligible for Long Term Care services have the opportunity to choose and control (hire, fire, supervise, manage) individuals who provide their personal care, and to exercise choice and control over a specified about of funds and a fiscal agent to assist in making informed decisions that are consistent with their needs and that reflect their individual circumstances.

“This program is just wonderful,” Susan explains. “It allows people to stay at home.  It allows you to have people who you want to, to take care of you, on your terms and on your time.”

Not long ago, Neighborhood encouraged John to visit an adult day program at a local senior center. That’s where he met a young Certified Nursing Assistant named Caitlyn. The two hit it off, and John has hired her to be his one-on-one, personal care attendant.

“Nursing facilities, hospitals, if [the member’s] level of care is that high, it makes sense,” Susan says. “However [people] can still be at home with a high level of care… with the services that are offered through the personal choice program.”

And John, like so many people, definitely prefers living in his own home, with some supports, rather than moving into a full-time care facility. That independence has helped John’s life do a 180.

“Not that I was going to kill myself – nowhere near there,” he says. “It was to a point where I didn’t care about doing anything no more. I didn’t want to get up and get dressed. I just laid around the house…very depressing. But see I’m a different person, and I was back then.  I wanted to bring that person back out. Neighborhood did that!”

John’s now vocal.
He joined two different Neighborhood advisory groups, where he is an active participant, offering the member’s perspective on what’s working – and what isn’t – in the health plan. Neighborhood takes John’s input and uses it to improve its plans.“I think John really feels like he’s been helped a great deal by Neighborhood and the Advisory Committee is really a way for him to give something back to the health plan,” explains Ken Pariseau, who helps to run the Neighborhood groups in which John participates.

In a way, John feels renewed these days.

“After my wife died, I had my two kids, and then my grandkids, but now it’s my time,” John says.

“It’s been a great experience working with John. It makes my heart happy to see him happy,” Janet adds.

John sums it up nicely: “Like I said, I was so depressed I didn’t care. Now I care about everything, I care about me and I care about people around me. I care about just general life. It’s great now! And that’s how it is!”