Lavinia W. recites the date of Feb. 8, 2021, as if it’s her birthday. For the record, it’s not – but in many ways, that is when Lavinia’s new chance at life started.

It’s also the day the Inland Empire Health Plan (IEHP) member went to a hospital Emergency Room (ER), thinking she might die.

“On Feb. 8, 2021, I couldn’t breathe because I have congestive heart failure,” Lavinia recalled. “And I found out that when I got to the hospital, I only had 2% oxygen left – they didn’t think I was going to make it.”

Even after her immediate medical issues were addressed and she was sent home, Lavinia experienced bouts of panic and anxiety attacks, compounding her heart issues – so severe, at times, she returned to the ER repeatedly. 

“I was going to the hospital … every other day almost,” she said.

Meanwhile, IEHP had identified the need for additional services for members like Lavinia.

The goal: Provide focused support coordination for patients with congestive heart failure, who often experience frequent ER visits and hospitalizations.

Through a pilot program to address congestive heart failure, IEHP started: 

• A partnership with Mom’s Meals to provide six months of fully-prepared, heart-healthy meals – breakfast, lunch and dinner – delivered directly to members’ homes.

• Collaborations with IEHP’s multidisciplinary team of nutritionists, care management representatives and providers to ensure members are on track for a healthier life.

• In-home visits by IEHP’s health navigator team to deliver a weight scale, review the use of a glucometer and blood pressure cuff, show how/where to track important information from these devices, and answer the members’ questions.

“Getting out into the community is huge – it makes a big change,” said IEHP Care Manager Jonathan Lee. “Throughout this process, I’ve felt that being present in what you’re doing [is important], not just doing it to complete tasks — understanding that there is a person on the other side of the phone, on the other side of the computer screen.” 

Essentially, Jonathan said: “Be there for the member.”

And sometimes, that means providing an emotional sounding board in addition to expert guidance on health-related matters.

“Being able to be that person that they can socialize with, laugh with – even for just, maybe 30 minutes that we were there, it made a whole difference in their life, knowing that they had that support,” said IEHP Health Navigator Lucia Reyes.

The support for these IEHP members continues beyond those in-home visits as well. 

“IEHP was calling … ‘Lavinia, what can we do to help you?’ … And that’s what helped me, because I realized there were people that cared,” said Lavinia, her voice cracking with emotion.

Jonathan called Lavinia for weekly check-ins, receiving inspiring progress reports about following her diet of no salt/no sodium and partnering with her providers on her road back to health.

Soon enough, Lavinia saw positive results on the scale – a 44-pound weight loss so far.

Today, more than 18 months after that fateful Feb. 8, 2021 date, Lavinia feels better and stronger and has learned how to control her weight, crediting the tasty and healthy meals provided to her via IEHP’s collaboration with Mom’s Meals. 

“She was progressing very, very positively – quickly,” Jonathan said. “Her symptoms were almost nonexistent anytime I would talk to her. Vital signs stable, everything great. She was awesome.”

For Lavinia, IEHP is the “awesome” one in this story of rebirth.

“IEHP helped me be a better person – because if it wasn’t being part of that program, I don’t think I would be here,” Lavinia said. “They saved my life – thank you. You guys did more than what you know.”