Member Spotlight: Marciano

Date: 04/04/18

WICHITA, KS - Marciano Arguelles has a tough history of congestive heart failure with physical deterioration from alcoholism and malnutrition. 

Marciano was assigned to Sunflower Nurse Care Manager, Stephanie McIntyre in November 2016.  At that time, he was an active drinker with severe heart failures and a history of multiple hospital admissions.  He was established with a local primary care physician and a local cardiologist. 

During the course of the case, Marciano would frequently have difficulty getting to his appointments because of being unable to walk long distances or tolerating very cold or hot weather related to his heart condition. He would use our transportation service frequently when he was able, but his significant spend down amount would limit his use of the transportation benefit. 

During the months he had an active spend down, he would not pay for his needed medication and go to the emergency room for healthcare, since he couldn’t pay for doctor’s appointments or for transportation.

After several months of working with this member, Stephanie was able to successfully coach about the importance of stopping his alcohol use, improving his nutrition, and consistent medication use to help maintain and improve his cardiac function. She also made a referral for assistance with his substance abuse.

Sunflower Behavioral Health Case Manager Sonja Ostrander connected with him, and Marciano has been able to finally stop drinking. Within a month after starting his sobriety, he had a six-month follow up with his cardiologist, who told him that his 2D echocardiogram and EKG had improved and that his cardiac function percentage had gone from 15% to 50%, putting him almost outside the range for congestive heart failure.  

Marciano’s spend down continued to be an obstacle for the healthcare he needed. A fare to one of his providers would cost him around $20-$40 round trip. Even though his health continued to decline during these times, he would choose between rescheduling appointments or not paying utilities because he didn’t have a support system in place that would assist him with transportation.  Using the standard bus route was not an option either because he had difficulty climbing the stairs to get into a regular city bus. Stephanie was able to help Marciano apply and get approved for the Paratransit system in Wichita that allowed him to get transportation more affordably when his spend down was unmet. Marciano is now able to pay a small fee for rides to appointments when he has a spend down.

Marciano is now sober and improving his cardiac condition each month. He says, “Sunflower has made a big difference in my life. Stephanie and Sonja are my friends, not just my health insurance representatives. I’m grateful for what they have done for me; they never gave up on me.”