NCCPPR North Carolina Center for Public Policy Research

Erma Cofield of Rocky Mount is 70 years old, and she has diabetes, hypertension, and heart failure. Erma is on Medicaid and enrolled in Community Care. She lives in a home for senior citizens. She says she does not feel any stigma associated with being on Medicaid or Community Care.

Erma arrives for her appointment at Heritage Hospital Chronic Heart Failure Clinic with a plastic bag filled with all of the bottles of pills she takes. Caroline Gardner, RN, BSN, is a nurse case manager in Edgecombe County with the Community Care Plan of Eastern Carolina. She checks the medications and realizes that Erma has two bottles of the same medicine. Erma cannot read, but she had realized the names of the medications matched. If Erma had taken pills from both bottles, she would have ended up dehydrated and in the hospital.

This is an example of the health benefits and cost savings provided by Community Care. Erma sees her primary care physician, but she has been referred to heart and lung specialists. This is why she often has duplicate medications. Nurse Caroline’s job is to work directly with the patient to keep it all straight.

Erma used to end up in the hospital at least once a year, but it has been 18 months since she was hospitalized. “Our number one job is to keep clients out of the hospital,” says Denise Poland-Torres, a Physician’s Assistant with the Heart Failure Clinic.

Medicaid pays for a personal care assistant to come to Erma’s home three days a week for two hours. The helper cleans, cooks, and checks Erma’s sugar levels.

Erma also likes having her own nurse that she “loves to death.” The relationships are close; enough so that practical jokes are not uncommon. When Caroline was visiting Erma one day, they decided to play a joke on Denise. Erma called Denise to report that she had a hot dog and a dill pickle for lunch. Denise was upset, knowing these foods are not good for Erma, given her medical conditions. Then, Erma told Denise it was a joke, and the three women are still laughing about it to this day. Erma said, “They know their stuff!” And while Erma may not know she has a “medical home” or understand what “Community Care” is, Erma knows that Caroline is her Medicaid nurse.

Learn more about Medicaid and North Carolina's Aging Population