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From left to right / De izquierda a derecha: Connie Daniel, Robert and April Gomez.

OneWorld Plattsmouth clinic helps patient reclaim his health

The first time Robert Moreno, OneWorld patient, entered the OneWorld Plattsmouth clinic in February 2022 his health was in such a fragile state he was unable to walk or push himself in his wheelchair. Stage four liver cirrhosis and hepatic encephalopathy had transformed his life into a series of emergency room trips, but without insurance, Robert and his family were unsure what help he needed and if he could afford it.

April Gomez, BSN, RN, Family Practice Nurse Manager, helped Robert check in for his appointment with Connie Daniel, APRN, Family Medicine Nurse Practitioner.

“Robert had no health care plan or gastrointestinal consult arranged and with his liver cirrhosis, which is very critical, he was so fragile,” April said. “He was all on his own before coming to OneWorld.”

Based on Robert’s age, he was eligible for Medicare, but missed the cut-off to apply. April knew Robert could still qualify for Medicaid Expanded Care, so she referred him to the OneWorld Marketplace to begin the application process. While this was a solution for the long-term, Robert was in need of immediate coverage due to his urgent health concerns.

Connie and April worked together to screen Robert for the Hope Medical Outreach Coalition program, which would cover Robert’s medical expenses while he waited for his acceptance into Medicaid.

“Our clinic doesn’t place many Hope referrals, but with the help of Juanita Valadez Garcia, we were able to submit the urgent referral,” April said. “Robert happened to qualify, which was amazing.”

Soon after his appointment with Connie, Robert saw a liver specialist at Midwest GI to create a treatment plan. When Robert began treatment he was too fragile to be considered for a liver transplant, but that quickly changed.

“By this point, Robert had Medicaid, and he was doing well enough that the liver specialist referred him to the UNMC liver transplant list,” April said. “Applying is a large undertaking, so we were able to help make sure every record was transferred, every lab order was correct and he met all of the requirements to ensure he could qualify for a liver transplant.”

With the OneWorld Sliding Fee Scale program, Robert is able to get the frequent lab draws his liver specialist and the UNMC liver transplant team require at the Plattsmouth clinic at a reduced cost.

“Our staff is very responsive to his needs, and he is able to see me in clinic quickly when needed,” Connie said. “He has been connected to many other OneWorld services to make sure he is able to afford his care including the OneWorld Pharmacy when he was waiting for Medicaid.”

In addition to connecting Robert to financial programs and services, the Plattsmouth team assisted Robert’s daughter to apply for Family and Medical Leave so she could care for Robert full-time when his health was so fragile.

The team also emphasizes education to help Robert and his daughter understand Robert’s diagnosis and treatment plan.

“There are so many questions patients have and important things they need to know,” April said. “The ER doesn’t always have time to sit down and talk through what a patient’s new normal is, and that is so scary. We have been able to educate Robert and his family and give them a sense of safety and understanding. We ensure all pieces are tied together so he doesn’t fall through the cracks.”

Less than six months after stepping through the Plattsmouth doors for the first time, Robert’s health has improved so drastically he is walking independently into his appointments with a smile on his face.

“OneWorld gives me great advice and medical care and they have been so helpful,” Robert said. “I’ve had a stem liver implant surgery and I’m still waiting to get on the transplant list, but right now they say I’m too healthy, or that I’m stable enough to not need a liver transplant. That feels really great.”

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