At 9 a.m. on a warm Tuesday in May, Kim Fink was in the BlueCross office in Johnson City – a strange place for her to be.
As a care coordinator with the BlueCare CHOICES program, Kim is rarely sitting at a cubicle or in a conference room. Her duties frequently require her to visit members in their homes or care facilities.
A Jonesboro native and licensed clinical social worker, Kim has taken a career journey from agency work on behalf of seniors to joining BlueCross in 2011.
“I’ve always had a passion for helping others, trying to make sure they have the resources to meet their needs and make their lives better,” Kim says. “As a social worker, I initially worked with older adults in a hospital setting. That led me to BlueCross and CHOICES.”
The CHOICES long-term support program serves members age 21 and over with physical or cognitive disabilities, and the 65-and-older population. Based on their health and at-risk status, members may live at home or in a health care facility – but CHOICES works to offer as much independence as possible either way.
On this day in May, Kim was visiting three members in their homes for their quarterly check-ins. After a brief stop by the office, she hit the road.
9:50 a.m. – Kenny Brown
Growing up in Jonesboro and Johnson City, Kim knows the windy back roads of the area well. That familiarity allowed her to arrive early for her first member visit with Kenny Brown and his wife, Banna.
Thirteen years ago, Kenny suffered a stroke, followed by a heart attack while en route to the hospital, putting him the intensive care unit for 18 days. He’s since struggled with his health, undergoing ankle, back and hip surgeries, among others, and joined CHOICES four years ago.
Since then, CHOICES has widened doorways and installed outdoor/indoor wheelchair ramps and a roll-in shower, among other services.
Recovering from a recent eye surgery, relaxing on his couch and watched over by an impressive collection of porcelain angel figurines on the mantle, Kenny brightens when Kim enters his home.
“My back’s hurting a little bit, but I slept well last night,” he replies when asked how he’s feeling. “I had a little problem with anesthesia after my eye surgery. I needed three or four days to get over it.”
Kim gets settled on a loveseat opposite Kenny, pulls out her laptop, and asks if he’d mind answering some questions while he eats breakfast.
Kim takes her time with each one, listening intently, taking notes on her laptop, giving Kenny all the time he needs to respond and pressing for additional information when needed. She asks questions like:
- “How are you doing with your goals?”
- “Have you been exercising?”
- “Have there been any changes in your weight?”
- “Did you get your shoes re-stretched?”
- “Any falls lately?”
- “What doctors have you seen since your last visit to the ER?”
- “What’s your level of pain at the moment?”
- “Does the in-home helper [who comes weekly] always treat you with respect?”
It’s a process that may seem invasive, but for members like Kenny, it’s familiar – and appreciated. Kim’s methodical attention ensures she’s up to speed on all of her members’ health concerns and progress , and allows her to follow up on their behalf with any providers or organizations as needed.
Once her questions are complete, Kim inspects the bathroom and the refrigerator, checks the smoke detector, and requests to see Kenny’s medications.
Kenny can’t say enough about her advocacy on his behalf.
“She’s been wonderful,” he says as Kim packs her laptop.
“She’s good to us, tells us things straight, doesn’t pull any punches. Without CHOICES, I don’t know what we would do.”
11:05 a.m. – Documentation
Kim says goodbye to Kenny and Banna, promising to follow up quickly on a request for a pulse oximeter.
Establishing that comfort level and making members like Kenny feel at ease doesn’t happen overnight.
“You have to be honest, open and willing to answer any questions or provide any assistance they need,” Kim says as she buckles herself into her car. “If they see you truly care about meeting their needs, you build that trust a little at a time, especially if you’re consistent and show a willingness to help.”
With under an hour before her next visit, she returns to the office to document Kenny’s status and return a handful of calls to other members.
12:00 – Paulette Rutherford
Kim’s next stop is to check in with Paulette Rutherford and meet with her sister and power of attorney, Sharon Hawkins.
Paulette was born with brain damage as a result of breech during delivery and being left in the birth canal too long. She needs assistance with eating, bathing and other daily activities, and currently resides in a group home staffed with full-time, certified professional caregivers. Kim helped the family with placement and approval through CHOICES.
While Paulette – who is primarily nonverbal but loves having visitors and welcomes them with a warm smile – watches “Gunsmoke” in an adjacent room, Kim and Sharon talk at the kitchen table. Today, Sharon shares some concerns about how tired Paulette seemed during a recent visit.
“I left here Sunday very sad because I thought Paulette was sad,” Sharon says. “But she was actually just tired, and I picked up on that. There’s always a certain amount of guilt when I tell her goodbye.”
Despite the high quality of the home and staff, moving Paulette to unfamiliar territory was difficult for the family, particularly Sharon and her other sister, Rosemary Pleasant.
“Kim offered us different options for Paulette, and she understands what we want for her,” Sharon says. “But it’s been very hard for us as a family to let go. For all of our lives, we have been involved in her care. We lost our father 25 years ago, and my mom, who never drove, passed away at 97. Rosemary and I were caretakers for both Mom and Paulette for at least 20 years.”
“With Paulette, we couldn’t let go – she’s like our child. That empty-nest syndrome is real, and we thought we would lose all control.”
One of the many advantages of Paulette’s current living situation is that Sharon and family can visit her any time they wish, day or night – and Paulette is free to leave with them and spend time at their homes.
“That helps tremendously with the family’s stress levels,” Kim says. “A big part of my job is to take as much of that off of their hands as possible.”
To help manage Paulette’s bouts with exhaustion, Kim speaks with the house manager and suggests steps the staff can take to help Paulette rest and be more comfortable. She also asks how Paulette is doing with meals and mobility exercises. The discussion then ranges from Paulette’s interactions with her housemates to changes in her oral health to whether Sharon would like for her to have a mammogram this year.
“We have some really fabulous caretakers here, and we are very thankful to Kim, because she knows how to lead you to the right decision,” Sharon says. “She’s gotten to know our family, we love her, and we appreciate what she’s done.”
“We wouldn’t be here if Kim hadn’t used her method of helping us.”
As Kim said following the day’s earlier visit with Kenny, these are decisions made after trust and confidence in a care coordinator are established.
“She didn’t push it on us – she very gently recommended it to us over the course of several months,” Sharon adds. “She gave us time to accept we couldn’t provide the care Paulette needed any longer. We’ve grown to be very fond of this home. CHOICES has really been a blessing and a lifesaver in so many ways. ”
1:20 – Lunch
During a quick stop for Subway sandwiches, Kim reflects on a career path that brings new challenges every day. Care coordinators often work long hours and have to be flexible, as member needs can change at any time. Fortunately, Kim’s husband Matt understands the demands of her work.
“He doesn’t fuss too much when I come home at 7 and start making phone calls,” she says with a laugh. “He’s always been supportive with whatever I need to get my job done. It’s just us and our dog Carly, and we’re kind of homebodies, anyway.”
Perhaps not surprisingly, when she and Matt take time off for themselves, they prefer a degree of consistency with their relaxation.
“We love to rent bikes on Tybee Island in Georgia,” Kim says. “It’s wonderful because it’s very flat and easy to get around.”
2:30 p.m. – Jeff Johnson
Kim’s final visit is with a member she’s worked with for nearly five years.
Jeff Johnson was born with arthrogryposis, a bone and muscle disease that causes joints to contract, putting him in and out of physical rehab along with multiple surgeries as a child. His parents, Norma and Tom, had to fight with school systems in Virginia and Tennessee to allow him in the classroom, rejecting their suggestions he’d be better educated at home or with mentally challenged students.
His parents persevered, and Jeff graduated from high school and then from ETSU. At that point he was able to walk and drive, and got hired as a news producer at WCYB in Bristol.
Despite his disability, Jeff used his hands all his life, learning to make the most of his limited dexterity.
“They called him ‘Lightning Johnson’ at the news station because he was so fast with his hands,” Tom recalls.
All of that changed one night in 1991, when Jeff was involved in a severe car accident. His red Honda CRX flipped across four lanes of traffic.
“Our daughter’s a nurse, and she was working at the hospital that night,” Norma remembers. “Jeff was in rough shape when he arrived. The only way she recognized him was his hands.”
Jeff suffered a traumatic brain injury and has been unable to work in the decades since. He’s been with the CHOICES program since its inception eight years ago. He lives in the lower level of his parents’ home, which has been equipped with a special bed, bath tub, ceiling lift and a chair lift for the stairs.
The entire family feels Jeff’s best care has been provided under Kim’s guidance.
“Kim’s the best around,” Jeff says.
“We go from day to day, and we’ve had several case managers,” Norma says. “But Kim and Jeff are just so at ease with each other. ”
Seated in Jeff’s “man cave” decorated with framed nature photos taken by Tom, Kim settles into questioning. She asks Jeff about some swelling in his legs, how his aquatic therapy is going, his recent and upcoming doc appointments, and if he’s still a greeter at his church every Sunday morning.
Like the day’s other conversations, this one is thorough, respectful and comfortable for all involved. Kim presents an updated care plan to Jeff and his parents to continue his ongoing authorization for CHOICES consumer direction services – meaning he can hire his own workers. She also promises to follow up with his primary care physician and a durable medical equipment company regarding recommendations for compression wraps to help with swelling in his lower legs.
4:15 p.m. – Last stretch on the road
The Johnson family visit concludes and Kim says her goodbyes, but her work for the day is far from over. She heads home – where she keeps an office, as well – with plans to document data, return more calls and prepare to meet with other members tomorrow.
When asked what success looks like for her, Kim turns the focus back to her members.
“If my members are happy and healthy, if they’re able to have a good quality of life and if they feel supported, then I know I’m meeting their needs,” she says. “I want them to have the desire, the drive and the ability to do the things they love.”
And with that, she pulls away toward the next stop.