Better Together: Members, Providers and CareOregon Teaming for Positive Outcomes
By Jeanie Lunsford, Communications Manager, CareOregon

When you meet Zachary, Penelope and Sigourney Tucker, you are instantly struck by how happy and healthy these adorable 18-month-olds’ are. These triplets don’t have a care in the world. And that’s the way their parents Debbie Deles-Dernier, 38, and Tom Tucker, 42, like it.
                              
But for Debbie and Tom, things haven’t always gone so smoothly. When they found out that they were expecting triplets, both were students and Tom had recently been laid off from Boeing, in the wake of Sept. 11th cut backs. Neither had health insurance, and a high-risk pregnancy with attendant medical costs was a shock. But Debbie and Tom were ready to face the challenge. He took temp jobs while searching for a permanent position, and she contacted the Oregon Health Plan (OHP) to find out about insurance for expectant moms. Debbie wanted a health plan that would allow her to use OHSU, and OHP assigned her to CareOregon.

“That worked out really well,” said Debbie. “I got excellent care, I had ultrasounds once a month because it was a high-risk pregnancy. I didn’t have to wait long for my appointments and it was really good care.”

The pregnancy wasn’t an easy one, with morning sickness lasting all day for many months. Debbie has scoliosis and, as the babies grew, so did her back pain. She worked with her favorite CareOregon member service representative, Julie Joachims, to let her needs be known, and the Utililization Management Team helped by making sure it would be covered by the program. 

Julie, like all CareOregon member service representatives, really enjoys working with the members to make sure that all their needs are met. “Because we work with members who are facing special challenges, we try to look beyond the obvious health question to what is really needed. Back braces aren’t always covered by OHP, but in a special case like this, it was possible to get it for her.”

Debbie was determined to have healthy babies, despite the risks associated with multiple births. “The last half [of the pregnancy] got physically hard. My resting heart rate was 180. Even going up four stairs would wear me out.  My doctor said it was likely that I might have to stay in the hospital for a month or more toward the end of the pregnancy.  I asked what I could do to avoid this and she said ‘rest, rest, rest.’ “

Determined to stay out of the hospital, Debbie tried to rest as much as possible, while Tom began making the rounds of new apartments because their lease had ran out.  Finding a new home, while Debbie was unable to work and Tom was working temporary jobs, was a challenge. Julie, at CareOregon, gave them suggestions of places that would take them. Making referrals to other support agencies or resources is common practice at CareOregon, since every aspect of a person’s life affects their health.

While Debbie and her providers worked hard to avoid complications, almost all multiple births are premature and the babies came eight weeks early. They had to be placed in incubators—but only for a few hours. The two girls were only 2 lbs., 4 oz. with Zachary at 3 ½ lbs. and all required gavage (surgical) feeding, rather than bottle or breast-feeding. Because preemies have underdeveloped lungs and hearts, these organs sometimes stop unexpectedly, as was the case with Sigourney.

“Sigourney also had to have a blood transfusion,” said Debbie. “I learned that preemies are only allowed to draw from a select group of blood donors who have to meet a much higher standard of safety than the average blood bank. I don’t even want to think about what that would have cost if we hadn’t had CareOregon insurance.”

When the babies were born, they stayed on CareOregon’s plan for their first year, which is typical for newborn members. After the first year, Tom was able to go back to Boeing full-time and now has insurance for the family through his work. Debbie was delighted that she could continue to use the same clinic and doctor when the babies transferred from CareOregon to private insurance.

“Tom was so happy that after he got the job, he stopped in to CareOregon’s office to thank us for all of our help and to bring pictures of the babies,” said Julie. “He really appreciated the fact that we could serve as a bridge for his family when they were going through a difficult time. And we were delighted to have helped bring three beautiful and healthy new Oregonians into the world.”