{"sno": "new", "year": "2025", "answer": [{"options": {"value": "RICHARD VINCENT", "optionId": "u4v"}, "questionId": "K-lowx"}, {"options": {"value": 60001053200, "optionId": "vvv"}, "questionId": "B-lowx"}, {"options": {"value": "1954-02-01", "optionId": "tdb"}, "questionId": "M-iz6p"}, {"options": {"value": "2025-07-11T14:14"}, "questionId": "W-iz6p"}, {"options": {"value": "6032035036", "optionId": "uphno"}, "questionId": "U-Phno"}, {"options": {"value": "c.hembrick@focuscares.com", "optionId": "b4v"}, "questionId": "Q-lowx"}, {"options": {"value": "Focus Care", "optionId": "p4v"}, "questionId": "X-lowx"}, {"options": {"value": "Candace Hembrick ", "optionId": "q4v"}, "questionId": "N-lowx"}, {"options": {"value": "Other, Behavioral Health", "optionId": ["epq", "bhd"]}, "questionId": "U-w165"}, {"options": {"value": "Transportation Disparities, Medication Adherence, Appointment Reminders, Mental Health/Seizure evaluation Assistance (medication revamp - PHQ9 21), Dental Health Consult (denture fitting), Hearing Aids, Dementia consult", "optionId": "C-MV65"}, "questionId": "C-MV65"}, {"options": {"value": "8048745660", "optionId": "i4v"}, "questionId": "S-lowx"}, {"options": {"value": "Yes", "optionId": "su8"}, "questionId": "Q-jtcz"}, {"options": {"value": "No", "optionId": "l6B"}, "questionId": "A-que"}, {"options": {"value": "No", "optionId": "l6D"}, "questionId": "B-que"}, {"options": {"value": "Member has several medications that are empty, and he needs to get them refilled.  He stated that they changed his pharmacy from Rite Aid to another one down the street and they do not send him reminders or refill his medications automatically like the other one used to.  The member either needs his medication dispenser to start working properly or get his medications dispensed in a pill pack all together.  Will send referral for assistance.  Member has an aid that comes to check on him for 3 hours a day.  He received a medication dispensing machine but he is not able to get it to work and dispense his medications.<br>Member is experiencing transportation disparities and has a roach infestation in his apartment.  <br>He received hearing aids but states that they do not work and he is not able to hear out of them or connect them to his phone like they say he should be able to do.  <br>Mental Health/Seizure follow up  - Member has an elevated PHQ9 score of 21 and is currently taking Cymbalta.  States that he does counselor/therapist - he has someone that he speaks with, but he has missed several months.  Has been able to go at least once a month to get his medications from his psychiatrist.  Discussed with member that he definitely may need to have a medication revamp to assist with his mental health since his PHQ9 is so elevated.  He states that he just started taking the Cymbalta a little bit ago and does feel it is helping but that he may need more assistance.  He states that his memory is the biggest issue that he is having, and he thinks that he may be developing dementia or Alzheimer's like his mother.  Since the member is having increasing moments of forgetfulness it may be possible that he is having seizures and is not able to tell if he is having them.  It has been several years since the member has had an EEG.  Will send referral.<br>Mini-Cog - Poor recall noted.  Member is a poor historian and scored a 3 on his Mini-Cog.  He is only able to remember 1 word on the word recall section even after we stated the words several times before moving forward. Further evaluation warranted.  Mother has a history of Alzheimer's.  ", "optionId": "l6l"}, "questionId": "P-gbms"}], "clientId": "client_013", "memberId": 60001053200, "referralId": "vu8", "submittedBy": "chembrick", "sentToQADate": "2025-07-11T18:32:08.008Z", "submittedUserType": "nurse", "referralFormStatus": "0", "sentToHelpLineDate": ""}