Iowa Home Providers Share How Medicaid Has Improved Lives, What’s at Stake Without It

Robyn Agu is ready and willing to share her first-hand experience about how Medicaid funding is changing lives, even if it means pausing a family walk around her Altoona, Iowa neighborhood to visit with friends and acquaintances.

As uncertainty around Medicaid funding grew in Washington, D.C, Robyn and other Home Providers made sure their Congressional representatives, friends and neighbors saw the faces and heard the names of people who rely on services made possible through the program.

People like Deannalue Bales and Patrick “Ricky” Flatjord, whom Robyn and her husband, Abraham, care for as Mosaic at Home® Shared Living Home Providers.

Deannalue and Ricky are among 4 million people in the U.S., and more than 4,500 at Mosaic, who receive home- and community-based services (HCBS) through Medicaid. HCBS enables people to receive personalized care in their community, rather than an institutional setting.

Robyn said her neighborhood conversations have been eye-opening. Her neighbors are often surprised to learn that people with intellectual and developmental disabilities—like Deannalue and Ricky—would likely be impacted if Medicaid funding is reduced, leading Robyn to realize more education is needed.

“It’s really important for people to see who we’re talking about,” Robyn said, adding that once her neighbors learn that Deannalue and Ricky’s care is funded by Medicaid they are supportive.

Beyond the neighborhood, Robyn’s advocacy efforts led her to Washington, D.C. this past spring with the Progress Iowa group. U.S. Rep. Zach Nunn was among the lawmakers the group addressed.

After the trip to Washington, D.C., Robyn and Deannalue visited Rep. Nunn at his Des Moines office twice to deliver an Easter basket and birthday balloons before securing an in-person meeting with him and Mosaic Iowa State Operations Director Brandi Bretthauer.

During the meeting, Rep. Nunn presented Deannalue with a challenge coin while Robyn shared the different levels of care Deannalue and Ricky receive and the critical need for Medicaid. They also invited him to visit their home for a firsthand look at the benefits of at-home care.

Robyn, a former case manager who also worked as a nurse for Mosaic in Central Iowa from 2004 to 2007, believes that Medicaid cuts will affect the entire healthcare system, including people with private insurance and already-struggling rural hospitals.

“As a case manager, I saw how limited services were already across the state,” she said. “If we have fewer funds and fewer people able to use them, the resources we do have are going to dry up even more.”

Personally, she’s concerned about disruptions in Deannalue and Ricky’s services that could affect their daily medications, doctor’s care and possibly change their living situation. With tears in her eyes, Robyn said she can’t imagine the pair thriving in a state institution setting.

“Deannalue would go rapidly downhill,” she said. “Same with Ricky. To think he would be back where people don’t know him and don’t know what he wants and likes or what he’s trying to say, is extremely upsetting.”

At 61 years old, Deannalue has experienced a range of care services since leaving her parents’ home in her early 20s. She first lived in a 15-person group home and later in an apartment with a roommate before moving back to a group home. While living in the group home, Deannalue, the youngest of five children, longed to be part of a family again. So when she heard about the Mosaic at Home program, she wanted to try it out.

Robyn and Abraham, who met as case workers 27 years ago and later worked in a group home together, and their three daughters welcomed Deannalue into their home five years ago.

“What she told me is she was happy when she lived with her family and she wanted to be where there was a mom, dad and others in the house,” Robyn said.

Ricky’s arrival nearly three-and-a-half years ago fulfilled another wish for Deannalue.

“I wanted to be part of a family of seven, just like mine,” she said.

Robyn and Deannalue agree that Ricky is “a perfect match” for the family.

Ricky also lived in a group home after spending his youth with a foster family. The Agu’s desire to care for Ricky came after Abraham retired from his job at the height of the COVID-19 pandemic to protect Deannalue from the virus.

Robyn said she’s seen positive growth in Ricky and Deannalue.

“One of Ricky’s goals is to be involved in making choices for himself,” Robyn said. “He might choose between what shirts he’s going to wear when I ask him.”

He also likes to be part of the group, which wasn’t the case when he first arrived.

“We have a group of Home Providers that we get together with for birthday parties, movies and crafts,” Robyn said. “He might not sit and do the craft, but he wants to be at the table.”

Living in the family setting she desired, and with the help of Robyn’s extended family, Deannalue has learned how to control her emotions and be flexible when her schedule changes. She’s also a big help with Ricky.

“Being a part of something makes her feel good,” Robyn said.

Ricky and Deannalue aren’t the only ones to experience positive outcomes from the host-home setting.

“We’ve had so much growth as a family,” Robyn said. “Our daughters have more gratitude because they see the challenges Ricky and Deannalue have. It has shaped their outlook tremendously.”

Robyn isn’t letting Medicaid funding’s uncertain future deter her family’s path or the care they provide to Ricky and Deannalue.

“I’ll continue being a voice for them and sharing how effective this program has been for us,” she said.

For her willingness to step up and advocate, Robyn recently received Mosaic’s first Advocate of the Year award.

“Robyn has been bold in advocating with us to protect Medicaid, and we are honored to recognize her,” said Cheryl Wicks, Mosaic’s Vice President of External Affairs.