IA Health Link: Success Stories

Iowa Total Care Goes Above and Beyond to Help Members Weather the Storm

The August 10, 2020 derecho that moved across the state and caused widespread damage affected many Iowans. Soon after the storm passed, Iowa Total Care (ITC) was on the ground in the some of the hardest hit areas helping their members. Here are some of those stories.

Smart Start Program Helps Pregnant Member

A pregnant member needed help following the derecho and she turned to the ITC Smart Start program for assistance.

Within hours of her request, Smart Start representatives delivered nonperishable food, bottled water, and baby supplies to the member. She was extremely grateful because the help affected her own well-being and the survival of her unborn baby.

ITC Helps Mother and Newborn Apply for Food Replacement Assistance

An ITC Member Connections Representative (MCR) reached out to a mother as part of ITC's postpartum program and learned of the mother's spoiled food due to no power and no refrigeration.

The MCR helped the mother and her newborn apply for food replacement through the Department of Human Services (DHS) without leaving home. The mother expressed appreciation for ITC's assistance, as well as the recovery assistance provided by everyone. She is also grateful for her baby's health, happiness and calm disposition during a stormy first week of life.

Disaster Response Team Replaces Diabetic Member's Medicine

When electric power lines went down during the derecho, two ITC case managers rose to the need.

The case managers knew the power outage meant food spoilage for most in the derecho's path, but that lack of refrigeration - vital to the effectiveness of medicines for diabetes - was risking the health of an elderly member cut off by the storm.

The case managers delivered food to the member at risk. They learned she had disposed of her medications because they were spoiled. They then conducted a Telehealth visit with her physician and ITC leadership to get new prescriptions approved, filled, and covered.

The vital diabetic medicines were delivered to the member the same day. The case manager delivered the rest of the prescriptions the next day, along with ice, a hot meal, and a meal for later.

The case manager observed this member was in "rough shape mentally," so she stayed and talked. She learned that due to COVID-19, the member's homemaker services staff had not been to her house in several months. When the case manager checked back the next day, the member was in better spirits for several reasons: The power was back on, homemaker services staff had returned, and she had her diabetes medicine. 

Members Receive Flashlights

With several members losing power, ITC's Community-Based Case Manager (CBCM) team worked quickly. The team found two members who were without power and had minimal flashlights or candles in their homes. One ITC member had small children in the home and the other was elderly/disabled. The CBCM team purchased flashlights for both homes and dropped them off at the doorstep for them to use. Both members were very appreciative.

 

Care Coordination Helps Expectant Mother Find Housing

A new mother in eastern Iowa has a place to live thanks to the coordinated team effort of Iowa Total Care (ITC) and a local PATH provider.
 
Earlier this year, an expectant mother had reported homelessness to a PATH (Projects for Assistance in Transition from Homelessness) worker. The PATH worker determined that she was an ITC member and worked with an ITC Housing Management Specialist to arrange for housing and financial assistance for the member.
 
The ITC Housing Management Specialist and the PATH worker were able to find housing for the member and she moved in just one day prior to being induced to have her baby. They also worked together to find essentials for the new apartment. The member's new landlord also donated several baby items to help the expectant mother prepare for bringing her baby home. 
 
Mother and baby are doing well today thanks to the care coordination provided by her managed care organization.

 

Amerigroup's CHAMP Program Helps Des Moines Family with Surgical Recovery

A referral from school officials to Amerigroup's CHAMP program helped a Des Moines family through a difficult time earlier this year.
 
In February 2020, the CHAMP (Changing Health: Amerigroup - Monroe Partnership) program flex fund aided the family's transition after one child suffered a difficult and extended surgical recovery.
 
Amerigroup received the referral from Monroe Elementary, part of the Des Moines Public School District. Staff members at Monroe work in partnership with Amerigroup to identify ways in which social drivers of health affect families of children who attend the school. 
 
The referral was for a family that was struggling financially and had other needs. School officials were not sure why the family's 7-year-old had received emergency care, and made a referral for CHAMP assistance.
 
The Amerigroup specialist performed an assessment in which the child's mother reported her son had recently undergone a very sensitive abdominal surgery and was suffering complications after being kicked twice by other boys in a way that harmed his healing process. The complications required a second surgery on March 13. The recovery time, care and focus put additional strain on the family. 
 
The Amerigroup specialist arranged for financial assistance, referred the mother to the relevant school principal to set up a meeting regarding her concerns, and connected the family to food resources.
 
The referral to the CHAMP program flex-fund ultimately provided the family with rental and utility assistance as well as gift cards for gasoline. Upon follow up with the family, the mother's stress level had decreased significantly due to CHAMP assistance, which allowed her to focus on her son's recovery. She told Amerigroup she was very grateful for CHAMP, because the amount of assistance the family received would have been difficult to obtain through other community resources. Following the second surgery, the mother reported her son was recovering well.
 

Member Receives Home Modification During MCO Transition

An Amerigroup Iowa community-based case manager (CBCM) ensured a member's needs were met all while helping him transition to Amerigroup from another Managed Care Organization (MCO).
 
In July 2019, a central Iowa member who receives waiver services was making the transition to Amerigroup and was in need of a home modification. The member's mother, who acts as his daily caregiver, was finding it impossible to manage his lift across the existing carpet in the home. An Amerigroup CBCM, who was assigned to reach out to the family, learned of the issue during the MCO transition and took immediate action.
 
The solution was an accessible vinyl flooring installation to make the member's lift transfers safer and easier. The CBCM made contact with the family in late July 2019, completed a plan update, estimates for the work and approvals so that flooring installation could start in early September 2019.
 
Within a few weeks of transitioning to Amerigroup, the family had brand new flooring appropriate for the member's needs.
 
This is just one example of how the work of CBCMs improves the health and quality of life for IA Health Link members. 

 

Member Testimonials

The IA Health Link program ensures members get the right care, at the right time, in the right place. A coordinated team of caregivers - doctors, nurses, case managers, social workers and others - work together to provide the support that members need to improve their health and quality of life.
 
The following are testimonials from Amerigroup members about the care they received from their case manager:
 
From a parent in Dubuque:
I appreciate the time you (our case manager) took to drive here and meet with us. You were very patient and informative. Thanks for helping us keep services intact. This has been one of the best combination of services our daughter has had. She appreciates them and is very happy. Thanks so much for all you are doing to bring this same level of comfort to other families.
 
From parents in Boone:
I just wanted to send a little note to let you know how much we appreciate Tiffany, our Amerigroup case manager. It seems like we only hear the bad things that happen, and I wanted to send a thankful note. When we found out about AmeriHealth's plan to leave Iowa, we were very nervous and afraid of what that might mean for our son's care. Tiffany is knowledgeable, about the available programs, compassionate and has been a great advocate for our son.
 
From a member in Garner:
I wanted to tell you what a great experience and comfort Rosanna was to me as my case manager. She is very compassionate and comforting. When she tells you she will do something, she does it. Unfortunately I have recently had the experience of "falling thru the cracks" with some medical care. That didn't happen with Rosanna.
 
From the parent of a Long Term Support Services (LTSS) member:
When Dena, our Amerigroup case manager first assisted us, we had not navigated Medicaid before and needed a lot of guidance. She patiently heard our concerns and went to work trying to make our son's complicated life more livable. He struggles with intractable epilepsy and autism. Dena has been so pleasant to deal with and quickly responded to any concern we raised. We felt lost before she finally got us on the right track. She was truly a blessing in our life.
 

Amerigroup Caseworker Helps Struggling Teen

A Grinnell teen received the behavioral health intervention services she needed with the help of her Amerigroup caseworker
 
When a Grinnell family called Amerigroup a year ago, their 14-year-old daughter was in crisis. She was in the hospital following an overdose. The teen suffered from Type 1 diabetes, depression, anxiety and ADHD.
 
The family was deeply concerned about their daughter's behavior and considered placing her in an out-of-state facility for children with serious behavioral health problems. They didn't know if that was the best option, but they did know they didn't want to be so far away from their daughter.
 
An Amerigroup caseworker, who had a child with mental health issues, reached out to the family. She knew firsthand what they were going through. She participated in meetings with the girl's doctors and treatment specialists and even attended meetings at the girl's school to advocate for the best interests of the family.
 
And while some behavioral health intervention services are not typically available from children's health insurance programs, Amerigroup made arrangements with a local organization to provide the services she needed.  
 
A year later, the teen is on a better path. She's been able to receive care locally and stay in her home, rather than in an out-of-state facility. She also recently attended a camp where kids learn skills to help control their diabetes.
 

Amerigroup Case Manager Makes Life Saving Call for Member

Seventy-three-year-old Sandy of Sioux City believes she is alive today because of a decision her Amerigroup Iowa community-based case manager, Kara, made to call 911 when Kara recognized that she was having a stroke.
 
Sandy has monthly calls and quarterly in-person visits with Kara to check on her overall health and discuss numerous conditions she manages. But there was nothing normal about their monthly call in July 2018. Immediately, Kara noticed that Sandy's speech was slurred, her cognition was impaired, and she had difficulty answering Kara's basic questions.
 
Recognizing that Sandy may be having a stroke, Kara asked her if she would push her medical alert bracelet to alert emergency services. She said she didn't want to. Sandy also declined to call 911 herself. Kara finally convinced her to let her call 911 on her behalf.
 
Paramedics soon arrived and transported Sandy to the hospital. Her symptoms were soon diagnosed as a Transient Ischemic Attack (TIA), what sometimes called a "mini stroke". But there is nothing mini about it. If Sandy or anyone else who experiences a TIA doesn't receive care within an hour, the lasting impact can be serious.
 
Sandy spent six hours at the hospital before she was released, speaking with Kara during her stay and two days later in a follow-up phone call. Less than two weeks later, Sandy called Kara to thank her, her supervisors, and those involved with treating her, noting that she felt like Amerigroup saved her life.
 
Sandy's experience with a TIA makes her more prone to having a major stroke, prompting Kara to use a recent monthly call to educate her about her risk and empower her to act FAST if and when symptoms arise. A simple acronym, FAST helps those at risk for a stroke recognize the symptoms and remember to act quickly:
 
  • Facial drooping
  • Arm weakness
  • Speech difficulties
  • Time to call emergency services
 
Kara plans to continue using their phone calls and in-person meetings to educate Sandy and support her in managing her overall health.
 

Care Coordination Helps Improve Health of Des Moines Man


Click the video above to view Gerry's story.
 
A UnitedHealthcare member has improved his outlook on life with the coordination of services provided to him under the IA Health Link program.
 
Gerry Peterson, 62, of Des Moines was born with a hole in his heart. He says he lived a pretty normal life as a child, but other health issues developed as he grew older.
 
He credits his UHC case manager with helping him live a healthy life.
 

IA Health Link Member Named 'Smile Ambassador'


Click the video above to view Madison's story.

Madison Sander-Maurer of Lawton, a 16-year-old IA Health Link member who is legally blind and has experienced brain trauma, has made significant strides in her communication skills with the help of her UnitedHealthcare (UHC) case manager.
 
UHC Case Manager Sarah Barger worked closely with Madison's family to not only evaluate her medical needs but identify opportunities to participate in valuable respite programs that provide temporary care and enrichment activities for those living with disabilities. Through those efforts, Madison enrolled and attended a number of weekend and week-long camps at Camp High Hopes in Sioux City where she participated in a variety of specialized programs including canoeing, archery, and nature exploration. As a result, she made significant strides in her communication skills and made a number of new friends in the process.
 
After completing these programs, the organization named Madison their Camp High Hopes Youth Smile Ambassador for 2018. In that capacity, she represents the program in public events and activities across the state.
 
During this time, Madison has been able to receive meaningful therapeutic programs and additional opportunities to live a more active, healthier life.
 

Amerigroup's Care Team Helps Improve Quality of Life for Member

With care coordination from Amerigroup Iowa, the future is looking bright for a Medicaid member from northwest Iowa.
 
Amerigroup's care team helped Jasmine Garcia, a young, expectant mother from Le Mars, receive her high school diploma, and found an opportunity for her to begin working toward a medical career, all before her baby was born.
 
An Amerigroup case manager, who is a trained obstetrics nurse, was with Jasmine along her journey to provide education and guidance on how to have a healthy pregnancy. When Jasmine asked her case manager about job training resources, an employment outreach specialist on Amerigroup's care team met with Jasmine to discuss options. That's when the care team learned that Jasmine had dropped out of high school to help with basic needs around the house. The care team also learned that Jasmine had a career goal to work in health care.
 
Knowing that information, Amerigroup's care team went to work. An Amerigroup employment specialist found a Job Corps program in Denison. Jasmine could live in a college dorm, finish high school and have the opportunity to enter the medical profession as a certified nurse's aide or pharmacy technician. There would be no cost to enroll and no cost for room and board. If she applied for the program, Amerigroup's employment specialist told Jasmine she'd drive to Denison to join her for a campus tour.
 
Last fall, Jasmine got her high school diploma and is now working toward a nurse's aide certification, with a new career goal of becoming a registered nurse one day. She gave birth to a healthy baby boy in January.
 

Timely Intervention Brings Siblings Together in a Safe Home

A brother and sister who were removed from their home due to unhealthy living conditions and abuse, will soon be reunited in a new safe environment thanks to the work and persistence of an Amerigroup Community-Based Case Manager.
 
Sixteen-year-old Michael and nine-year-old Samantha (note: their names have been changed for this story) were living with a single parent who was not providing them with healthy living conditions. They were frequently dirty, and it wasn't unusual to find cockroaches alongside their medications. Their situation reached a breaking point in December 2016 when there was a physical abuse incident which resulted in both children being removed from the home.
 
Unfortunately, Michael and Samantha were split up into a series of separate, constantly changing living conditions. They needed an advocate. And that's where Amerigroup Community-Based Case Manager Dena came into play.
 
Dena jumped headfirst into trying to improve the situation for Michael and Samantha. Spending significant amounts of time working directly with them, Dena knew that what mattered most to the siblings was being able to live together again. Dena dedicated herself to finding safe housing where the two could be together and flourish. She spoke with foster families and toured potential homes for Michael and Samantha.
 
Working with the Iowa Department of Human Services, getting updates from the social worker about numerous court hearings regarding their custody and status, and advocating for funding, Dena achieved an initial victory: securing Michael a place in a home run by a charitable organization, which enabled occasional opportunities for his sister to visit him.
 
But the work was only half finished. Knowing how important it was to the children to be together full-time, Dena persisted in her efforts to find a way for the siblings to live in the same house. Through her hard work and countless hours spent advocating for them, Dena succeeded in making arrangements for them to be more permanently reunited. This year, Samantha will join Michael in his home. They will live safely with two other children who reside there, and be taught skills for independence, such as cooking, cleaning, medication and money management. But most importantly to them, they will be together.
 

Amerigroup Caseworker Helps Find Solutions for Expectant Mother

Iowa's Managed Care Medicaid system gave an expectant mother the support she needed to make tough medical and financial decisions for her family.
 
The expectant mother was thrilled when she found out she was expecting twins. But her excitement turned to anxiety when the 23-year old was diagnosed with a condition where both babies shared the same amniotic sac and the same placenta -- a very high risk situation.
 
Additionally, both babies were diagnosed with major cardiac defects that would require surgery soon after delivery. Doctors recommended the twins undergo surgery at a hospital in Michigan, 12 hours away.
 
For a young couple with limited financial means, this presented a major hardship. An Amerigroup caseworker helped the couple find a cardiac surgeon much closer to home where family and friends would be able to visit and provide much-needed support.
 
The twins were delivered by C-section and were taken into surgery soon after. Both are doing well today.

 

Amerigroup Helps Member with Home Modification

An Amerigroup (AGP) Caseworker took the lead on helping install a new sidewalk at the home of a southeast Iowa member with cerebral palsy.

The member's home didn't have a sidewalk leading up to the front door. The boy's wheelchair was always getting stuck in the mud and just getting out of the house and off to school was a challenge.

There was a significant safety issue as well. If the member suffered a seizure and needed to be taken to the emergency room, EMS workers may have had a difficult time administering to him quickly.

The AGP Caseworker recognized these problems and worked to find a subcontractor to install a simple sidewalk outside the home. This work was completed in time for the start of the school year.

 

Amerigroup Works to Restore Medicaid Coverage, Services for IA Health Link Member

Every day a lot of behind-the-scenes work occurs in the IA Health Link program. It often goes unnoticed and unrecognized, but it's the kind of work that is making a big difference in the lives of nearly 700,000 Iowans across the state.
 
Take the recent case of an Amerigroup (AGP) member from Altoona, whose chronic illnesses require much care coordination and a high level of specialized services. Amerigroup case managers spent several months lining up the right care and support for him.
 
Due to a hospitalization that lasted several months last year, he no longer met the federal and state requirements to be eligible for Home- and Community-Based Services. Without this waiver, he didn't meet the financial requirements for traditional Medicaid. After temporary funding from other sources ran out, he would be uninsured. If the eligibility issue could not be resolved, his stay at a facility that specializes in services for people with his condition would be at risk. In fact, a date was set when the man would be discharged from this stable environment to his guardian, who would not be able to provide the level of care and support needed to maintain a good quality of life.
 
The AGP clinical staff and case managers anticipated the risk to the patient and quickly took the lead to solve this complex situation. In the course of a couple days, AGP coordinated with Iowa Department of Human Services, Iowa Medicaid Enterprise, county officials and the facility to solve the problem. The focus was always on the patient's needs, ensuring all stakeholders in the Medicaid system were coming together on his behalf.
 
The teamwork paid off, the AGP member got their Medicaid coverage restored. As a result, the member would continue to receive the necessary services without any interruption. The member's guardian was thankful and told AGP that she was afraid of what might have happened were it not for the team's intervention.
 

Care Coordination Helps IA Health Link Member Live Independently

A UnitedHealthcare (UHC) member is able to live independently, maintain her mental and physical health, and has improved her outlook on life with the coordination of services provided to her under managed care.

The 60-year-old struggled with her physical and mental health for much of her life. Just when she felt that she was back in control of her life and on a path forward, an accident caused severe frostbite on both of her hands, resulting in the amputation of nine fingers and the need for serious medical care.

Because she needed to be close to her doctors in Iowa City and required daily assistance learning how to adjust to her new disability, she was required to stay in a skilled nursing facility. Her limited income was dedicated primarily to paying her obligation at the facility. When she was physically ready to move back into an apartment by herself, she couldn't save up money to apply for apartments, pay a security deposit, or cover the first month of rent. She also did not have the community supports necessary to help her adjust to life living on her own - she had very few personal belongings and no friends or family in the area. She was stuck.

As part of her benefits with UHC, she was assigned a case manager, who called in support from a UHC Housing Navigator.

Together, the member and her housing navigator worked to find affordable housing options that would also meet her physical and mental health needs. The member needed to have access to transportation so that she could continue her medical care; she also needed to be connected to organizations that could help her access food, furnish her apartment, and provide social support. The UHC Navigator was able to connect with multiple community-based organizations and social service agencies that, combined, ensured she had the support she needed to leave the nursing facility.

Through the coordination of services provided by managed care, she is now able to live independently - improving her outlook on life, maintaining her mental and physical health, and giving her the tools she needs to continue moving forward.

 

Care Coordination Helps IA Health Link Member Get Healthy, Find Housing

By the time a 53-year-old Amerigroup (AGP) member had entered treatment for methamphetamine addiction, she had become homeless and had been living in a homeless camp in central Iowa, suffering from deteriorating health. In addition to her struggles with mental health, she was dealing with untreated asthma, a thyroid disorder, and warped toes that needed surgery.

An AGP Outreach Specialist met with the member and developed a comprehensive plan to help not only improve her health but also reclaim other parts of her life. The AGP Outreach Specialist first helped to enroll the member in an alcohol and drug treatment program. Even while the member was in the middle of that program, the AGP Outreach Specialist was already planning the next steps to reintroduce the member to daily life once she completed the program. The AGP Outreach Specialist ensured that she would have support for her various challenges, including her physical health, her addiction, and her homelessness. The support included primary care services, sponsorships through Narcotics Anonymous, as well as Integrated Health Home and intensive outpatient services.

Today, the member is thankful to be alive and has expressed appreciation for her outreach specialist's guidance and encouragement. The member is in better physical health than she has been in years and is in ongoing recovery for her mental health and addiction challenges. Additionally, she has secured safe and stable housing and has reconnected with family. She says she's happy to have found purpose in her life.

This AGP member's story is a reminder that supporting long-term health requires a team approach to address both immediate medical needs and the environmental factors that influence mental and physical health.

 

IA Health Link Member Realizes Her Potential

 
A UnitedHealthcare member is now living as independently as possible and is active in her community. However, her journey to get here was long and required careful and coordinated work between UnitedHealthcare's case managers and dedicated health care providers. 
  
After being diagnosed with dementia, this member lived in a locked dementia unit for several years until a doctor reevaluated her psychological medication. The results were positive. Her condition drastically improved. After working with physical therapy and occupational therapy providers, she graduated from the dementia unit to a nursing home. 
  
She made great strides and wanted to live on her own. Her UnitedHealthcare case manager recognized the potential to make this happen and began the process to help transition the member to an assisted-living apartment. Her care providers, social services and her family discussed removing the barriers to living on her own. Her case manager helped her apply for elderly waiver services, and started preparing her to move from the nursing home to her own assisted-living apartment. 
  
Through regular and ongoing communications, her case manager was able to identify and address her needs to help make the transition successful. Her case manager worked with her and her family to find an apartment, offered counseling services and obtained a cell phone. Her case manager also secured home items such as furniture, linens and toiletries. The UnitedHealthcare case manager continues to support this member by going to the food pantry to make sure she has healthy food in her home and regularly checks on her health. 
  
Today, this member is fully adjusted in her new home, walks three miles every morning with her neighbor, and takes care of her adopted cat named Oreo. She also leads exercise groups at her assisted-living apartment facility, and often participates and leads Bible study programs. She is happily living in a safe space where she can manage her health. 

 

IA Health Link Member Gains Independence, Culinary Career

 
Amerigroup has been closely working with a 33-year-old Des Moines area member who qualifies for Medicaid Long Term Services and Supports through Iowa's Brain Injury waiver. This member suffered a brain injury during an accident and was living in an out-of- state facility when he became an Amerigroup member. He was receiving assistance for anxiety disorder and other health issues. 
  
After he joined Amerigroup, their care management team began talking to him and assessing his situation. He shared his desire to move back home to Iowa, live independently and pursue a career in culinary arts. The Amerigroup care management team was able to identify supports that would enable him to achieve his goals.  
 
Through a program called Money Follows the Person (MFP), the Amerigroup care management team was able to transition him from the out-of- state facility to a group home in Pleasant Hill, IA. The care management team then helped him secure in-home supports that enabled him to move out of the group home and into his own independent living space in Des Moines, IA. 
  
Amerigroup's employment support team also got involved to help him pursue a career in culinary arts by helping him secure a work skills certificate from Iowa Workforce Development. This member has overcome tremendous hurdles and achieved amazing successes. He has transitioned out of hospital-style living to independent living. He is on his way to achieving his goal of becoming a productive member of society through a new culinary career.
 

Cedar Falls Man Gets Much Needed Services

 
Good health is often taken for granted. The reality is that many Iowans face barriers that make good health elusive.   
  
Amerigroup recently helped connect a 69-year old man from Cedar Falls to much needed services. He was facing numerous barriers to good health, including Chronic Obstructive Pulmonary Disease (COPD), neuropathy and osteoarthritis. But, these weren't the most significant problems he faced. 
  
When Amerigroup case managers met this man four months ago, he was anemic, underweight and malnourished. Between the rent for his apartment, utilities and other bills, there wasn't much left for food. If there was ever any money left, he would purchase meal replacement shakes. As a result, the member weighed just 131 pounds. The lack of consistent quality nutrition undoubtedly played a part in numerous digestive and gastrointestinal problems that required frequent hospitalization. 
  
His Amerigroup caseworker arranged to have his nutritional needs met under a Medicaid waiver for the elderly and educated the member on the importance of visiting his doctor monthly. In addition, by coordinating with the home health aides, the Amerigroup caseworker was able to help the man get on a path to better health. 
  
Today, the member has made it back to a healthy weight and reports he is feeling much better. He's attending his medical appointments regularly, and he's managed to stay out of the hospital. The support he's received under Medicaid Long Term Services and Supports has enabled  him to live independently.