Waterloo-Cedar Falls Courier. June 29, 2019
’Visionary’ leader needed to fix DHS
The Iowa Department of Human Services may be the most difficult state agency to manage.
It oversees Medicaid and Hawki (Healthy and Well Kids in Iowa), mental health facilities, child care licensing, child protection, foster care, adoptions, juvenile justice and placement, food assistance, welfare, elderly programs, nursing facility care, adult abuse, developmental disabilities, runaways and refugees.
Amid seemingly endless stories of things gone awry, DHS director Jerry Foxhoven resigned, prompted by Gov. Kim Reynolds’ decision “to go in a new direction,” according to her spokesperson. She is “assembling a new team . to carry out her vision.”
Reynolds hasn’t shared her “vision” or reasons for removing Foxhoven. She appointed Iowa Department of Public Health Director Gerd Clabaugh as interim director.
Foxhoven, a former Drake University law professor well regarded on child welfare issues, was appointed two years ago. He led a 2013 task force looking into the use of isolation cells at the state’s Toledo school for juvenile girls. Then-Gov. Terry Branstad closed the facility.
DHS has a $6.5 billion budget - $5 billion split between state and federal governments for the low-income Medicaid health program - that nearly rivals Iowa’s overall $7.6 billion budget.
Under Branstad and Reynolds, according to the Des Moines Register, the DHS “has lost 1,058 workers from its 4,998 in 2011,” including 558 field operations workers, comprising social workers and income maintenance employees.
Branstad unilaterally privatized Medicaid in 2015, leading to a revolving door of management companies, alleged savings and complaints from providers and clients about payments and services delayed and/or withheld.
UnitedHealthcare - one of four original companies (one left before implementation), reduced to two - is out. Iowa Total Care, a Centene subsidiary, replaces it. UnitedHealthcare served 425,000, doubling its clientele after AmeriHealth Caritas left last year. Both cited huge financial losses.
Reynolds maintained UnitedHealthcare bolted because of contract provisions on quality standards. UnitedHealthcare claimed it meets those marks with its Medicaid operations in 18 other states, but was losing more than $100 million in Iowa annually.
Something doesn’t add up.
The Des Moines Register, citing the nonpartisan Legislative Services Agency, reported that since Medicaid’s first full year of privatization in fiscal 2017 per-member costs have risen an average of 4.4 percent annually compared to a 1.5 percent average during the prior six years of state management.
The DHS also came under scrutiny after the starvation deaths of two teens - Natalie Finn of West Des Moines in October 2016 and Sabrina Ray of Perry - adopted out of foster care and home schooled.
The consulting Child Welfare Group reported abuse investigations subsequently increased by 43 percent, adding that mandatory reporters - educators and others in caretaker roles - had been frustrated by the failure of authorities to investigate complaints.
The report also cited DHS staffers concerned about foster home care, including many families “unable or unwilling to provide the quality of care that children require.”
That’s not an isolated predicament.
The nonpartisan Every Child Matters found one of six Iowa children lives in poverty, while one in four receives public assistance.
The DHS also is facing a federal class-action lawsuit filed by Disability Rights Iowa and Children’s Rights Inc. against the Eldora Boys State Training School, claiming its staff subjected teens to restraints and isolation.
That comes as two Iowa young women - transferred from the closed Toledo facility to one in Wisconsin for troubled girls - settled for $1.95 million each after alleging severe abuse, including isolation for 22 hours a day and physical mistreatment. They are suing Iowa, too. A trial is set for May.
Branstad not only unilaterally closed the Toledo facility, but the Independence Mental Health Institute pediatric unit and the Clarinda and Mount Pleasant mental health institutes.
Once a mental health treatment leader, Iowa was left with two state mental health beds per 100,000 residents. The national average is 12. Mental health in Iowa ranked 47th for psychiatrists, 44th for mental health workforce availability and 51st (including the District of Columbia) for the ratio of state psychiatric beds to residents.
“We’re better than the average bear,” Foxhoven contended. The DHS cited combined public and private unit crisis beds of 24 per 100,000 residents, yet a Psychiatric Times study recommended 40-60.
The Legislature added six regional “access centers” in 2018 for people experiencing mental health crises who don’t need hospitalization.
The Republican mantra of “smaller, smarter government” has boosted the state economy, although mainly in the metroplexes. But the “smarter” part is lacking when many needy residents are left behind, requiring DHS assistance and oversight.
Branstad’s unilateral decisions left a mess behind. In its wake, Reynolds needs a visionary DHS leader and a willing Legislature to grapple with many complex issues. Lives literally depend on it.
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Sioux City Journal. June 30, 2019
If it’s apolitical, ’Salute to America’ should be fun
July 4 is a national day of celebration by Americans about America. As far as we’re concerned, the bigger the celebration, the better.
To this end, we welcome plans by President Trump for an enlarged “Salute to America” Independence Day party in Washington, D.C., this year. We take no issue with plans for inclusion of more people, more entertainment, more fireworks and more opportunities for demonstration of patriotism.
We have read and heard criticisms President Trump is hijacking the traditional July 4 capital festivities for personal and political reasons. The biggest focus of critics is his plan to make an early evening speech at the Lincoln Memorial.
So long as President Trump, or any sitting president, makes an apolitical address focused properly on shared love of country on America’s birthday, we will not quarrel with the idea of a presidential Fourth of July speech.
If, on the other hand, this or any president stains the national celebration with an improper infusion of partisan politics, however, small, we will be among the first to share outrage.
Finally, a note of caution as we in Siouxland join all Americans in entering the stretch run to July 4.
Between highway accidents, fireworks-related injuries and deaths, drownings, boating accidents and heat-related illnesses, the Fourth of July is, unfortunately, a dangerous time in our country.
The National Safety Council estimates nearly 600 people may die and more than 64,000 may be injured in traffic accidents during the long July 4 weekend. According to the Consumer Product Safety Commission, five people were killed and more than 9,000 were injured in fireworks-related incidents on and near July 4 last year.
Local and area quality of life will be on full display this week as we enjoy activities tied to the Fourth of July holiday weekend.
By all means, take full advantage of a plentiful, diverse mixture of entertainment, cultural, recreational and leisure opportunities in observance of our nation’s 243rd birthday. We all should.
Just don’t abandon common sense, courtesy (for those who include fireworks in their celebration, do so within the law and with respect for neighbors) and safety.
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Fort Dodge Messenger. June 30, 2019
Strengthening rural Iowa
Gov. Reynolds’ Empower Rural Iowa Initiative deserves support
Iowa is a great place to live. Its economy is strong and the quality of life it affords has few equals anywhere in the nation.
Even so, some of our state’s rural communities aren’t fully sharing the generally upbeat prognosis for the Hawkeye State’s future. Gov. Kim Reynolds is determined that as Iowa continues to thrive in the years ahead no part of the state will be forgotten. That’s why she launched the Empower Rural Iowa Initiative in July 2018. Last year task forces that included a wide array of community stakeholders were appointed by the governor. They developed preliminary recommendations for the governor and the Legislature.
In her Condition of the State Address in January, Reynolds asked the Legislature to provide support for this innovative undertaking. The lawmakers passed the Empower Rural Iowa Act, which the governor signed on May 20.
“We are one step closer to achieving growth and prosperity in every single corner of our state,” said Reynolds at the signing ceremony. “We’re connecting, investing and growing our rural communities through this collaborative initiative. This new law will not only continue the positive momentum taking place across rural Iowa, but strengthen our way of life to keep our young people here and attract others to our state.”
On June 27, Reynolds announced the appointment of Liesel Seabert as the Rural Community Revitalization Program manager. Seabert has been given the challenge of helping turn Reynolds’ vision for the Empower Rural Iowa Initiative into a success story.
As a result of recommendations developed by the task forces that began working in 2018, the initial priorities for Empower Rural Iowa will be:
. Workforce development,
. Addressing workforce housing needs,
. Broadband connectivity and
. Evolving the next generation of community leaders.
“I am honored to work on Iowans’ behalf in developing creative strategies to strengthen our rural communities,” Seabert said on accepting her new post.
The Messenger welcomes her to this role. We also commend the governor for developing and championing this superb investment in the future of the Hawkeye State’s rural communities. The Empower Rural Iowa Initiative demonstrates that as our state builds for the future the governor and her team are determined that all Iowans will benefit from tomorrow’s opportunities - no matter where they happen to live.
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