Welcome to Iowa, the Care Less State
A former Iowan now living out of state emailed me about a recent column I had written titled "Iowans Agree – Older Iowans Are Not a Priority."
Her question – “What’s wrong with Iowa? Doesn’t it care anymore?”
My answer: “It still cares, but it cares less.”
The column highlighted then-recent news: that Iowa’s Long-Term Care Ombudsman’s Office, the office charged with the responsibility to protect the health, safety and rights of Iowans in nursing facilities, had told their eight regional staff that due to budget cuts, they could no longer travel to investigate complaints and advocate for residents and their families.
The travel stoppage sparked media attention across the state. Several print and television outlets commented on the cuts and made the case that action should be taken to get these ombudsmen back on the road to do the important work they are expected to do.
That hasn’t happened. The ombudsmen are still tethered to their desks. Older Iowans and Iowans with disabilities are being poorly treated and inadequately served. To make matters worse, the staffing of the office is being gutted to further respond to budget cuts. An office of 16 a few months ago is now down to 12. Recent losses, some by voluntary departures and some by position elimination and termination of employees, include:
The coordinator of volunteers across the state who visit nursing facilities and talk to residents about their concerns.The program manager who assisted Iowans with concerns about or disagreements with decisions made by the managed care organizations that administer the Medicaid program.
The discharge specialist position that dealt with residents and facility management when a facility discharged a resident inappropriately, or when a facility closed.The legislative liaison for the office who addressed policy issues raised by the legislature and who provided the voice of Iowans in nursing facilities to elected leaders.
Many might not view the cuts of positions in state government as bad news. But this IS bad news, and Iowans should be disturbed by it.
Iowans should also be disturbed by this – the budget proposal submitted by the Office of the Long-Term Care Ombudsman for the next fiscal year doesn’t seek funding to reinstate the travel or the positions that have been eliminated.
And why doesn’t it? Because the independence that the office is supposed to have, independence that is called for in federal law and regulations, doesn’t exist.
If it did exist, the director of the office would be submitting a candid budget proposal. The director would say “Here’s what we have and here’s what we really need to do the job Iowans expect us to do.” That person would be publicly advocating for the resources requested, and explaining the implications of continuing to limp along with what’s currently provided.
Sadly, the independence of this office is an illusion. The reality is that the director of the office reports through a chain of command that leads to the Governor. If the Governor wants state agency directors to submit budget proposals that maintain the status quo, that’s what they do. To do otherwise would be to find oneself out of a job.
Bottom line – Iowans deserve better from the Office of the Long-Term Care Ombudsman. Aging Iowans and Iowans with disabilities in nursing facilities deserve to be well served, not minimally served.
I ask two things of elected leaders:
Find the money right away to get the eight regional ombudsmen back on the road. The state has money. It found millions for Apple to locate here. It finds millions to defend lawsuits or to pay damages from lawsuits. It can find the approximately $60,000 needed to fund travel costs.Reject the proposed budget submitted by the Office of the Long-Term Care Ombudsman. Rather than looking at what’s being asked for, look at what’s needed. Fund the office at a level that allows it to serve Iowans the way they deserve to be served.
And one more thing. Start caring more, and about the right things. If your caring continues to be placed primarily on cutting taxes, then the result will be that we’ll live in a state known for its cheapness, not its goodness.
John Hale and his wife, Terri, own The Hale Group, an Ankeny-based consulting, advocacy and communication firm that encourages thought and action on aging and caregiving issues.