On Dec. 8, 2021, the U.S. Department of Justice Civil Rights Division released its investigation of the Glenwood Resource Center (GRC) — recently announced by Iowa Gov. Kim Reynolds to be closed in 2024 — and Woodward Resource Center (WRC). It is not an easy read.
The report states, “After an extensive investigation, the United States Department of Justice (DOJ) concludes there is reasonable cause to believe that the State of Iowa violates Title II of the Americans with Disabilities Act (ADA),” and it does so “by failing to provide services to people with intellectual/developmental disabilities (IDD) in the most integrated setting appropriate to their needs.”
This is not the first time the DOJ has investigated the conditions and practices at GRC and WRC. In 2002 the DOJ found that “conditions at Glenwood and Woodward were constitutionally deficient. In 2004, DOJ and Iowa entered a settlement agreement to guide reforms at Glenwood and Woodward.
The agreement also required Iowa to take several actions to ‘encourage and assist people to move to the most integrated settings’ appropriate (2004 Agreement). Iowa came into compliance with the 2004 Agreement, and it terminated in 2010.”
In late 2019, Iowa’s Department of Human Services (DHS) was notified of the DOJ’s intent to investigate Glenwood and Woodward again. Therefore, it is no surprise that the 2021 report stated that “these violations are pursuant to a pattern or practice of resistance to the full enjoyment of rights protected by the Fourteenth Amendment to the United States Constitution.”
“Although the State has known for years that its community service system is insufficient, it has failed to meaningfully assess and correct the deficiencies.” The State has “failed to meaningfully invest in community services.”
Since Iowa’s motto is “Our liberties we prize, and our rights we will maintain,” can we find within ourselves the same energy we have previously used to rail against other perceived or real slights or attacks on our rights to rail now against our documented and acknowledged historical “resistance to the full enjoyment of rights” for Iowans with IDD?
Sit with that a moment. “Resistance” to a portion of Iowans experiencing “the full enjoyment of rights.” Denying, rejecting, dismissing rights.
While the state acknowledges community options are absent, it “lacks an effective strategy to identify or develop individualized community options.”
Where services are available, there is no strategy to match individuals to effective community options, effectively transition them or provide meaningful oversight once the match is made.
“The State does not have processes to ensure consistent monitoring of people in transition, so as to confirm that they are safe and receiving appropriate services.” Not only is the process lacking, but the case manager completing the forms used for follow-up visits might not have “sufficient expertise in the needs of people with IDD,” that is, not qualified to be completing the inadequate and insufficient forms.
Furthermore, Iowa’s “provider oversight process does not include regular in-person visits to these homes, and the State does not otherwise have a system to oversee reliably the quality of community-based services.”
Iowa does not offer the needed continuum of services or adequately know the current gaps in its services. Case managers potentially lack the expertise to assess the needed care. Transition planning is ineffective. There is no process to ensure the quality of community-based services, and proper oversight is lacking. Add to that, waivers may be unavailable, and wait lists for placement are long.
Iowa has known of these problems for years and not taken the appropriate steps to ensure people with IDD were not denied their rights. Funding remained biased toward institutional care rather than effective, quality community care — which in the long run will cost taxpayers less.
The gaps in care can be devastating to the protected persons and their families and may result in the protected person’s community placement abruptly shifting to an emergency room or prison.
You’ve got a lot of work to do over many years, Iowa.
Yes, you’ve been working on it and making improvements, but you’re a long distance from where you need to be, Iowa.
The people who work for and support Iowans with IDD provide essential services. I am continually thankful for what they do for my protected-person and me. The direct-care workers and their supervisors, directors and administrators, the social workers, medical staff, psychological and psychiatric staff and others — all are doing unbelievable and needed work.
Everyone from the food-prep departments to accounting are serving some of Iowa’s most vulnerable residents. But they must be provided the resources, funding, pay and benefits, expertise, training and development, engagement, staffing, leadership and support they need to do their jobs effectively and safely.
Direct-care workers cannot change the services that waivers will cover. They cannot change the state’s oversight process, the funding model that favors institutionalization, the pay rates and benefits, the staff-training processes and other ongoing deficiencies in Iowa’s system of care and support for people with IDD.
Leaders within the Iowa DHS, legislators, voters, organizations that support and advocate for persons with IDD and more need to move Iowa past acknowledgement of the issues and onward to effective implementation and oversight of the needed spectrum of community services.
This is a major cultural change for WRC and Iowa. Significant changes and actions are required to move Iowa from our past negligence of community care toward an effective infrastructure of safe and ADA-compliant community care with proper oversight.
What will it be, state government and Iowa voters? What will Iowa value, fund and prioritize? Rights and liberties for all, or is our state motto more selective?
Laura Stebbins of Perry is the guardian of a resident at the WRC.
