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Update on DOJ Investigation
Earlier this year, the US Department of Justice (DOJ) told Iowa it was violating the rights of people with disabilities by giving them too few options to live in the community. Instead, the DOJ said Iowa was over-institutionalizing people. They wrote a report telling the state about these problems, and now the state must work with them to develop a plan on how to address these issues. That plan probably won't be ready until this summer or fall, but we the new Iowa Department of Health and Human Services to give you an update.
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Iowa DHS Update on DOJ Investigation into State Resource Centers From Director Kelly Garcia
The U.S. Department of Justice (DOJ) released a report on their investigation into the Glenwood and Woodward resource centers in December 2021. The report found that Iowa relied heavily on institutionalization because the state lacks a full array of services to care for people with intellectual and developmental disabilities (IDD) in their home communities.
The investigation began in late 2019 and focused on two main areas; facility needs to adequately care for institutionalized residents, and community supports to care for individuals in the community.
The report’s findings were significant, but not surprising. Department of Human Services (DHS) leadership has worked closely with the DOJ over the last two years to correct deficiencies and work out solutions to problems identified during the investigation. The department has also kept an open dialogue with residents, guardians, advocates, and policymakers to keep them informed. DHS leadership also held discussions with legislators to discuss how the state will finance improvements to the resource centers to address the DOJ’s findings.
The Governor’s FY2023 budget recommendation includes funding to address facility needs related to the first part of the investigation. DHS is in ongoing negotiations with DOJ and is close to having a finalized consent decree addressing facility improvements.
The budget includes an increase in general funds for both state resource centers and the flexibility to use carry forward funds. The Governor’s budget recommendation included a general fund increase for Glenwood Resource Center in the amount of $1,485,866 and for Woodward Resource Center in the amount of $1,171,357 and takes advantage of the enhanced Federal Medical Assistance Percentage (FMAP) due to the ongoing federal public health emergency (PHE). DHS anticipates sufficient funds to cover the portion of the work we can complete in one fiscal year, acknowledging that additional, ongoing investment in our facilities will need to occur.
Beginning in 2020, DHS began holding focused discussions with residents and guardians about the best setting in which to provide care for residents of our state resource centers. If a resident can receive quality care in their own community rather than in an institutional setting, that should be a goal for that resident. However, many parts of Iowa lack these community supports, so the state has over relied on institutionalization.
Although we do not yet have a draft consent decree from DOJ on the second part of the investigation, we know it will require a large investment in community integration.
Director Garcia continues to discuss the importance of ensuring a broad continuum of supports for Iowans with intellectual and developmental disabilities. To move forward in this space, we must balance resource investment, building high-caliber services at the state resource centers that can support community living, while targeting investment in community capacity. This investment must start with bolstering the workforce and build from there to stabilize and significantly increase community capacity to lessen Iowa’s reliance on institutionalization.
The DOJ investigation will require Iowa to invest in our facilities, while also making a significant and ongoing investment in the community. These funding needs, and discussions around them, will continue for years to come. DHS is proud of the work we’ve already done and committed to continued progress. We are also thankful for our tremendous team at the resource centers who have dedicated their lives to serving Iowans with disabilities and who have remained flexible and up to the challenge of constant shifting over the last year. We are equally thankful for our team of social workers, Medicaid team members and other team members who work to support community placement and ensure strong oversight.
And, finally, to the guardians, loved ones, and self-advocates who have helped us shape this north star vision of what Iowa can be – we couldn’t do this work without you. There is more to come and we remain deeply grateful for the feedback, constructive criticism and partnership. Our work is better because of you!
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The full DOJ report can be viewed here.
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You can view all of DHS’ public documents on the DOJ investigation here.
What This Means To You:
- Iowa has too many people living in institutions.
- Iowa needs to give people more choices: where they want to live, where they want to work, who they want to support them.
- To give Iowans a choice, the state needs to put money and support into community providers.
- The state will need to make big changes to serve people better, so now is your chance to help create the system you want!
- Stay tuned for learn how you can help (but the Action Alerts above are a great start!)
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