Sunday, March 22, 2009

Iowa disability agencies clash over reporting abuse cases

From the Des Moines Register in Iowa:

Three state agency heads clashed March 20 over how aggressive the state should be in asking Iowans to report suspected cases of abuse involving disabled adults.

The agencies headed by those men are charged with protecting the mentally retarded and other vulnerable Iowans from abuse, neglect and discrimination.

The debate occurred March 20 at a meeting of the task force that was formed last month by Gov. Chet Culver in response to the Atalissa scandal involving Henry's Turkey Service. For most of the past 34 years, Henry's paid dozens of mentally retarded men as little as 44 cents an hour, plus room and board, to work in a West Liberty processing plant.

The men were removed last month from an Atalissa bunkhouse where they lived until being placed in state protective custody. State officials have since determined some of the men were malnourished and had significant dental issues.

The task force is looking at ways to close the gaps in Iowa's regulatory system and strengthen state laws dealing with unlicensed care centers that house the disabled.

All of the task force members have agreed that the state needs to encourage Iowans to report unlicensed care centers and cases of suspected abuse and neglect.

But Gene Gessow, the director of the Iowa Department of Human Services, told his fellow task force members Friday that he has concerns about where that may lead.

He pointed out that the unlicensed care facilities, while operating illegally, might not be subjecting residents to abuse or neglect. Also, he said, some disabled adults are independent and the state must be careful not to encourage Iowans to simply report where disabled people are living.

"The existence of dependency is not a reportable issue, and we don't want to make it a reportable issue," he said.

Gessow said he also is concerned that efforts to encourage reporting could cause Iowans to believe that just because people are disabled they also are dependent and warrant extra attention as to their welfare.

"I don't want to set the tone that you should always take a second look at a disabled person and maybe make a call just to be safe because by definition a disabled person is dependent and potentially at risk," Gessow said.

Iowa Department of Inspections and Appeals Director Dean Lerner argued that the state must encourage Iowans to report any suspicions, even if a subsequent investigation by the state shows those concerns to be unfounded.

"If you know about somebody who is being abused in the community or in a setting that is unlicensed, we damn well want to know about it," he said. "We should take the responsibility of separating the wheat from the chaff, and we should make those determinations."

Ralph Rosenberg of the Iowa Civil Rights Commission agreed and said there's nothing wrong with encouraging people to report their concerns to trained workers who will then make a determination as to whether there is a problem with abuse, neglect or licensing.

"I really think that's what we want," he said.

The Department of Inspections and Appeals investigates abuse and neglect in state-licensed care facilities, while the Department of Human Services investigates abuse in all other settings, such as unlicensed group homes. The Civil Rights Commission protects all Iowans, including dependent adults, from discrimination in housing, employment and other matters.

Task force members also expressed concern with the state's worsening budget situation and the impact that will have on its recommendations for improving Iowa's protection of mentally retarded adults.

Jim Larew, the governor's legal counsel, called the budget situation an "800-pound gorilla" that threatens services already being provided to Iowans. He said the task force should try to identify new sources of revenue to pay for some of the planned recommendations.

"We've got to be realistic about that," he said. "I think we're determined not to have this be a task force that issues a report that ends up on a bookshelf somewhere collecting dust."

Task force chairman John McCalley agreed. "We don't want to surprise the governor or the general assembly with a report that has a big price tag," he said.

The task force has to resolve some issues, but is expected to agree on a series of recommendations that it will make to Culver by April 1.