No. 1 constituents: Vulnerable Iowans
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The editorial page is exploring how Iowa can make this the best and safest place for people to grow older.
To read Sunday's editorial about cuts to nursing home oversight staff, visit www.DesMoinesRegister/aginginiowa.
To read Sunday's editorial about cuts to nursing home oversight staff, visit www.DesMoinesRegister/aginginiowa.
Campaign contributions can influence what lawmakers do. But there are other explanations besides money for why legislators might be reluctant for the state to crack down on bad nursing homes.
Frederick Boehmke, a University of Iowa professor, has studied the relationship between contributions and state oversight of nursing homes. He found homes that contribute to state elected officials receive better overall inspection results. They are cited for fewer severe violations and have fewer overall problems with state inspectors.
Frederick Boehmke, a University of Iowa professor, has studied the relationship between contributions and state oversight of nursing homes. He found homes that contribute to state elected officials receive better overall inspection results. They are cited for fewer severe violations and have fewer overall problems with state inspectors.
But he recognizes what goes on behind the scenes isn't just about money. Elected legislators may view nursing homes as constituents - and feel compelled to protect them from state regulators.
"This is a case of perhaps facilities being significant employers or playing some important role in the district," Boehmke said. "Some of these reps likely view it as doing constituency service for a member of their district."
But lawmakers need to work for all their constituents - especially vulnerable seniors living in facilities. These Iowans don't always write campaign checks. They do rely on the state to keep them safe.
"This is a case of perhaps facilities being significant employers or playing some important role in the district," Boehmke said. "Some of these reps likely view it as doing constituency service for a member of their district."
But lawmakers need to work for all their constituents - especially vulnerable seniors living in facilities. These Iowans don't always write campaign checks. They do rely on the state to keep them safe.
Yet it frequently appears elected officials side with the powerful senior housing industry at the expense of seniors' safety. It looks like "payback" for campaign contributions. The money can also influence the executive branch - the part of government that executes and enforces laws, conducts inspections and imposes penalties for violations.
During his campaign Gov. Terry Branstad met with nursing home administrators at the headquarters of the industry's main lobbyist. The meeting generated 47 campaign contributions totaling $33,200. Branstad also joined in the chorus of accusing state inspectors at the Iowa Department of Inspections and Appeals of being too tough on homes.
During his campaign Gov. Terry Branstad met with nursing home administrators at the headquarters of the industry's main lobbyist. The meeting generated 47 campaign contributions totaling $33,200. Branstad also joined in the chorus of accusing state inspectors at the Iowa Department of Inspections and Appeals of being too tough on homes.
The accusation puts lawmakers at odds with regulators - and it's not true. A federal report found Iowa's inspectors cite fewer homes for deficiencies than inspectors in 39 other states. It's actually the regulators who are bullied by lawmakers.
A report from the Government Accountability Office in late 2009 cited egregious examples of the "external pressures" placed on state inspectors in Iowa. Among the incidents: Lawmakers showing up at inspections "to question surveyors about their work." Dean Lerner, the former director of DIA, has told of a lawmaker badgering him to recertify a home that had been decertified by the federal government for serious care violations.
A report from the Government Accountability Office in late 2009 cited egregious examples of the "external pressures" placed on state inspectors in Iowa. Among the incidents: Lawmakers showing up at inspections "to question surveyors about their work." Dean Lerner, the former director of DIA, has told of a lawmaker badgering him to recertify a home that had been decertified by the federal government for serious care violations.
Yet lawmakers fail to take action to address these problems.
They refuse to pass a bill that would prohibit lawmakers from trying to influence state inspectors. They have failed to close loopholes in the law that allows assisted living centers to "decertify" themselves and escape all government oversight.
That sends a message that Iowa is a place that doesn't take care of its most vulnerable people.
And there is no one more vulnerable than a senior living in a nursing home. Assisted living centers are not simply "apartment complexes," as one lawmaker has called them. They are home to many seniors with health problems, including dementia, who need a high level of care.
They refuse to pass a bill that would prohibit lawmakers from trying to influence state inspectors. They have failed to close loopholes in the law that allows assisted living centers to "decertify" themselves and escape all government oversight.
That sends a message that Iowa is a place that doesn't take care of its most vulnerable people.
And there is no one more vulnerable than a senior living in a nursing home. Assisted living centers are not simply "apartment complexes," as one lawmaker has called them. They are home to many seniors with health problems, including dementia, who need a high level of care.
Lawmakers should remember their most important constituency is vulnerable people. They should share the goal of protecting them with state regulators.