Auditor: Test Iowa program violates the law, creates needless risks

A worker checks a clipboard at a Test Iowa site in Waukee on June 17, 2020. (Photo by Kathie Obradovich/Iowa Capital Dispatch)

The state auditor said Tuesday that the Iowa Department of Public Health is violating the law and exposing Iowans to greater health risk through the delayed reporting of COVID-19 test results.

Auditor of State Rob Sand issued a report Tuesday that alleges the results from the COVID-19 testing conducted through the Test Iowa program are not being passed immediately to IDPH, as the law requires. He said the results are instead sent from the State Hygienic Laboratory to two private companies affiliated with the Test Iowa contractor, and then to the office of Iowa’s Chief Information Officer, and then to IDPH.

At a press conference Tuesday, Sand said it appears this reporting process is something IDPH itself has insisted on, adding that the department has refused to explain why such a process is being used.

“We have asked this question multiple times and have yet to receive a direct answer,” Sand said.

Iowa Auditor of State Rob Sand speaks during a news conference about his efforts to audit Iowa’s Medicaid program. (Photo courtesy of Iowa Auditor of State’s office.)

In response to Sand’s report, IDPH spokeswoman Amy McCoy issued a written statement that said: “Test Iowa has been a huge success for Iowans throughout the state, providing widespread access to testing and supporting the state’s contact tracing efforts. As the (attorney general’s) office has verified, every part of the Test Iowa reporting process is in accordance with Iowa Code.”

While Sand didn’t quantify the extent of the delay caused by the four-step process, he cited a specific statute that he said is being violated. That law requires health care providers or laboratories that are attending a person infected with a reportable disease to “immediately report the case” to IDPH.

In May, Assistant Attorney General Heather Adams sent Sand’s office a letter indicating the time it takes for test results to be uploaded to IDPH’s database ranges from three to 10 hours, a process that IDPH considers “timely” and in compliance with the law.

Sand noted that while the reporting process now being used stems from an order that was issued by IDPH itself, the public health agency has not turned over a copy of any written order to that effect, despite requests from the auditor’s office.

“When the Iowa Department of Public Health issues an order, it publishes it, it puts it on paper,” he said. “That is required by the same statute that requires immediate reporting. However, there is no written order that we have been provided that shows this lengthy reporting chain was actually due to an order from the Department of Public Health — and yet that doesn’t seem to be disputed by any of the parties.”

Sand, a Democrat, noted that in addition to violating Iowa law, the reporting process now being used creates additional risk for Iowans by hindering contact tracing and decision-making at both governmental and individual levels.

“It creates apparently pointless risk because it has a long reporting chain before (the results) actually get to public health officials,” he said. “Every step along that chain is another place where something can negatively affect Iowa’s pandemic response.”

The process also exposes taxpayers to greater liability since the state could be sued for failing to follow the legally required procedures for testing, Sand said.

The Auditor of State’s office is recommending that the State Hygienic Laboratory begin immediately reporting to IDPH all results of tests conducted through the Test Iowa program.

Clark Kauffman
Deputy Editor Clark Kauffman has worked during the past 30 years as both an investigative reporter and editorial writer at two of Iowa’s largest newspapers, the Des Moines Register and the Quad-City Times. He has won numerous state and national awards for reporting and editorial writing. His 2004 series on prosecutorial misconduct in Iowa was named a finalist for the Pulitzer Prize for Investigative Reporting. From October 2018 through November 2019, Kauffman was an assistant ombudsman for the Iowa Office of Ombudsman, an agency that investigates citizens’ complaints of wrongdoing within state and local government agencies.