The Iowa Department of Human Services is trying to find placements “in the community” for intellectually disabled residents now living at the Glenwood Resource Center. Many people believe this will prevent atrocities like the ones highlighted by Iowa Capital Dispatch.
Sadly, the reality is that there are not enough community placements for people who need this level of care, and many community placements have staff and management who are under-trained, under-funded, and not well regulated. This results in residents in those facilities being abused, neglected, and not well cared for in these settings as well. So, this is not a real solution for most of these residents.
Are there solutions? Yes! They begin with people in our state government and general population recognizing that we need to stop “othering” the people who need residential care for their physical and mental disabilities. Instead, the state should do the following:
- Prioritize funding their facilities and services, just the same as we would if these were our own loved ones.
- Hire people to run them who are well-qualified, caring, and passionate about their intense commitment to the care of these residents.
- Increase reimbursement rates for the professional and direct care staff who work in both residential and community settings, to help with the recruitment, training and retention of more qualified and experienced staff.
- Increase oversight of day-to-day operations, with concurrent, unscheduled visits to ensure residents are not being neglected and abused. (The Iowa Department of Inspections has professional staff who do site visits for other medical facilities and practices in this state to ensure compliance with Medicare standards, so this should be possible for a state facility as well.)
- Implement training for all the professional and direct care staff to raise the level of care, compassion, and understanding of the conditions the residents present with, as well as best practices for treating and caring for them.
- End the IMD (Institutions for Mental Disease) exclusion. This is a federal policy that was part of the Medicaid Act of 1965 that limits Medicaid federal matching dollars to facilities with less than 16 beds for people with “mental diseases” which includes both intellectual deficits and serious brain disorders such as schizophrenia. This was meant to keep facilities smaller to avoid abuse and neglect. Clearly, it has left facilities such as this under-funded and under-staffed, and the atrocities have not been ended. This has been a legal form of discrimination for people with brain disorders that has led to the massive over-deinstitutionalization in our country. It is time for it to end.
- Iowa should apply for the IMD waiver. This would allow the state to access these federal Medicaid matching dollars to help these facilities have more funding.
We do have new leadership at the Department of Human Services, and I am grateful for this. The governor and Legislature need to more amply fund the Department of Human Services, so that Director Kelly Garcia has the resources she needs to improve the situation.
These types of residential and community facilities do not need to be horrible places for people to live, work, visit, or volunteer. We absolutely can make them state-of-the-art, caring, compassionate places that we can all be proud of.