Long-term care office is failing Iowa

The Office of the State Long-Term Care Ombudsman (OSLTCO) - a state office advocating for and supporting the tens of thousands of vulnerable Iowans who reside in long-term care facilities - is failing to do its job.

The office is in turmoil. Leadership at the OSLTCO is not adequately communicating with or supporting front line staff. Morale among staff and volunteers has tanked. Too many Iowans are not familiar with what the OSLTCO does, and therefore don't use its services. Too many Iowans who do use it are being inadequately served due to staff reductions and travel budget cuts.

Change is needed, promptly.

We're led to this conclusion by what we've been hearing from concerned residents of long-term care facilities, Iowans who volunteer to visit those residents, current and former staff of the OSLTCO, as well as advocates for older Iowans and people with disabilities.

Their concerns focus on:

l A total breakdown in communications and teamwork within the office. No meetings between the head of the office and all staff have been held in the past two years.

l Continued reductions in staff needed to respond to complaints from residents in over 800 facilities.

l The recent proposal by the OSLTCO and the Department on Aging to outsource six of 11 positions to another entity, and the failure to get input from any stakeholders.

l Too few unannounced visits to facilities to talk informally with residents about the quality of care and concerns.

l Significant reductions in dollars needed for staff to travel to facilities (Current staff travel is limited to 150 miles a month).

l Office leadership has failed to be assertive in requesting state funds, or additional federal funds.

l An absence of advocacy on behalf of residents of long-term care facilities by office leadership at the Legislature.

l Confusion over what laws and regulations say about both the independence of the OSLTCO, and the authorities to hire and fire the person who heads it.

The concerns shared with us have also been shared with the OSLTCO, the Department on Aging, the Commission on Aging, the Governor's office, the State Ombudsman's Office (the office that exists to investigate complaints about any entity of state government), state legislators, and various others.

So here's the question - who will do something about this?

The executive branch could, but it has allowed the situation to get to this point. When we and others have asked them to address the issues, they respond by either denying that problems exist or by passing the buck.

Then there's the Legislative Branch of state government. Lawmakers have the authority to not only investigate and give visibility to the issues, but also to deal with them through the budgeting process by either reducing or providing additional funds to the OSLTCO.

We believe the Iowa Legislature needs to step up. We urge legislators to dig into what's going at the OSLTCO, identify the problems, and take the actions needed to give Iowans what they deserve - an OSLTCO that is adequately funded, runs smoothly and effectively, and provides exceptional service to residents of long-term care facilities.

John and Terri Hale own The Hale Group, an Ankeny-based advocacy, consulting and communications firm focused on older Iowans, Iowans with disabilities, and caregivers.