Resident counts drop, but costs increase at Iowa’s six state-run institutions

Although the average number of patients and residents decreased at Iowa’s six state-run institutions, the total cost to maintain them increased over the past five fiscal years, according to a new state auditor’s report.

The Iowa State Auditor’s Office released a report this month on the cost to maintain facilities under the control of the Iowa Department of Human Services for the five-year period ending June 30, 2020. The audit is part of the state’s comprehensive annual financial report for the 2020 fiscal year.

Iowa’s six institutions are the Mental Health Institutes in Cherokee and Independence; the Woodward Resource Center; the Glenwood Resource Center; the State Training School in Eldora; and the Civil Commitment Unit for Sexual Offenders, which is housed at the Mental Health Institute in Cherokee.

Separate from the auditor’s report, the U.S. Department of Justice earlier this month issued a strong condemnation following yearlong investigation at two of the state run facilities that house people with complex behavioral or medical needs — Glenwood Resource Center and Woodward Resource Center, the Associated Press reported.

In the first investigation opened in 2019, federal officials found the Glenwood facility likely violated the constitutional rights of residents by subjecting them to human experiments.

Following that December 2020 report, Justice Department officials notified the state that it would continue investigating state-run facilities for other possible violations. The 33-page report sent to state officials earlier this month was the result.

In that report, federal investigators found there is reasonable cause to believe Iowa violates the Americans with Disabilities Act by failing to provide services that integrate people with intellectual disabilities into their communities, the AP reported.

According to State Auditor Rob Sand’s office, the average number of residents or patients at the six state-run facilities decreased 9.2 percent, falling from 687 in 2016 to 624 in 2020. Despite declining population counts, the average daily cost and the average annual cost have increased over the years. The report stated the average daily cost per person housed at these facilities increased 14.4 percent — from $776.71 to $888.20 per day in 2020.

Expenditures from the state general fund also increased 3.9 percent over the past fiscal years, tallying nearly $203 million in 2020. In 2016, it was about $195 million, the report stated.

The Iowa State Auditor’s report noted the Mental Health Institute in Cherokee, as well as the resource centers in Glenwood and Woodward, provide “significant outpatient services” that were not reflected in the data analyzed by the auditor’s office.

Of the six institutions, the Glenwood Resource Center had the highest allocation of funds from the state’s general budget at nearly $79 million for the fiscal year ending July 2020.

Cherokee had highest annual cost

As of June 2020, the average number of employees working across all six institutions was 1,795.

In 2020, the Mental Health Institute in Cherokee had the lowest number of patients, but the highest average cost per patient, according to the state auditor’s report. Those totals exclude the Civil Commitment Unit for Sexual Offenders.

The average daily cost at the Cherokee facility was $1,167.43 per patient, or $427,280 average annual cost per patient, for an average of 31 patients. Those patients had a median stay of 19 days, totaling to more than $22,000 cost per stay.

In 2016, the Cherokee mental health institution cost an average $1,063.08 per day, or $389,086 annually, for an average of 34 patients.

The Woodward Resource Center, located in Woodward in central Iowa, had the highest average annual cost per resident, per the report’s findings. The average annual cost was $451,849, or about $1,234 average daily cost, per resident.

Woodward had an average of 130 residents as of June 2020, the report stated.

The highest population count this past year fell to Glenwood Resource Center, with an average 195 residents as of the end of fiscal year 2020. The average daily cost per resident was $1,048.19, or an average annual cost of $383,636, according to the state auditor’s report.

Comments: (319) 398-8469; michaela.ramm@thegazette.com