In Johnson County, Iowa DHS director defends action on waiting list backlog

CORALVILLE - Although he cautioned that 2015 will be a 'very challenging year” financially, Iowa Department of Human Services Director Chuck Palmer was upbeat about progress his agency has made in recent years.

'The glass is clearly more than half full,” Palmer told a roomful of advocates and human services providers Monday.

For example, he said, the mental health redesign 'went very smoothly” due largely to work done at the county level.

The Iowa Health and Wellness Plan, the state's Medicaid expansion, is benefiting 113,000 people, including 26,000 who have received their first dental exam.

'Take a step back and celebrate,” Palmer said. 'We've done a lot in the last few years. Don't lose sight of that.”

However, advocates at a forum organized by the Johnson County Task Force on Aging were more concerned about what they say is not being done and, in some cases, the department's unwillingness to engage with local agencies.

Task force member Terry Cunningham wondered why waiting lists for a variety of human services have ballooned in recent years despite legislative appropriations specifically aimed at reducing the backlog. In some cases, he said, Gov. Terry Branstad has vetoed the appropriations or the funding has gone unspent.

As a result, the state is not in compliance with the U.S. Supreme Court's Olmstead ruling that individuals with mental health disabilities should be placed in the least restrictive setting.

'Is state waiting to be sued for not complying?” Cunningham asked Palmer

Palmer said he has no desire to see the department - or himself - sued, and said DHS has been putting out about 50 waivers a week to address Iowans on those waiting lists. Waivers allow people access to some services while they are on the waiting list.

Sen. Joe Bolkcom, D-Iowa City, told Palmer he had a 'really hard job because you work for a governor who doesn't always support the things people in this room care about.”

Republican Gov. Terry Branstad 'and his penny-pinchers” seem unwilling to spend funds the Legislature appropriated to address the waiting lists, Bolkcom said.

Palmer acknowledged there is a backlog. The Legislature appropriated $6 million to address roughly 9,000 people on waiting lists. That is enough to address about 1,200.

'Our goal is to spend that money and see how far it takes us,” Palmer said. 'There is no intent on the part of the DHS or the governor not to have those funds spent.”

Palmer agreed to meet with representatives of various agencies who raised concerns about what they see as a lack of willingness on the department's part to cooperate with local agencies on elder abuse investigations and death reviews.

Such concerns often stem from differences in how an agency perceives its role and how the DHS understands it, Palmer said.

Speaking about elder abuse, he said the hang-up often is on rules and the responsibility of agencies.

'Lot of advocates seem to start from ‘This is what my agency wants to do.” I don't want to start there,” Palmer said.