Iowa, a top retirement destination, underfunds elder care

Iowa consistently is ranked as a top-10 place to retire, based on low property costs, high quality of living and relatively easy access to health care.

However, if you are among the growing number of Iowans who live in a care facility, there are some very worrying signs.

The State Office of the Long-Term Care Ombudsman is seeking a public agency or nonprofit organization to take over the office's ombudsman positions, which are responsible for investigating complaints of misconduct at care facilities in Iowa, Gazette journalist Erin Jordan reported this week. The office also recently put out a call for volunteers to serve in those same positions.

'We're just looking for the best service-delivery method possible,” State Ombudsman Cynthia Pederson told The Gazette. 'A number of other states do have the decentralized model.”

If this new setup can provide adequate oversight and maintain costs, it is a good idea. However, previous experience seeing the state government outsource health and safety functions should make Iowans cautious. One can't help but wonder whether this is another sign of inadequate resources for the Long-Term Care Ombudsman, the result of budget cuts from the state government.

In 2017, the office slashed its travel budget in the face of a significant budget cut, preventing staff from investigating complaints on-site and speaking in person with the people involved. In the previous fiscal year, the staff made more than 5,000 visits to care facilities, the Des Moines Register reported.

Elderly and disabled Iowans are vulnerable to abuse and mistreatment. Investigating those claims is a government function that should be taken very seriously.

Remember how Iowans were told privatized Medicaid, imposed by then-Gov. Terry Branstad in 2016, would provide better service at a lower cost? Instead, with the system operated by outside firms, some patients are being denied care and providers aren't being paid on time. The savings have been much lower than promised, even assuming the state's widely criticized estimates are accurate.

Iowa policymakers' failure to support the Office of the Long-Term Care Ombudsman affects some of the same patients who are suffering under Medicaid reform. While these are separate issues, the Medicaid mess underscores the need for the state to maintain strong oversight when it farms out work.

Perhaps this 'decentralized model” will prove to be superior. Until it does, Iowans should pay close attention.

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