Iowa’s duty is to protect its vulnerable residents

By The Des Moines Register

---

This state has 5,371 names on its sex offender registry. Some have mental health problems and live in residential care facilities. Just like other Iowans, those convicted of sex crimes will grow older and may eventually need care in nursing homes or other facilities where they live alongside other residents.

William Cubbage is one of those people.

The 83-year-old man is a convicted sex offender and has dementia. While he was living at Pomeroy Care Center, he is suspected of assaulting another resident. The story has unfolded on the pages of The Des Moines Register in recent weeks, and it raises serious concerns about state government's and care center's actions.

The incident involving the woman in her 90s was witnessed by an 8-year-old girl who was visiting the nursing home. A judge had ordered Cubbage to live there. But the home's administrators did not inform other residents or their relatives about Cubbage's criminal history.

Now Gov. Terry Branstad is convening a group to examine Iowa's practice of placing sex offenders in nursing homes. The group should consider everything from more extensive evaluations of offenders to separate facilities in which these people would be housed. Like other states, Iowa should require nursing homes or residential care centers to notify residents and their families if someone on the sex offender registry moves in.

But the focus should not be only on how to handle those convicted of sex crimes. Many long-term care administrators have fewer safety concerns about them than residents who have no criminal records.

According to a 2006 report from the Government Accountability Office, those who work on behalf of vulnerable people worry more about the potential abuse committed by residents with cognitive impairments and mental illness than convicted sex offenders. Several officials interviewed by government investigators said they were alarmed by residents with Alzheimer's disease or dementia, whose behaviors can pose a risk to other residents as the disease progresses.

“The administrator of a facility in Ohio that specializes in residents with behavioral issues and that has housed multiple offenders said that he has had fewer problems with his residents who are identified sex offenders than with other residents who have behavioral problems,” the GAO reported.

Investigators also did not conclude residents with histories of sex crimes were more likely than other residents to commit abuse. “In addition, research on recidivism by sex offenders also suggests that most do not re-offend and the risk of re-offending may decline with age.” And while residents of homes are physically frail and vulnerable, those with criminal histories are frequently also very sick.

Yes, state officials should explore how to minimize risk of sexual assault in nursing homes and residential care institutions. It's clear things went wrong in the case of William Cubbage.

But the responsibility to keep people safe is also the job of elected officials in Washington, D.C. It was Iowa's Sen. Chuck Grassley who requested the GAO investigation into sex offenders living in long-term care facilities. The federal government sets guidelines for nursing homes and frequently pays the bills for care. Elder abuse is a problem across the country. Where is the leadership in Washington?

Everyone must do more to ensure the safety of the most vulnerable people, regardless of who is living in the room next door. As always, that comes down to having enough staff to monitor what is going on. A nursing home is essentially a hospital, caring for the sickest people who need intensive, around-the-clock supervision. There need to be more workers and a system in place to frequently check on residents.

The assault of a woman in her 90s in a government-regulated institution is heartbreaking and sickening. She could the mother or grandmother of any Iowan. And she cannot protect herself. She relies on the rest of us, including the government, to do that.