Health

Governor plans to take Department of Human Services 'in a new direction'

More changes to be announced in coming days

Jerry Foxhoven, then-director of the Iowa Department of Human Services, addresses members of the council at a meeting of the Council on Human Services at the Hoover State Office Building in Des Moines in June 2018. (Rebecca F. Miller/The Gazette)
Jerry Foxhoven, then-director of the Iowa Department of Human Services, addresses members of the council at a meeting of the Council on Human Services at the Hoover State Office Building in Des Moines in June 2018. (Rebecca F. Miller/The Gazette)
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DES MOINES — Gov. Kim Reynolds called for the resignation of the director of one of Iowa’s largest agencies as part of her plan to take the Department of Human Services “in a new direction.”

A spokesman for the governor’s office said Tuesday that she requested the resignation of Jerry Foxhoven after two years as director of the department, effective Monday, “because she wanted to go in a new direction at the Department of Human Services.”

“She has spent the first part of this year assembling a new team, from top to bottom, to carry out her vision,” said Pat Garrett, spokesman for the Governor’s Office, in a statement Tuesday. “More changes will be announced in the coming days and weeks ahead.”

Reynolds’ office had announced Foxhoven’s resignation Monday afternoon in a statement naming Gerd W. Clabaugh, director of the Iowa Department of Public Health, as interim director of Human Services.

That announcement ended with, “Clabaugh replaces Jerry Foxhoven, who resigned effective today.”

In a statement later Monday afternoon, Foxhoven said “at the request of the governor, I submitted my resignation.”

“It was an honor to serve Iowans at the Department of Human Services during an important time of transition,” Foxhoven said in the statement. “I wish the many hardworking employees at the department the very best and know that they will continue to serve the people of Iowa well.”

Foxhoven has not responded to requests for comment.

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The governor’s office has not commented on requests for more information about Reynolds’s plans for the Department of Human Services. Her office also did not respond to inquiries to interview Clabaugh about his new DHS duties.

Under the 2017 law signed by then-Gov. Terry Branstad, government bodies must provide the reason why a state employee is fired or resigns in lieu of termination.

Also recently leaving the Human Services department was Liz Matney, the Iowa Medicaid bureau chief of managed-care oversight and support, who accepted a position as health policy adviser to Reynolds.

Rick Shults, longtime division administrator for mental health and disability services at DHS, will retire in August.

Support for privatization

Foxhoven, now 66, oversaw a $6.5 billion department that often has been criticized for its role in Medicaid, foster care and state-run institutions. He was appointed by Reynolds in June 2017 and confirmed by state lawmakers for a four-year term.

He directed a workforce of about 4,600 that administers services that include food assistance, Medicaid, child welfare, mental health and disability services. The department serves more than one million Iowans annually, including many of the state’s most vulnerable children, elderly and disabled.

As director, Foxhoven was paid $154,300 in fiscal 2018, state records show.

A former Drake law professor, Foxhoven joined the department a year after state officials switched Iowa’s $5 billion program from a state-run system to a managed-care program administered by private insurance companies.

Foxhoven supported the privatization and often praised Reynolds for her support of the program.

But in the three years since the Iowa Medicaid program was privatized, it has been a source of controversy surrounding the department.

One managed-care organization has departed the program since it was launched in 2016, and UnitedHealthcare will leave at the end of June. According to company officials, chronic underfunding of the program and the loss of millions of dollars ultimately drove the insurer to back out.

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Iowa Total Care, the latest managed-care organization to sign onto the program, will join July 1.

On Tuesday, Iowa Total Care — a subsidiary of Centene — announced it had signed contracts with four of the state’s largest health care provider networks — UnityPoint Health, University of Iowa Health Care, Genesis Health System and MercyOne.

“Iowa Total Care is prepared and ready to go live on July 1,” a spokeswoman said by email Tuesday.

Spokespersons for UnitedHealthcare and Amerigroup did not respond to requests for comment in time for this report.

The Department of Human Services also oversees Iowa’s foster care system and manages six state institutions.

A federal trial over alleged abuse and inhuman treatment at the state institution in Eldora, the State Training School for Boys, began in Des Moines last week. Foxhoven — who is named individually in the suit, along with the department — testified in court Thursday, according to court records.

LAWMAKERS REACT

U.S. Rep. Abby Finkenauer, weighed in on the issue Tuesday, saying a staffing shake-up “won’t change the fact that Iowa families have paid a devastating price from day one of privatized Medicaid in our state.”

“This is not a Republican or Democratic issue,” Finkenauer said in her statement. “This about how we, as Iowans, treat our neighbors. I join State Sen. Janet Petersen in calling for a national search to fill this role with someone who will look out for “the most vulnerable” Iowans.

Petersen characterized Reynolds’ explanation for Foxhoven’s resignation “as clear as mud.”

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Sen. Pam Jochum, D-Dubuque, said state lawmakers are “in the dark” about Foxhoven’s resignation as well as details of Reynolds’ plan for the department.

With another transition in the Medicaid program in less than two weeks, Jochum expressed concern that this move would be “one more layer of mess on top of a disaster,”

“This is truly in Gov. Reynolds’ court to make this work now,” she said.

On the other side of the aisle, Rep. Bobby Kaufmann, R-Wilton. pushed back on Foxhoven being asked to leave.

“I think the governor made a terrible decision,” Kaufmann said. “Jerry Foxhoven is the best thing to happen to DHS in a generation.”

Gazette reporter James Lynch contributed to this article.

• Comments: (319) 368-8536, michaela.ramm@thegazette.com; (515) 243-7220, rod.boshart@thegazette.com

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