James C. Larew is an attorney in Iowa City who served as general counsel and chief of staff for former Governor Chet Culver. -promoted by Laura Belin
Former Governor Chet Culver wrote to Governor Kim Reynolds on May 7, urging her to have an immediate and comprehensive performance audit conducted of Nomi Health’s COVID-19 testing services in Iowa. The Utah-based company is providing testing at drive-through sites under a $26 million no-bid contract with the state.
Culver suggested that Reynolds ask State Auditor Rob Sand to perform such an audit, or order a comparable review by a competent and independent agency. His letter outlined serious problems already known to the public about the Test Iowa program. He warned that if not remedied immediately, by making Nomi Health’s performance fully compliant with all applicable federal and state laws, and with best pandemic practices, those difficulties will place the health of Iowans at great risk. The full text of the letter follows:
May 7, 2020
Governor Kimberly K. Reynolds
Des Moines, Iowa 50319
Dear Governor Reynolds:
I urge you to assure full accountability by the Utah corporation, Nomi Health, known to most Iowans as “TestIowa,” a vendor chosen to perform COVID-19 testing under a no-bid, federally-funded $26 million contract.
If your Administration expects employees to report to work at meat processing plants and other places that are viewed by many as health-risky locations, then those workers simply must have access to the very best coronavirus testing protocols possible. But that is not happening.
More specifically, I propose that you request Auditor of State Rob Sand to conduct an immediate and comprehensive performance audit of Nomi Health’s services, to assure that the company is performing in a manner that complies with the express provisions of its contract with Iowa, with all applicable federal and state laws, and with best pandemic practices.
According to published reports, Nomi Health had little prior, proven track record in the delivery of public health services before its Iowa contract.
There are reports of repeated instances of testing results being delayed to the extent that effective contact tracing and quarantine measures have been precluded.
When, as reported, as much as a week, or more, passes between the dates of tests and the dates that test results are delivered, the health-values of such tests are diminished or eliminated; no protection to Iowans’ welfare is provided.
Very unsettling reports indicated that an undetermined number of the tests taken by Nomi Health have not been processed at all because the coronavirus test results had been damaged. While, as yet, it is not clear where the error occurred, it seems that it must fall to Nomi Health to assure such issues are avoided in the future.
A comprehensive performance review conducted by the State Auditor, or by a comparably competent and independent agency, can assure that the frequency, reach of any COVID-19 tests performed by Nomi Health, and the timely production of results, will allow, thereafter, that type of contact tracing and quarantine practices that Iowans will need to employ if your Administration’s stated goal of opening up the State aggressively is to provide more benefits than harms.
Similarly, Nomi-Health’s reported use of testing protocols that have resulted in only one-half of the incidence of coronavirus infections, as compared to other tests administered to comparably-placed persons increases the risk that the coronavirus will be spread unknowingly to co-workers and family members.
It is reported that the limit of detection for viral RNA is quite high compared with the CDC assay. That limit would explain the observations made in Utah suggesting that a substantial number of test results are falsely negative, thus missing many individuals who are infected and potentially shedding sufficient viral particles to infect others. These concerns need to be clarified and can be addressed in the type of independent performance audit that I have proposed.
If existing reported deficient practices are not corrected immediately and comprehensively, Iowa taxpayers and their loved ones will be denied the full benefit of their State’s contract with Nomi Health. More importantly, the health of our most vulnerable Iowans will be placed unnecessarily at risk.
Our citizens deserve the peace of mind that an effective delivery of governmental services, aimed to diminish the harms of COVID-19, should be expected to provide. I urge you take the type of action that is proposed here, at the earliest possible moment.
Copy: Iowa Auditor Rob Sand