Clark Kauffman published a must-read story in today’s Des Moines Register about the advocacy group Disability Rights Iowa firing its longtime executive director, Sylvia Piper. About six weeks ago, Piper published a harsh open letter to Governor Terry Branstad about his administration’s policy on inspecting Iowa nursing homes.
Background and more details are after the jump.
Piper had run Disability Rights Iowa, a federally-funded non-profit organization, for eleven years before the board of directors fired her last week. Her open letter to the governor appeared in several newspapers as well as the Newton Independent blog. Excerpt:
I write to invite you to join me on what is certain to be an enlightening journey of discovery. I wish to host a two-day (a week would be better, but I know you’re busy) tour of Iowa’s nursing homes. I also invite Iowa Department of Inspections and Appeals (DIA) Director Rod Roberts to join us.
Recently, through Director Roberts, you fired 10 nursing home inspectors. Iowans thought this was part of your plan to slash spending and shrink government. But when the General Assembly, including the Republican controlled Iowa House, appropriated $650,000 to reinstate those positions, you and Director Roberts took the money and funneled it to other programs. No inspectors were reinstated; this despite the fact your DIA staff and the federal government insist those inspectors are desperately needed. Spending wasn’t cut, and the legislature’s intent – protecting nursing home residents – was blatantly ignored. […]
Since you have admittedly forgotten events from your previous tenure as governor, let me refresh your memory. Surely you remember when, in 1995, your own Republican state auditor, Richard Johnson, publicly stated DIA was not in compliance with Iowa’s legal requirement to inspect each nursing home at least once every 15 months. In 1997, the state ombudsman examined the state’s regulation of nursing homes and found the DIA had – for eight straight years – failed to enforce state and federal laws governing the operation of nursing homes. He concluded the department was violating federal law by failing to penalize care facilities for neglect of residents, even in cases where deaths had occurred. Other state agencies criticized you at the time for being “too lenient” on homes where elderly Iowans had been injured or died as a result of abuse or neglect. Certainly a man possessed of any intellectual horsepower at all would remember criticism so scathing. Do you honestly think Iowans buy it when you claim not to remember these reports? What an insult!
At this writing, hundreds of Iowa nursing homes are under citation for egregious, and often deliberate, violations of state and federal law. Many are guilty of multiple infractions and are habitual offenders. This can be traced directly to a culture fostered by you years ago and perpetuated by you now. If our food supply was subject to such lax regulation, countless Iowans would become ill, and perhaps die, of food-borne illness. If OSHA regulations were conveniently ignored, Iowa’s workers would be crushed, electrocuted, asphyxiated, buried alive, dismembered, and fall to their deaths in staggering numbers.
You get my point. Because of your political choices people are suffering and dying on a regular basis in Iowa’s nursing homes. I repeat: suffering and dying on a regular basis. […]
The larger part of me wants to believe that no one, especially not the governor, could be this callous toward any person or class of people (in this case, elderly persons) living in the state he runs. […]
I conclude then your insensitivity is not borne of malice, but of ignorance, a lack of personal experience with daily life in a nursing home. Come with me, Governor. We will visit a dozen nursing homes across the state. We will not notify them of our informal inspection. We won’t share our itinerary with Jean Yordi, as she gives nursing home operators advance notice that an inspection is coming. We’ll just show up.
I think you will be surprised, possibly even shocked, at what you see, hear, and smell. I know you will witness lots of nervous nursing home adminstrators and staff scurrying about, and most certainly scores of residents who will be desperate to tell you of the undignified, shameful, and often horrible things they have witnessed and experienced.
This invitation is genuine. I hope you will accept. For over 35 years I have advocated for nursing home residents and persons living with disabilities. I want you to see what I have seen. I want you to witness up close the effects of abuse and neglect. I wager that less than 24 hours after our return, if you are even remotely human, you will double the number of nursing home inspectors on your staff. You will give Rod Roberts a brand new set of tough, meaningful marching orders. […]
According to Kauffman, Piper’s open letter set off a “flurry of activity” in the governor’s office:
Nursing home industry lobbyists contacted other industry officials about a written response they said they were working on with the governor’s office. A guest opinion was distributed to, and published by, The Des Moines Register.
[Branstad Chief of Staff Jeff] Boeyink contacted the staff of U.S. Rep. Tom Latham, a fellow Republican, for information on the manner in which Disability Rights Iowa was being funded by the federal government, according Latham spokesman Fred Love.
Latham’s staff forwarded to Branstad’s staff the information they had received from the U.S. Department of Health and Human Services.
Disability Rights Iowa’s press release from earlier this week said nothing about the board’s reasons for firing Piper:
[…]”This was not an easy decision but the board has decided it is time for new leadership,” said Board President David Parr. “We greatly appreciate Sylvia’s loyal service and commitment to Iowans with disabilities. We wish her all the best in the future.”
The board of directors will closely monitor the management of the agency until a permanent replacement can be found. A search committee of the Board will be formed to oversee the process of hiring a new executive director.
The board is also working closely with the Federal agencies that oversee the nationwide system of protection and advocacy (P&A) agencies as well as the National Disability Rights Network who provides the training and technical assistance to the P&A agencies through the Training and Advocacy Support Center (TASC) and has expertise in various areas of protection and advocacy management.
The decision does not reflect a change in the overall mission nor are there plans for additional changes in either the structure or leadership of the agency at this time. […]
Kauffman dug a little deeper:
Piper, 68, said board member John Winkelman told her that her dismissal was intended to discourage Branstad from launching an effort to rein in Disability Rights Now by making it an agency of state government.
Winkelman told the Register that’s not an entirely accurate statement, but he acknowledged that the potential for action by the governor’s office was a concern. […]
Winkelman said the larger issue with regard to Piper’s dismissal was the agency’s finances. With federal funding, he said, there are restrictions on the use of money and there are reporting requirements that must be met.
Meanwhile, the leader of the National Disability Rights Network, Curtis Decker, told Kauffman he had figured that Piper’s open letter “would probably annoy the governor.” Decker met with Latham after hearing that Latham (a member of the House Appropriations Committee) was asking around about Disability Rights Iowa’s funding. He told Kauffman he was unaware that Branstad’s staff had asked Latham to make the inquiries.
Kauffman is likely to follow up on this story, since the Des Moines Register has requested copies of “all of the governor’s written communications with Disability Rights Iowa; Latham; the Department of Health and Human Services; and the national association of disability advocacy groups.” Meanwhile, share any relevant thoughts in this thread.