# Iowa Department Of Human Services



Iowa Republicans fund anti-abortion clinics but not proven maternal health solutions

Iowa’s health and human services budget for the coming fiscal year includes a $500,000 appropriation for a new “maternal health” initiative modeled on an ineffective, wasteful Texas program.

But the bill, negotiated by House and Senate Republicans and approved on party-line votes in both chambers May 23, does not extend postpartum coverage for Iowans on Medicaid, a documented way to reduce maternal mortality.

Continue Reading...

State appeals ruling on law targeting trans Iowans

The Iowa Department of Human Services (DHS) is appealing a Polk County District Court ruling that found the state law and policy designed to deny Medicaid coverage for gender-affirming surgery are unconstitutional. The state filed notice of its intent to appeal on December 17, near the end of its 30-day window to do so following the District Court’s decision in November.

The Iowa Attorney General’s office had no comment on the appeal. Governor Kim Reynolds’ office also had no comment on why the governor is determined to prevent transgender Iowans on Medicaid from receiving medically necessary care approved by their doctors.

Plaintiffs Aiden Vasquez and Mika Covington have been waiting for years to obtain surgery and first challenged the state law in court within weeks of Reynolds signing the provision into law in May 2019.

Continue Reading...

Court finds law targeting trans Iowans unconstitutional

For Aiden Vasquez and Mika Covington, the news was life-changing. Polk County District Court Judge William Kelly ruled on November 19 that Iowa’s law designed to deny Medicaid coverage for gender-affirming surgery “violates the equal protection clause of the Iowa Constitution.”

He ordered the Iowa Department of Human Services to change a longstanding regulation “excluding coverage for sex reassignment surgery” and said the agency must apply the revised rule to allow “transgender individuals coverage under Iowa Medicaid for medically necessary gender affirming surgery for the treatment of Gender Dysphoria and other relevant diagnoses.”

Vasquez and Covington are transgender Iowans who qualify for Medicaid and have been unable to obtain the health care they need for years. They have been seeking legal redress since soon after Governor Kim Reynolds signed the discriminatory statute in May 2019.

Naturally, not everyone was happy with what the ACLU of Iowa’s legal director Rita Bettis Austen described as a “historic win for civil rights in Iowa.” Soon after the court ruling was published on November 22, Reynolds’ spokesperson Alex Murphy told reporters, “The governor’s office is disappointed in today’s decision and disagrees with the district court’s ruling on Medicaid coverage for transgender reassignment surgeries.”

Reynolds echoed the sentiment when speaking to reporters on November 23: “Of course we were disappointed with the ruling and disagree […] My legal team is looking at it. There will be more to come later on. We’re still looking through it and trying to determine what our options are.”

She should stop fighting this battle.

Continue Reading...

Exclusive: Other agencies covered $900K in governor's office costs

Governor Kim Reynolds’ office was able to spend nearly 40 percent more than its $2.3 million budget appropriation during the last fiscal year, mostly by shifting personnel costs onto other state agencies.

Documents Bleeding Heartland obtained through public records requests show that eight state agencies covered $812,420.83 in salaries and benefits for nine employees in the governor’s office from July 1, 2020 through June 30, 2021. In addition, the Office for State-Federal Relations in Washington, DC remained understaffed, as it has been throughout Reynolds’ tenure. The vacant position should allow roughly $85,000 in unspent funds to be used to balance the rest of the governor’s office budget, as happened last year.

The governor’s communications director Pat Garrett did not respond to four inquiries over the past two weeks related to the office budget. But records indicate that unlike in 2020, federal COVID-19 relief funds will not be tapped to cover salaries for Reynolds’ permanent staffers in fiscal year 2021.

Continue Reading...

Former DHS director files wrongful termination lawsuit

Jerry Foxhoven asserts in a new lawsuit that Governor Kim Reynolds and her senior staff forced him out as Iowa Department of Human Services director “because he refused to engage in illegal activity” and to prevent him from seeking legal advice about possible misuse of federal Medicaid funds.

The petition filed in Polk County District Court on June 9 closely tracks allegations Foxhoven made in a wrongful termination claim soon after he resigned under pressure in 2019. Reynolds, her chief of staff Sara Craig Gongol, and her former senior legal counsel Sam Langholz are named defendants in addition to the state of Iowa.

Foxhoven’s court filing says the events leading to his ouster centered on a dispute over payments from DHS for work done by Reynolds’ deputy chief of staff Paige Thorson. The DHS director agreed in early 2018 to have the agency pay 69 percent of Thorson’s salary and benefits, as she assisted Iowa’s new Medicaid director Mike Randol. Foxhoven signed a similar agreement for the next fiscal year, which ran through June 2019. (Several of the governor’s staffers are mostly paid by other state agencies; the longstanding practice helps Reynolds keep more staff on payroll than her budget appropriation could support.)

Foxhoven says that in February or March 2019, he told Craig Gongol in a telephone conversation “that Randol was now adequately familiar with Iowa’s health care network,” adding that “Thorson was no longer performing duties that furthered the mission of Iowa Medicaid and that he did not believe DHS could legally divert federal Medicaid dollars to pay her salary.”

In the spring of 2019, Republican lawmakers approved an extra $200,000 for the governor’s office, supposedly for health and tax policy analysts. Foxhoven says he “believed that the issue was resolved,” and spoke with Craig Gongol in early June “hoping to confirm that DHS would not continue paying any portion of the Thorson’s salary with Medicaid funds in the next fiscal year.”

However, the governor’s chief of staff indicated that she expected the agency to keep compensating Thorson. Foxhoven “questioned the legality of such an arrangement” and asked Craig Gongol to consult with legal counsel Langholz, but she refused.

According to Foxhoven, he told Craig Gongol “that he intended to ask the assistant attorney generals assigned to DHS for a legal opinion” on June 18, after the expected conclusion of a federal trial they were working on. But he wasn’t able to send that email, because Craig Gongol and Langholz asked for his resignation on June 17. Foxhoven says during that meeting, the governor’s senior staff “demanded the immediate return of all of Foxhoven’s state issued equipment and told him not to return to his office.”

The lawsuit alleges that the defendants terminated Foxhoven:

  • “in order to prevent him from enforcing his statutory right to disclose information he reasonably and in good faith believed constituted a violation of the law, mismanagement, a gross abuse of funds or abuse of authority […]”;
  • “in order to prevent him from disclosing information he reasonably and in good faith believed constituted a violation of the law, mismanagement, a gross abuse of funds or abuse of authority […]”;
  • “because he refused to engage in illegal activity; that is committing Medicaid fraud and misuse of federal monies by continuing to pay Thorson’s salary despite the fact that she was no longer providing any duties relating to Medicaid or otherwise furthering the mission of DHS […]”; and
  • interfered with and prevented him from consulting with the Iowa Attorney General’s office about his agency continuing to pay Thorson’s salary.

Foxhoven told journalists in 2019 he would not have objected to using Medicaid funds to support Thorson’s compensation if legal experts determined the practice was still allowable. But he wanted a letter from the Attorney General’s office. That way, in case state or federal auditors questioned the payments later, “There might be a difference of opinion between the auditor and the AG’s office, but it isn’t a matter of Foxhoven diverting funds.”

State agency directors are at-will employees, who serve at the pleasure of the governor. But one exception to the at-will doctrine is firing someone in violation of public policy–for instance, because they refuse to engage in illegal conduct. Foxhoven’s lawsuit alleges that his “termination violates well established public policy of the State of Iowa as defined by statute, regulation, and judicial decision.”

The court filing notes that Foxhoven has suffered “substantial loss of earnings, insurance benefits, retirement benefits and other employee benefits” as well as “emotional distress and damage to his reputation.” It also argues that he’s entitled to punitive damages against Reynolds, Craig Gongol, and Langholz, because their termination of his employment “was willful and wanton and done in reckless disregard of his rights.”

The governor’s office did not immediately respond to Bleeding Heartland’s request for comment on the lawsuit. The Iowa Attorney General’s Office had no comment. Langholz has worked there since late last year, representing the Reynolds administration in several high-profile cases.

Reynolds said in 2019 that “many factors” influenced her decision to ask for the DHS director’s resignation. (The agency has faced lawsuits and investigations over its management of the State Training School for Boys and the Glenwood Resource Center for the intellectually disabled.) In early 2020, the governor told reporters “she was ‘not happy’ with the response she received” about an increase in deaths at Glenwood.

Reynolds also claimed Foxhoven “never raised concerns with me or my staff about the salary agreements in question, and he never asked my staff for a legal opinion or said he would be reaching out to the Attorney General’s office for one.”

Final note: Records I received while investigating the governor’s office spending indicated that DHS did not end up paying any portion of Thorson’s salary during fiscal year 2020, which began in July 2019. However, DHS did pay 100 percent of the salary and benefits of the governor’s new health policy adviser Liz Matney from July 2019 through mid-March 2020. Thorson and Matney were among 21 permanent staffers in Reynolds’ office who had about 62 percent of their compensation from mid-March through June 2020 covered through federal COVID-19 relief funds.


Appendix: Petition filed in Polk County District Court on June 9

Continue Reading...

Iowans face long wait for disability services

Kyla Claussen is one of some 16,000 Iowans on waiting lists for disability services. -promoted by Laura Belin

My name is Kyla Claussen and I’m from Avoca, Iowa. I have an unknown progressive neuromuscular disorder that has been slowly taking skills away from me over the past five years. By March 2020, I was unable to walk independently anymore or work. Last August, I went on Social Security Disability Insurance (SSDI) and then applied for the Physical Disability Waiver and the Health and Disability Waiver.

I’m now waiting for services in my home, along with 15,956 Iowans on the waiting list for one of the waivers for people with disabilities. Most likely, I will be waiting for one to three years.

Continue Reading...
View More...