# Iowa Department Of Public Health



A good Iowa court ruling for public employees—and open records

Iowans who handle public records requests for government bodies gained more protection from possible retaliation on June 23, when the Iowa Supreme Court ruled that former Iowa Department of Public Health communications director Polly Carver-Kimm can proceed with both of her wrongful termination claims against the state.

Four justices affirmed a Polk County District Court decision, which allowed Carver-Kimm to allege under Iowa’s whistleblower statute that she was wrongly forced to resign in July 2020, and that Iowa’s open records law protected her activities when fulfilling records requests for the public health agency.

The Iowa Supreme Court did reverse one part of the lower court’s ruling. All seven justices determined that Governor Kim Reynolds and her former spokesperson Pat Garrett should be dismissed as individual defendants, because they lacked the “power to authorize or compel” Carver-Kimm’s termination.

But the impact of the majority decision in Carver-Kimm v. Reynolds extends far beyond the named defendants in one lawsuit.

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Midwifery licensure would improve maternal health, infant outcomes

Bethany Gates is a Certified Professional Midwife from Vinton (Benton County), where she lives with her husband, Judah, and their 4 daughters.

Certified Professional Midwives are midwives who practice in an out-of-hospital setting. Iowa CPMs attend home births; in other states, CPMs attend home births and births in birth centers. 

Here in Iowa, CPMs are unregulated, and the Iowa Code does not have any section addressing their practice. While this may sound like freedom in theory, the reality is that midwives face many challenges as they strive to provide quality care, because Iowa does not license the profession.

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Analysis: Five years of maternal health data in Iowa

Rachel Bruns is a volunteer advocate for quality maternal health care in Iowa.

I recently recounted how it took the Iowa Department of Public Health (IDPH) 170 days to respond to my request for information on the total births, primary cesareans, total cesareans, and vaginal births after cesareans (VBACs) at Iowa hospitals. I eventually received aggregated five-year totals (2016 through 2020) for each birthing hospital in Iowa.

The International Cesarean Awareness Network (ICAN) of Central Iowa, where I serve as a volunteer chapter leader, has made the data available on our website. You can see it in table form below as Appendix 1. 

While I would have preferred for IDPH to provide the figures for a single year, as I requested, the compiled data still tells us a lot about the overuse of cesareans at several Iowa hospitals and the lack of VBAC access across much of the state.

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On COVID-19, governor is a day late and a dollar short—again

Jan Flora is Professor Emeritus at Iowa State University.

On January 9, new cases of COVID-19 reached an all-time high in Iowa. Governor Kim Reynolds may have known that when she gave her Condition of the State address two days later. By barely mentioning the pandemic, she attempted to relegate it to the past.

With the Omicron variant now dominant, COVID-19 cases were modeled to peak on January 15. Coronavirus-related hospitalizations are now near 1,000, the highest point since early December 2020. Iowa faces a grave hospitalization crisis that may not ease before March.

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Kim Reynolds gave up trying to fight COVID-19

This week, Iowa’s COVID-19 hospitalizations reached levels not seen for more than a year. Even with 100 out-of-state nurses and respiratory therapists helping to manage the workload, the state’s major medical centers are being crushed. Hospital leaders, health care workers, and public health officials in the Quad Cities, Cedar Rapids, and central Iowa have been begging for weeks: “We are overwhelmed.” “We’re exhausted.” “We need your help.”

Against this backdrop, Governor Kim Reynolds has not made even a token effort to encourage Iowans to slow the spread of a virus that has killed more than 8,200 of her constituents, claiming more than 100 lives each week in recent months.

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Iowa extends nurses' contract as COVID-19 hospitalizations surge

As COVID-19 hospitalizations reach levels not seen in Iowa for more than a year, the state has extended a contract for 100 out-of-state nurses and respiratory therapists to alleviate staff shortages at major medical centers.

Iowa Department of Public Health spokesperson Sarah Ekstrand confirmed to Bleeding Heartland via email that the state has twice extended the six-week contract signed with Kansas company Favorite Healthcare Staffing in early December—first to run through January 28, and more recently to run through February 11.

Ekstrand added that the state recently accepted bids “to establish a statewide hospital bed transfer line. The goal is to establish a call center to help relieve pressure on hospital staff in order for them to be able to spend more time caring for ill patients.”

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My effort to allow religious use of marijuana extracts in Iowa

Carl Olsen is the founder of Iowans for Medical Marijuana.

In October, I asked the Polk County District Court to declare religious use as a qualifying condition for participation in the state’s marijuana extract program, Iowa Code Chapter 124E.

On November 23, 2021, the state filed a Motion to Dismiss my Petition for Declaratory Judgment. The state said it had sovereign immunity and cannot be sued.

On November 24, 2021, I filed an application with the Iowa Department of Public Health (IDPH) for access to the program.

The state made three other arguments in its motion to dismiss:

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State agency took 170 days to produce maternal health records

Rachel Bruns recounts the saga of trying to obtain records that the Iowa Department of Public Health could have provided promptly.

In an article I wrote for this website in January 2021, Provider practices in Iowa lead to more c-sections, complications, I mentioned that I had requested records from the Iowa Department of Public Health (IDPH) on the number of cesarean births and vaginal births after cesarean (VBACs) in Iowa hospitals.

A lot has happened related to my request since then. I’m summarizing my experience in case it can help other Iowans seeking what should be public information from a government entity.

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Court ruling good for open records, bad for Kim Reynolds

A Polk County District Court has rejected the state’s motion to dismiss part of Polly Carver-Kimm’s wrongful termination lawsuit against the state of Iowa, Governor Kim Reynolds, her former communications director Pat Garrett, and several senior Iowa Department of Public Health (IDPH) officials.

Carver-Kimm handled press contacts and public records requests for the IDPH for thirteen years before being forced to resign in July 2020. She asserts that she was “stripped of her duties and later terminated after she made repeated efforts to comply with Iowa’s Open Records law (Chapter 22) by producing documents to local and national media regarding the State of Iowa’s response to the ongoing pandemic.”

District Court Judge Lawrence McLellan’s December 22 ruling (enclosed in full below) affirmed the importance of the open records law and rejected the state’s effort to remove Reynolds as a defendant in this case.

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Where are they now? Caitlin Pedati edition

Iowa’s former State Medical Director Dr. Caitlin Pedati began working last week as Virginia Beach Health District Director, the city of Virginia Beach announced on December 10.

Jason Clayworth reported on December 14, “Pedati’s new gig is a recently created position that pays $190,000 a year, according to records obtained by Axios Monday.” He noted that was substantially less than Pedati’s annual salary in Iowa. The state employee salary book lists Pedati’s annual gross pay at $229,545.41 for fiscal year 2020 and $282,131.62 for the 2021 fiscal year.

Governor Kim Reynolds’ disaster emergency proclamations allowed state employees who normally would not be eligible for overtime pay to receive it for work related to the COVID-19 response. Bleeding Heartland reported last year that Pedati received more than $55,000 in overtime pay from March through early July 2020. Documents I received through a subsequent public records request showed that Pedati collected a total of $67,653.29 in overtime pay during the first six months of the pandemic.

Pedati grew up in the Virginia suburbs and attended college and medical school in the Washington, DC area. So it’s not surprising she would want to return to her home state—even for a lower salary—after four and a half years in the Midwest.

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Amid COVID-19 surge, state orders traveling nurses for Iowa hospitals

As Iowa’s COVID-19 hospitalizations reach levels not seen since December 2020, the state is contracting for 100 traveling nurses and respiratory therapists to be deployed in hospitals around Iowa.

Iowa Department of Public Health spokesperson Sarah Ekstrand did not list the participating hospitals but said in a December 7 email that the deployment will support seventeen facilities “that provide 1, 2, and 3 Trauma Level care.”

Communications staff for Mercy Cedar Rapids, MercyOne (which operates hospitals in Des Moines, West Des Moines, Dubuque, Clinton, Sioux City, Mason City, and Waterloo), Genesis Health System in Davenport, and UnityPoint’s Allen Hospital in Waterloo confirmed to Bleeding Heartland that they will receive some of the staffing assistance. UPDATE: The full list can be found at the end of this post.

Ekstrand said the deployment “will enhance capacity, reduce ED [emergency department] wait room times, facilitate additional transfers of critically ill patients and reduce strain at lower level trauma care facilities allowing their teams to focus on care for those who are less critically ill.”

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Ten ways Dr. Caitlin Pedati failed Iowans

State Medical Director and Epidemiologist Dr. Caitlin Pedati is leaving the Iowa Department of Public Health (IDPH) in late October, the agency announced on September 22.

The leader of Iowa’s COVID-19 response had hardly been seen in public all year and granted few media interviews. Pedati was an occasional speaker at Governor Kim Reynolds’ televised news conferences during the first eight months of the pandemic, but had not appeared at one since November 2020.

The unexplained departure raised questions about whether Pedati walked or was forced out. Reynolds’ new spokesperson Alex Murphy told Bleeding Heartland via email that no one in the governor’s office asked the medical director to leave. “This was a personal decision by Dr. Pedati.” Murphy also said the governor won’t pick her successor; rather, IDPH Director Kelly Garcia “and her team will handle the hiring.”

I’ll be seeking records that could show whether Pedati (a board-certified pediatrician) disagreed with any aspects of Iowa’s COVID-19 mitigation strategy, such as grossly inadequate guidance for schools or the retreat from recommending masks, even for unvaccinated people crowded together indoors.

Whether or not Pedati had any private misgivings, she repeatedly failed to keep Iowans safe or adequately informed during this pandemic, which has already killed more than 1 in 500 Iowa residents who were alive eighteen months ago.

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Health agency hiring temporary help with public records requests

The Iowa Department of Public Health is hiring a temporary staffer to assist public information officer Sarah Ekstrand in processing open records requests. The job listing says the new hire will help review and update the agency’s system for tracking requests, communicate with members of the public about the status of requests, help refine search terms, provide cost estimates, and review documents to see if they can be withheld as confidential.

The application deadline for the position was September 16. The temporary hire will be paid between $26.61 and $40.50 an hour, for at most 780 hours of work in the current fiscal year. That works out to about 20 weeks of full-time efforts devoted to processing records requests between now and June 30, 2022.

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1 in 500 Iowans have died of COVID-19

At least 6,390 Iowans have died of COVID-19, according to U.S. Centers for Disease Control statistics published on September 13. That’s just over one in 500 of the 3,190,369 Iowans who were living in the state as of April 1, 2020 (the U.S. Census Bureau’s resident population count).

The state’s COVID-19 dashboard, which lags behind federal data and is updated less frequently, now shows 6,337 total deaths. Sara Anne Willette draws on federal databases when updating her Iowa COVID-19 Tracker website, which now shows 6,392 total deaths.

Statistics compiled by the New York Times indicate that Iowa is the 25th state to pass the grim milestone of losing one in 500 residents in the pandemic. The highest per capita fatality rates are mostly found in densely populated northeastern states, where the novel virus spread widely before mitigation practices were in place, or in the deep South.

Among the states bordering Iowa, South Dakota has the highest fatality rate, followed by Illinois. Missouri’s per capita deaths are a little lower than Iowa’s, while Wisconsin, Minnesota, and Nebraska have all lost far fewer residents than Iowa as a percentage of their populations.

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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.

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Governor muzzles public health experts on masks

Once upon a time, Governor Kim Reynolds postured as an advocate for mask wearing to reduce community transmission of COVID-19. Although she never consistently masked up when near others, and often sent mixed messages about whether face coverings were advisable for everyone or mainly for vulnerable people, she appeared in videos last year that promoted masks as one way to “step up and stop the spread.”

The governor stopped touting masks some months ago. In recent interviews and public appearances, she has claimed it’s not clear whether face coverings reduce virus transmission in schools, and has asserted that masks can harm children.

The Iowa Department of Public Health has similarly retreated from recommending masks as part of a layered COVID-19 mitigation strategy. The governor’s staff have micromanaged the public health agency’s communications with the media since the earliest days of the pandemic. At Reynolds’ latest news conference, she and a staff member intervened twice to stop IDPH Director Kelly Garcia from answering questions about the benefits of masks.

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Governor, ER doctor on how COVID-19's affecting Iowa hospitals

Some 524 Iowans were hospitalized with COVID-19 as of September 1, according to the latest available figures on Iowa’s official coronavirus website. The first time pandemic hospitalizations reached that level here was in late October 2020. Before this week, the last time Iowa marked seven straight days with more than 500 people being treated for coronavirus in the hospital was in early January.

Governor Kim Reynolds put a positive spin on recent trends during a news conference on September 2. The same morning, Dr. Lance VanGundy, an emergency room physician at UnityPoint’s Marshalltown hospital, posted a weary assessment of the current situation on his Facebook feed.

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Iowa's COVID-19 hospitalizations reach October 2020 levels

COVID-19 case counts and hospitalizations continue to accelerate in Iowa, reaching levels not seen for many months. Data published on the state’s official website on August 25 show Iowa reported 7,112 new coronavirus cases over the previous week. The last time the state averaged 1,000 new cases a day was in late January.

Statewide, 498 Iowans are now hospitalized with COVID-19, an increase of 25 percent from the 396 reported on August 18. The last time this many Iowans were hospitalized with coronavirus was in mid-January. The number of patients being treated for the virus in intensive care units (133) is at its highest level since late December 2020. Iowa also reported 89 new daily admissions for COVID-19 on August 25, the highest level since mid-January.

Hospitalizations have risen sharply this summer, quadrupling in the last month alone. Current numbers are ten times higher than the low point for Iowa’s COVID-19 hospitalizations in late June.

The slope of this past month’s increases resembles what happened in Iowa last October, as you can see from graphs published on the RMCC Data page of the state’s website. Total hospitalizations and new daily admissions are now approximately where they were on October 20, 2020.

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Governor blocks Iowa schools from opening "safely and responsibly"

Governor Kim Reynolds loves to boast that Iowa “led the way” in bringing kids back to school during the COVID-19 pandemic, “and we did it safely and responsibly.” The talking point was debatable last year, since Iowa’s new cases and hospitalizations began surging several weeks after schools reopened.

It’s laughable now, as Iowa schools prepare to welcome kids back this week. While the Delta variant has caused spikes in pediatric cases and hospitalizations where schools are already in session, Reynolds and leaders of Iowa’s education and public health departments have blocked nearly every practice that helped reduce COVID-19 spread in schools last year.

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Utah attorney sues state agency for Test Iowa records

An attorney representing the board chair of the Salt Lake Tribune has sued the Iowa Department of Public Health (IDPH) and its records custodian for failing to provide email correspondence related to the $26 million Test Iowa program.

Paul Huntsman confirmed on July 30 that the lawsuit Suzette Rasmussen filed in Polk County the previous day is part of his Jittai initiative. The Tribune’s board chair recently created Jittai in order “to learn more about TestUtah and its sister programs” created through similar no-bid contracts in Iowa, Tennessee, and Nebraska. Florida also implemented parts of the program.

According to the court filing, which is posted in full below, Rasmussen wrote to Sarah Ekstrand in March seeking “copies of all correspondence between the Iowa Department of Public Health, including but not limited to Interim Director Kelly Garcia, and the Iowa Governor’s Office, Utah state officials, Nebraska state officials, and Tennessee state officials regarding the Test Iowa Contract” from March 1, 2020 to March 11, 2021.

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Governor bashes CDC, blames immigrants for COVID-19 spread

As the more transmissible Delta variant causes COVID-19 cases to rise in all 50 states, the U.S. Centers for Disease Control changed its guidance for fully vaccinated individuals on July 27. The CDC now recommends that they “wear a mask indoors in public” in areas “of substantial or high transmission.” In addition, anyone living with unvaccinated or immunocompromised household members, or those at higher risk of severe disease, “might choose to wear a mask regardless of the level of transmission.”

Despite having no science background, Governor Kim Reynolds bashed the new guidance as “not grounded in reality or common sense.” Only a few hours earlier, she had absurdly suggested that immigrants entering Texas might be to blame for accelerating community spread of COVID-19.

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State medical director misleads on COVID-19 nursing home data

State Medical Director and Epidemiologist Dr. Caitlin Pedati asserted that publicly available information about coronavirus cases in Iowa nursing homes is “pretty similar” to what was long disclosed on the state’s official COVID-19 website.

Pedati made the false claim during a wide-ranging interview with Andy Kopsa of Iowa Watch, conducted soon after the state switched from daily to weekly updates on coronavirus.iowa.gov. As part of the revamp, officials removed a page that had shown current outbreaks in long term care facilities.

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Vaccinated Iowa Veterans Home resident dies of COVID-19 (updated)

This story has been updated to note that a second resident infected in the latest outbreak has died.

Two of the seven Iowa Veterans Home residents who recently contracted COVID-19 have died, the home told relatives and guardians. The first resident who passed away “was in end of life care prior to testing positive” for coronavirus, an email sent on July 2 said. The message announcing the second death on July 4 did not provide further details.

All residents and staff affected by the latest coronavirus outbreak–the fifth at the state-run facility in Marshalltown–had been living or working in the Malloy 3 unit, which “remains in isolation.” Five of the residents who tested positive in late June returned from the facility’s COVID unit to Malloy 3 last week.

According to previous emails the facility sent to relatives and guardians, the residents who became infected in late June were all vaccinated for COVID-19.

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Company that provided Test Iowa tests faced SEC investigation

Co-Diagnostics, the Utah-based company that provided hundreds of thousands of COVID-19 tests for the Test Iowa program, faced a U.S. Securities Exchange Commission (SEC) investigation last year, Andrew Becker exclusively reported for the Salt Lake Tribune on June 17. Nomi Health, which signed no-bid contracts to provide COVID-19 testing with Utah, Iowa, and Nebraska, subcontracted with Co-Diagnostics for polymerase chain reaction (PCR) tests.

Records obtained and sources interviewed by Becker indicated that Co-Diagnostics went to a small regional hospital in Utah to validate its PCR tests while seeking Food and Drug Administration approval, instead of using equipment at Utah’s Public Health Laboratory. Senior state officials pushed for allowing the tests to be used in the Test Utah program prior to FDA emergency use authorization. In addition, the FDA issued the emergency approval more quickly than expected, even though officials within the federal agency reportedly “had concerns because Co-Diagnostics tests were manufactured in China.” 

The SEC began asking Utah officials questions in late April, Becker’s reporting shows. That was a few weeks after Test Utah launched and one week after Governor Kim Reynolds announced her administration had partnered with the same Utah-based companies for Test Iowa.

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Update on efforts to obtain a federal cannabis exemption for Iowa

Carl Olsen is the founder of Iowans for Medical Marijuana. promoted by Laura Belin

In February 2019, I asked the Iowa Medical Cannabidiol Board, which regulates our state’s medical cannabis program, if there was anything we could be doing about federal drug law, such as obtaining a federal exemption (21 C.F.R. § 1307.03) like the one that currently exists for another federal Schedule I controlled substance, peyote (21 C.F.R. § 1307.31).

In August 2019, at my request, the board recommended that the Iowa Department of Public Health (IDPH) obtain a federal exemption for cannabis. However, the department refused, saying none of the other 46 states that have enacted medical cannabis laws have requested federal exemptions, and that Iowans were not being injured by the federal criminalization of cannabis.

Keep in mind that patients had been testifying before the board about discrimination in schools and health care facilities because of the federal criminalization of cannabis. Iowa Attorney General Tom Miller signed a September 2019 bipartisan letter from attorneys general saying the current federal policy “poses a serious threat to public safety.”

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Iowa Republicans have abandoned executive branch oversight

Governor Kim Reynolds has been lucky at key points in her political career. Terry Branstad passed over more experienced contenders to select her as his 2010 running mate, allowing a little-known first-term state senator to become a statewide elected official. Six years later, Donald Trump won the presidency and named Branstad as an ambassador, setting Reynolds up to become governor without having to win a GOP primary first.

Most important, Reynolds has enjoyed a Republican trifecta her entire four years as governor. Not only has she been able to sign much of her wish list into law, she has not needed to worry that state lawmakers would closely scrutinize her administration’s work or handling of public funds.

During the legislative session that wrapped up last month, the GOP-controlled House and Senate rejected every attempt to make the governor’s spending decisions more transparent. They declined to hold even one hearing about questionable uses of federal COVID-19 relief funds or practices at state agencies that disadvantaged thousands of Iowans.

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Governor's complacency on vaccinations endangers Iowans (updated)

COVID-19 vaccinations increased significantly in Ohio after Governor Mike DeWine announced vaccinated residents would be eligible for five $1 million lottery drawings or full-ride scholarships to state universities. In contrast, vaccinations have been plummeting in Iowa lately. Most county health departments have been declining their vaccine allocations. Average daily shots are down 80 percent from their peak in early April.

Eighteen states and Washington, DC are now ahead of Iowa in terms of percentage of the population fully vaccinated, and 22 states plus DC have a higher percentage of residents who have received at least one shot. Less than two weeks ago, Iowa ranked sixteenth in the country on that metric.

Governor Kim Reynolds isn’t worried, though. She told reporters on June 2, “I am really happy with where we’re at” in terms of vaccinations. From Brianne Pfannenstiel’s article for the Des Moines Register,

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Data show no clear trend for Iowa suicides during pandemic

While defending her approach to the COVID-19 pandemic last year, Governor Kim Reynolds repeatedly asserted that Iowa was seeing an “uptick” in suicides, and listed suicides among the mental health problems that were “exponentially increasing.”

Preliminary data on Iowa deaths by suicide in 2020 paint a more complex picture. An estimated 557 Iowans took their own lives last year, the highest number recorded in two decades. However, many of the increased deaths occurred during January and February, before COVID-19 was identified in Iowa and well before any restrictions were imposed to slow the spread of the novel virus.

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Iowa Public Health abandons COVID-19 safety in schools

Governor Kim Reynolds told Iowans this week to “lean further into normal,” since “There’s no reason for us to continue to fear COVID-19 any longer.”

Iowa Department of Public Health Director Kelly Garcia obliged with new guidance urging schools and child care providers to “approach COVID-19 like other child illnesses.”

To justify abandoning precautions like mandatory face coverings and quarantines for children exposed to coronavirus, Garcia misrepresented the latest advice from the U.S. Centers for Disease Control.

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Iowa concealed COVID-19 testing help for well-connected firms

State officials deployed “strike teams” involving the Iowa National Guard to more businesses last year than previously acknowledged.

Records the Iowa Department of Public Health (IDPH) released on April 26 show seventeen workplaces received COVID-19 testing assistance through a strike team. The agency had stated in January that only ten workplaces (operated by nine companies) had strike team visits. Several newly-disclosed events benefited businesses linked to Governor Kim Reynolds’ major campaign donors.

Iowa used the strike teams mostly during the spring of 2020, when COVID-19 testing supplies were scarce. However, a strike team was sent to Iowa Select Farms administrative headquarters in mid-July, more than five weeks after the state had stopped providing testing help to other business. That company’s owners are Reynolds’ largest campaign contributors.

The governor asserted at a January news conference that the state had facilitated coronavirus testing for more than 60 companies, saying no firm was denied assistance. The newly-released records show nineteen businesses received testing kits from the state, and another nineteen were directed to a nearby Test Iowa site where their employees could schedule appointments.

The public health department’s spokesperson Sarah Ekstrand has not explained why she provided incomplete information about the strike team program in January. Nor has she clarified what criteria state officials used to determine which companies received which kind of testing assistance.

The governor’s spokesperson Pat Garrett did not respond to any of Bleeding Heartland’s emails on this subject. Reynolds walked away when I tried to ask her about the strike team decisions at a media gaggle on April 28.

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Iowa turned down $95 million to test school kids for COVID-19

Governor Kim Reynolds revealed on April 29 that she is sending back $95 million in federal funds designated for testing students for COVID-19.

During a Fox News event featuring Republican governors, Reynolds said of President Joe Biden,

I think he thinks the COVID just started. I just returned 95 million dollars because they sent an additional 95 million dollars to the state of Iowa to get our kids back in the classroom by doing surveillance testing. And I said, “We’ve been in the classroom since August. Here’s your 95 million dollars back.”

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States must apply for federal exemption when authorizing use of cannabis

Carl Olsen is the founder of Iowans for Medical Marijuana. -promoted by Laura Belin

Don’t be fooled by quasi-legal schemes to tax and regulate cannabis. There is a federal solution for doing this the right way.

If legislators tell you it makes their eyes glass over, tell them to leave the capitol and don’t come back until they are sober. They should not be legislating unless they can clearly see the road ahead.

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Iowa reports dozens of "new" COVID-19 deaths from 2020

Iowa’s official COVID-19 website added 68 more deaths over the weekend, bringing the state’s death toll to 5,822 (roughly one out of every 540 Iowans who was alive before the pandemic). The large increase was surprising; COVID-19 hospitalizations have been trending upward in recent weeks, but haven’t risen sharply enough to produce dozens of fatalities in just a few days.

It turns out that most of the newly reported deaths occurred more than three months ago.

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Racial disparities narrow in Iowa's COVID-19 vaccinations

As Iowa prepares to expand COVID-19 vaccine eligibility to all adults on April 5, racial and ethnic disparities in the state’s vaccination rates have narrowed slightly since Bleeding Heartland last reviewed this data four weeks ago. However, people of color have still received far fewer vaccine doses per capita, compared to white Iowans.

At least 1,588,117 COVID-19 vaccine doses have been administered to Iowa residents, according to the state’s vaccination dashboard on April 4. At least 662,885 Iowans have received all required doses of a COVID-19 vaccine (that is, two shots of the Pfizer or Moderna vaccines, or a single shot of the Johnson & Johnson vaccine). Another 368,646 Iowans “have received one dose of a two-dose COVID-19 vaccine series, but have not completed the series.”

Breaking down the numbers by race and ethnicity, it’s apparent that Iowa has a long way to go to achieve equity in vaccine distribution.

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Twelve facts about Iowa's staggering COVID-19 death toll

Kathy Davis passed away on March 24, 2020, having fallen ill shortly after an overseas vacation with her husband. The Iowa Department of Public Health later determined that the retired community college counselor from Dubuque was the first Iowan to die of the novel coronavirus.

One year later, the state’s official website shows that 5,689 Iowans have died of COVID-19. The real death toll is somewhat higher, since the process of confirming and reporting coronavirus deaths usually involves weeks of delay. In addition, some Iowans who died in the early weeks of the pandemic may not have had a positive test during their illness.

This post attempts to put Iowa’s coronavirus fatality numbers into context. But since statistics don’t convey the loss that thousands of families have experienced, I hope readers will take time to reflect on those who have passed. The Dubuque Telegraph-Herald’s Bennet Goldstein wrote about Kathy Davis and her widower Chuck’s journey of bereavement. The Carroll Times Herald’s Jared Strong covered the aftermath of a card game among friends in Crawford County. Newspaper reporters from around the state have profiled hundreds of the dead as part of the Iowa Mourns series, available on the Des Moines Register’s website. One of those featured was Jay Daniels, a longtime family friend whose funeral we couldn’t attend, due to COVID safety protocols.

Bereavement on this scale is hard to fathom, especially in a culture some might call “grief-illiterate,” where death is often “unseen and denied.” Even so, it’s worth looking at the numbers.

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State auditor to review Iowa's COVID-19 "strike teams"

State Auditor Rob Sand announced on January 26 that his office will examine the state’s use of COVID-19 “strike teams” involving the Iowa National Guard. A news release noted,

Reports show public record emails in which a metal-working manufacturer owned by major donors to Governor Reynolds received a strike team deployment upon a personal request made to her office, while the same county’s public health department saw its requests for locations with higher needs ignored.

Bleeding Heartland exclusively reported on those emails. In one exchange, an employee of the GMT Corporation in Waverly told Bremer County’s public health administrator, “I requested testing and was told that we would most likely be denied with only one case. Our owners contacted the governor directly and she authorized the testing for us.”

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Exclusive: Governor fast-tracked COVID tests for firm linked to major donor

Governor Kim Reynolds authorized using state resources to conduct COVID-19 tests at a workplace that had only one confirmed case after the company’s owners reached out to her last May.

Iowa National Guard and Iowa Department of Public Health (IDPH) personnel facilitated coronavirus testing at GMT Corporation, a machine parts manufacturer in Waverly, on May 22, 2020. Fewer than a dozen Iowa businesses received such visits during the two months the state’s “strike team” program was active, when coronavirus testing kits were not widely available.

Summit Ag Investors, the asset management arm of Bruce Rastetter’s Summit Agricultural Group, owns a majority interest in GMT. Emails Bleeding Heartland obtained through a public records request indicated, and GMT’s top executive confirmed, that someone from Summit Ag “contacted the governor directly” after GMT staff learned they “would most likely be denied” testing assistance from the state.

Neither Summit Ag executives nor staff in the governor’s office responded to Bleeding Heartland’s inquiries.

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Birthing a conference: A celebration of Black kin

Des Moines-based holistic doula and lactation counselor Olivia Samples first published this post on Kismet Doula Services’ blog. -promoted by Laura Belin

Last year I attended two conferences centered around Black Maternal Health. After the first one I attended, I had a dance party in my room to the playlist they sent us. The discussion, resources, and connection I got from this event totally filled my cup; left me energized and ready for more.

A few weeks later, during the second conference, I felt the anger rising from my gut into my face. I cried and stepped away after hearing so many statistics of the disparities for Black birthing people in Iowa. I learned a lot from other sessions throughout the conference, but at the end of the day, I closed my laptop, journaled, and took a nap.

Something that sticks out from the entry that day:

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The 20 most-viewed Bleeding Heartland posts of 2020

Since I started reviewing Bleeding Heartland’s most widely-read posts at the end of each year, I’ve had mixed feelings about the practice. My organizing principle on any given day is not chasing clicks, but looking for ways to add value, either by covering Iowa political news not reported elsewhere, or by offering a different perspective on the big story of the day. I try not to be hyper-aware of traffic numbers, so as not to let those drive editorial decisions.

On the other hand, it is fun at year-end to recap the posts that were particularly popular with Bleeding Heartland readers, and I usually find a few surprises.

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Best of Bleeding Heartland's original reporting in 2020

My primary goal in running this website is to provide Iowa political news and analysis that’s not available anywhere else. I’m proud of what Bleeding Heartland accomplished in 2020 and want to highlight some of the investigative reporting and accountability journalism published first or exclusively here.

A forthcoming post will review the site’s most popular pieces from 2020, which included many I worked hardest on or most enjoyed writing.

As always, I’m grateful for readers whose appetite for this kind of reporting keeps me going.

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Maternal health in Iowa: You don't know what you don't know

Rachel Bruns is a volunteer advocate for quality maternal health care in Iowa. -promoted by Laura Belin

As I plan to write several posts in the coming weeks related to maternal-child health in Iowa, I want to introduce myself to Bleeding Heartland readers. For this piece, I’m going to provide some high-level information on the landscape around maternal health in Iowa from my perspective as a maternal-child health advocate.

But first, some background on myself and how I became involved in this work.

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What we've learned from Iowa's newly accurate COVID-19 death count

Since the Iowa Department of Public Health (IDPH) changed how it counts and reports COVID-19 deaths on December 7, fatality numbers on the official website coronavirus.iowa.gov have become more accurate in several respects. The state’s dashboard no longer routinely lowballs how many Iowans have died in the pandemic. Instead, the IDPH numbers track closely with weekly figures published by the U.S. Centers for Disease Control.

We now know that COVID-19 deaths accelerated in Iowa this fall even more rapidly than was previously apparent. Through the end of November alone, at least 3,308 Iowans had died in the pandemic. That number was more than 600 higher than the state website indicated before the IDPH began implementing the new counting method.

Two drawbacks have accompanied this important policy change. First, there is a greater lag time between when an Iowan dies and when that fatality tends to appear on the dashboard. In addition, updates to the state website have become more erratic, with IDPH staff adding few or no deaths on some days, and more than 100 deaths on others.

Now more than ever, media organizations that report COVID-19 statistics daily must put those numbers in context. Anyone following news on the pandemic needs to understand that changing totals from one day to the next on the IDPH website do not reflect how many Iowans died of COVID-19 during the previous 24 hours.

That said, the more accurate counting method is bringing the horrifying scale of the pandemic into focus.

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Vaccine council's secrecy rests on questionable reading of Iowa law

Iowa’s new Infectious Disease Advisory Council will continue to meet behind closed doors, Iowa Department of Public Health (IDPH) interim Director Kelly Garcia confirmed on December 16. Garcia established the council earlier this month, naming 25 “external and internal subject matter experts” to help the agency develop guidelines for allocating limited supplies of COVID-19 vaccines and therapeutics.

Iowans are unable to observe council members as they consider how to balance the needs of disparate groups at high risk from the novel coronavirus. Ryan Foley reported for the Associated Press on December 16 that the council “has met twice this month without giving prior notice to the public, publishing an agenda or allowing the public to participate as required by the Iowa Open Meetings Act.”

The IDPH maintains that Iowa Code Chapter 21 does not apply to an advisory council created by a state agency. But not every expert on the law concurs.

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Feds deny exemption for Iowa's medical cannabis program

Carl Olsen recounts the latest legal steps in his effort to reconcile state and federal drug laws. -promoted by Laura Belin

On November 10, just a week after the election, the U.S. Drug Enforcement Administration (DEA) denied our petition for a new federal regulation exempting state medical cannabis programs to be added as 21 C.F.R.

DEA explained that denying the exemption was necessary because it would create an exemption:

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Exclusive: Iowa's official COVID-19 website undercounts deaths

UPDATE: State officials changed their methodology for counting COVID-19 deaths in early December 2020. Original post follows.

The state’s official website on the coronavirus pandemic regularly understates the number of Iowans who have died of COVID-19, Bleeding Heartland’s analysis of U.S. Centers for Disease Control data indicates.

The Iowa Department of Public Health submitted information to the CDC indicating that 2,099 Iowans had died from COVID-19 through the week ending November 7. The latest figures published on coronavirus.iowa.gov show 2,206 total deaths, but account for only 1,920 deaths through November 7.

Sara Anne Willette, who maintains the Iowa COVID-19 Tracker website, has noticed the same discrepancy. It may explain why IDPH communications staff never answered Bleeding Heartland’s many inquiries about how the state counts coronavirus fatalities.

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Exclusive: Iowa medical director's 45% raise violated state policy

Iowa Medical Director Dr. Caitlin Pedati received a 45 percent raise this summer despite a state policy limiting within-grade pay increases, records obtained by Bleeding Heartland show.

Department of Administrative Services (DAS) Interim Director Paul Trombino III advocated for Pedati to receive the unusually large raise three weeks after informing state agency directors that they could give employees within-grade salary hikes of up to 3 percent.

State rules also require that “any within grade pay increase must be accompanied by a current performance evaluation,” Trombino reminded directors in the same memo. However, staff with the Iowa Department of Public Health (IDPH) and DAS did not answer questions about whether anyone has formally reviewed Pedati’s work this year.

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As Iowa's COVID-19 trends worsen, Kim Reynolds is out campaigning

Governor Kim Reynolds isn’t on the ballot this November, but you wouldn’t know it from her schedule lately. She’s been putting in full-time hours at campaign events for other Republican candidates.

Since Reynolds’ last televised news conference on October 7, and even since Bleeding Heartland last reviewed this topic a week ago, key statistics reflecting the novel coronavirus pandemic have worsened. Iowa is reporting more deaths and setting new records for hospitalizations, as new daily cases and the fourteen-day test positivity rate also increase.

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Kim Reynolds' commitment to "normalcy" is getting a lot of Iowans killed

Governor Kim Reynolds found a way to make a bad situation worse.

In the past month, Iowa’s coronavirus deaths have accelerated, while hospitalizations have nearly doubled, far surpassing the previous peak in early May.

Despite numerous warnings from experts that Iowa is on a dangerous path, Reynolds refuses to take any additional steps to slow community transmission of the virus. Instead, she is sticking with the “trust Iowans to do the right thing” playbook, confident that hospitals will be able to handle the influx of COVID-19 patients.

The numbers speak for themselves.

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State seeking federal exemption for Iowa's medical cannabis program

Carl Olsen, the founder of Iowans for Medical Marijuana, brings us up to date on his efforts to reconcile state and federal drug laws. -promoted by Laura Belin

Retail sales of medical cannabis products began in Iowa on December 1, 2018, implementing Iowa House File 524, which lawmakers passed on the final day of the 2017 legislative session.

Iowans for Medical Marijuana submitted an application to the U.S. Drug Enforcement Administration in January 2019, seeking to exempt Iowa’s Medical Cannabis Program from federal drug laws. That application used the process in Title 21, Code of Federal Regulations, Chapter 1307, 21 C.F.R. §1307.03. I then began to lobby the state legislature and the Iowa Department of Public Health to support the application.

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Ousted public health staffer alleges Iowa open records law violations

Update: Carver-Kimm amended her lawsuit in June 2021 to include the two claims originally filed with the State Appeal Board. She amended it again in August 2021 to add more plaintiffs and remove the third count related to First Amendment claims. You can read the latest version of the petition here. The case is scheduled for trial in the summer of 2022. Original post follows.

The Iowa Department of Public Health’s longtime communications director Polly Carver-Kimm filed suit on September 2, claiming she was wrongfully terminated, in violation of the state’s whistleblower law. Stephen Gruber-Miller first reported on the lawsuit for the Des Moines Register. I’ve enclosed below the District Court filing and Carver-Kimm’s parallel claims filed with the State Appeal Board.

Carver-Kimm was the lead media contact at IDPH for thirteen years before she was told to resign or be fired in mid-July. Her attorney, Tom Duff, has represented other well-known Iowans who have sued the state on whistleblower claims or alleging wrongful termination, including former criminal investigator Larry Hedlund (who had caught the SUV carrying then Governor Terry Branstad speeding) and former Department of Human Services Director Jerry Foxhoven.

The day she was ousted, Carver-Kimm told the Des Moines Register’s Tony Leys she was “embarrassed and saddened by the way the media has been treated during COVID.” She asserted that she was stripped of her duties and eventually removed for being too open with journalists seeking information about the pandemic.

Her court filing and an accompanying news release from Duff’s office are more specific about alleged violations of Iowa’s open records law.

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Iowa's COVID-19 website rewrites history every day

If you visit coronavirus.iowa.gov and view the graphs on the “case counts” page, you might expect to learn how many Iowans were tested for COVID-19 on any given day, and how many of those tests came back positive or negative.

You would be wrong.

Every day, records of hundreds or thousands of old tests disappear from the website. Consequently, it is impossible to reconstruct an accurate picture of Iowa’s testing numbers or positivity rates, either statewide or at a county level.

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State flying blind on Test Iowa's positivity rate

The Iowa Department of Public Health is not tracking the rate of positive, negative, or inconclusive results from COVID-19 tests performed through Test Iowa, Ethan Stein reported for KCRG-TV on August 26.

State officials have declined to segregate data from Test Iowa so that the public could compare those results to COVID-19 tests performed in other settings. But I had assumed the state was collecting that information for its own analysis and quality control.

Not so, KCRG learned.

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Iowa health officials knowingly rolled out flawed COVID-19 positivity data

“Our state coronavirus website now includes the county by county 14-day average positivity rate for our school districts,” Governor Kim Reynolds announced at her August 6 news conference. “Schools and others will be able to check to see where each county stands on this important metric.”

State Medical Director Caitlin Pedati appeared via computer link at the same press conference, answering reporters’ questions about state policies on reopening schools.

Pedati acknowledged on August 19 that the Iowa Department of Public Health’s epidemiology team knew in late July that the positivity rates were inaccurate, because many recent COVID-19 cases were recorded as occurring weeks or months in the past.

An announced “fix” did not appear to solve the backdating problem. On the contrary: newly posted totals on the state’s coronavirus website increased the number of cases recorded for March and April.

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Iowa's COVID-19 deaths on upward trend as total surpasses 1,000

Less than five months after the first Iowan succumbed to the novel coronavirus, the official count of COVID-19 fatalities reached 1,002 on the evening of August 18.

The pandemic has now claimed more Iowa lives than 60 years of foreign wars. Data compiled by the Iowa Department of Veterans Affairs shows 868 military service members died in Vietnam, as did two in Panama or Grenada during the 1980s, seven in the Persian Gulf war of the early 1990s, 64 in the Iraq War that began in 2003, and 31 in Afghanistan.

COVID-19 has killed more Iowans in five months than diabetes, the state’s seventh-leading cause of death, does in a typical year.

More Iowans have passed away of coronavirus since March than died in vehicle accidents during 2017, 2018, and 2019 combined.

Publicly available data show the pace of deaths has been accelerating, even before most Iowa students return to K-12 schools or colleges. Those official numbers almost certainly undercount the lives lost.

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Iowa's COVID-19 website has backdated some cases for months

The Iowa Department of Public Health has erroneously recorded thousands of positive COVID-19 test results, distorting reported case numbers and positivity rates.

Rob Ramaekers, the lead epidemiologist for the department’s Surveillance Unit, acknowledged in an August 14 email that Iowa’s coronavirus website has recorded some recent cases as occurring weeks or months in the past. According to Ramaekers, state officials are aware of the problem and working on a fix.

The backdating means that publicly available numbers underestimate the positivity rate for COVID-19 tests conducted over the past two weeks, a key metric for measuring community spread.

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Exclusive: Iowa's state medical director received 45% pay raise

The base pay for Iowa’s medical director and state epidemiologist Dr. Caitlin Pedati increased by 45 percent as the current fiscal year began on July 1, records obtained by Bleeding Heartland show. The additional $3,144 that Pedati began receiving per two-week pay period would translate to an extra $81,744 in base salary over twelve months.

The doctor leading the state’s COVID-19 pandemic response also received more than $55,000 in overtime pay from March through early July, even though her job class would not normally be eligible for overtime compensation.

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Now she tells us

More than four months into the novel coronavirus pandemic, Governor Kim Reynolds and the Iowa Department of Public Health are finally acknowledging that slowing the spread of COVID-19 will require many more Iowans to routinely cover their faces in public.

Their “#StepUpMaskUpIA” campaign might have been more successful if state officials had pushed the message before reopening businesses and lifting other COVID-19 mitigation strategies in May and June. Instead, top officials waited until new coronavirus cases, hospitalizations, and deaths had been trending upward in Iowa for weeks.

Public health experts at the University of Iowa urged state leaders months ago to call for universal use of face coverings. But at her televised news conferences, Reynolds repeatedly asserted that expanded testing would allow the state to “manage” and “control” the virus. At the same events, the governor regularly portrayed face masks as something vulnerable Iowans might need, or a precaution people could bring with them in case they found themselves in a crowded setting.

As recently as last week, Reynolds was photographed in close proximity to others, with no one’s face covered. Even now, she refuses to delegate authority so local governments can issue enforceable mask orders.

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State won't clarify how Iowa counts COVID-19 deaths

This project started with the goal of clearing up some confusion surrounding Iowa’s novel coronavirus (COVID-19) death statistics.

Specifically, I wanted to debunk a conspiracy theory making the rounds on Facebook, Twitter, and Reddit.

I also planned to explain why the number of deaths for a given day on the state’s official website (coronavirus.iowa.gov) didn’t always match the number of new deaths that had been announced on that date. Many readers had asked about the discrepancy.

I was almost ready to publish in early July, but I needed to nail down one detail. Did the total fatalities on the state website (793 at this writing) reflect all of what the U.S. Centers for Disease Control describes as “multiple cause” COVID-19 deaths, or only what the CDC labels “underlying cause” deaths?

After asking that question more than half a dozen times over two and a half weeks, I still haven’t received an answer. So much for the Iowa Department of Public Health’s supposed “transparency” and “constant communication with media” on the pandemic.

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Ousted staffer pulls back curtain on Iowa's COVID-19 information blockade

“I am embarrassed and saddened by the way the media has been treated during COVID,” Polly Carver-Kimm wrote in an email to the Des Moines Register on July 15. “You are not receiving timely answers and you are getting scripted talking points when you do get an answer.”

Carver-Kimm discussed the state’s handling of press inquiries hours after being shown the door as communications director for the Iowa Department of Public Health.

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Why I'm asking Iowa to seek an exemption from federal drug laws

Carl Olsen recounts his long battle to reschedule cannabis and the latest legal steps in his effort to reconcile state and federal drug laws. -promoted by Laura Belin

Last month, I filed a petition with the Iowa Department of Public Health, asking the agency to start the process of obtaining a federal exemption for Iowa’s medical cannabis law.

I had presented this idea to Iowa’s Medical Cannabidiol Board in August 2019. The board members unanimously approved the concept and recommended in January 2020 that the legislature protect schools and long-term care facilities, which “are hesitant to allow medical cannabidiol products to be administered and stored at the facilities due to the current scheduling of Cannabis at the federal level.” The board suggested “Developing language to protect these facilities or seeking exemption for Iowa’s program from federal drug laws.”

Instead of adopting my proposal, Republican lawmakers approved and Governor Kim Reynolds signed House File 2589, which instructed the Department of Public Health to “request guarantees” from federal agencies that they would not withhold federal funding from educational or long-term care facilities that allow patients to possess or staff to administer medical cannabidiol.

That approach makes no sense, because it would put Iowa in direct conflict with federal drug law. As I wrote in my petition, “There is no formal process for requesting guarantees from federal agencies not to withhold funding for violation of federal drug laws.”

Here’s why Iowa should take a different path.

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Iowa's COVID-19 fatalities surpass eighth leading annual cause of death

At least 702 Iowans have died from novel coronavirus infections, according to the state’s official website at midday on June 26. Less than four months since the state recorded its first case, the death toll from COVID-19 alone is higher than the number of Iowans who have died in any recent year of flu or pneumonia, which has been the state’s eighth leading cause of death. Those fatalities occurred despite social distancing and other unusual precautions like restricted nursing home visits since March.

Statistics archived by the U.S. Centers for Disease Control indicate that 697 Iowans died of flu or pneumonia in 2018, reflecting a worse than usual flu season. Iowa deaths in that category numbered 582 in 2014, 618 in 2015, 504 in 2016, and 578 in 2017.

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Model shows distancing, PPE could reduce Iowa's COVID-19 cases, deaths

Novel coronavirus (COVID-19) infections and deaths could increase or decrease substantially in the coming months, depending on how many Iowans practice social distancing or wear personal protective equipment (PPE) routinely in public, according to a modeling app designed by University of Iowa faculty and graduate students.

Six professors of biostatistics or epidemiology collaborated on the model, while a group of graduate students worked on the app and translated materials for a Spanish-language version. The university’s College of Public Health COVID-19 Response Team “developed this tool as a free public service to state and local policymakers, business leaders, and others to assist in guiding the community response to the coronavirus pandemic.”

This incredibly useful resource was derived from publicly-available data, so is not subject to restrictions on release state government imposed as part of the contract the Iowa Department of Public Health and UI College of Public Health signed in April to develop Iowa-specific modeling for COVID-19. Governor Kim Reynolds and state health officials largely ignored that modeling when drafting plans to reopen businesses and venues in May and June, saying “real-time data” was informing such policies.

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Iowa OSHA visits two more meatpackers; other plants cleared with no inspection

Occupational Safety and Health Administration (OSHA) staff conducted on-site inspections of two more Iowa meatpacking plants this week, the Iowa Division of Labor confirmed to Bleeding Heartland on June 2.

Documents provided the following day show regulators closed at least four coronavirus-related complaints against Iowa pork processors with no inspection.

Inspectors toured the Tyson Foods turkey plant in Storm Lake and the Perdue Premium pork facility in Sioux Center on June 1. Both site visits stemmed from “media referrals” rather than complaints, meaning officials acted on unspecified news reports or information relayed to OSHA by a journalistic source.

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"Projections" on Iowa's COVID-19 website have no scientific basis

UPDATE: Hours after this piece was published, the plus/minus feature disappeared from the state website. Original post follows.

The state of Iowa’s official website for information about the novel coronavirus pandemic incorporated a few tweaks this week. The most noticeable: Department of Public Health staff update various statistics throughout the day, rather than once in each 24-hour period. During her May 18 news conference, Governor Kim Reynolds asserted that the new practice would make data on COVID-19 more “transparent.” Critics pointed out that the frequent updates would make it harder for Iowans to keep tabs on daily changes in coronavirus cases, tests, hospitalizations, and deaths.

Reynolds didn’t announce another addition to the website, which has attracted relatively little notice. Several of the bar graphs can now be adjusted to project the number of daily cases, tests, hospitalizations, or deaths weeks or months into the future.

The trouble is, those projections are not grounded in any principles of epidemiology.

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Test Iowa's contractor discouraging some from seeking COVID-19 tests

A company hired to ramp up Iowa’s capacity to test for novel coronavirus has been sending messages to sick Iowans that could discourage them from seeking a COVID-19 test.

Some people who reported respiratory symptoms when completing the Test Iowa online assessment, but did not qualify for an appointment at a drive-through site, received a message warning that COVID-19 testing “is quite invasive and uncomfortable” and that tests should be reserved “for those who need it the most.”

Neither Nomi Health nor state officials have clarified whether the Iowa Department of Public Health helped write or approved the wording.

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Staying 6 feet apart won't stop COVID-19 from spreading at church

Religious institutions across Iowa are now allowed to hold large services, under Governor Kim Reynolds’ latest proclamation related to novel coronavirus, which took effect on May 1. While most churches declined to schedule in-person services for this Sunday morning, some are looking at ways to modify their space or practices in order to resume face-to-face worship soon.

In mid-March, the governor temporarily prohibited religious or spiritual gatherings of more than ten people. Her April 27 order lifted that ban, provided that houses of worship “implement reasonable measures […] to reduce the risk of transmission of COVID-19 consistent with guidance issued by the Iowa Department of Public Health.” Among other things, the department recommends that people practice good hygiene and adjust the layout so congregants not from the same household can “sit at least six feet apart.”

That advice is insufficient to keep those carrying the virus from infecting others.

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Iowa governor's COVID-19 strategy more faith-based than data-driven

For weeks, Governor Kim Reynolds told reporters at her daily news conferences that “data” and “metrics” informed her approach to slowing the spread of novel coronavirus (COVID-19) in Iowa.

That narrative flew out the window on April 27, when she unveiled her plan to lift some mitigation measures statewide and allow many kinds of businesses to reopen in 77 Iowa counties, effective May 1.

Reynolds and Dr. Caitlin Pedati, the state medical director and epidemiologist, sought to spin the new policy as “evidence-based.” In reality, they are betting Iowans’ lives on the potential for data collection that has barely begun.

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COVID-19 crisis unmasks health care system's failures

Dr. Glenn Hurst: The nursing homes know that if they accept one COVID-19 patient in their facility, they will likely be sending ten new patients to either the hospital or the coroner. -promoted by Laura Belin

As we look to reopen the U.S. economy, many questions arise regarding whose interests the economy serves. In the health care sector, the answer is large health systems, often at the expense of some of the most vulnerable populations in our state. Their vertical integration of the profitable components of health care provision, hospitals, surgery centers, rehab and physicians, and the casting off of components such as nursing care and hospice have acutely left the older generation at grave risk.

Today’s crisis illustrates the problem. The continued outbreak of novel coronavirus (COVID-19) cases in Iowa nursing homes should be shocking. The response to calls for assistance to protect these patients should be met with the same distress.

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New COVID-19 testing program may miss Iowans in high-risk groups

“I do want to encourage every Iowan to go to TestIowa.com and take the assessment,” Governor Kim Reynolds said as she rolled out a program to increase the state’s coronavirus testing capacity during an April 21 news conference. The governor announced the following day that more than 80,000 Iowans had completed an initial assessment during the first 24 hours the website was online.

However, the online survey at the new site is not accessible to all Iowans in high-risk groups for COVID-19 infections and complications. Representatives of the governor’s office and Iowa Department of Public Health did not respond to Bleeding Heartland’s repeated questions about barriers to taking the survey.

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The Iowa COVID-19 peak that wasn't

Three weeks ago today, Iowa Department of Public Health Deputy Director Sarah Reisetter told reporters our state’s novel coronavirus (COVID-19) infections might hit “a first peak in the next two to three weeks.” But Iowa has racked up more confirmed cases and deaths attributed to COVID-19 during the past three days than in any previous three-day period. Outbreaks continue to be identified in long-term care facilities and meatpacking plants, where one infected person can pass the virus to many others.

Governor Kim Reynolds imposed stricter limits on socializing outside the household in fourteen northeast Iowa counties on April 16. The next day, she ordered all schools in the state to remain closed through the remainder of this academic year. But even as the governor encouraged Iowans to stay home if they can, she asserted on April 17 that “there are a lot of really positive signs” and suggested officials may be ready to start opening things up in parts of the state soon.

Meanwhile, the country’s most widely-cited model for COVID-19 now projects that use of hospital resources and coronavirus deaths in Iowa will peak on May 7 and 8, respectively. The Institute for Health Metrics and Evaluation (IHME) at the University of Washington also indicates that “relaxing social distancing may be possible” in Iowa after June 29. By comparison, the same model projects that the states of Washington and California already passed their peak for deaths and hospital resource use and may be able to scale down mandatory social distancing on May 18.

Why hasn’t Iowa turned the corner?

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Iowa slightly expands COVID-19 testing criteria

UPDATE: The state altered testing criteria again on May 6, but the changes were minimal (see new policy at the end of this post).

Iowa’s State Hygienic Laboratory posted new testing requirements on April 17 for people who suspect they have novel coronavirus (COVID-19) infections. The updated criteria are nearly identical to earlier versions, with a change designed to reduce the risk of asymptomatic patients bringing the virus to assisted living facilities.

Also on April 17, Iowa Department of Public Health Deputy Director Sarah Reisetter confirmed that some workers without symptoms will be tested at meatpacking plants where other employees are known to have COVID-19 infections.

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Iowans deserve more transparency to help stop COVID-19

Democratic State Senator Janet Petersen is the Iowa Senate minority leader. -promoted by Laura Belin

When trouble hits our state, Iowans want leaders who talk straight and make sure all Iowans can be part of the solution.

That’s true when we are helping fellow Iowans recover from flooding, tornados and other natural disasters. And it’s certainly true of our efforts to battle the COVID-19 pandemic.

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Flawed assumptions, missing elements in Kim Reynolds' COVID-19 plan

Joe Gorton is a criminology professor at the University of Northern Iowa. -promoted by Laura Belin

During her March 19 press conference, Governor Kim Reynolds presented her social distancing strategy for protecting Iowa from the novel coronavirus (COVID-19 or SARS-CoV-2) pandemic. Unfortunately, she failed to discuss or even acknowledge any of the significant risks associated with her particular approach.

The purpose of this article is to provide information about the unreported hazards the Reynolds plan incorporates.

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Iowa governor, local officials at odds over shelter-in-place order

Governors of seventeen states have issued shelter-in-place orders to slow the spread of novel coronavirus (COVID-19). But Governor Kim Reynolds again maintained on March 24 that data do not support that action in Iowa. She and top Iowa Department of Public Health officials are betting that closures already in place, along with official efforts to encourage social distancing, will be sufficient to keep serious COVID-19 infections from overwhelming our health care system.

A growing number of local leaders disagree.

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A dangerous time in Iowa

Tanya Keith is an activist and small business owner in Des Moines, and author of the recently published Soccer Stars on the Pitch. -promoted by Laura Belin

On Sunday, my son coughed as he was unloading the clean dishes. Thus began my adventure of losing faith in Iowa’s COVID-19 response.

I grabbed the forehead scanner and “beeped” him. Normal. But it gave me pause. With three kids, and kids not presenting with symptoms, I decided to beep all the foreheads in the house. I was normal, the teen was normal, but the preschooler scanned at 100.4 and my husband at 99.9. 

Holding out hope that testing standards had relaxed enough to include all symptomatic Iowans, I called the Urgent Care associated with our doctor’s office. They told me I would need to call the Iowa Department of Public Health’s hotline at 211. So I did.

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Iowa Democrats postpone county conventions; No changes at legislature

UPDATE: The Iowa legislature on March 16 suspended the 2020 session for at least 30 days. The Iowa Democratic Party sent guidance to county chairs the State Central Committee on March 23 on conducting county conventions “using an absentee system.” I’ve enclosed that document at the end of this post.

The Iowa Democratic Party is postponing county conventions scheduled for March 21 “to a future date to be determined,” the party announced today.

But for now, leaders of the Iowa legislature have no plans to pause activities at the state Capitol. They should reconsider.

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Planned Parenthood on track to receive sex ed grants

Two Iowa state agencies announced on May 31 an intent to award Planned Parenthood of the Heartland sex education grants for the fiscal year beginning on July 1.

Republican lawmakers approved and Governor Kim Reynolds signed legislation seeking to deny Planned Parenthood access to the federally-funded Community Adolescent Pregnancy Prevention and Services Program (CAPP) and the Personal Responsibility Education Program (PREP) grants. However, a Polk County District Court put that provision on hold this week, saying Planned Parenthood was “likely to succeed on the merits of its equal protection claim” under the Iowa Constitution.

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Exclusive: Two health giants block Iowans from medical cannabis program

Doctors affiliated with Mercy Cedar Rapids and The Iowa Clinic are refusing to sign paperwork their patients need to register for the Iowa Department of Public Health’s medical cannabis program. Iowa law requires applicants to obtain their doctor’s signature attesting that the patient has a “qualifying debilitating medical condition.” But the law stipulates that health care practitioners have “no duty to provide” written confirmation of the patient’s diagnosis.

Mercy Cedar Rapids appears to have instructed its 503 physicians not to sign the IDPH paperwork, according to two sources with qualifying conditions, who receive health care at different facilities in that network. Most if not all of the 250-plus health care providers at The Iowa Clinic, a doctor-owned group in the Des Moines area, are also refusing to sign medical cannabis card applications.

Without cooperation from a primary care provider, Iowans cannot start the process of receiving authorization to use cannabidiol legally. The number of patients affected by their health care group’s policies is unknown but potentially large. Mercy Cedar Rapids handled 451,400 outpatient visits last year at offices around Iowa’s second largest metro area. The Iowa Clinic averages 450,000 visits annually, serving about 148,000 unique patients across its central Iowa locations.

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Judge orders state agency to list same-sex spouse on child's birth certificate

A Polk County District Court Judge has ordered the Iowa Department of Public Health to list a birth mother’s same-sex spouse on the child’s birth certificate without requiring the non-birthing mother to go through the adoption process.

However, the ruling does not automatically apply to all Iowa same-sex couples seeking to have both parents listed on their children’s birth certificates.

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Miller-Meeks to Public Health and other Branstad appointment news

Governor-elect Terry Branstad announced today that ophthalmologist Dr. Mariannette Miller-Meeks will run the Iowa Department of Public Health in his administration. A press release noted that Miller-Meeks “has served as the first woman President of the Iowa Medical Society and was the first [woman] on the faculty in the Department of Ophthalmology at the University of Iowa and councilor for Iowa to the American Academy of Ophthalmology.” Miller-Meeks was the Republican nominee in Iowa’s second Congressional district in 2008 and 2010. She worked hard during both campaigns but lost to Dave Loebsack in Iowa’s most Democratic-leaning Congressional district.

Also on December 9, Branstad announced that he will tap Chuck Palmer to head the Department of Human Services in his administration. Palmer did that job during Branstad’s previous time as governor from 1989 to 1999. Most recently he has been president of Iowans for Social and Economic Development, “an asset development organization with the mission of creating opportunities for low and moderate income Iowans to increase income and achieve financial stability.”

Branstad has pledged to reduce the size of state government by 15 percent, and keeping that promise would likely require significant cuts in the departments Miller-Meeks and Palmer will be running. The current budget (fiscal year 2011) allocated $935.5 million from the general fund to health and human services. That’s 17.7 percent of the general fund budget alone, or 15.9 percent of total state expenditures, including federal stimulus money and reserve funds as well as general fund spending. More than $200 million in federal stimulus money supported Iowa’s Medicaid budget in the current budget year, but similar support won’t be forthcoming in future years now that Republicans have a majority in the U.S. House of Representatives.

Branstad administration press releases on Miller-Meeks and Palmer are after the jump.

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Iowa Department of Public Health having trouble with marriage equality

When some Republicans tried to convince county recorders not to issue marriage licenses to same-sex couples last April, Iowa Department of Public Health officials made clear that ignoring the Iowa Supreme Court’s Varnum v Brien ruling was not an option. Unfortunately, the IDPH has determined that marriage equality does not require equal treatment for married gay couples who become parents. Now IDPH Director Tom Newton has foolishly decided to fight a lawsuit brought by a married lesbian couple seeking to have the non-birthing spouse listed on their child’s birth certificate. Heather and Melissa Gartner sued senior IDPH officials on behalf of their daughter this week, having tried and failed to resolve the matter through administrative channels.

Based on advice from the Iowa Attorney General’s Office, the IDPH contends that the non-birthing spouse must complete the adoption process in order to be listed as the second parent on a child’s birth certificate, even if the child was born after the parents were legally married. I’m a big fan of Attorney General Tom Miller, but his office blew it on this one.  

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Don't make gay spouses adopt their own children

The Iowa Attorney General’s Office has advised the Iowa Department of Public Health that a married lesbian who gives birth cannot list her spouse on the child’s birth certificate, according to Michael Gartner’s must-read scathing commentary in this week’s Cityview. Excerpt:

[Attorney General Tom] Miller’s lawyers based their advice on the fact that the decision made no direct reference to the Iowa Code section on birth certificates, which refers to “husband.” “The Supreme Court ruling “does not authorize an interpretation of chapter 144 (vital statistics, including birth certificates) in a manner that would allow for a same-sex spouse to be automatically listed as the parent on birth certificates,” they said. And, insultingly and gratuitously, they added: “Using the adoption process is the best way to protect the interests and rights of all parties involved.”

How shameful.

For more than 125 years, the Iowa Supreme Court has consistently ruled that a child born in wedlock is presumed to be the legitimate child of the woman and her spouse – even if the woman was pregnant by another man at the time of the wedding, even if the woman was impregnated by another man during her marriage. “The law presumes that a child born in wedlock is legitimate,” the court said in 1882. More than 100 years later, in 1995, the court ruled in a similar case that “the state’s interests involve preserving the integrity of the family [and] the best interests of the child….” Yes, “the best interests of the child.”

The Iowa Code couldn’t be clearer. Section 252 says: “A child or children born of parents who, at any time prior or subsequent to the birth of such child, have entered into a civil or religious marriage ceremony, shall be deemed the legitimate child or children of both parents, regardless of the validity of such marriage.” And the Supreme Court says gays can marry one another.

Go read Gartner’s whole piece, which highlights key passages from the Iowa Supreme Court ruling in Varnum v Brien. He also points out that adopting a child involves significant time and expense.

I’m surprised that the Attorney General’s Office would give the Iowa Department of Public Health bad advice on this matter. Tom Miller strongly praised the court’s “clear and well-reasoned opinion” the day Varnum v Brien was announced. Miller’s advice helped persuade Governor Chet Culver not to seek to overturn the ruling. Assistant Attorney General Heather Adams wrote a memo reminding all Iowa county recorders that they must comply with the decision and issue marriage licenses to same-sex couples.

The Iowa Department of Public Health should give married spouses equal protection under the law.

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Smoking rate declines in Iowa

I mentioned in this post that it’s been a full year since the Iowa Smokefree Air Act went into effect. The public smoking ban was one of the most controversial bills considered during the 2008 legislative session, and advocates praised the law’s success at a press conference this week.

According to a recent Iowa Department of Public Health survey, 14 percent of Iowans smoke. In 2007, IDPH research estimated the smoking rate at 19 percent. That’s a significant decline, suggesting that around one-quarter of Iowans who smoked in 2007 have since quit. The $1 a pack tax hike on cigarettes approved in 2007 was probably a major factor in this trend as well.

The overwhelming majority of Iowa businesses are complying with the smoking ban, according to a June 30 press release from the IDPH. A little more than 1 percent of Iowa businesses with employees (1,015 to be exact) have received a “Notice of Potential Violation” from the IDPH. Of those, approximately half are bars and restaurants. I’m not surprised, since bar and restaurant owners were the smoking ban’s most vocal opponents (despite research showing that smoking bans do not hurt businesses in the hospitality industry). For those who want more details on compliance with the Smokefree Air Act, I’ve posted the IDPH press release after the jump.

Although some Democrats were angry that the legislature took on this issue last year, I’m proud to have supported the smoking ban at this blog for all the reasons I listed here.  

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I wonder where Rants and Vander Plaats stand on this stimulus spending

Nearly every day I see reports on this or that program in Iowa receiving additional funding thank to the federal economic stimulus bill, passed in February over loud Republican objections. This news caught my eye on Monday. Iowa will receive about $7.5 million out of $100 million appropriated to the U.S. Department of Housing and Urban Development’s Lead-Based Paint Hazard Control Program:

Polk County will receive $3 million to eliminate lead in 206 housing units; Marshalltown will get nearly $2.6 million to remove lead from 150 housing units; and Sioux City will be awarded nearly $2 million to create 75 lead-safe housing units.

Two potential Republican candidates for governor next year happen to be from Sioux City: businessman Bob Vander Plaats and State Representative Chris Rants. I know some conservatives are clueless about the dangers posed by lead paint, but I wonder if Rants and Vander Plaats can see the benefit of creating lead-safe housing.

Background: lead poisoning can cause mental retardation and behavioral problems, and not only in children. “Exposure to excessive amounts of inorganic lead during the toddler years may produce lasting adverse effects upon brain function.” Decades later, people poisoned by lead can show signs of cognitive deficits and mental illness. People exposed to high levels of lead in the womb and in early childhood have cells missing in key areas of the brain and have been found to be “more likely to be arrested for crimes, especially violent crimes.”

If Republicans claim they support lead remediation but don’t think it belongs in an economic stimulus bill, remember that lead remediation requires human labor and therefore creates jobs. I also would like Republicans to explain where they would find the money for this important work, since Republican politicians want deep spending cuts at the state level as well as a federal spending freeze.

I’m glad to learn that more funding to get lead out of homes was included in the stimulus bill. Reducing children’s exposure to lead has long been a priority for Barack Obama.

The Iowa Department of Public Health’s Bureau of Lead Poisoning Prevention has more background on lead poisoning in Iowa.

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World AIDS Day open thread

Today is the 20th World AIDS Day. President George W. Bush marked the occasion:

When the administration launched the President’s Emergency Plan For AIDS Relief in 2003, the goal was to support 2 million people with lifesaving anti-retroviral treatment in five years.

“I’m pleased to announce that we have exceeded that goal early,” said Bush, standing with first lady Laura Bush on the North Lawn of the White House, which was decorated with a giant red ribbon to mark the occasion. “The American people through PEPFAR are supporting lifesaving treatment for more than 2 million people around the world.”

Pregnant women who are HIV-positive should be aware that there are ways to reduce the risk of passing the virus on to your child.

Daily Kos user sfbob posted this reflection on having lived with AIDS for 28 years while losing more than 160 “friends, neighbors, co-workers and acquaintances” to the disease.

Daily Kos user rserven put up this thread where many people are sharing their AIDS stories.

The Iowa Department of Public Health’s HIV/AIDS program information is here.

The Iowa Center for AIDS Resources and Education (ICARE) has a website here:

 Who We Are

ICARE is a non-profit AIDS organization with staff and volunteers who provide comprehensive practical, emotional, and financial support to persons living with HIV/AIDS, their partners, families, friends and others concerned about HIV or AIDS in a safe, accepting and non-judgmental atmosphere.

What Is HIV?

HIV (Human Immunodeficiency Virus) is an infection that disables the human immune systems ability to fight infections and overcome illnesses. HIV is the virus that causes AIDS (Acquired Immune Deficiency Syndrome).

Our Mission

ICARE’s mission is to enrich the quality of life for persons living with and affected by HIV/AIDS. Through the distribution of information and services, we aim to foster the self-empowerment necessary to live productively and positively in the face of HIV/AIDS.

Our Approach

ICARE offers a client-centered, holistic service approach that actively involves the client and family in the service delivery process. All services are free and confidential.

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Restaurant (n.): A place where meals are served to the public

Earlier this month the Iowa Department of Public Health released draft regulations for implementing the smoking ban that will go into effect on July 1. You can view the draft regulations here.

The Des Moines Register reported a few days ago that the people who have always opposed the smoking ban are furious about the IDPH’s draft rules:

“In my mind and in the minds of just about every single legislator I’ve talked with in the past week – and that’s about 20 or so – this is an absolute perversion of the legislative intent. Period,” said Rep. McKinley Bailey, a Webster City Democrat who voted against the bill in April.

The state’s administrative rules are intended to help clarify and implement laws and spell out details of enforcement. The Legislature’s Administrative Rules Review Committee discussed the proposed rules for the smoking ban Wednesday.

The Legislature this year approved a ban on smoking, effective July 1, in almost all indoor public places, including bars and restaurants. One provision in the law allows bar owners to permit smoking in their outdoor patio areas but prohibits restaurants from allowing outdoor smoking.

The rules, also effective July 1, say that bar food is limited to ice, pre-packaged snacks, popcorn, peanuts and the reheating of commercially prepared foods that do not require assembly, such as frozen pizza.

Under that definition, bars that have a grill and serve a burger, for example, would be considered a restaurant.

McKinley Bailey is a good Democrat, but I think he’s wrong on this issue. A restaurant is commonly understood to mean “a place where meals are served to the public.” I looked that up in several dictionaries.

If you look up definitions of “bar,” you will find that it refers to a counter or an establishment where beverages, especially alcoholic beverages, are served. Some of the definitions mention that food may be served at bars as well. The IDPH draft regulations account for this, by explaining the types of food that a bar may serve.

If you allowed every establishment that serves drinks to evade the smoking ban, you’d have hundreds of restaurant owners placing a few tables outside and declaring themselves to be “bars.”

It seems reasonable to say that if a business is serving the public food cooked to order, that establishment is a restaurant subject to the smoking ban.

I want to address this part of the Register article as well:

“This is a clear case where a state agency is going beyond the scope of the intended legislation,” said Tom Baldwin, owner of Drink, a Clive bar.

Roughly 3 percent of Drink’s sales are from food. But because of the proposed rules, the facility would be considered a restaurant for the purposes of enforcement of the statewide smoking ban, he told the rules committee Wednesday.

Baldwin has a simple choice to make. If he thinks that his business depends on letting patrons smoke, he can stop serving meals cooked to order and serve pre-packaged food instead. By his own admission, food accounts for only about 3 percent of his business’s sales.

Or, if he feels that cooking food for customers is vital for his business, he can go smoke-free.

Either way, I don’t think his argument about legislative intent holds water.

As I’ve written before, the research on smoking bans suggests that they do not hurt the bottom line. This report is worth reading in full, but here is the main conclusion:

A significant body of scientific research has been accumulated on the economic impact of smoking bans on hospitality business, particularly bars and restaurants. The only research that shows any long-term negative effect on bar or restaurant sales is unscientific research that has been sponsored by the tobacco companies.

All independent published studies conducted in the US and Canada that used tax data in the analysis concluded that “smoking restrictions do not impact negatively on hospitality sales, employment, or tourism activity in the long run.”

The current economic climate, with rising costs for food and transportation hitting restaurants and forcing many consumers to reduce their discretionary spending, is a genuine threat to the hospitality industry. In contrast, restaurant and bar owners’ anger over the new smoking ban is misplaced.  

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