Third in a series of stories from the Fall 2018 Inclusion magazine.
DES MOINES — Long-term care facilities were among those hardest-hit during COVID-19’s first surge this summer.
Now, with the virus raging through Iowa, those facilities are once again bearing the brunt of the pandemic.
So severe has the situation become that the state public health department has given its blessing — as a last resort in emergency situations — for long-term care workers with a confirmed COVID-19 infection to provide care to patients without the virus.
As of Friday night, there were COVID-19 outbreaks — defined as three or more confirmed cases in a facility — at more than a fourth of Iowa’s roughly 440 long-term care facilities. There have been nearly 1,000 deaths.
Nursing homes throughout the state are facing critical shortages of available workers and personal protective equipment like gloves, protective eye wear, gowns, and medical-grade face masks.
As of mid-October, 38% of Iowa nursing homes reported having less than a one-week supply PPE, and 43% of state nursing homes reported being short on staff, according to survey responses nursing homes send periodically to the federal Centers for Medicare and Medicaid Services.
While facilities across the country have been hit, Iowa is higher than the national average for nursing home resident cases and deaths per capita, and nursing home staff cases per capita, according to federal data compiled by AARP. The state also is worse than the national average in the percentage of nursing homes that say they are short on staff and personal protective equipment for that staff.
“It is serious,” said Di Findley, executive director of Iowa CareGivers, a nonprofit that works to address shortages among direct care workers like certified nurse aides and home care aides. “The people who work in these jobs, the nurse aides, social distancing isn’t really an option. You can’t give somebody a bath or assist somebody to the toilet or help them with oral hygiene from six feet apart. Because of that, (those workers) are a little higher risk of contracting and spreading the virus.
“So they live in fear. They love their jobs, but they still live and work in fear now.”
Findley said direct care workers worked in difficult conditions for years before the pandemic hit in March. There is high turnover and low pay. The median salary for a direct care worker in Iowa is $13.80 per hour.
“They’re putting their lives on the line for $13.80 per hour,” Findley said. “Things were not good before, so you can imagine now, in the midst of a pandemic, how challenging it is for those folks on the front line and their employers.”
Anthony Carroll, advocacy director for the Iowa chapter of AARP, said the 38% of nursing homes with less than a one-week supply of PPE is “troublingly high,” particularly at the pandemic’s eight-month point.
“We’re halfway through November, and that is troubling,” Carroll said.
The state has a PPE stockpile, and Gov. Kim Reynolds last week urged nursing homes in need to request equipment. A spokesman later clarified that a facility must be dealing with an outbreak before it can tap the stockpile. Facilities not experiencing an outbreak will be evaluated on a case-by-case basis.
Carroll said the state should do what it can to make it easier to get the PPE they need.
“Iowa should streamline this process to make it easier to get PPE in the hands of long-term care facility staff and residents,” Carroll said. “For the sake of residents, families and staff, Iowa needs to do whatever it takes to ensure that we no longer have over 38% of Iowa nursing homes reporting that they don’t have a one week’s supply of PPE.”
On Thursday Reynolds announced she is dedicating $14 million in federal funding designated for COVID-19 response efforts to help long-term care facilities with staffing and testing. When asked if the funding can also be used to purchase PPE, she referred to the state stockpile.
She noted the state has worked on guidance for long-term care staffing. One of the new guidelines from the state public health department says workers with a confirmed COVID-19 infection may provide direct care to patients with a suspected infection, and “as a last resort in emergency staffing situations,” workers with a confirmed COVID-19 infection may provide direct care to patients without an infection.
Reynolds said she expects to announce an initiative next week to recruit nurses and other critical care workers to come to Iowa to bolster the state’s strained workforce. The governor’s spokesman said details will be available this week.
“Like our hospitals, it’s important that we also provide assistance to long-term care facilities at this time, and that every Iowan continues to do their part to protect the most vulnerable of our health care workforce,” Reynolds said.
Carroll and Findley both suggested Reynolds should consider deploying the Iowa National Guard to help with Iowa’s overwhelmed health care workers, and both proposed a state registry for direct care workers to help employers find workers when faced with shortages. Legislation to create such a registry was proposed during the 2020 session of the Legislature before the pandemic hit and derailed the session.
Findley would like to see some federal pandemic response funding put toward hazard pay and address increased child care needs for direct care workers.
“You hear a lot about doctors and nurses, and they are very, very important. But let’s not forget about these people (direct care workers),” Findley said. “They’re on the front line and they are an important piece of our ability to mitigate and fight this virus. And they need our support, too.”
Rod Boshart of the Gazette in Cedar Rapids contributed.
Two turkeys from a Walcott farm’s “presidential flock” are headed to Washington, D.C., to be pardoned by President Donald Trump.
Iowa Secretary of Agriculture Mike Naig stopped Friday at the farm of Ron and Susie Kardel to help send off two toms for the president’s review and pardoning on Tuesday.
The Walcott family is the eighth from Iowa to raise the turkeys for the annual pardoning, the Iowa Department of Agriculture & Land Stewardship tweeted.
The first Presidential Turkey Proclamation event was held in 1947, when President Harry Truman received a live turkey from the National Turkey Federation, according to the Iowa Department of Agriculture. And “pardoning” as a custom began with President George H.W. Bush in 1989.
One of the birds will be named the official Thanksgiving Turkey and the other will serve as an alternate, according to an Iowa State University news release. Both will then live out their days at Iowa State — where animal science students, faculty and College of Veterinary Medicine students will contribute to their care — and will be available for public viewing starting at 10 a.m. Dec. 5.
Individuals can also follow along with their journey to the White House on the National Turkey Federation Facebook page. The turkeys will make their way to D.C. this week via van for a stay at The Willard Hotel before visiting the White House.
“They’ve kind of been pampered,” Ron Kardel said. “We built a 10-by-24-foot building with ventilation, heating, air conditioning and a little patio outside” for the “presidential flock” of 30 turkeys, from which the two toms were chosen.
The turkeys hatched in early July and have been “gobbling along to oldies tunes” to help them get used to crowd noises, according to the National Turkey Federation.
A sixth-generation turkey and row crop farmer, Ron Kardel serves as the current chairman of the National Turkey Federation and is responsible for supplying a turkey for the annual National Thanksgiving Turkey Presentation.
Kardel said having his turkeys selected as this year’s National Presidential Turkeys is an honor he relishes in an otherwise tough year for the turkey industry.
“Especially in 2020 it’s kind of nice to have something good happening, and it’s a feel-good celebration,” Kardel said. “It’s been a tough year for lots of industries for lots of different reasons, and it’s nice to have a feel-good story.”
The COVID-19 pandemic lopped off a large portion of the industry’s market as restaurants closed their doors, said Kardel, who also serves as vice chairman of West Liberty Foods, which supplies sliced turkey to Subway sandwich shops and other restaurants and grocery chains.
“It was a huge implications for us, and the irony was that we had too much meat and people in food lines, and no nobody likes to see that,” Kardel said. “With help of some relaxed labeling laws, we were able to divert from one stream into a different stream to keep America fed,” shifting some production to retail packaging.
As a result, growers have temporarily paused their flocks this fall to allow the company to clear its freezers, Kardel said.
The Iowa Farm Bureau Federation’s 35th annual Thanksgiving survey released Friday shows the cost of turkey — at roughly $1.21 per pound — it is the lowest price since 2010.
“Our livestock and poultry farmers still face the challenge of recovering from lost markets and supply chains impacted by COVID, but that hasn’t stopped them from producing sustainably grown, real meat products we enjoy at Thanksgiving,” Sam Funk, IFBF director of agriculture analytics and research, said in a press release.
Iowa ranks seventh in the nation in turkey production, with 130 turkey farmers, and the fifth-largest state for turkey processing. The turkey industry generates $10.64 billion in total economic activity throughout Iowa, according to Iowa State University.
WATERLOO — Recent talk of moving from four to two City Council meetings per month garnered mixed feelings from residents and council members.
But it wouldn’t be unique.
It’s a schedule used for years by the majority of Iowa’s largest cities. Cedar Falls, Cedar Rapids, Davenport, Des Moines, West Des Moines, Iowa City, Ankeny and Council Bluffs all have two meetings per month, according to online records.
Waterloo’s potential meeting change was first discussed at a Sept. 28 work session as a way to achieve more planning time and advanced agendas. But some residents and Ward 3 council member Patrick Morrissey oppose the change, noting it could limit opportunities for public participation.
“To me, moving to these two meetings a month is fixing something where there has not been a problem,” Morrissey said.
Cedar Rapids City Council shifted from four to two meetings per month in 2010. City Clerk Amy Stevenson said the change gave staff members more time to submit documents for agenda items and put together agendas. She said it gives council members more time to engage with their other responsibilities, and does not limit public comment opportunities.
“It just kind of improves their efficiency and balances out the workload a little bit,” Stevenson said. “It just allows them to efficiently use their time to address those other duties since they are part-time.”
Under Waterloo’s proposed change council members would get draft agendas a week in advance. Members currently get agendas the Friday before Monday meetings, with only the weekend to review items and contact departments if they have questions. The new plan would give members of the public the agenda the Wednesday before meetings.
Stevenson said the main challenge with twice-a-month meetings is adding an “emergency item” — such as a time-sensitive liquor license for an event — to the agenda at the last minute. In such cases, people may not be able to wait two weeks for the next council meeting to seek approval.
Waterloo’s mayor and council members — like those in other cities — can call special meetings if needed to discuss additional issues. The city clerk can add emergency items to regular meeting agendas, too.
“There are times when special session had to be held ... but those times are very far and few between,” Stevenson said.
Morrissey previously suggested two meetings per month could cause lengthy consent agendas. Those items can be approved with one vote rather than considered individually.
Though Stevenson acknowledged some Cedar Rapids agendas can get long, she said Mayor Brad Hart runs the meetings efficiently.
“I seriously cannot think of any reason to go back,” Stevenson said. “This has been working well.”
Cedar Falls began holding two meetings per month more than 15 years ago, said City Administrator Ron Gaines. Council members get agendas before 3 p.m. the Friday before meetings. The council holds work sessions, goal-setting meetings and committee meetings outside of general meetings, he said.
The Waterloo change would add council planning sessions to the fifth Mondays in March, May, August and November 2021.
“When you have three or four meetings per month, you have a staff that’s probably in what I’ll refer to as almost a perpetual council meeting mode,” Gaines said.
He said providing city staff with more time to prepare agendas can lessen the chance of mistakes or missed items.
WATERLOO — Even as Iowa’s governor has allocated more money toward helping keep people in their homes, both homeless advocates and those relying on rent payments warn more needs to be done.
Local agencies like Amani Community Services and Friends of the Family are two of 54 organizations across Iowa that signed onto a letter earlier this month asking Gov. Kim Reynolds to allocate at least $80 million in unspent CARES Act money toward the Iowa Eviction and Foreclosure Program.
“About one-third of all Iowa households are rentals, and pre-COVID, 28% of Iowa renter households were extremely low-income,” the letter read. “And rent is now more difficult for many to pay as the state sees record increases in unemployment.”
Reynolds on Wednesday announced additional money from federal CARES Act dollars will go toward the state’s program, but of $37.4 million allocated, only $8 million is still available to qualified renters and homeowners who apply by Dec. 4.
The directors of both the ACLU of Iowa and the Iowa Coalition Against Domestic Violence thanked the governor for adding funds, calling the money “crucial,” but directors Mark Stringer of the ACLU and Laurie Schipper of the ICADV also noted Reynolds has another $82 million in CARES Act funding to spend by the end of the year.
“There is more federal money that Gov. Reynolds should allocate to this important safety net to keep people in their homes,” they wrote Thursday, asking her to develop a state response next year as well, “since the economic impact of COVID-19 will be felt by Iowans for months to come.”
Nearly 11,000 renters and 500 homeowners in Iowa have applied for assistance since the program began earlier this year, according to the governor’s office. But agencies say the need is growing.
“Especially now that it’s holiday time, we always see a little uptick,” said Lisa Ambrose, CEO of Amani.
Third in a series of stories from the Fall 2018 Inclusion magazine.
COVID-19 and the stop-start economy it’s produced are putting pressure on more people than ever before, said Ben Brustkern, executive director of Friends of the Family.
“We’re really starting to see a spike toward more need for housing assistance,” he said.
On the other side of that equation are landlords, whose livelihoods are at stake when rental income doesn’t come in, said Tony Miller, executive director of the Black Hawk County Landlords, an association of property owners.
“There’s landlords that haven’t gotten any rent since this started, and they’re looking at bankruptcy,” he said.
Without rental income, a landlord can’t pay the mortgage on a property or do any upkeep, Miller noted. And with a federal moratorium expiring at the end of the year, he’s worried about the long-term implications.
Reynolds said Tuesday during her daily briefing on the state’s pandemic response efforts that she will not extend the moratorium.
“It’s a horrible domino effect, and it’s going to affect our economy in Black Hawk for a long time,” he said.
In Iowa, between 119,000 and 139,000 households were unable to pay their rent in October and were at risk of eviction, meaning a loss of rent of at least $121 million, according to a survey by Stout Risius Ross, a global advisory firm.
By Nov. 9, 28.5% of renters across all income categories had only slight confidence or no confidence they could pay rent on time, according to the same survey. That’s more than double the 13.5% that said the same Oct. 26.
And the problem may be worse in Waterloo, which in 2016 — the last year for which data were available — had the highest eviction rate in Iowa among mid-size cities at 5.73%, according to evictionlab.org, a project maintained by Princeton University. Cedar Falls was 18th on the list, with an eviction rate of just 0.99% in 2016.
Ambrose said she’s optimistic funding will come through in time to help clients. Brustkern isn’t so sure, but said if a safety net isn’t in place to prevent homelessness, it will cause other problems like food insecurity, domestic violence, family pressures and inadequate schooling.
“It’s really important to have something like this so we can offset any issues occurring in the future,” Brustkern said.