On Thursday, Rep. Cindy Axne (IA-03) sent a letter to Iowa Governor Kim Reynolds expressing concern over recent announcements from her administration about the inability of the State Hygienic Laboratory to meet federal testing requirements at Iowa’s long-term care facilities.
“It is unacceptable we are only just learning from your team that there is not enough testing capability to ensure the safety of our most vulnerable populations,” wrote Rep. Axne. “Our nursing and long-term care facilities are doing all they can to ensure patients have limited exposure, but they cannot do their jobs safely without adequate testing support.”
Last week, the Iowa Department of Public Health State Hygienic Laboratory (SHL) told Iowa’s long-term care facilities that they cannot meet the U.S. Department of Health and Human Services’ (HHS) standards for testing nurses, staff, and volunteers – and will be unable to provide the required amounts of routine testing for nursing staff and employees who work in skilled, nursing, and other long-term care and living facilities.
In her letter, Rep. Axne urged Governor Reynolds to share with her any federal investments her administration may require to meet the testing needs of Iowa’s long-term care facilities – and implored her to pursue private laboratory capacity to bridge the gap in testing capacity. Additionally, Rep. Axne sought clarification on the financial impact this could have on senior living facilities if they are required to pay for their own private COVID-19 testing.
As of Thursday, over half of Iowa’s 1,300 COVID-19 related deaths have occurred at long-term care facilities. Polk County, which Rep. Axne represents in Congress, currently has the most active COVID-19 outbreaks in long-term care facilities of any county in Iowa.
Polk County has also lost the most residents of any county in Iowa – more than the next three counties combined.
In July, Rep. Axne wrote to Governor Reynolds seeking additional testing and improved data disclosure for Iowa’s nursing, long-term care, and other assisted and congregate living facilities.
The full text of today’s letter can be found below:
Dear Governor Reynolds,
I am writing to express my deepening concerns about access to COVID-19 testing for Iowans. Last week, the Iowa Department of Public Health State Hygienic Laboratory (SHL) announced they can no longer provide routine testing for nursing staff and employees who work in skilled, nursing, and other long-term care and living facilities. The SHL stated they would not be able to meet the U.S. Department of Health and Human Services’ (HHS) standards for testing nurses, staff, and volunteers as a preventative measure against COVID-19. It is unacceptable we are only just learning from your team that there is not enough testing capability to ensure the safety of our most vulnerable populations.
The August 26th Centers for Medicare and Medicaid Services (CMS) interim final rule directed these long-term care facilities test to their residents and their staff in the case of an outbreak, testing anyone with symptoms, perform routine testing, as well as testing those who volunteer or otherwise provide contract work for these living facilities. It is deeply concerning that we do not have enough state capacity to test up to these standards for prevention. These testing requirements are meant to detect COVID-19 at the soonest possible moment to protect older Iowans. We are more than six months into this global health crisis, and yet these basic preventative requirements are still not able to be met.
We already know the stakes of not properly protecting these residences. Iowans aged 60 and above make up 89% of all recorded COVID-19 deaths in our state. More than half of all deaths in Iowa have occurred at long-term, nursing, and senior living facilities. And as of today, 677 deaths have occurred in long-term care facilities alone with over 900 positives cases.
In Polk County alone, there are six active outbreaks within senior living facilities. We have known since March 2020 that seniors are at the highest risk of serious illness from COVID-19 – especially if they have an underlying health issue. I wrote to you in July to remind that, according to the Center for Disease Control and Prevention (CDC), “nursing home populations are at the highest risk of being affected by COVID-19”. On coronavirus.iowa.gov, your Administration lists “retired” as the number one most likely “occupation” for those who have died due to COVID-19. It is a tragedy that the most dangerous job in Iowa is to be a grandparent.
I have heard from nursing, assisted, and long-term care facilities who are confused and concerned about what the CMS decision will mean for their ability to test residents and employees when they are unable to access testing through the SHL. There is uncertainty if these living facilities will be forced to pay for their own testing in order to abide by CMS guidelines, or if they will face violations and fines due to their inability to get COVID-19 testing done on a weekly basis. The costs of private testing would be financially impossible for many congregate living facilities in Iowa. I am requesting that the Iowa Department of Public Health provide clarity to long-term care facilities, seniors, and to my office about what financial and legal impacts this CMS rule and the SHL’s inability to provide enough testing will have.
You are already aware that Iowa has a per capita rate (PCR) of 10.8% positive cases. We are ranked among the top ten states for growing outbreaks. I am writing to offer any and all assistance I can as a federal partner and elected official. If the SHL cannot process the number of tests needed, I also implore you to reach out to private labs. I was successfully able to advocate for UnityPoint to get increased Cephid testing equipment and capacity at its facilities with a couple of phone calls – there is no question your office could accomplish the same.
You must ensure that our nursing staff is receiving adequate testing once to twice per week to detect COVID-19. Our nursing and long-term case living facilities are doing all they can to ensure patients have limited exposure, but they cannot do their jobs safely without adequate testing support.