We've been hearing a lot about the state's long term care ombudsman (try saying that ten times quickly!) in the news, but what's the fuss really all about?

First, the long term ombudsman is actually not the state's creation. It's a federal mandate. The Older Americans Act required each state to set up an ombudsman program for long term care, and that program is to be headed by a state long term care ombudsman. Then, the program says that local volunteer ombudsmen would be available to seniors and their families to investigate complaints about care and advocate for them. It's been hugely successful nationwide in getting issues resolved.

But another duty of the state ombudsman in Title VII of the Older Americans Act is for the state ombudsman to:

• represent the interests of residents before governmental agencies and seeking administrative, legal and other remedies to protect residents;
• analyze, comment on and recommend changes in laws and regulations pertaining to the health, safety, welfare and rights of residents;
• educate and inform consumers and the general public regarding issues and concerns related to long-term care and facilitate public comment on laws, regulations, policies and actions;
• promote the development of citizen organizations to participate in the program;
• provide technical support for the development of resident and family councils to protect the well-being and rights of residents, and
• advocate for changes to improve residents’ quality of life and care.

(from the US Administration on Aging's "Long Term Care Ombudsman factsheet)

These are the duties where now-departed Iowa Department of Aging director John McCalley and Jeanne Yori, the long term care ombudsman collided. You see, McCalley was appointed to the job by Gov. Chet Culver, having last worked as head of AARP Iowa and working at AARP in Minnesota. McCalley was used to being the one to advocate and suggest policy, and it's clear that he viewed himself the superior to Yori in that regard.

The Register stories on this issue lately clearly detail that McCalley wanted to be the lone voice on the issue. He even had a change made in the department's rules (that was scheduled to go into effect in August) which would even take away the federally-mandated supervision of the ombudsman program from Yori and place it in the power of the director. All the long term care ombudsman would be empowered to do is collect complaints and turn them over to the director under the new rule.

McCalley told Yori that she couldn't give opinions on legislation to lawmakers, something the federal government says is integral to her job. She was, basically, pressured to take early retirement by McCalley. Only after her retirement was announced did Yori feel able to speak freely about what was going on.

When word of the treatment she was given by McCalley reached the US Administration on Aging, they ordered the state to restore the independence of the ombudsman. Gov. Chet Culver issued an executive order that, at first glance, would appear to guarantee that. And he appointed former state representative Ro Foege to take over the helm at the Department of Aging on an interim basis.

But Foege needs to take quick action and cancel the proposed rule change or the state will be back in the federal hotseat. It was taken off the agenda by the Rules Review Committee of the legislature. They could have blocked its implementation.

But by removing it from the agenda, the department must now essentially cancel its proposed rule change or it could go into effect in August. That rule essentially codifies all the things that the feds say were wrong with McCalley's administration and makes the ombudsman little more than a paper-shuffler. The governor has the power to rescind any proposed rule as well, so he could take quick action today to remove this problem from his administration.

There are federal funds at stake in this game. And the need for the families and patients at the state's long term care facilities to know they have someone to turn to who isn't beholden to a political agenda or politician. That's what this was supposed to be about in the first place: making sure their rights are protected in all facets, including legislation.

It's now up to Ro Foege and Governor Culver to ensure Iowa has a strong, independent long term care ombudsman.