Top DHHS official says state is on track to close Glenwood by the end of the month

Editor's note: This story was updated on Wednesday, June 19 to include transition information about Glenwood residents provided by the Iowa Department of Health and Human Services.

On June 30, the state will close the Glenwood Resource Center , a state-run facility for Iowans with severe disabilities. It's faced significant challenges and controversies in recent years, including several Department of Justice investigations into the care of its residents.

IPR’s health reporter Natalie Krebs spoke with Iowa Department of Health and Human Services Director Kelly Garcia about Glenwood’s upcoming closure. Here are some highlights:

How is the state progressing in relocating Glenwood residents and trying to get staff members new jobs?

When Gov. Kim Reynolds announced Glenwood was closing two years ago, the facility had 152 residents, according to records from Iowa HHS.

As of this week, just six residents remain, and they should be moved out by the end of the week, Garcia said.

Some "medically fragile" residents were moved to Woodward Resource Center, the state’s other facility for severely disabled Iowans, while others were moved into services like group homes, nursing homes, host homes, even hospice care, she said.

Iowa DHHS records show:

• 26 residents were moved to Woodward
• 83 were moved to home and community-based services
• 8 residents went to immediate care facilities
• 7 residents went to home and community-based services in host homes
• 6 residents went to a nursing home
• 7 residents went to hospice
• 5 residents have died at Glenwood since the closure was announced

As of May 22, six residents had initial placements that "failed," with four residents returning to Glenwood and two residents going directly to other placements.
Fourteen Glenwood residents who transitioned out of the facility died within a year after moving. Causes of death included "cancer, respiratory conditions, cardiac arrest as well as cardiac conditions," according to HHS documents.

• 5 residents died in hospice care that they directly went to from Glenwood
• 6 residents died in hospice care after going into community care
• 3 residents died in community care without going into hospice

As for staff, Garcia said the approximately 200 current employees will remain on staff until the final closure date of June 30.
"There's still work to do, though, in terms of the operations," she said. "It's a large campus. There's a lot of work that we need to do to transition the equipment and all of the furniture out of the actual facility."

Iowa HHS will retain just about 25 people starting in July in order to maintain the 380-acre campus, according to Garcia.

However, the state is working with staff members who are getting laid off to help find them other jobs, she said.

Why did officials choose to close down Glenwood?

Glenwood has been the center of a lot of controversy over the past few years.

A 2019 Department of Justice investigation found the center was likely violating residents’ constitutional rights when senior staff subjected residents to harmful experiments without their consent, including alleged sexual arousal studies.

In a separate DOJ investigation in 2022, the feds concluded that the state was providing inadequate care to disabled Iowans by keeping too many of them in institutions

The facility also saw a spike in deaths in recent years , according to reporting from the Des Moines Register.

Iowa HHS has struggled to attract and retain staff in general — including hiring a required medical director following the recent DOJ investigations — despite raising the salary significantly and going to Omaha to recruit physicians, Garcia said.

"I had countless conversations, and physicians told me time and time again, 'There's really no amount of money that would overcome, what to me, would be kind of career failure to go there. Why would I go there?'" Garcia recalled.

Garcia said she made the decision to close Glenwood because she couldn’t ensure it was running safely. But, she called that decision, "one of the hardest things I've had to do in this job."

The state remains under the supervision of the Department of Justice following those two investigations. Where does the state stand with compliance in those cases?

The DOJ is continuing to monitor the situation at Glenwood through court-appointed monitors.

The DOJ’s monitor released a report last fall that found Iowa was still missing most of its markers when it comes to adequate clinical and medical care of Glenwood residents, and in transitioning them into community settings.

Iowa HHS took that feedback "incredibly seriously," and found a big part of the issue was that staff was failing to coordinate services in a timely manner, Garcia said.

She pointed to things that were overlooked, such as making sure a wheelchair ramp was installed before a resident moved.

"Translating what we have learned from Glenwood now to broader systems, we've really learned a tremendous amount about how to put the right systems in place so that that failure to communicate doesn't occur," Garcia said.

On the bigger scope of things, Garcia said the state is investing more than $250 million to increasing home-based and community-based services for Iowans, and is working on adding providers and more support for them.

"We've added to the number of community providers that operate in the state, and really made an effort to ensure that we're supporting them in those activities," she said. "This work is hard. There are challenging behaviors, and challenging circumstances that come with serving people with disabilities."

Glenwood covers hundreds of acres and has a long history in the area. What’s the state’s plan with the facility and the land?

The plan is ultimately for the state to sell it, Garcia said.

Mills County, where Glenwood is located, has been working on a redevelopment plan that includes transforming it into housing.

The site includes Native American burial grounds and a cemetery. Garcia said the state plans to ensure those burial grounds are protected when they sell it and wants to find some way to pay tribute to the Iowans who have worked there over time.