A top health official for the state of Iowa knew of plans for a “sexual preoccupation” study at a state-run institution for people with severe disabilities well before federal officials began investigating the facility late last year, according to newly released emails.
Rick Shults, the mental health and disability services administrator for the Iowa Department of Human Services, approved a software request on May 21, 2018, for studies on patients at the Glenwood Resource Center and on patients who are part of a state-run program for sexual offenders, according to emails DHS provided to the Des Moines Register as part of a records request.
“Nice write up,” Shults wrote in response to the request. “Yes, I approve. Please keep the justification and my approval should questions arise later.”
The newly released emails show, for the first time, how far back top state officials knew about plans for human experimentation at the center, which houses some of the most vulnerable Iowans. The ongoing federal investigation has led to a separate state inquiry that, to date, has involved multiple Iowa agencies.
The request Shults approved, sent from a DHS employee, explained that the software would be used for research led by Jerry Rea, the former superintendent at the Glenwood center.
“The project has implications for treatment of sexual preoccupation issues in CCUSO patients and problematic behaviors in GRC individuals. It will look at implicit behaviors and ways to alter reinforcement around problematic stimuli,” the DHS employee wrote in the email to Shults. The email references the Civil Commitment Unit for Sexual Offenders (CCUSO) and the Glenwood Resource Center (GRC).
Shults retired from DHS on Jan. 23, according to the agency.
Asked about the emails, DHS spokesman Matt Highland told the Register on Monday, “It’s clear there was an intent to conduct research, and we’re working with our state and federal partners to determine what did and did not happen.”
The documents released Monday included an agenda for an August 2018 meeting titled, “Research Project Discussion Agenda.” The agenda was on state government letterhead.
Former DHS Director Jerry Foxhoven, DHS Deputy Director Mikki Stier, Rea, Shults and two additional staffers attended the meeting, Highland confirmed. Karalyn Kuhns, who sent the May 2018 email requesting software approval, was one of those staffers.
A PowerPoint-style presentation included in the materials for the meeting included details on the use of behavioral research at the time and the planned use of a penile strain gauge and pharmaceuticals. The presentation included:
- An explanation that the overall objective is partly to address pathology that includes “people with impulsivity issues (e.g., drugs, gambling, sexual behaviors).”
- A slide, titled “Right Now,” says the group is “currently planning to use AAT with individuals … with an intellectual disability who have committed sexual offenses.” A different slide defines AAT as “Approach Avoidance Task (AAT).”
- Another slide reads: “Second area of research to decrease arousal/impulsivity” through pharmaceuticals.
Ex-Glenwood center employees claim managers prepared to buy porn
Six former Glenwood center employees filed a lawsuit earlier this month alleging poor care at the facility. They claim top managers directed that public funds be used to buy “silk sheets or silk boxer shorts,” sexual lubricants and “stock photos which included pornographic images” as part of plans to conduct sexual arousal research on patients at the center.
They also claim that the medically fragile patients’ medications were changed in preparation for planned sexual arousal studies.
“They intended to use, and did use, highly vulnerable GRC patients as the ‘guinea pigs’ in research experiments,” according to the suit. The suit lists Shults and Foxhoven among the defendants.
Other documents DHS released Monday show that Foxhoven received multiple emails from Glenwood center employees, some of whom were part of the lawsuit, warning of alleged problems at the facility.
The emails include messages in February 2018 from Katherine Rall, the facility’s director of quality management at the time, who told Foxhoven that Rea had created a dangerous environment for patients and staff.
“I believe that my suspension came as a result of Mr. Rea wanting me out of his way at the facility so he could implement policies and processes that are of great danger, to include death, to the clients that reside there,” she wrote.
Rea, who indicated before he came to the Glenwood center that his areas of interest included an “assessment and treatment of deviant sexual behavior in persons with developmental and intellectual disabilities,” was fired in December 2019. Federal officials told Gov. Kim Reynolds the month before that they would investigate Glenwood.
Another Glenwood employee, Tami Skarin, told Foxhoven of concerns at the center in a series of emails beginning in early 2018.
In February of that year, Foxhoven replied: “Yes, it will take a bit for us to take action, but I am totally confident that we will be doing something soon. hang in there.”
Skarin was the Glenwood treatment services director in 2019, according to state documents.
In April 2019, a Register investigation showed Glenwood center employees had repeatedly warned state officials about eroding medical care, including a higher rate of patient deaths.
Following the Register’s reporting, Foxhoven defended care at the center.
The Glenwood center is a sprawling multi-building campus that includes residential homes for patients with severe intellectual disabilities. Many of the roughly 200 residents, who often can’t speak, walk or feed themselves, have a dual diagnosis of mental illness.
State now spending $333,000 to make improvements
Kelly Garcia, the new director of DHS, has said she takes seriously the allegations of wrongdoing at the center. She has sent additional staff to the center to monitor patient care, and her agency held town halls this month with Glenwood center employees and families of patients.
The Legislature this month also approved $333,000 in additional state funding for the center, including for staff at the University of Iowa to perform clinical assessments.
Reynolds in December said the alleged wrongdoing at the center was “unacceptable” and that she was committed to making changes. She declined to comment on the lawsuit ex-workers filed, but last week she offered reporters a timeline of what she knew and when.
Reynolds told reporters that she did not know about allegations involving sexual arousal studies until the DOJ alerted her office in November. She said she was concerned about the deaths at the center months earlier after the Register’s reporting.
“One of the areas that I had raised concerns with the agency was with the number of deaths that was taking place,” Reynolds said. “I was aware of that and concerned about that.”
Register reporter Stephen Gruber-Miller contributed to this report.