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Iowa said crisis standards of care during COVID aren’t warranted, as other states updated plans

Published: Feb. 8, 2022 at 10:08 PM CST
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CEDAR RAPIDS, Iowa (KCRG) - While other states updated their Crisis Standards of Care plans, Iowa believed enacting a similar plan during the pandemic wasn’t warranted.

Crisis Standards of Care are state guidelines to help hospitals on making ethical decisions on who to treat when resources, like staffing levels or the number of hospital beds, are extremely stressed. These plans provide hospitals with a legal framework to make decisions as a whole, rather a patient-by-patient basis.

Rachel Lookadoo, who is the director of Legal and Public Health Preparedness at the University of Nebraska Medical Center, said she helped develop the plan in Nebraska. She said a statewide framework creates consistency rather than each provider creating their own policies.

“That’s not going to be consistent,” Lookadoo said. “You’re going to have differences across providers, across facilities and there’s not going to be a consistency in how these standards are applied.”

Lookadoo said she helped the Iowa Hospital Association create a similar plan in Iowa. The Iowa Hospital Association hasn’t returned our repeated requests for comment and the Iowa Department of Public Health didn’t answer us directly about how far along in the process Iowa was in updating the plan. State documents show a sub-committee to establish a state framework occurred in December 2017.

Dr. Dustin Arnold, who is the chief medical officer and hospitalist at UnityPoint Health-St. Luke’s Hospital, said he was aware of plans to update the document, but didn’t know the current status of the plan on Wednesday. He said without a state guideline, UnityPoint has its own set of standards to make decisions.

”The whole concept of Crisis Standard of Care is just to give some direction and some function and format,” Dr. Arnold said. “So, you’re not just scrambling in the eleventh hour.”

A spokesperson for UIHC said it does not have any plans that are like Crisis Standards of Care and those are guidelines created by the state rather than individual hospitals.

He also said his hospital hasn’t been close to getting to a place where it needs a Crisis Standards of Care and believes a statewide plan could go into effect if it was needed.

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