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Nursing home worker shortages continue to plague Iowa, Brad Anderson, state director of AARP of Iowa tells Axios.

Why it matters: Staffing shortages can result in subpar or even neglectful care in nursing homes — and nearly 42% of Iowa's facilities have a shortage of nurses and aides.

That's almost double the national average of 22%, according to the Centers for Medicare & Medicaid Services, which examined four weeks of shortages ending April 23.

Zoom in: Rural nursing homes are especially facing "over-bedding," or when the capacity for residents is too high compared to staffing, Anderson says.

Rural towns lean older, making it harder to properly staff nursing homes.

There's also a lack of incentive to enter the care industry, which has an average hourly rate of $16, according to AARP of Iowa.

What they're saying: Iowa lawmakers approved $15 million earlier this year to go towards nursing homes and adjusting Medicaid rates for inflation.

Anderson says he wants to see that funding help go towards alleviating worker shortages.

The big picture: More older Iowans are wanting to "stay-in-place" and live out their lives in their current homes, rather than the U.S. cultural norm of going to a care facility, Anderson says. That could help lower the need for more nursing home workers.

Working towards this dynamic could include funding amenities like smart technology, voice control or grips for bathrooms, Anderson says.

Iowa's nursing home worker shortage is double the national average

Nearly 42% of Iowa nursing homes have a nurse or aide worker shortage.

Illustration of a nurse walking with an elderly man.

Nursing home worker shortages continue to plague Iowa, Brad Anderson, state director of <a class="gtmContentClick" data-vars-link-text="AARP of Iowa" data-vars-click-url="https://states.aarp.org/iowa/" data-vars-content-id="0a9a60a9-fecd-4079-a6ab-c4c5acfbca14" data-vars-headline="Iowa&#x27;s nursing home worker shortage is double the national average" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://states.aarp.org/iowa/" target="_blank">AARP of Iowa</a> tells Axios.Why it matters: Staffing shortages can result in subpar or even neglectful care in nursing homes — and nearly 42% of Iowa&#x27;s facilities have a shortage of nurses and aides.

News

Axios Des Moines, anchored by Jason Clayworth and Linh Ta, is here to help readers get smarter, faster on the most consequential news and developments unfolding in their own backyard.

Put on your best theater outfit — the national tour of "Dear Evan Hansen" opens at the Des Moines Civic Center tomorrow.

State of play: The contemporary musical follows a young man who has a social anxiety disorder and wants to connect with those around him.

The story centers on his fabrication of having had friendship with a student who died by suicide and his becoming close to the deceased's family.

Ahead of the performances, we chatted with cast members John Hemphill and Lili Thomas about the show and their lives on tour:

What do you hope the audience gets from the story?

Even though we're in a social media age, everyone wants personal connections —  especially young people, Hemphill says.

The song, "You will be found" represents that.

A fun fact about the show: The actor who plays the lead role of Evan Hansen goes off stage just twice.

"He gets out of the scene and sprints to the bathroom ... and then comes back to the stage," Hemphill says.

What will you do in Des Moines? "We love getting DM's and Instagram messages from people saying, 'Hey, while you're in town, you've got to check this out,'" Thomas says.

"Unless somebody's visited before, we go in blind."

What's next: The show runs through Sunday.

The "Dear Evan Hansen" cast wants Des Moines recommendations

The touring show opens at the Des Moines Civic Center on June 6.

John Hemphill and Lili Thomas. Photos: Courtesy of Des Moines Performing Arts

Put on your best theater outfit — the national tour of &quot;<a class="gtmContentClick" data-vars-link-text="Dear Evan Hansen" data-vars-click-url="https://desmoinesperformingarts.org/events/dear-evan-hansen/" data-vars-content-id="5e307e5b-34d8-479f-894a-8dc6e3619d1f" data-vars-headline="The &quot;Dear Evan Hansen&quot; cast wants Des Moines recommendations" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://desmoinesperformingarts.org/events/dear-evan-hansen/" target="_blank">Dear Evan Hansen</a>&quot; opens at the Des Moines Civic Center tomorrow.State of play: The contemporary musical follows a young man who has a social anxiety disorder and wants to connect with those around him.

Things to Do

A mural titled "We are one" is proposed for the underpass of the east side of the Iowa Women of Achievement pedestrian bridge and the Principal Riverwalk trail.

Catch up fast: The underpass is the frequent site of graffiti. In other areas, city officials have discovered that art alleviates the problem.

Operation Downtown, a business advocacy group, agreed to solicit proposals from artists.

It will pay for the project and oversee its maintenance through at least March  2033, under a proposal going  before the Des Moines City Council next week.

Details: "We are one" is  designed by local artist Ally Frame.

She previously painted an image of  Frieda Kahlo on the side of Manhattan Deli and a psychedelic-like interpretation of the Iowa Capitol in  the East Village.

This mural would show children holding hands across the ceiling of the underpass with the words "We are connected."

New mural proposed along Des Moines' riverwalk

City leaders hope the art alleviates graffiti problems.

Digital rendering: Ally Frame via the city of DSM

A mural titled &quot;We are one&quot; is proposed for the underpass of the east side of the Iowa Women of Achievement pedestrian bridge and the Principal Riverwalk trail.Catch up fast: The underpass is the frequent site of graffiti. In other areas, city officials have discovered that art alleviates the problem.

Iowa's treasurer listed the contents of dozens of abandoned safe deposit boxes for auction last week.

Why it matters: Millions of dollars in abandoned property are turned over to the state treasurer's office each year from financial institutions and businesses that have lost contact with owners.

Dormant bank accounts, uncashed checks and utility deposits are among the common items turned over to the state.

People can search and lay claim to their items online via "Great Iowa Treasure Hunt."

Driving the news: The office's last safe deposit box auction was in 2018 and the state's unclaimed property vault is now full.

Nearly 30 of the first auction lots end June 14. Sales will be canceled if rightful owners lay claim before then.

What they're saying: These auctions are difficult because they're often people's most prized possessions, Russ Trimble, the treasurer offices' chief of staff, tells Axios.

The contents frequently have more sentimental value to owners than monetary worth, he says.

Auction revenues are held by the state for owners or their heirs to claim into perpetuity — as is done with other financial accounts.

The intrigue: Some of the goodies include a sports card collection, jewelry and a fancy shaving set.

Iowa is auctioning off abandoned safe deposit boxes

Some of the goodies include a sports card collection, jewelry and a fancy shaving set.

Inside the vault holding abandoned safe deposit box contents at the Iowa treasurer's office. Photo: Courtesy of the State Treasurer of Iowa

Auctions

Iowa&#x27;s treasurer <a class="gtmContentClick" data-vars-link-text="listed" data-vars-click-url="https://www.lso.cc/allitems/seller_R3JlYXQgSW93YSBUcmVhc3VyZSBIdW50" data-vars-content-id="400dee13-1168-4943-9433-e7b599a2c475" data-vars-headline="Iowa is auctioning off abandoned safe deposit boxes" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.lso.cc/allitems/seller_R3JlYXQgSW93YSBUcmVhc3VyZSBIdW50" target="_blank">listed</a> the contents of <a class="gtmContentClick" data-vars-link-text="dozens of abandoned safe deposit boxes" data-vars-click-url="https://www.lso.cc/allitems/seller_R3JlYXQgSW93YSBUcmVhc3VyZSBIdW50" data-vars-content-id="400dee13-1168-4943-9433-e7b599a2c475" data-vars-headline="Iowa is auctioning off abandoned safe deposit boxes" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.lso.cc/allitems/seller_R3JlYXQgSW93YSBUcmVhc3VyZSBIdW50" target="_blank">dozens of abandoned safe deposit boxes</a> for auction last week.Why it matters: Millions of dollars in abandoned property are turned over to the state treasurer&#x27;s office each year from financial institutions and businesses that have lost contact with owners.

A new system that estimates Des Moines' future public infrastructure costs shows a potential annual shortfall of tens of millions of dollars beyond a debt limit set by the City Council.

Why it matters: The city isn't facing an immediate budget emergency but the long-term outlook is necessary to avoid crises like the one in 2004, when it temporarily shut off streetlights, city manager Scott Sanders tells Axios.

What's happening: DSM's finance department and city manager is now calculating the lifespan, maintenance or replacement costs for hundreds of infrastructures like bridges, buildings, parks and sewers.

The outlook is intended to better reflect future expenses while helping the city assess and improve its overall infrastructure.

What they found: Annual costs to maintain existing infrastructure starting in 2030 will be around $80 million.

After accounting for other revenue sources, that number would create an annual $21 million debt capacity deficit.

That estimate does not calculate new or expanded projects added between now and then.

What they're saying: Some of the council members were taken aback by the projection. Joe Gatto, for example, said in a council meeting it appears that DSM wouldn't be able to pay its bills in 2030.

Mayor Frank Cownie responded by noting that the projection gives the city time to act.

The city can potentially seek new revenue sources and pair back future spending, Sanders added.

State of play: State law sets city debt limits to 5% of the value of its taxable property, which is around $16 billion in DSM.

The council's policy is stricter, setting its own debt ceiling at 4%.

Zoom in: In the fiscal year that ended in June 2022, DSM had nearly $600M of debt.

That's roughly $200M under the state's limit and $40 million under the city's self-imposed restriction, according to information that Nick Schaul, the city's finance director, presented to the City Council this week.

Of note: The city's costs associated with its debt is "approaching high levels" and taking on more could result in a lower credit rating, S&P Global Ratings warned in the city's latest analysis.

That would increase DSM's future borrowing costs.

The big picture: Cities like Johnston also recently received S&P's high-level debt warning.

Iowa cities took on nearly 15% more debt between 2020 and 2022 — from about $6.6 billion to just over $7.5 billion, according to the most recent state debt report.

What's next: Multiple city workshops about the issue are being planned, Sanders says.

Des Moines is approaching its debt ceiling

Long-term infrastructure costs are being factored into future debt projections.

Illustration of a hundred dollar being built by construction vehicles.  

Iowa

A new system that estimates Des Moines&#x27; future public infrastructure costs shows a potential annual shortfall of tens of millions of dollars beyond a debt limit set by the City Council.Why it matters: The city isn&#x27;t facing an immediate budget emergency but the long-term outlook is necessary to avoid crises like the one in 2004, when it temporarily shut off streetlights, city manager Scott Sanders tells Axios.

A new immersive art exhibit opening at Mainframe Studios today highlights  the perspectives of people who are neurodivergent or those who have mental illnesses.

Why it matters: People who are neurodivergent are often taught how to "fit in." This art instead celebrates their uniqueness, Christina Smith, president of exhibit host Community Support Advocates, tells Axios.

State of play: "Take Up Space," features the work of five different artists, including:

Hyperfocus: Abby Niederhauser, who has autism, will show an "explosion" of '90s pop culture in her art.

Social isolation: Leo Bird created a three-dimensional piece where people can experience what isolation can be like for someone with autism in a cafe.

Voices: Mindspring, the local mental health organization, is sharing a simulation of what it's like to hear voices.

Perspective: Jonathan Dwight Photography is showing photos that represent what it's like for people with differences to be judged by society.

Wellness Center: The B. Well Foundation is providing resources on mental wellness.

Most of the exhibit will be on show until June 19.

New art exhibit highlights neurodivergent experiences

The exhibit "Take Up Space" is now at Mainframe Studios through June 19.

Abby Niederhauser's art exhibit at Mainframe Studios. Photo: Courtesy of Christina Smith

A new immersive art exhibit opening at <a class="gtmContentClick" data-vars-link-text="Mainframe Studios" data-vars-click-url="https://mainframestudios.org/" data-vars-content-id="3da88fcb-78b2-4a40-8f1a-11322beaf564" data-vars-headline="New art exhibit highlights neurodivergent experiences" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://mainframestudios.org/" target="_blank">Mainframe Studios</a> today highlights the perspectives of people who are neurodivergent or those who have mental illnesses.Why it matters: People who are <a class="gtmContentClick" data-vars-link-text="neurodivergent" data-vars-click-url="https://www.webmd.com/add-adhd/features/what-is-neurodiversity" data-vars-content-id="3da88fcb-78b2-4a40-8f1a-11322beaf564" data-vars-headline="New art exhibit highlights neurodivergent experiences" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.webmd.com/add-adhd/features/what-is-neurodiversity" target="_blank">neurodivergent</a> are often taught how to &quot;fit in.&quot; This art instead celebrates their uniqueness, Christina Smith, president of<a class="gtmContentClick" data-vars-link-text=" exhibit host Community Support Advocates" data-vars-click-url="https://teamcsa.org/" data-vars-content-id="3da88fcb-78b2-4a40-8f1a-11322beaf564" data-vars-headline="New art exhibit highlights neurodivergent experiences" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://teamcsa.org/" target="_blank"> exhibit host Community Support Advocates</a>, tells Axios.

Ruts left at Water Works Park in Des Moines last month by organizers of a canceled rally for former President Donald Trump are being fixed this week.

Yes, but: The grass hasn't rooted and the damaged areas are still off limits for people attending the Iowa Craft Brew Festival tomorrow, Sam Carrell, director of the park's foundation, tells Axios.

Trump's campaign is working with park officials to fix the damage, Carrell says. 

He declined to provide a repair cost estimate.

Des Moines is fixing ruts left at cancelled Trump event

Damaged areas are still off limits for people attending a festival Saturday.

A photo of ruts at Water Works Park in Des Moines.

Looking smoother, right, but still off limits this weekend. Photos: Jason Clayworth/Axios

Ruts left at Water Works Park in Des Moines last month by organizers of <a class="gtmContentClick" data-vars-link-text="a canceled rally" data-vars-click-url="https://www.axios.com/local/des-moines/2023/05/16/desmoines-ruts-donald-trump-rally-lauridsen" data-vars-content-id="2f7cb041-ac96-4d02-829f-86529f211fa6" data-vars-headline="Des Moines is fixing ruts left at cancelled Trump event" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/local/des-moines/2023/05/16/desmoines-ruts-donald-trump-rally-lauridsen" target="_self">a canceled rally</a> for former President Donald Trump are being fixed this week.Yes, but: The grass hasn&#x27;t rooted and the damaged areas are still off limits for people attending the <a class="gtmContentClick" data-vars-link-text="Iowa Craft Brew Festival" data-vars-click-url="https://www.iowacraftbrewfestival.com/" data-vars-content-id="2f7cb041-ac96-4d02-829f-86529f211fa6" data-vars-headline="Des Moines is fixing ruts left at cancelled Trump event" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.iowacraftbrewfestival.com/" target="_blank">Iowa Craft Brew Festival</a> tomorrow, Sam Carrell, director of the park&#x27;s foundation, tells Axios.

Post-pandemic reductions in federal commodities are contributing to local food pantry struggles.

Why it matters: It's forcing pantry organizers to make difficult choices at a time when access to food assistance through other programs is getting tougher.  

Catch up quick: The Emergency Food Assistance Program (TEFAP) helps supplement the diets of low-income people at no cost using USDA commodities that are distributed by food agencies across the U.S.

The program received hundreds of millions in extra federal assistance dollars during the pandemic.

The big picture: Feeding America, the nation's largest hunger-relief organization, distributed 5.2 billion meals in the 2022 fiscal year, a spokesperson tells Axios.

That's down just over 21% from the previous year's 6.6 billion meals, mostly due to a drop in availability of federal commodities.

But it is ahead of its pre-pandemic distribution levels of 4.2 billion meals in the 2019 fiscal year.

Yes, but: Iowa's food needs are growing due to inflation, the increasingly strict qualification requirements for government assistance and the scaling back of extra pandemic-era programs, Anne Bacon, CEO of DSM-based nonprofit IMPACT, tells Axios.

What's happening: The Food Bank of Iowa, which is part of the Feeding America network, is purchasing more food than ever before for its charities, a spokesperson tells Axios.

About 30% of its 2023 inventory so far has been purchased, 15% came from TEFAP and the rest was donated.

State of play: The availability of free or low-cost items like eggs through the food bank has been inconsistent in recent months, Althea Holcomb, director of West Des Moines Human Services (WDMHS), tells Axios.

Plus, the amount of food rescued from restaurants and stores has taken a hit as the economy tightens, so WDMHS’s pantry is now more frequently purchasing things like milk and produce from retailers.

Meanwhile, IMPACT recently applied for a $25,000 private grant to help cover extra costs that its Boone pantry faces because of fewer TEFAP commodities, Bacon says.

And the Des Moines Area Religious Council’s (DMARC) pantry network has recorded 13 consecutive months of all-time records for first-time visitors, a spokesperson tells Axios.

DMARC's busiest day in its 47-year history was May 2, with 1,725 food recipients.

Food pantries struggle as pandemic relief ebbs

Inflation and increasingly strict assistance qualifications are playing into hardships.

Illustration of a hands holding a fork and knife next to an empty plate sitting on an American dollar

Food security

Post-pandemic reductions in federal commodities are contributing to local food pantry struggles.Why it matters: It&#x27;s forcing pantry organizers to make difficult choices at a time when <a class="gtmContentClick" data-vars-link-text="access to food assistance" data-vars-click-url="https://www.desmoinesregister.com/story/news/politics/2023/04/14/iowa-house-passes-new-eligibility-requirements-for-public-assistance-snap-medicaid/70112482007/" data-vars-content-id="15694946-1d50-459e-9c35-5cfbbd37fe9e" data-vars-headline="Food pantries struggle as pandemic relief ebbs" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.desmoinesregister.com/story/news/politics/2023/04/14/iowa-house-passes-new-eligibility-requirements-for-public-assistance-snap-medicaid/70112482007/" target="_blank">access to food assistance</a> through other programs is getting tougher. Catch up quick: The Emergency Food Assistance Program (<a class="gtmContentClick" data-vars-link-text="TEFAP" data-vars-click-url="https://fns-prod.azureedge.us/sites/default/files/resource-files/tefap-program-fact-sheet-2019_1.6.20.pdf" data-vars-content-id="15694946-1d50-459e-9c35-5cfbbd37fe9e" data-vars-headline="Food pantries struggle as pandemic relief ebbs" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://fns-prod.azureedge.us/sites/default/files/resource-files/tefap-program-fact-sheet-2019_1.6.20.pdf" target="_blank">TEFAP</a>) helps supplement the diets of low-income people at no cost using USDA commodities that are distributed by food agencies across the U.S.<ul><li>The program received <a class="gtmContentClick" data-vars-link-text="hundreds of millions" data-vars-click-url="https://www.fns.usda.gov/tefap/additional-information-fy-2020-funding-sources" data-vars-content-id="15694946-1d50-459e-9c35-5cfbbd37fe9e" data-vars-headline="Food pantries struggle as pandemic relief ebbs" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.fns.usda.gov/tefap/additional-information-fy-2020-funding-sources" target="_blank">hundreds of millions</a> in extra federal assistance dollars during the pandemic.</li></ul>The big picture: Feeding America, the nation&#x27;s largest hunger-relief organization, distributed 5.2 billion meals in the 2022 fiscal year, a spokesperson tells Axios.<ul><li>That&#x27;s down just over 21% from the previous year&#x27;s 6.6 billion meals, mostly due to a drop in availability of federal commodities.</li><li>But it is ahead of its pre-pandemic distribution levels of 4.2 billion meals in the 2019 fiscal year.</li></ul>Yes, but: Iowa&#x27;s food needs are growing due to inflation, the increasingly strict qualification requirements for government assistance and the scaling back of extra pandemic-era programs, Anne Bacon, CEO of DSM-based nonprofit <a class="gtmContentClick" data-vars-link-text="IMPACT" data-vars-click-url="https://www.impactcap.org/" data-vars-content-id="15694946-1d50-459e-9c35-5cfbbd37fe9e" data-vars-headline="Food pantries struggle as pandemic relief ebbs" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.impactcap.org/" target="_blank">IMPACT</a>, tells Axios.What&#x27;s happening: The Food Bank of Iowa, which is part of the Feeding America network, is purchasing more food than ever before for its charities, a spokesperson tells Axios.<ul><li>About 30% of its 2023 inventory so far has been purchased, 15% came from TEFAP and the rest was donated.</li></ul>State of play: The availability of free or low-cost items like eggs through the food bank has been inconsistent in recent months, Althea Holcomb, director of West Des Moines Human Services (WDMHS), tells Axios.<ul><li>Plus, the amount of food rescued from restaurants and stores has taken a hit as the economy tightens, so WDMHS’s pantry is now more frequently purchasing things like milk and produce from retailers.</li></ul>Meanwhile, IMPACT recently applied for a $25,000 private grant to help cover extra costs that its Boone pantry faces because of fewer TEFAP commodities, Bacon says.<ul><li>And the Des Moines Area Religious Council’s (<a class="gtmContentClick" data-vars-link-text="DMARC" data-vars-click-url="https://www.dmarcunited.org/" data-vars-content-id="15694946-1d50-459e-9c35-5cfbbd37fe9e" data-vars-headline="Food pantries struggle as pandemic relief ebbs" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.dmarcunited.org/" target="_blank">DMARC</a>) pantry network has recorded 13 consecutive months of all-time records for first-time visitors, a spokesperson tells Axios.</li><li>DMARC&#x27;s busiest day in its 47-year history was May 2, with 1,725 food recipients.</li></ul>

National

Americans hunt for air purifiers as Canada wildfire smoke drifts over

Wildfires

After a record economic expansion, the coronavirus pandemic sent the U.S. economy into a recession as unemployment soared to staggering heights. The country now faces urgent questions about how much stimulus is needed for reeling consumers and businesses, and what a recovery might look like.

Economy & Business

Supreme Court says Medicaid patient's family can sue nursing home

Nursing home care

The U.S. faces a range of health care flashpoints — unaffordable drugs, opioids, vaping — as we debate whether to adopt universal care. For now, the Affordable Care Act is the law of the land, but Republicans want to issue it a final death blow.

Health

Google to launch News Showcase product in U.S.

Google

From the Valley to D.C., Big Tech players like Facebook, Google and Amazon are under more scrutiny than ever as new technology develops and privacy and antitrust concerns grow in lockstep with companies’ ambitions.

Technology

Ukraine says Russia shelled flood-hit Kherson after Zelensky visit

Russian invasion of Ukraine

China is becoming the most formidable rival America has faced, and the risk of confrontation with Russia, North Korea or Iran still looms. Authoritarians are rising, the chaotic Afghanistan exit revealed the limits of U.S. power, and the pandemic, climate change and other critical challenges continue to pose grave threats.

World

Veteran who subdued Club Q gunman to be honored at Pride parade

Hispanic and Latino Americans

President Biden has made the COVID-19 crisis and a post-Trump return to national unity and traditional democratic ideals his top priorities. From vaccinations to stimulus to schools, Biden is seeking bipartisan compromise while showing a willingness to use executive authority and bare Democratic majorities in the U.S. House and Senate to implement his policies. Republican leaders are navigating deep party divisions over if and how to move beyond former President Trump.

Politics & Policy

Canadian wildfire smoke drives record poor air quality in East Coast

Ominous forecasts about the impact of climate change serve as the backdrop for the world — led by U.S. lawmakers and companies — to debate big action on the problem, which could upend energy systems and our way of life.

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