(Des Moines, Iowa) – The state of Iowa says it will not necessarily disclose to the public the rationale for disciplinary charges against licensed professionals such as physicians, nurses, therapists and nursing home administrators. The Iowa Capital Dispatch reports the determining factor appears to be whether the state’s licensing boards choose to include the allegations within the text of a final order in a disciplinary case. If a board opts to omit those allegations from the final order, the public may never know what gave rise to the charges. The result is that Iowa’s licensing boards are now, in some cases, keeping secret the alleged misconduct that is tied to charges of professional incompetence, ethical violations, patient abuse and even criminal convictions.

Over the past three years, public access to information from Iowa’s licensing boards has been greatly restricted. Prior to October 2021, all state licensing boards publicly disclosed charges against practitioners at the time they were filed or at the time the practitioners were notified of the charges. That disclosure included not just the charges themselves — which are often vague, such “professional incompetence” or “unethical conduct” — but also the specific underlying conduct that gave rise to the charges, such as a botched surgery or the theft of patient medications.

In October 2021, the Iowa Supreme Court ruled that the basic facts and circumstances surrounding disciplinary action against licensed professionals must be kept confidential at least until the licensing boards issue their final rulings in the matter – a process that sometimes takes years. The court’s decision was based on a statute that says “investigative information” gathered as part of a complaint against a licensee must be kept confidential at least until the board issues its final decision. The court concluded that the basic facts and circumstances surrounding a case are “investigative” in nature.

In the aftermath of the court’s decision, most of Iowa’s licensing boards began issuing redacted statements of charges to keep secret the facts and circumstances of the cases until the cases were closed. Last fall, however, some boards took the position that the basic facts and circumstances that triggered the charges should remain sealed from public view even after a case was finalized.

For example, the Iowa Board of Nursing repeatedly refused a request from Iowa Capital Dispatch for an unredacted copy of the written statement of charges against a nurse whose license has been revoked. The redacted portion of that document outlines the specific conduct that led to the charges against the nurse. In a Board of Chiropractic case involving Bruce Lindberg, the board resolved the case with a settlement calling for Lindberg to surrender his license. The basic facts and circumstances in that case remained sealed until an Open Records Law request was filed by the Iowa Capital Dispatch. That request led to the unredacted version of the statement of charges being published on the website of the Iowa Department of Inspections, Appeals & Licensing, which oversees many of the state’s licensing boards.

Last fall, DIAL attributed widespread inconsistency on public disclosure by the various licensing boards to the agency having taken over their administration just a few months before in July 2023. Prior to that, the boards were overseen by four different state agencies. “The goal of DIAL has been to standardize, modernize and simplify its processes in order to promote best practices across the entire department and provide Iowans great service,” a DIAL spokesperson said last fall. “The department is working closely with the attorney general’s office to ensure all information is timely and accurately provided to the public in accordance with Iowa law.”

In recent months, some of the boards under DIAL’s control have taken to not only keeping secret the facts and circumstances in their statements of charges, but also the terms of board agreements to reinstate licenses. Historically, Iowa’s licensing boards have tended to disclose far less information on licensees’ alleged wrongdoing than is common practice in other states.