DES MOINES — Republican Iowa Attorney General Brenna Bird's office says an audit of the state's victim services program is delaying a decision on whether the state should continue to reimburse emergency contraception for sexual assault victims.
The Iowa Attorney General’s Office said the audit, which has held up funding for emergency contraception for victims of sexual assault, is in its “final stages” and a report would be released soon.
"That audit is ongoing. Until that review is complete, payment of these pending claims will be delayed,“ Alyssa Brouillet, communications director for the office, said in a statement.
Bird paused the funding when she took office 14 months ago while awaiting the results of the audit to decide whether to continue those payments.
Federal regulations and state law require Iowa to pay expenses for sexual assault victims who seek medical help, such as the costs of forensic exams and treatment for sexually transmitted infections.
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Though the payments are not explicitly required by law, it has been the state’s longtime practice to cover the cost of emergency contraception from the victim compensation fund, which comes from fines, fees and penalties paid by criminals. No taxpayer dollars go into the fund. In rare cases, the fund also has paid for abortions for rape victims.
Bird’s office said in April of last year that it was reviewing the practice to evaluate “whether this is an appropriate use of public funds."
The Attorney General’s Office did not respond to questions from The Gazette about the scope of the audit, how it was conducted, why it’s taken so long, what’s delaying the release of the report and when a decision will be made whether to continue payments.
Bird on Tuesday walked away from a group of reporters at the Iowa Capitol who asked to speak with her.
The current status of the audit was first reported by The Des Moines Register, which filed an open records request in October. After five months, Bird’s office completed the records request but declined to release the document to the Register, citing a section of Iowa public records law that excludes preliminary documents from disclosure.
Victim advocates, including the Iowa Coalition Against Sexual Assault and Iowa Coalition Against Domestic Violence, have urged Bird to continue using the program’s funds to cover emergency contraception and abortion. They say cost should never be a barrier for rape victims seeking medical care, including contraception to prevent an unintended pregnancy or abortion.
Bird has not publicly said why she paused reimbursement for those services, and her office has not identified particular concerns.
State auditor condemns AG for using audit to justify halting payments
Iowa State Auditor Rob Sand, a Democrat, held a news conference Wednesday to condemn Bird for using the audit to justify halting payments for care provided to victims of sexual assault and rape.
He clarified that his office is not and has not been asked by the office to conduct the audit.
“We are not performing any such audit. There is no third party performing any such audit. There is no audit going on here,” Sand said. “There might be an internal review. But again, this is a decision (made on) Day One in the Attorney General's Office.”
Sand noted other state agencies routinely conduct audits without suspending operations.
“It's worth pointing out you don't stop doing something without suspecting massive fraud just while you're getting an audit or review done, right?” Sand told reporters.
He said “there's been no suggestion whatsoever” that money from the victims compensation fund has been misspent during the decades under former Attorney General Tom Miller when the state was providing reimbursements for sexual assault survivors use of emergency contraception.
Sand said Bird’s decision to pause payments “is a disservice to sexual assault survivors.” He said many of those helped by the fund are juvenile victims of sexual abuse.
“And the trauma and the pain that the attorney general’s decision is putting victims through in this case literally makes my skin crawl,” Sand told reporters.
“And this sort of word choice is simply a way to help her avoid accountability for her own decision“ to quit paying for emergency contraception for sexual assault survivors.
Planned Parenthood echoes auditor
Mazie Stilwell, director of public affairs for Planned Parenthood Advocates of Iowa, said “it’s absolutely deplorable that sexual assault survivors in Iowa have gone more than a year without state-covered emergency contraceptives — all because of politics.”
As of August of last year — the most recently reported figures from Bird’s office — more than 160 reimbursement requests for emergency contraception for sexual assault survivors were pending approval from the Iowa Attorney General’s Office.
The backlog of requests for Crime Victim Compensation Funds at that time totaled approximately $7,500. The reimbursement requests came from hospitals and pharmacies across the state, with several dating as far back as 2020. One includes a case of child abuse.
“The State Auditor and Planned Parenthood are flat wrong,” Brouillet, Bird’s press secretary, said. “It is a shame that the auditor is playing politics with a critical audit of victim services and blasting misinformation to boost his own profile. We will publicly release the report once it is final.”
Bird has been a vocal opponent of abortion. But sexual assault nurse examiners, along with other victim advocates, have emphasized that emergency contraceptives are not abortion pills. The medication delays or prevents ovulation, preventing a pregnancy from occurring, according to the U.S. Food and Drug Administration.
Polk, Johnson counties paying for help
Sexual assault nurse examiners who care for victims after their attack say they have continued to provide emergency contraceptives to those who request them.
They also have pledged to take steps to ensure that the cost of the medications will never fall on victims.
Polk and Johnson counties have set aside funding to help cover those expenses in their area while the state program remains in question.
To date, $2,319 has been spent in Johnson County, said Katy Rasmussen, coordinator for the Johnson County Sexual Assault Response Team.
Initially, hospitals and pharmacies either agreed to cover the cost or held off on submitting claims while awaiting the outcome of the audit. But once a year had passed, University of Iowa Hospitals and Clinics decided to go forward with billing Johnson County for the costs they had been holding, Rasmussen said.
“We are incredibly fortunate that Johnson County agreed to give us funding to cover this cost,” she said.
Some hospitals are still sending bills to the Attorney General’s Office. Some have agreed to cover the cost for patients. And many victim advocates are exploring fundraising options to pay for it, Rasmussen said.
Shannon Knudsen serves as the coordinator for sexual assault nurse examiners for Polk and Story counties.
Knudsen said she is working with a pharmaceutical company to develop a statewide voucher program where the company would directly donate medications, including emergency contraception and prescriptions to treat sexually transmitted diseases, to pharmacies who dispense them to victims of sexual assault.
Victim care providers said the longer the payments are halted, the less optimistic they remain that funding will ever be reinstated.
“The lack of communication of any timeline has made it very difficult to navigate next steps,” Rasmussen said.
Many of the programs and services the team provides to victims are grant funded and have faced budget cuts the past few years.
“We have limited time and resources to do this work, and without clear directions on when this will end, it is difficult to determine how much effort to devote to finding other solutions,” Rasmussen said.