Report on the six divisions of the Iowa Department of Commerce for the year ended June 30, 2008

Report on the six divisions of the Iowa Department of Commerce for the year ended June 30, 2008

Report on a special investigation of the Food Service Department of the Springville Community School District for the period July 1, 2005 through March 31, 2009

Report on a special investigation of the Food Service Department of the Springville Community School District for the period July 1, 2005 through March 31, 2009

Department of Commerce - Iowa Utilities Board, Performance Report, Performance Results Achieved for Fiscal Year 2008

The report highlights the services the IUB provided to Iowans, along with results achieved to ensure reliability, and to improve and expand utility service infrastructure in Iowa. This information is provided in accordance with the State of Iowa Accountable Government Act, Iowa Code chapter 8E. The two basic business functions of the IUB are utility regulation and compliance, and resource management. This report covers performance information for both of these areas.

Department of Commerce - Iowa Utilities Board, Performance Report, Performance Results Achieved for Fiscal Year 2009

The report highlights the services the IUB provided to Iowans, along with results achieved to ensure reliability, and to improve and expand utility service infrastructure in Iowa. This information is provided in accordance with the State of Iowa Accountable Government Act, Iowa Code chapter 8E. The two basic business functions of the IUB are utility regulation and compliance, and resource management. This report covers performance information for both of these areas.

Support services for vulnerable patients by a multidisciplinary team in an emergency department

Introduction: Individuals with poor social determinants of health aremore likely to receive improper healthcare. Frequent Users (FUs) ofEmergency Departments (ED) (defined as >4 visits in the previous12 months) represent a subgroup of vulnerable patients presentingwith specific medical and social needs. They usually account for highhealthcare costs by overusing the healthcare system. In 2008-2009,FUs accounted for 4% of our ED patients but 17% of all our ED visits.Methods: We conducted a prospective cohort of patients admitted toour ED with vulnerabilities in ≥3 specific domains (somatic or mentaldiseases, risk behaviors, social determinants of health, and healthcareuse). Patients were either directly identified by a multidisciplinary team(two nurses, one social worker, one physician) or referred to that teamby the ED staff during opening hours from July 1st 2010 to April 30th2011.Results: 127 patients were included (67% males), aged 43 years (SD15); 65% were migrants. They had a median of 6 ED visits (interquartilerange (IQR) 8-1) in the previous 12 months, representing a total of 697visits. The most frequently affected domains during the index visit were:71% somatic, 61% psychiatric, 75% risk behaviors, 97% social and84% healthcare use issues. Each case required a median of 234minutes (IQR 300-90) dedicated to assess their outpatient network(99% of the patients), to set up an ambulatory medical follow-up (43%)or a meeting with social services (40%).Conclusions: Vulnerability affected ED patients in more than onedomain. Vulnerable patients have complex needs that were difficult toaddress in the time-pressured ED setting. Although ED consultationoffers immediate access to medical care, EDs are dedicated more foracute short-term somatic care. Caring for a growing number ofvulnerable patients requires a different type of management. Limitedevidence shows that multidisciplinary case-management interventionshave demonstrated positive outcomes in terms of reducing ED useand costs, and improvement of patient's medical and social outcomes.A randomized trial of case-management is underway to confirm theresults of observational studies.

Audit report on the Iowa Department of Natural Resources for the year ended June 30, 2009

Audit report on the Iowa Department of Natural Resources for the year ended June 30, 2009

Report on the Iowa Department of Inspections and Appeals for the year ended June 30, 2009

Report on the Iowa Department of Inspections and Appeals for the year ended June 30, 2009

Report on the Iowa Department of Agriculture and Land Stewardship for the year ended June 30, 2009

Report on the Iowa Department of Agriculture and Land Stewardship for the year ended June 30, 2009

Report on the Iowa Department for the Blind for the year ended June 30, 2009

Report on the Iowa Department for the Blind for the year ended June 30, 2009

Report on the Iowa Department of Justice for the year ended June 30, 2009

Report on the Iowa Department of Justice for the year ended June 30, 2009

Report on the Iowa Department of Education for the year ended June 30, 2009

Report on the Iowa Department of Education for the year ended June 30, 2009

Report on the Iowa Department of Public Defense for the year ended June 30, 2009

Report on the Iowa Department of Public Defense for the year ended June 30, 2009

Report on the Iowa Department of Public Health for the year ended June 30, 2009

Report on the Iowa Department of Public Health for the year ended June 30, 2009

Report on a review of selected general and application controls over the Iowa Department of Transportation’s Internal Billing System for the period April 6, 2009 through July 31, 2009

Report on a review of selected general and application controls over the Iowa Department of Transportation’s Internal Billing System for the period April 6, 2009 through July 31, 2009

Iowa Department of Administrative Services Annual Report, Fiscal Year 2009

Annual Report for the Iowa Department of Administrative Services