Report on a special investigation of the Rodman Volunteer Fire Department and Park and Recreation Department for the period January 1, 2006 through September 30, 2009

Report on a special investigation of the Rodman Volunteer Fire Department and Park and Recreation Department for the period January 1, 2006 through September 30, 2009

Iowa Department of Revenue Performance Report FY09

The Iowa Department of Revenue Performance Report is presented in accordance with the Accountable Government Act to improve decision-making and increase accountability to stakeholders and citizens of Iowa.

Audit report on the Iowa Water Pollution Control Works Financing Program (Clean Water Program) and the Iowa Drinking Water Facilities Financing Program (Drinking Water Program), joint programs of the Iowa Finance Authority and the Iowa Department of Natural Resources for the year ended June 30, 2009

Audit report on the Iowa Water Pollution Control Works Financing Program (Clean Water Program) and the Iowa Drinking Water Facilities Financing Program (Drinking Water Program), joint programs of the Iowa Finance Authority and the Iowa Department of Natural Resources for the year ended June 30, 2009

Report on the IowaCare program administered by the Iowa Medicaid Enterprise, a division of the Department of Human Services (DHS-IME), for the period July 1, 2005 through June 30, 2009

Report on the IowaCare program administered by the Iowa Medicaid Enterprise, a division of the Department of Human Services (DHS-IME), for the period July 1, 2005 through June 30, 2009

Wireless E911 Emergency Communications Fund Iowa Homeland Security and Emergency Management Division of the Iowa Department of Public Defense independent auditor's reports, basic financial statements and supplementary information, June 30, 2009.

Audit report on the Wireless E911 Emergency Communication Fund of the Iowa Homeland Security and Emergency Management Division of the Iowa Department of Public Defense for the year ended June 30, 2009

Report on a review of selected general and application controls over the Iowa Department of Human Services’ Issuance Verification System for the period March 19, 2009 through April 17, 2009

Report on a review of selected general and application controls over the Iowa Department of Human Services’ Issuance Verification System for the period March 19, 2009 through April 17, 2009

Report on the Juvenile Detention Home Fund administered by the Department of Human Services for the period July 1, 2007 through November 10, 2009

Report on the Juvenile Detention Home Fund administered by the Department of Human Services for the period July 1, 2007 through November 10, 2009

Audit report on the Sherrill Sewer Department, Sherrill, Iowa for the year ended June 30, 2009

Audit report on the Sherrill Sewer Department, Sherrill, Iowa for the year ended June 30, 2009

Report of Recommendations to the Iowa Department of Revenue for the year ended June 30, 2009

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

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