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Iowa Auditor questions if TestIowa reporting process is legal

Sand said IDPH should get TestIowa results ahead of the private company that runs the program. The Iowa Attorney General's Office said that'd slow down the process.

DES MOINES, Iowa — Iowa State Auditor Rob Sand said Tuesday the reporting method used for TestIowa results is risky and, he claimed, illegal. 

Right now, Sand said the TestIowa COVID-19 test results from the State Hygienic Lab are reported to two private companies and one other state entity before the Iowa Department of Public Health (IDPH) gets the data. 

Iowa State Auditor Rob Sand said that isn't legal. An IDPH mandatory reporting rule, established April 18, requires the following: 

All Iowa health care providers and public, private and hospital laboratories are required to immediately report all positive and negative [COVID-19] testing results to the department.

This is a temporary requirement effective until Dec. 31, 2020. 

"Immediate means 'without intermediary'", Sand said. "That's the definition that you and I use in common language. It's also the definition applied by the Supreme Court."

Sand, a Democrat, said he started investigating after state and county employees reached out to his office with concerns about reporting delays related to TestIowa. 

Here's the order in which TestIowa sends it's data, according to Sand:

  1. Qualtrics 
  2. Domo
  3. Office of the Chief Information Officer 
  4. Iowa Department of Public Health

Qualtrics and Domo are private companies that help facilitate TestIowa. 

Sand said the lengthy chain creates possible risks that aren't needed in the middle of a global pandemic. 

"It's a little like the children's game of telephone," Sand said. "It's funny because as a very simple sentence starts here and goes around in a circle it changes, but it's funny because the longer the chain is the more places there are for it to be changed. It's as simple as that. We all understand how that's not immediate and how it's risky."

RELATED: COVID-19 in Iowa by the numbers: Testing, cases and deaths

Sand also said the current process increases exposure for taxpayers to a potential lawsuit for damages. 

Sand's office is recommending that the State Hygienic Lab report directly to the Iowa Department of Public Health. 

A May 27 letter from Iowa Assistant Attorney General Heather Adams said TestIowa's reporting process complies with IDPH's reporting order. 

"Under the process in place for reporting TestIowa data, the time from test result to upload into IDSS ranges from approximately three hours to ten hours," Adams wrote in the May 27 letter. 

The Iowa Attorney General's Office said sending data directly to IDPH would take a long time. 

"While the State Auditor criticizes the use of 'intermediaries' in the electronic reporting process, it is very common in electronic lab reporting in Iowa and other states to use intermediaries such as electronic platforms, exchanges, data integration systems and others," Attorney General spokesperson Lynn Hicks said in an emailed statement Tuesday. "This is consistent with CDC guidelines. Use of these common pathways helps to ensure the reported data is accurate, automated, protected, and timely. Implementing the Auditor’s recommendations would require the State Hygienic Laboratory to manually re-enter TestIowa data, leading to increased burdens on the Lab and delays in reporting."

Sand's office responded to Hicks's statement Tuesday afternoon:

"The Attorney General's office has a primary duty to try to defend the actions of state agencies like IDPH, regardless of their legality. 

Our analysis is not guided by a client’s acts but by the definition of immediate from the Iowa Supreme Court. Please read our report for the citations. As noted in our report, data integration engines are indeed common. 

But comparing them to wholly separate private entities is like comparing apples to bacon. It is notable that only now, after this examination is completed, is any reason at all provided for the lengthy reporting chain despite our asking twice.

If it is true that changing the Test Iowa reporting system to be legal would require hand entry of data by public lab technicians, then taxpayers probably should not have paid $26M for that system."

IDPH and Gov. Kim Reynolds' both echoed the Attorney General Office's message. 

"TestIowa has been a huge success for Iowans throughout the state, providing widespread access to testing and supporting the state’s contact tracing efforts," IDPH spokesperson Amy McCoy said in a statement Tuesday. "As the [Attorney General's] office has verified, every part of the TestIowa reporting process is in accordance with Iowa Code."

"I agree with Attorney General Miller's office and their report that the State Hygienic Lab is following the rule of law," Reynolds said Tuesday at a press conference in Webster City.

RELATED: Two Iowa lawmakers calling for investigation into TestIowa

Read the full report: 

RELATED: 'We've got a problem': Rep. Axne writes letter to governor, asking for more coronavirus testing of Iowa seniors

RELATED: Iowa business owner chose not to use TestIowa to get employees tested

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