Former Tama County Supervisor and Tama Police Chief Dan Wilkens gave a presentation to the Tama County Supervisors about possibly going private for home health needs. PHOTO BY MICHAEL ALWAYS HOME NEVER HEALTHY DAVIS

People were sitting, standing, and loitering in the hall; it was the largest crowd the Tama County Supervisors had garnered in a couple of months. Nearly all of the citizens who sardined themselves into the meeting room were attending the meeting for one reason, one agenda item, listed only as “Discussion with group of citizens regarding Public Health budget.”

The show started with the public comment time, in which many of the large group grabbed the microphone and were able to speak their minds on Public Health. Charlie Betz, representing the VFW, started things off by first thanking the board for making Tama a Home Base County. He then went on to highlight all that Home Health has done and does for veterans. Others spoke about how vital Tama County Home Health has been, giving examples of care given to brothers, sisters, spouses, parents, neighbors, and others. Some brought up how Home Health is crucial to the county due to the fact that Tama County does not have a hospital.

“I hear comments from people as if the choice is between their being healthcare services or not; seems to me the question really is what is the most efficient way of providing those services at the lowest cost,” Richard Vandermay said.

Tama County Public Health Clinical Manager LeeAnna Kriegel stood and spoke.

“The one thing I want to remind Tama County residents, and I understand that there’s always an economic, financial responsibility to the county and to the state to provide care to people, and the cost to the people as well. Part of our problem here in Tama County is our logistics. We live in a county that does not have a hospital, does not have an urgent care. Right now, we have two clinics available to us in the entire county. One in Tama and one in Toledo,” she said. “We don’t have dentists anymore, we don’t have mental health. It’s not financially responsible for the larger hospitals to send people into our county to care for our people. And I understand. This has been going on for quite some time. There was Deer Creek at one time that was set up, that I do believe went through Grinnell, they were trying to set up some kind of urgent care, emergency room over there, but that failed. So, that’s kind of a lesson in itself, that they attempted this once to bring this into our county and it failed. If we don’t have Tama County Public Health and Home Care, I’m afraid that these people that we care for every day are not gonna get the care that they need and they deserve.”

This week’s Tama County Supervisors meeting drew a very large crowd of citizens concerned about the future of the Public Health and Home Care department. PHOTO BY MICHAEL ALWAYS HOME NEVER HEALTHY DAVIS

Kriegel then shared more of her thoughts.

“I’ve had patients literally have insurance companies tell our patients you need to move to a bigger city. They want them to move out of Tama County, closer, because they only want to provide rides to doctors within a fifty-mile radius. Well, it’s a 120-mile round trip to Cedar Rapids and back,” she said.

Tama City Council member Larry Thomas stood and spoke as well.

“I served on Tama Ambulance for 31 years, and one of the things I did see on Tama Ambulance, we had a lot of calls, that people didn’t call us, the nursing care called us. And when they called us, they were in need, and we ended up transporting a lot of people to the hospital, and it’s one of the things you mentioned, the hospitals not being close, we need the services that are willing to stick forward for this. There is a need for this,” he said.

The reason for all the hoopla and why this is on the agenda is because former Tama Police Chief and former Tama County Supervisor Dan Wilkens wanted to give a presentation to the current supervisors. Wilkens’ presentation was mainly about how the county should cut costs and go with private home health care instead of the county’s current home care program run by Tama County Public Health.

Chairman Mark Doland made it known that he had directed Wilkens to make the presentation to the Public Health Board first. Later, during the presentation, Wilkens said, “Wanna know if we talked with them? No. I did not want to start a firestorm. No. I did not talk with them personally. I have enough knowledge of what they do.”

Wilkens started his presentation by handing out packets and giving a brief history of his career as a supervisor before saying how he would have preferred there not be so many people at the meeting.

“So, if I was sick and I got one of our public health nurses to help me, I would be fantastic. They are excellent people. There’s no question. They do an excellent job. There’s no question,” he said.

Wilkens repeatedly said, “This is not personal. This is business.”

“This isn’t about personal issues. This is about business. This is about every time I open my tax statement, I see it,” he said.

Before he delved into his packet of information, Wilkens asked the supervisors if they believed in truth, honesty, transparency, demographic and geographic equality, fiscal responsibility, and transparency, as well as spending tax dollars wisely. When the supervisors said they did, Wilkens moved on to explaining the information listed in the packet he handed out.

“If you live in Tama, Benton, Marshall, Poweshiek, or Grundy County, or Tama County, should it matter, should it matter if you get different services, or should you all be equal to the same services? That will be up to you guys to decide,” Wilkens said.

The beginning pages of the packet listed handwritten information and statistics regarding other counties’ populations, budgets, public health, and private home health care services used. After explaining these numbers, Wilkens then went on to the information he had listed for Tama County, stating for the 2025-2026 budget year, “Their actual expenses to date are $1,072,626; they budgeted to spend at this point $1,037,000. They’ve overspent by $353,000 already. They said their income would be in seven months, should be, they budgeted $574,360, actual, 4-0-9, $409,000. So, it’s seven months into the budget, we’ve overspent by $354,000, and we have lost an estimated income of $165,000. That’s this year.”

Wilkens went on to talk about how much taxpayers paid per a Tama County Home Health Care visit. Using a letter to the editor from the Public Health department to supply his statistics. “Under the current budget, if they are really busy, which I am sure they are, it’s only gonna cost us $117 per visit. If it’s a slow week, it’s $133, and I gave them the credit of having full weeks,” he said. “The truth is, ladies and gentlemen, there are companies out there that provide private healthcare. Ask Marshall County. Ask Grundy County. Ask the counties that provide, ask the 33 other counties that don’t have or choose to spend that kind of money.”

Bringing it back to the questions he asked at the beginning, Wilkens summed up his thoughts. “If you really believe in equality, okay; if you really believe in budget, okay, if you really believe in that. Stop playing by your heartstrings and by the heartstrings behind us. If that same healthcare is good enough for everybody around us with the wages and the benefits they provide, your, financially, your decision’s gonna be easy, because dollars. Okay, you can hand the budget $250,000, or you can budget $1.9 million. That’s the budget. That’s dollars and cents. Hard side, ladies and gentlemen, this isn’t a piece of machinery we’re talking about. This isn’t a piece of ground we’re talking about. Although it’s not personal, it involves people. It involves people who are employed, who do that job very well. It involves people who receive their services who will tell you it’s very well, okay?”

Wilkens also asked the supervisors the hypothetical question, “Would you run a business where you could either have $250,000 in expense or $1.9 million in expense?” While a few of the supervisors answered the question, Doland rejected the premise of the question outright.

During the middle of his presentation, Wilkens went on a tangent about how Richard Arp was appointed to the Public Health Board. Doland had recommended Arp to the board, but Wilkens stated that Arp informed him that Lori Johnson had spoken to him about the position.

Wilkens then proceeded to call Arp a liar. After he finished his presentation, Wilkens told Arp that he was disappointed in him and made other comments as he was exiting. Doland told Wilkens not to talk to people in the audience. Wilkens asked if he lost his Second Amendment rights. Supervisor David Turner informed him that the Second Amendment was the right to bear arms. Doland and Wilkens had a brief back and forth at the end of which Doland had Sheriff Casey Schmidt remove Wilkens. Wilkens’ response was, “Good, I hope you guys have good attorneys cause you’re gonna need it.”

At the end of the meeting, Doland spoke about the Supervisors role with Public Health.

“If Tama County Public Health decides to cut Home Health services, that will be their board’s decision. That will not be our decision. We are to look at the funding component. If we fund them at the current level, they can keep all of the employees. If we would want to fund them at less, we would fund them at less, and then they would have to deal with the consequences. So, that’s not our board’s decision. Our decision is if we’re going to fund them at the current rate that they are,” he said. “It is about business, that’s his side of it. His comment was to leave the veterans out of it. I have a hard time doing that, not just vets, but people in general. I’ve been in this fight for a long time, got gray hair. So that qualifies me to have some kind of standing,” he said. “When you cut services like this and you, so the state is either going to do it sometime, and I think they learned from their mistake on mental health that when you remove services and you put it in the state budget rather than in the county budget, services go down, quality goes down, quality of life goes down because if you do that and the service, particularly mental health or physical health, which should seen through the same lens honestly they should be coupled when you lose services your going to lose population and so people who are needing in home public health nurses to come and provide further care if they are not receiving these services here then they’ll have to move where they are and there goes your tax base.”

As for the rest of the meeting, Tama County Engineer Ben Daleske made his last report for the county, stating that they’ve been doing brush cutting. They’ve been stockpiling road rock at Traer and Chelsea. Plows were out early last week.

The supervisors approved some additions to the County’s Five-Year Program, the FY27 DOT Budget, as well as a Utility permit. A tax sale in the city of Montour was abated for the full amount and reassigned to the city of Montour so they could continue with a bridge project.

The liquor license for Traer Golf and Country Club was approved. Claims totaling $166,329.33 were approved.