Anisa Mikah Smith Vs. Iowa Department Of Human Services And Iowa Department Of Inspections And Appeals

Supreme Court of Iowa·Decided August 15, 2008·No. 61 / 07–0546·Published

Opinion

IN THE SUPREME COURT OF IOWA No. 61 / 07–0546

Filed August 15, 2008

ANISA MIKAH SMITH, Appellant, vs.

IOWA DEPARTMENT OF HUMAN SERVICES and IOWA DEPARTMENT OF INSPECTIONS AND APPEALS,

Appellees.

Appeal from the Iowa District Court for Hardin County, Carl D. Baker, Judge.

Appellant seeks reversal of district court decision affirming agency finding she committed dependent adult abuse. AFFIRMED.

Lawrence B. Cutler of Craig & Smith, LLP, Eldora, for appellant.

Thomas J. Miller, Attorney General, and Mark Hunacek, Assistant Attorney General, for appellees.

CADY, Justice.

In this appeal from a district court decision that affirmed a finding by the Iowa Department of Inspections and Appeals (DIA) that a caretaker committed dependent adult abuse, we must decide under our standard of review whether DIA erred in concluding the conduct of the caretaker constituted sexual exploitation of a dependent adult. We agree with the conclusion of the district court and affirm the district court order.

I. Background Facts and Proceedings.

Anisa Smith was employed as a certified nursing assistant at a licensed healthcare facility in Iowa. One of the residents at the facility was an elderly man identified in these proceedings as E.M. E.M. was ninety years old. He suffered from a number of health issues, including depression. He was a dependent adult, and Smith was one of his caretakers.1 Over time, E.M. became emotionally attached to Smith, and his amorous feelings led him to physically express his affections. On more than one occasion, E.M. placed his hand on Smith’s legs and inner thigh. On another occasion, E.M. attempted to touch her breast. On March 18, 2005, Smith alerted her supervisor, the director of nursing, to the conduct. Smith

was told to avoid caring for E.M.

On March 20, 2005, Smith was on duty at the facility. Her shift was

nearly concluded, and she had completed her required tasks. Instead of assisting other caretakers until the conclusion of her shift pursuant to the

1A dependent adult is defined as “a person eighteen years of age or older who is unable to protect the person’s own interests or unable to adequately perform or obtain services necessary to meet essential human needs, as a result of a physical or mental condition which requires assistance from another, or as defined by departmental rule.” Iowa Code § 235B.2(4) (2003). A caretaker is defined as “a related or nonrelated person who has the responsibility for the protection, care, or custody of a dependent adult as a result of assuming the responsibility voluntarily, by contract, through employment, or by order of the court.” Id. § 235B.2(1). It was agreed by the parties in this case that E.M. was a dependent adult and Smith was a caretaker.

policy of the facility, Smith visited E.M. in his room. Another staff member located outside the room heard E.M. ask Smith, “[W]hen are we going to

have a night like last night?”2 Smith giggled in response. At about the same time, two other staff members arrived, and all three entered the room

together.

The staff members observed Smith sitting in a reclining chair with her feet on E.M.’s walker. She was fully clothed. E.M. was seated next to Smith in his wheelchair, facing her. His arm was extended over the side of the chair, and his hand was touching her inner thigh. As the three staff members entered, Smith removed E.M.’s hand from her lap and said “no.” Smith promptly left the room. She was eventually fired over the incident. E.M. became distraught and depressed. He believed Smith’s termination was his fault and later felt he had been unfaithful to his late wife.

The health care facility notified the DIA of the incident. The DIA conducted an investigation and determined Smith committed dependent adult abuse by sexually exploiting E.M. Smith appealed and requested a hearing. An administrative hearing was held where Smith and five of the facility’s employees testified and a number of exhibits were admitted. Smith testified E.M.’s hand was only on her inner thigh for an instant and that she was verbally telling him to remove it when the other staff members entered the room. She claimed she did not consent to the actions by E.M.

The administrative law judge who presided over the hearing upheld the previous finding of abuse made by the DIA. The judge found Smith allowed E.M. to place his hand between her clothed inner thighs for the purpose of arousing or satisfying the sexual desires of either Smith or E.M. and

2The previous night, staff members heard allegations of inappropriate activity between E.M. and Smith. Thus, staff members were on the lookout for inappropriate conduct between the two.

concluded this conduct amounted to dependent adult abuse by sexual exploitation under section 235B.2(5)(a)(3). Smith requested review by the director of the department. The director affirmed the decision of the administrative law judge. Smith petitioned for judicial review. On judicial review, the district court held the findings of the agency were supported by substantial evidence, and the statute was not unconstitutional. Smith appealed and essentially raises three claims of error. First, Smith argues the agency erred in its interpretation of the definition of sexual exploitation found in Iowa Code section 235B.2(5)(a)(3). Second, Smith asserts the evidence does not adequately support the agency’s conclusion that she consented to sexual conduct. Finally, Smith argues Iowa Code section 235B.2(5)(a)(3) is facially unconstitutional.

II. Standard of Review.

Dependent adult abuse proceedings are reviewed pursuant to chapter 17A. Iowa Code § 235B.10(3). When reviewing district court decisions on judicial review of agency action under chapter 17A, “we determine whether our conclusions are the same as those reached by the district court.” Mosher v. Dep’t of Inspections & Appeals, 671 N.W.2d 501, 508 (Iowa 2003). “The agency decision itself is reviewed under the standards set forth in section 17A.19(10).” Id. To the extent Smith raises constitutional questions, our review is de novo. Grovijohn v. Virjon, Inc., 643 N.W.2d 200, 202 (Iowa 2002).

III. Dependent Adult Abuse by Sexual Exploitation.

Iowa Code section 235B.2(5)(a)(3) prohibits sexual exploitation of a dependent adult. It defines sexual exploitation, in relevant part, as

any consensual or nonconsensual sexual conduct with a dependent adult for the purpose of arousing or satisfying the sexual desires of the caretaker or dependent adult, which includes but is not limited to kissing; touching of the clothed or

unclothed inner thigh, breast, groin, buttock, anus, pubes, or genitals . . . .

Iowa Code § 235B.2(5)(a)(3). Importantly, sexual exploitation requires a caretaker to engage in sexual conduct, either consensual or nonconsensual, with a dependent adult for the purpose of arousing or satisfying the sexual desires of the caretaker or the dependent adult. The conduct specifically includes touching certain areas of the body, including the inner thigh and groin.

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