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Tim Hynds, Sioux City Journal 

Logan Holbrook rests in the wheel well of a combine as his third-grade classmates climb a ladder to look in its cab Tuesday at Sioux City's Spalding Park Elementary School. The combine was on display as part of the school's fall harvest party and as part of an agriculture education program by Siouxland Agriculture in the Classroom, a nonprofit that provides agriculture curriculum to elementary schools in seven counties in Iowa.

Court records detail USD players' alleged sexual assault

VERMILLION, S.D. | While their teammate was having sex with a woman in his room, two other University of South Dakota football players entered the room and sexually assaulted her, a police affidavit showed.

Danny Rambo Jr. is charged with second-degree rape and Dale Williamson Jr. is charged with attempted second-degree rape. Both turned themselves in Monday.

Neither player was represented by an attorney during their initial appearances Tuesday morning in Clay County Circuit Court, and neither requested a court-appointed attorney.

Magistrate Judge Kasey Sorensen scheduled a status hearing for 9 a.m. Nov. 7. Sorensen also continued bonds of $25,000 for Rambo and $20,000 for Williamson.

Both players have been indefinitely suspended from competition but remain on the football team and in school, USD spokeswoman Tena Heraldson said. Rambo, 20, a junior defensive back from Donaldsonville, Georgia, who had started the first seven games this season, and Williamson, 21, a sophomore from Texarkana, Texas, and a top reserve who had started one game, both had been suspended prior to last Saturday's game against Southern Illinois.

A third teammate, Adam Harris, also was suspended before Saturday's game. Harris, a senior starting defensive back and team captain from Clearwater, Florida, has not been arrested.

The three Coyote players are named in an affidavit for probable cause filed by Vermillion Police Lt. Crystal Brady, who said in the document that she received a report on Oct. 24 of a sexual assault from the USD Police Department.

Brady's affidavit gave the following account of the incident that led to the charges against Rambo and Williamson:

The victim said that on the evening of Oct. 22, Harris invited the victim and two of her friends to the off-campus home he shares with Rambo and Williamson. The three football players and three women watched a movie in Harris' bedroom until about 10:26 p.m., when the victim's two friends left the residence. There was no alcohol consumed, the victim said.

Rambo and Williamson left Harris' bedroom, according to the affidavit. The victim and Harris later began to have consensual sex. While they were having sex, Rambo and Williamson entered the room. According to the graphic account in the affidavit, Rambo approached the victim from behind without her knowing and inserted his fingers into her vagina. The victim stopped him and he left the room.

Williamson twice tried to force the victim to perform a sex act with him, the affidavit said, and on one of those occasions grabbed the woman by the hair on the back of her head. The victim told Harris to tell Williamson to leave the room. Williamson re-entered the room and was again told to leave. The victim told police that Harris did not seem surprised that his roommates entered the room while they were having sex and he did not initiate asking them to leave.

According to the affidavit, the victim was reluctant to speak because she feared backlash from the football team, other students and community.

During police interviews, Harris verified that Rambo and Williamson had entered the room while he and the woman were having sex. Rambo admitted to touching the victim, the affidavit said. Williamson denied any involvement and said he was not in the room.

The incident remains under investigation.

USD athletic director David Herbster said his department would continue to cooperate with authorities.


"South Dakota athletics is taking this accusation very seriously," Herbster said in a statement. "The athletic department became aware on Wednesday, Oct. 25, and immediately notified the appropriate university officials, who in turn notified the Vermillion Police Department. We have been cooperating fully with VPD’s investigation and will continue to do so. We are steadfast in our support of the university’s commitment to providing a safe and supportive environment for all students."

Herbster said USD coaches and student-athletes cannot discuss the investigation and referred further questions to Heraldson.

In a letter to students, faculty and staff Tuesday, USD President James Abbott said the three players will remain suspended while the legal process continues, and USD's Title IX officer is doing a separate investigation as required by federal law, which prohibits sexual discrimination, including sexual assault, in education programs and activities.


"I am saddened by this very serious incident and the concerns it raises with our USD community," Abbott said in the letter, a copy of which was obtained by the Journal. "Our university is not immune to issues that affect our society, but we understand that as a public university we are uniquely positioned to be leaders creating a safe and inclusive environment for everyone on campus. The university offers support and counseling for persons who have been affected by the situation."

AmeriHealth Caritas leaving Iowa Medicaid program

AmeriHealth Caritas Iowa — the Medicaid insurer with the largest concentration of the state’s special-needs population — will withdraw from the Medicaid program, which covers one in four Iowans, at the end of November, officials announced Tuesday.

The Department of Human Services already is searching for a replacement, DHS Director Jerry Foxhoven said during a news conference in Des Moines. A request-for-proposal is now online, and the new insurer will be available July 1, 2018.

“It isn’t a shock that we would lose one. Other states have lost (managed care organizations) as well,” Foxhoven said. “This has happened elsewhere. We’re not the first state to have MCOs decide they didn’t want to move forward with it and we won’t be the last, I’m sure.

“I don’t think we’ll have any problem finding another company to replace” AmeriHealth.

Foxhoven said the state is working with the insurers to achieve high-quality, cost-effective health care while ensuring sustainability to the program and state budget. To do that, the state has produced strong oversight expectations, he said.

“I think it’s indicative of we’re doing really continuous improvement,” Foxhoven said. “We’re trying to make this program as strong and robust as we can possibly make it. From time to time, that will mean a company may leave or enter. I don’t think that’s a challenge to the program.

“If anything, I think it’s a good thing because I think if you didn’t see any changes it would mean that we’re not holding anybody accountable or we’re not expecting any improvements.”

The more than 213,000 Iowans enrolled with AmeriHealth will be reassigned to the remaining two Medicaid insurers — Amerigroup Iowa and UnitedHealthcare of the River Valley — both of which re-signed contracts with the state of Iowa.

The state has agreed to raise the managed-care organization’s capitation rates — the per-member per-month fees — by 3.3 percent. Foxhoven said the state agency will not need to ask the Legislature for additional appropriations, noting the current budget will cover the increase.

“This is a very small increase when compared to other national trends and insurance carriers who are seeking a 57 percent increase,” he said, referring to Minnesota-based Medica.

Medica is the only insurer selling individual plans statewide on the Affordable Care Act marketplace.

DHS has developed a comprehensive transition plan and will closely monitor patients as they transition from one insurer to another. AmeriHealth enrollees will start coverage with their new insurer on Dec. 1, however, families have until March 1 to change insurers.

DHS officials said this is to ensure there is no gap in coverage or access to care.

“Members can see a doctor as they normally would, and they should watch their mail and our website for more details as it becomes available,” said DHS Deputy Director and Acting Medicaid Director Mikki Stier in a news release.

'My heart is sinking'

But it may not be as simple as that for all AmeriHealth enrollees.

“We are at 99.5 percent of clients and business being with AmeriHealth,” said Marilyn Althoff, executive director of Hills and Dales, a Dubuque-based intermediate care facility. “We are really in a lurch on transitioning.”

Hills and Dales provides 24-hour care to nearly 50 medically fragile children and young adults who live there. The children have intellectual disabilities, physical disabilities or autism.

“It’s not as simple as changing a family doctor,” she said. “It’s very complex — they have complex pharmaceutical needs, therapy needs, durable medical equipment needs.”

And because the doctors group in Dubuque chose to sign only with AmeriHealth Caritas, Hills and Dales had to work with each of the 50 families to get the children switched over to that insurer.

“My heart is sinking right now thinking what we’re going to have to go through again,” she said.

AmeriHealth said it chose to withdraw from the state Medicaid program “after months of negotiations yielded no agreement on contract rates and terms,” adding it will now focus on working collaboratively with Iowa to provide a seamless transition.

“We wish the state of Iowa well as it continues this important program,” said Regional President of AmeriHealth Caritas Russell Gianforcaro in a statement.

Financial challenges

All three private insurers saw large financial losses — more than $500 million collectively — during their first year of operation in Iowa, but AmeriHealth by far saw the largest. The company lost nearly $300 million, while Amerigroup reported a loss of $133 million and UnitedHealthcare said it lost more than $100 million.

AmeriHealth lost another $65 million as of June 2017, according to Iowa Insurance Division financial disclosures.

To help deal with the losses, AmeriHealth announced a series of changes in early 2017 to better control costs, including moving case management services in-house and cutting reimbursement rates to home and community based services providers.

AmeriHealth has the highest number of Medicaid enrollees, with more than 213,000 beneficiaries compared with Amerigroup Iowa’s 187,000 and UnitedHealthcare’s 167,000, according to the most recent DHS quarterly report.

The insurer also has the biggest share of the state’s special-needs population — with more than 23,300 beneficiaries receiving long-term services and supports, compared with Amerigroup’s 7,700 and UnitedHealthcare’s 6,500.

Long-term enrollees include elderly Medicaid beneficiaries as well as those with disabilities receiving waiver services.

Iowa Democrats said Tuesday’s announcement proves the decision to move to Medicaid managed care in 2016 was a mistake. A chorus of state senators, representatives and candidates for governor said the move has been a bad one for patients and providers, adding it’s time to reevaluate the system.

“For too long, Gov. (Kim) Reynolds and Republican legislators have been telling Iowans that the privatized Medicaid experiment was a huge success. That’s nonsense,” said Sen. Janet Petersen, D-Des Moines, and the Senate Democratic Leader. “The best advice for Gov. Reynolds and legislative Republicans is this: ‘You’ve dug yourself into a hole. You need to stop digging.’”

mdockter / Mason Dockter, Sioux City Journal