Last Updated: September 17, 2018
Method and Scoring: State involuntary civil commitment laws are evaluated using a 100-point grading scale. The scoring criteria is in accordance with the Treatment Advocacy Center’s values and policy preferences. Up to 50 points are awarded to a state based on the quality of its inpatient commitment law and up to 50 points are awarded based on the state’s assisted outpatient treatment law. Final letter grades are computed using the following scale:
| 97 or above A+ 93-96 A 90-92 A- |
87-89 B+ 83-86 B 80-82 B- |
77-79 C+ 73-76 C 70-72 C- |
67-69 D+ 63-66 D 62-60 D |
59 or below F |
| PART ONE: Inpatient Commitment Statute (up to 50 points) | |||
| Criterion | Citation | Specifications | Points |
| 1. Citizen access to court, emergency evaluation (5 pts) | Iowa Code § 229.6(1) | ☒Authorizes family/enumerated adults (3 pts) ☒Authorizes any responsible adult (2 pts) |
5 |
| 2. Quality of emergency petition process (5 pts) | Iowa Code §§ 229.11(1), 229.22 | ☒Process specified and reasonable (2 pts) ☒Timelines specified and reasonable (2 pts) ☒Responsible entities identified (1 pt) ☐Requires certification by more than one professional (-2 pts) ☒Emergency evaluation criteria inconsistent with inpatient commitment criteria (-5 pts) (See comments below) |
0 |
| 3. Emergency hold duration (5 pts) | Iowa Code § 229.22(3) | ☒At least 48-hour hold allowed (3 pts) ☐At least 72-hour hold allowed (2 pts) Not to exceed 48 hours |
3 |
| 4. Citizen access to court, inpatient petition (5 pts) | Iowa Code § 229.6(1) | ☒Authorizes family/enumerated adults (3 pts) ☒Authorizes any responsible adult (2 pts) |
5 |
| 5. Quality of criteria for harm or violence to self or others (up to 10 pts) | Iowa Code §§ 229.1(20)(a), (b) | ☒Contains explicit criteria (10 pts) ☐Language is vague/ambiguous (-3 pts) ☐Harm must be imminent (-3 pts) |
10 |
| 6. Quality of criteria for grave disability/basic needs (up to 10 pts) | Iowa Code § 229.1(20)(c) | ☒Contains explicit criteria (10 pts) ☐Language is vague/ambiguous (-3 pts) ☐Endangerment must be imminent (-3 pts) ☐Criteria require family to turn person out of home to receive treatment (-3 pts) ☐Unreasonably high risk of harm (-3 pts) |
10 |
| 7. Quality of criteria for psychiatric deterioration (up to 10 pts) | ☐Contains explicit criteria (10 pts) ☐Language is vague/ambiguous (-3 pts) |
0 | |
| SUBTOTAL | 33 | ||
| PART ONE: Extra Credit | |||
| 1. Specifies in which court a petition for inpatient commitment shall be filed (1 pt) | Iowa Code § 229.6(1) | District court | 1 |
| Extra Credit | 1 | ||
| PART ONE TOTAL | 34 | ||
| PART TWO: Outpatient Commitment Statute (up to 50 points) | |||
| Criterion | Citation | Specifications | Points |
| 1. AOT explicitly authorized (5 pts) | Iowa Code § 229.13(3) | ☐Requires local government to adopt (-3 pts) | 5 |
| 2. Citizen access to court for AOT (5 pts) | Iowa Code § 229.6 | ☒Authorizes family/enumerated adults (3 pts) ☒Authorizes any responsible adult (2 pts) ☐Authorizes citizen petition to mental health system only (-2 pts) |
5 |
| 3. Criteria sufficiently broad to provide actual access (up to 10 pts) | Iowa Code § 229.1(20)(d) | Evaluate applicable provision only: ☐If inpatient/outpatient criteria are the same: ☐Inpatient criteria include psychiatric deterioration standard (10 pts) or ☐No psychiatric deterioration standard, adequate grave disability standard (5 pts) or ☒If outpatient criteria are distinct from inpatient criteria: ☒Allows consideration of length of treatment history ≥ 36 months (2 pts) ☐Does not exclude periods of incarceration or hospitalization (-1 pt) ☒Does not limit application to those currently dangerous or unstable (4 pts) ☒Does not limit application to those refusing service or currently lacking insight (4 pts) |
10 |
| 4. Authorizes AOT directly from community (5 pts) | Iowa Code § 229.13 | 5 | |
| 5. Procedures sufficiently detailed to guide practitioners (up to 5 pts) | Iowa Code §§ 229.13, 229.14, and 229.15 | ☒Process specified and reasonable (1 pt) ☒Timelines specified and reasonable (1 pt) ☒Responsible entities identified (1 pt) ☒Periodic reporting to court required (1 pt) ☒Renewal process expressly specified (1 pt) |
5 |
| 6. Procedures require the treatment plan to be shared with the court (5 pts) | 0 | ||
| 7. Specifies procedures and consequences for nonadherence (5 pts) | Iowa Code §§ 229.13(7), 229.14(2) | 5 | |
| 8. Duration of initial order (5pts) | Iowa Code §§ 229.13, 229.15 | ☐=90 days (2 pts) or ☒>90 days (5 pts) Indefinite term |
5 |
| 9. Duration of continued order (5pts) | ☐=180 days (2 pts) or ☒>180 days (5 pts) No need for continuations because initial order is periodically reviewed but indefinite in length |
5 | |
| SUBTOTAL | 45 | ||
| PART TWO: Extra Credit | |||
| 1. Specifies court for AOT (1 pt) | Iowa Code § 229.6 | District court | 1 |
| 2. Court monitoring of voluntary settlement agreements (5 pts) | |||
| Extra Credit | 1 | ||
| PART TWO TOTAL | 46 | ||
| FINAL SCORE | |
| PART ONE TOTAL | 34 |
| PART TWO TOTAL | 46 |
| TOTAL | 80 |
| GRADE | B- |
Comments:
- Emergency standard adds “likely to injure” to inpatient criteria.
- Newly added criteria under Iowa Code § 229.1(20)(d), effective July 1, 2018, although not explicitly for outpatients only, should be considered as such because they are unsuitable as inpatient criteria. They authorize commitment on the basis of a history of lack of compliance with treatment.