Iowa Code ch. 229

Hospitalization of Persons with Serious Mental Impairment

Iowa Code Chapter 229 establishes the legal procedures for both voluntary and involuntary hospitalization of persons with serious mental impairment in public and private psychiatric hospitals. It governs the application process, court hearings, patient rights, discharge procedures, and confidentiality requirements for inpatient psychiatric care. Facility operators must comply with admission, detention, treatment, and discharge standards set forth in this chapter, including specific due-process protections for minor patients. The chapter applies to state mental health institutes and private hospitals equipped to provide inpatient psychiatric care.

1
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS,
§229.1
CHAPTER
229
HOSPIT
ALIZA
TION
OF
PERSONS
WITH
MENT
AL
ILLNESS
Referred
to
in
§125.75
,
228.6
,
229A
.1
,
230.7
,
232.51
,
232.52
,
235B.2
,
235B.3
,
235E.1
,
235E.2
,
235F
.1
,
237.15
,
331.381
,
602.6306
,
602.6405
,
602.8102(41)
,
726.24
,
902.10
229.1
Definitions.
229.1A
Legislative
intent.
229.1B
Administrative
services
organization.
229.2
Application
for
voluntary
admission
—
authority
to
receive
voluntary
patients.
229.2A
Dual
filings.
Repealed
by
2013
Acts,
ch
130,
§55
.
229.3
Discharge
of
voluntary
patients.
229.4
Right
to
release
on
application.
229.5
Departure
without
notice.
229.5A
P
reapplication
screening
assessment
—
program.
229.6
Application
for
order
of
involuntary
hospitalization.
229.6A
Hospitalization
of
minors
—
jurisdiction
—
due
process.
229.7
Service
of
notice
upon
respondent.
229.8
P
rocedure
after
application
is
filed.
229.9
Respondent’s
attorney
informed.
229.9A
Advocate
informed.
229.10
Physicians’
or
mental
health
professionals’
examination
—
report.
229.11
Judge
may
order
immediate
custody
.
229.12
Hearing
procedure.
229.13
Evaluation
order
—
treatment
—
unauthorized
departure
or
failure
to
appear
.
229.14
Chief
medical
officer
’s
report.
229.14A
Placement
order
—
notice
and
hearing.
229.14B
Escape
from
custody
.
229.15
P
eriodic
reports
required.
229.16
Discharge
and
termination
of
proceeding.
229.17
Status
of
respondent
during
appeal.
229.18
Status
of
respondent
if
hospitalization
is
delayed.
229.19
Advocates
—
appointment
—
duties
—
employment
and
compensation.
229.20
Reserved.
229.21
Judicial
hospitalization
referee
—
appeals
to
district
court.
229.22
Hospitalization
—
emergency
procedure.
229.23
Rights
and
privileges
of
hospitalized
persons.
229.24
Records
of
involuntary
hospitalization
proceeding
to
be
confidential.
229.25
Medical
records
to
be
confidential
—
exceptions.
229.26
Exclusive
procedure
for
involuntary
hospitalization.
229.27
Hospitalization
not
to
equate
with
incompetency
—
procedure
for
finding
incompetency
due
to
mental
illness.
229.28
Hospitalization
in
certain
federal
facilities.
229.29
T
ransfer
to
certain
federal
facilities.
229.30
Orders
of
courts
in
other
states.
229.31
Commission
of
inquiry
.
229.32
Duty
of
commission.
229.33
Hearing.
229.34
Finding
and
order
filed.
229.35
Compensation
—
payment.
229.36
Limitation
on
proceedings.
229.37
Habeas
corpus.
229.38
Cruelty
or
official
misconduct.
229.39
Status
of
persons
hospitalized
under
former
law
.
229.40
R
ules
for
proceedings.
229.41
V
oluntary
admission
—
state
mental
health
institute.
229.42
Costs
paid
by
county
—
state
mental
health
institute.
Repealed
by
2024
Acts,
ch
1161,
§135,
137
.
229.43
Nonresident
patients
—
state
mental
health
institutes.
229.44
V
enue.
229.45
P
rovision
of
summary
of
procedures
to
applicant
in
involuntary
commitment.
229.1
Definitions.
As
used
in
this
chapter
,
unless
the
context
clearly
requires
otherwise:
1.
“
Administrative
services
organization
”
means
the
same
as
defined
in
section
225A
.1
.
2.
“
Advocate”
means
a
mental
health
advocate.
3.
“
Auditor”
means
the
county
auditor
or
the
auditor
’s
designee.
4.
“Behavioral
health
district”
means
the
same
as
defined
in
section
225A
.1
.
5.
“Chemotherapy
”
means
treatment
of
an
individual
by
use
of
a
drug
or
substance
which
cannot
legally
be
delivered
or
administered
to
the
ultimate
user
without
a
physician
’s
prescription
or
medical
order
.
6.
“Chief
medical
officer”
means
the
medical
director
in
charge
of
a
public
or
private
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

§229.1,
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS
2
hospital,
or
that
individual’s
physician
-designee.
This
chapter
does
not
negate
the
authority
otherwise
reposed
by
law
in
the
respective
superintendents
of
each
of
the
state
mental
health
institutes,
established
by
chapter
226
,
to
make
decisions
regarding
the
appropriateness
of
admissions
or
discharges
of
patients
of
that
state
mental
health
institute;
however
,
it
is
the
intent
of
this
chapter
that
if
the
superintendent
is
not
a
licensed
physician
the
decisions
by
the
superintendent
shall
be
corroborated
by
the
chief
medical
officer
of
the
mental
health
institute.
7.
“Clerk”
means
the
clerk
of
the
district
court.
8.
“Department”
means
the
department
of
health
and
human
services.
9.
“Director”
means
the
director
of
health
and
human
services.
10.
“Disability
access
point”
means
an
organization
designated
by
the
department
for
a
behavioral
health
district
to
serve
as
the
primary
local
access
point
for
individuals
with
disabilities,
and
the
individuals’
caregivers,
to
provide
person
-centered
assistance
that
facilitates
the
coordination
of
the
individuals’
services,
simplifies
service
navigation,
and
improves
overall
accessibility
to
disability
-related
resources.
11.
“Hospital”
means
either
a
public
hospital
or
a
private
hospital.
12.
“Licensed
physician
”
means
an
individual
licensed
under
the
provisions
of
chapter
148
to
practice
medicine
and
surgery
or
osteopathic
medicine
and
surgery
.
13.
“Magistrate”
means
the
same
as
defined
in
section
801.4
.
14.
“Mental
health
professional”
means
the
same
as
defined
in
section
228.1
.
15.
“Mental
illness”
means
every
type
of
mental
disease
or
mental
disorder
,
except
that
it
does
not
refer
to
an
intellectual
disability
as
defined
in
section
4.1
,
or
to
insanity
,
diminished
responsibility
,
or
mental
incompetency
as
the
terms
are
defined
and
used
in
the
Iowa
criminal
code
or
in
the
rules
of
criminal
procedure,
Iowa
court
rules.
16.
“P
atient”
means
a
person
who
has
been
hospitalized
or
ordered
hospitalized
to
receive
treatment
pursuant
to
section
229.14
.
17.
“P
rivate
hospital”
means
any
hospital
or
facility
not
directly
supported
by
public
funds,
or
part
of
such
hospital
or
facility
,
which
is
equipped
and
staffed
to
provide
inpatient
care
to
persons
with
mental
illness.
18.
“Psychiatric
advanced
registered
nurse
practitioner”
means
an
individual
currently
licensed
as
a
registered
nurse
under
chapter
152
or
152E
who
holds
a
national
certification
in
psychiatric
mental
health
care
and
who
is
licensed
by
the
board
of
nursing
as
an
advanced
registered
nurse
practitioner
.
19.
“Public
hospital”
means
any
of
the
following:
a.
A
state
mental
health
institute
established
by
chapter
226
.
b.
The
state
psychiatric
hospital
established
by
chapter
225
.
c.
Any
other
publicly
supported
hospital
or
facility
,
or
part
of
such
hospital
or
facility
,
which
is
equipped
and
staffed
to
provide
inpatient
care
to
persons
with
mental
illness,
except
the
Iowa
medical
and
classification
center
established
by
chapter
904
.
20.
“Respondent”
means
any
person
against
whom
an
application
has
been
filed
under
section
229.6
,
but
who
has
not
been
finally
ordered
committed
for
full-time
custody
,
care,
and
treatment
in
a
hospital.
21.
“Serious
emotional
injury
”
is
an
injury
which
does
not
necessarily
exhibit
any
physical
characteristics,
but
which
can
be
recognized
and
diagnosed
by
a
licensed
physician
or
other
mental
health
professional
and
which
can
be
causally
connected
with
the
act
or
omission
of
a
person
who
is,
or
is
alleged
to
be,
mentally
ill.
22.
“Seriously
mentally
impaired”
or
“serious
mental
impairment”
describes
the
condition
of
a
person
with
mental
illness
and
because
of
that
illness
lacks
sufficient
judgment
to
make
responsible
decisions
with
respect
to
the
person
’s
hospitalization
or
treatment,
and
who
because
of
that
illness
meets
any
of
the
following
criteria:
a.
Is
likely
to
physically
injure
the
person
’s
self
or
others
if
allowed
to
remain
at
liberty
without
treatment.
b.
Is
likely
to
inflict
serious
emotional
injury
on
members
of
the
person
’s
family
or
others
who
lack
reasonable
opportunity
to
avoid
contact
with
the
person
with
mental
illness
if
the
person
with
mental
illness
is
allowed
to
remain
at
liberty
without
treatment.
c.
Is
unable
to
satisfy
the
person
’s
needs
for
nourishment,
clothing,
essential
medical
care,
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

3
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS,
§229.2
or
shelter
so
that
it
is
likely
that
the
person
will
suffer
physical
injury
,
physical
debilitation,
or
death.
d.
Has
a
history
of
lack
of
compliance
with
treatment
and
any
of
the
following
applies:
(1)
Lack
of
compliance
has
been
a
significant
factor
in
the
need
for
emergency
hospitalization.
(2)
Lack
of
compliance
has
resulted
in
one
or
more
acts
causing
serious
physical
injury
to
the
person
’s
self
or
others
or
an
attempt
to
physically
injure
the
person
’s
self
or
others.
[R60,
§1468;
C73,
§1434;
C97,
§2298;
C24,
27,
31,
35,
39,
§
3580;
C46,
50,
54,
58,
62,
66,
§229.40;
C71,
73,
75,
§229.40,
229.44;
C77,
§229.1,
229.44;
C79,
81,
§229.1
;
82
Acts,
ch
1100,
§7
]
83
Acts,
ch
96,
§157,
159
;
84
Acts,
ch
1323,
§2
;
85
Acts,
ch
21,
§35
;
87
Acts,
ch
90,
§1
;
89
Acts,
ch
275,
§1
;
95
Acts,
ch
24,
§1
;
96
Acts,
ch
1035,
§12
;
96
Acts,
ch
1129,
§57,
113
;
96
Acts,
ch
1183,
§18
;
97
Acts,
ch
169,
§15
;
2000
Acts,
ch
1112,
§37
;
2002
Acts,
ch
1119,
§107
;
2004
Acts,
ch
1090,
§33
;
2008
Acts,
ch
1082,
§4
;
2008
Acts,
ch
1088,
§112
;
2011
Acts,
ch
121,
§52,
62
;
2012
Acts,
ch
1019,
§80
;
2012
Acts,
ch
1079,
§6
–
8
;
2015
Acts,
ch
56,
§17
;
2015
Acts,
ch
69,
§57,
58
;
2015
Acts,
ch
76,
§1
;
2018
Acts,
ch
1056,
§7
;
2020
Acts,
ch
1063,
§85
;
2022
Acts,
ch
1071,
§4
;
2023
Acts,
ch
19,
§515
;
2024
Acts,
ch
1161,
§72,
73,
137
;
2025
Acts,
ch
135,
§2
Referred
to
in
§125.75
,
225.1
,
229.6
Subsection
1
effective
July
1,
2025;
2024
Acts,
ch
1161,
§137
2024
strike
of
former
subsections
11,
18,
and
19
effective
July
1,
2025;
2024
Acts,
ch
1161,
§137
Section
amended
and
editorially
internally
renumbered
229.1A
Legislative
intent.
As
mental
illness
is
often
a
continuing
condition
which
is
subject
to
wide
and
unpredictable
changes
in
condition
and
fluctuations
in
reoccurrence
and
remission,
this
chapter
shall
be
liberally
construed
to
give
recognition
to
these
medical
facts.
89
Acts,
ch
275,
§2
229.1B
Administrative
ser
vices
organization.
Notwithstanding
any
provision
of
this
chapter
to
the
contrary
,
any
person
whose
hospitalization
expenses
are
payable
in
whole
or
in
part
by
an
administrative
services
organization
shall
be
subject
to
all
administrative
requirements
of
the
administrative
services
organization.
96
Acts,
ch
1183,
§19
;
2004
Acts,
ch
1090,
§33
;
2015
Acts,
ch
69,
§59
;
2015
Acts,
ch
138,
§29,
161,
162
;
2024
Acts,
ch
1161,
§74,
137
2024
amendment
effective
July
1,
2025;
2024
Acts,
ch
1161,
§137
Section
amended
229.2
Application
for
voluntar
y
admission
—
authority
to
receive
voluntar
y
patients.
1.
a.
An
application
for
admission
to
a
public
or
private
hospital
for
observation,
diagnosis,
care,
and
treatment
as
a
voluntary
patient
may
be
made
by
any
person
who
is
mentally
ill
or
has
symptoms
of
mental
illness.
b.
In
the
case
of
a
minor
,
the
parent,
guardian,
or
custodian
may
make
application
for
admission
of
the
minor
as
a
voluntary
patient.
(1)
Upon
receipt
of
an
application
for
voluntary
admission
of
a
minor
,
the
chief
medical
officer
shall
provide
separate
prescreening
interviews
and
consultations
with
the
parent,
guardian,
or
custodian
and
the
minor
to
assess
the
family
environment
and
the
appropriateness
of
the
application
for
admission.
(2)
During
the
interview
and
consultation
the
chief
medical
officer
shall
inform
the
minor
orally
and
in
writing
that
the
minor
has
a
right
to
object
to
the
admission.
If
the
chief
medical
officer
of
the
hospital
to
which
application
is
made
determines
that
the
admission
is
appropriate
but
the
minor
objects
to
the
admission,
the
parent,
guardian,
or
custodian
must
petition
the
juvenile
court
for
approval
of
the
admission
before
the
minor
is
actually
admitted.
(3)
As
soon
as
is
practicable
after
the
filing
of
a
petition
for
juvenile
court
approval
of
the
admission
of
the
minor
,
the
juvenile
court
shall
determine
whether
the
minor
has
an
attorney
to
represent
the
minor
in
the
hospitalization
proceeding,
and
if
not,
the
court
shall
assign
to
the
minor
an
attorney
.
If
the
minor
is
financially
unable
to
pay
for
an
attorney
,
the
attorney
shall
be
compensated
by
an
administrative
services
organization
at
an
hourly
rate
to
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

§229.2,
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS
4
be
established
by
the
administrative
services
organization
in
substantially
the
same
manner
as
provided
in
section
815.7
.
(4)
The
juvenile
court
shall
determine
whether
the
admission
is
in
the
best
interest
of
the
minor
and
is
consistent
with
the
minor
’s
rights.
(5)
The
juvenile
court
shall
order
hospitalization
of
a
minor
,
over
the
minor
’s
objections,
only
after
a
hearing
in
which
it
is
shown
by
clear
and
convincing
evidence
that:
(a)
The
minor
needs
and
will
substantially
benefit
from
treatment.
(b)
No
other
setting
which
involves
less
restriction
of
the
minor
’s
liberties
is
feasible
for
the
purposes
of
treatment.
(6)
Upon
approval
of
the
admission
of
a
minor
over
the
minor
’s
objections,
the
juvenile
court
shall
appoint
an
individual
to
act
as
an
advocate
representing
the
interests
of
the
minor
in
the
same
manner
as
an
advocate
representing
the
interests
of
patients
involuntarily
hospitalized
pursuant
to
section
229.19
.
2.
Upon
receiving
an
application
for
admission
as
a
voluntary
patient,
made
pursuant
to
subsection
1
:
a.
The
chief
medical
officer
of
a
public
hospital
shall
receive
and
may
admit
the
person
whose
admission
is
sought,
subject
in
cases
other
than
medical
emergencies
to
availability
of
suitable
accommodations
and
to
the
provisions
of
section
229.41
.
b.
The
chief
medical
officer
of
a
private
hospital
may
receive
and
may
admit
the
person
whose
admission
is
sought.
[R60,
§1480;
C73,
§1399;
C97,
§2264;
C24,
27,
31,
35,
39,
§
3544;
C46,
§229.1;
C50,
54,
58,
62,
66,
71,
73,
75,
§229.1,
229.41;
C77,
79,
81,
§229.2
]
87
Acts,
ch
90,
§2
;
99
Acts,
ch
135,
§17
;
2009
Acts,
ch
41,
§263
;
2015
Acts,
ch
69,
§60
;
2015
Acts,
ch
138,
§30,
161,
162
;
2023
Acts,
ch
19,
§516
;
2024
Acts,
ch
1161,
§75,
76,
137
Referred
to
in
§229.4
,
229.6A
,
229.41
,
331.910
2024
amendment
to
subsection
1,
paragraph
b,
subparagraph
(3)
effective
July
1,
2025;
2024
Acts,
ch
1161,
§137
2024
amendment
to
subsection
2,
paragraph
a
effective
July
1,
2025;
2024
Acts,
ch
1161,
§137
Subsection
1,
paragraph
b,
subparagraph
(3)
amended
Subsection
2,
paragraph
a
amended
229.2A
Dual
filings.
Repealed
by
2013
Acts,
ch
130,
§55
.
229.3
Discharge
of
voluntar
y
patients.
Any
voluntary
patient
who
has
recovered,
or
whose
hospitalization
the
chief
medical
officer
of
the
hospital
determines
is
no
longer
advisable,
shall
be
discharged.
Any
voluntary
patient
may
be
discharged
if
to
do
so
would
in
the
judgment
of
the
chief
medical
officer
contribute
to
the
most
effective
use
of
the
hospital
in
the
care
and
treatment
of
that
patient
and
of
other
persons
with
mental
illness.
[C77,
79,
81,
§229.3
]
96
Acts,
ch
1129,
§113
Referred
to
in
§226.19
229.4
Right
to
release
on
application.
A
voluntary
patient
who
requests
release
or
whose
release
is
requested,
in
writing,
by
the
patient’s
legal
guardian,
parent,
spouse,
or
adult
next
of
kin
shall
be
released
from
the
hospital
in
accordance
with
all
of
the
following,
as
applicable:
1.
If
the
patient
was
admitted
on
the
patient’s
own
application
and
the
request
for
release
is
made
by
some
other
person,
release
may
be
conditioned
upon
the
agreement
of
the
patient.
2.
If
the
patient
is
a
minor
who
was
admitted
on
the
application
of
the
patient’s
parent,
guardian,
or
custodian
pursuant
to
section
229.2,
subsection
1
,
the
patient’s
release
prior
to
becoming
eighteen
years
of
age
may
be
conditioned
upon
the
consent
of
the
parent,
guardian,
or
custodian,
or
upon
the
approval
of
the
juvenile
court
if
the
admission
was
approved
by
the
juvenile
court.
3.
If
the
chief
medical
officer
of
the
hospital,
not
later
than
the
end
of
the
next
secular
day
on
which
the
office
of
the
clerk
of
the
district
court
for
the
county
in
which
the
hospital
is
located
is
open
and
which
follows
the
submission
of
the
written
request
for
release
of
the
patient,
files
with
that
clerk
a
certification
that
in
the
chief
medical
officer
’s
opinion
the
patient
is
seriously
mentally
impaired,
the
release
may
be
postponed
for
the
period
of
time
the
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

5
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS,
§229.6
court
determines
is
necessary
to
permit
commencement
of
judicial
procedure
for
involuntary
hospitalization.
That
period
of
time
may
not
exceed
five
days,
exclusive
of
days
on
which
the
clerk’s
office
is
not
open
unless
the
period
of
time
is
extended
by
order
of
a
district
court
judge
for
good
cause
shown.
Until
disposition
of
the
application
for
involuntary
hospitalization
of
the
patient
is
determined,
if
an
application
is
timely
filed,
the
chief
medical
officer
may
detain
the
patient
in
the
hospital
and
may
provide
treatment
which
is
necessary
to
preserve
the
patient’s
life,
or
to
appropriately
control
behavior
by
the
patient
which
is
likely
to
result
in
physical
injury
to
the
patient
or
to
others
if
allowed
to
continue,
but
may
not
otherwise
provide
treatment
to
the
patient
without
the
patient’s
consent.
[C50,
54,
58,
62,
66,
71,
73,
75,
§229.41;
C77,
79,
81,
§229.4
]
2023
Acts,
ch
19,
§517
Referred
to
in
§229.23
229.5
Departure
without
notice.
If
a
voluntary
patient
departs
from
the
hospital
without
notice,
and
in
the
opinion
of
the
chief
medical
officer
the
patient
is
seriously
mentally
impaired,
the
chief
medical
officer
may
file
an
application
on
the
departed
voluntary
patient
pursuant
to
section
229.6
,
and
request
that
an
order
for
immediate
custody
be
entered
by
the
court
pursuant
to
section
229.11
.
[C77,
79,
81,
§229.5
]
2013
Acts,
ch
130,
§42
229.5A
P
reapplication
screening
assessment
—
program.
P
rior
to
filing
an
application
pursuant
to
section
229.6
,
the
clerk
of
the
district
court
or
the
clerk’s
designee
shall
inform
the
interested
person
referred
to
in
section
229.6,
subsection
1
,
about
the
option
of
requesting
a
preapplication
screening
assessment
through
a
preapplication
screening
assessment
program,
if
available.
2012
Acts,
ch
1079,
§9
;
2013
Acts,
ch
130,
§43
;
2018
Acts,
ch
1165,
§133
Referred
to
in
§229.6
229.6
Application
for
order
of
involuntar
y
hospitalization.
1.
a.
P
roceedings
for
the
involuntary
hospitalization
of
an
individual
pursuant
to
this
chapter
or
for
the
involuntary
commitment
or
treatment
of
a
person
with
a
substance
use
disorder
to
a
facility
pursuant
to
chapter
125
may
be
commenced
by
any
interested
person
by
filing
a
verified
application
with
the
clerk
of
a
district
court.
b.
If
the
verified
application
was
filed
with
a
district
court
where
the
respondent
is
not
located
and
does
not
reside,
the
court
shall
transfer
jurisdiction
of
the
case
to
the
district
court
of
the
county
where
the
respondent
is
presently
located,
or
which
is
the
respondent’s
place
of
residence.
c.
The
clerk,
or
the
clerk’s
designee,
shall
assist
an
applicant
in
completing
the
verified
application.
2.
The
application
shall:
a.
State
the
applicant’s
belief
that
the
respondent
is
a
person
who
presents
a
danger
to
self
or
others
and
lacks
judgmental
capacity
due
to
either
of
the
following:
(1)
A
substance
use
disorder
as
defined
in
section
125.2
.
(2)
A
serious
mental
impairment
as
defined
in
section
229.1
.
b.
State
facts
in
support
of
each
belief
described
in
paragraph
“a”
.
c.
Be
accompanied
by
any
of
the
following:
(1)
A
written
statement
of
a
licensed
physician
or
mental
health
professional
in
support
of
the
application.
(2)
One
or
more
supporting
affidavits
otherwise
corroborating
the
application.
(3)
Corroborative
information
obtained
and
reduced
to
writing
by
the
clerk
or
the
clerk’s
designee,
but
only
when
circumstances
make
it
infeasible
to
comply
with,
or
when
the
clerk
considers
it
appropriate
to
supplement
the
information
supplied
pursuant
to
,
either
subparagraph
(1)
or
(2).
3.
P
rior
to
the
filing
of
an
application
pursuant
to
this
section
,
the
clerk
or
the
clerk’s
designee
shall
inform
the
interested
person
referred
to
in
subsection
1
about
the
option
of
requesting
a
preapplication
screening
assessment
pursuant
to
section
229.5A
.
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

§229.6,
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS
6
4.
The
supreme
court
shall
prescribe
rules
and
establish
forms
as
necessary
to
carry
out
the
provisions
of
this
section
.
[R60,
§1480;
C73,
§1399;
C97,
§2264;
C24,
27,
31,
35,
39,
§
3544;
C46,
50,
54,
58,
62,
66,
71,
73,
75,
§229.1;
C77,
79,
81,
§229.6
]
2012
Acts,
ch
1079,
§10
;
2013
Acts,
ch
130,
§44
;
2017
Acts,
ch
34,
§12
;
2023
Acts,
ch
19,
§518,
519
;
2025
Acts,
ch
95,
§3
Referred
to
in
§218.92
,
222.7
,
225.11
,
226.31
,
229.1
,
229.5
,
229.5A
,
229.6A
,
229.7
,
229.8
,
229.9
,
229.19
,
229.21
,
229.22
,
229.24
,
229.26
,
229.27
,
229.38
,
331.910
Summary
of
involuntary
commitment
procedures
available
from
clerk;
see
§229.45
Subsection
1
amended
229.6A
Hospitalization
of
minors
—
jurisdiction
—
due
process.
1.
Notwithstanding
section
229.11
,
the
juvenile
court
has
exclusive
original
jurisdiction
in
proceedings
concerning
a
minor
for
whom
an
application
is
filed
under
section
229.6
or
for
whom
an
application
for
voluntary
admission
is
made
under
section
229.2,
subsection
1
,
to
which
the
minor
objects.
In
proceedings
under
this
chapter
concerning
a
minor
,
notwithstanding
section
229.11
,
the
term
“court”
,
“judge”
,
or
“clerk”
means
the
juvenile
court,
judge,
or
clerk.
2.
The
procedural
requirements
of
this
chapter
are
applicable
to
minors
involved
in
hospitalization
proceedings
pursuant
to
subsection
1
and
placement
proceedings
pursuant
to
section
229.14A
.
3.
It
is
the
intent
of
this
chapter
that
when
a
minor
is
involuntarily
or
voluntarily
hospitalized
or
hospitalized
with
juvenile
court
approval
over
the
minor
’s
objection
the
minor
’s
family
shall
be
included
in
counseling
sessions
offered
during
the
minor
’s
stay
in
a
hospital
when
feasible.
P
rior
to
the
discharge
of
the
minor
the
juvenile
court
may
,
after
a
hearing,
order
that
the
minor
’s
family
be
evaluated
and
therapy
ordered
if
necessary
to
facilitate
the
return
of
the
minor
to
the
family
setting.
87
Acts,
ch
90,
§3
;
92
Acts,
ch
1124,
§2
;
2001
Acts,
ch
155,
§29
;
2013
Acts,
ch
130,
§45
Referred
to
in
§218.92
,
222.7
,
226.31
,
229.19
,
229.22
,
229.24
,
229.26
,
229.38
,
602.6405
229.7
Ser
vice
of
notice
upon
respondent.
Upon
the
filing
of
an
application
pursuant
to
section
229.6
,
the
clerk
shall
docket
the
case
and
immediately
notify
a
district
court
judge,
district
associate
judge,
or
magistrate
who
is
admitted
to
the
practice
of
law
in
this
state,
who
shall
review
the
application
and
accompanying
documentation.
If
the
application
is
adequate
as
to
form,
the
court
may
set
a
time
and
place
for
a
hearing
on
the
application,
if
feasible,
but
the
hearing
shall
not
be
held
less
than
forty
-eight
hours
after
notice
to
the
respondent
unless
the
respondent
waives
such
minimum
prior
notice
requirement.
The
court
shall
direct
the
clerk
to
send
copies
of
the
application
and
supporting
documentation,
together
with
a
notice
informing
the
respondent
of
the
procedures
required
by
this
chapter
,
to
the
sheriff
or
the
sheriff
’s
deputy
for
immediate
service
upon
the
respondent.
If
the
respondent
is
taken
into
custody
under
section
229.11
,
service
of
the
application,
documentation
and
notice
upon
the
respondent
shall
be
made
at
the
time
the
respondent
is
taken
into
custody
.
[R60,
§1480;
C73,
§1400;
C97,
§2265;
C24,
27,
31,
35,
39,
§
3545;
C46,
50,
54,
58,
62,
66,
71,
73,
75,
§229.2;
C77,
79,
81,
§229.7
]
91
Acts,
ch
108,
§4
;
2013
Acts,
ch
130,
§46
Referred
to
in
§218.92
,
222.7
,
226.31
,
229.19
,
229.21
,
229.22
,
229.24
,
229.26
,
229.38
,
229.45
,
331.653
229.8
P
rocedure
after
application
is
filed.
As
soon
as
practicable
after
the
filing
of
an
application
pursuant
to
section
229.6
,
the
court
shall
do
all
of
the
following:
1.
Determine
whether
the
respondent
has
an
attorney
who
is
able
and
willing
to
represent
the
respondent
in
the
hospitalization
proceeding,
and
if
not,
whether
the
respondent
is
financially
able
to
employ
an
attorney
and
capable
of
meaningfully
assisting
in
selecting
one.
In
accordance
with
those
determinations,
the
court
shall
if
necessary
allow
the
respondent
to
select,
or
shall
assign
to
the
respondent,
an
attorney
.
If
the
respondent
is
financially
unable
to
pay
an
attorney
,
the
attorney
shall
be
compensated
by
an
administrative
services
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

7
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS,
§229.10
organization
at
an
hourly
rate
to
be
established
by
the
administrative
services
organization
in
substantially
the
same
manner
as
provided
in
section
815.7
.
2.
Cause
copies
of
the
application
and
supporting
documentation
to
be
sent
to
the
county
attorney
or
the
county
attorney
’s
attorney
-designate
for
review
.
3.
Issue
a
written
order
which
shall
provide
for
all
of
the
following:
a.
If
not
previously
done,
set
a
time
and
place
for
a
hospitalization
hearing,
which
shall
be
at
the
earliest
practicable
time
not
less
than
forty
-eight
hours
after
notice
to
the
respondent,
unless
the
respondent
waives
such
minimum
prior
notice
requirement.
b.
Order
an
examination
of
the
respondent,
prior
to
the
hearing,
by
one
or
more
licensed
physicians
or
mental
health
professionals
who
shall
submit
a
written
report
on
the
examination
to
the
court
as
required
by
section
229.10
.
[C73,
§1400;
C97,
§2265;
C24,
27,
31,
35,
39,
§
3548,
3549;
C46,
50,
54,
58,
62,
66,
71,
73,
75,
§229.5,
229.6;
C77,
79,
81,
§229.8
]
99
Acts,
ch
135,
§18
;
2013
Acts,
ch
130,
§47
;
2015
Acts,
ch
69,
§61
;
2015
Acts,
ch
138,
§31,
161,
162
;
2017
Acts,
ch
34,
§13
;
2023
Acts,
ch
19,
§520
;
2024
Acts,
ch
1161,
§77,
137
Referred
to
in
§218.92
,
222.7
,
226.31
,
229.9
,
229.9A
,
229.14A
,
229.19
,
229.21
,
229.22
,
229.24
,
229.26
,
229.38
2024
amendment
to
subsection
1
effective
July
1,
2025;
2024
Acts,
ch
1161,
§137
Subsection
1
amended
229.9
Respondent’s
attorney
informed.
The
court
shall
direct
the
clerk
to
furnish
at
once
to
the
respondent’s
attorney
copies
of
the
application
filed
pursuant
to
section
229.6
and
the
supporting
documentation,
and
of
the
court’s
order
issued
pursuant
to
section
229.8,
subsection
3
.
If
the
respondent
is
taken
into
custody
under
section
229.11
,
the
attorney
shall
also
be
advised
of
that
fact.
The
respondent’s
attorney
shall
represent
the
respondent
at
all
stages
of
the
proceedings,
and
shall
attend
the
hospitalization
hearing.
[C77,
79,
81,
§229.9
]
2013
Acts,
ch
130,
§48
Referred
to
in
§218.92
,
222.7
,
226.31
,
229.19
,
229.21
,
229.22
,
229.24
,
229.26
,
229.38
229.9A
Advocate
informed.
The
clerk
shall
furnish
the
advocate
appointed
for
the
county
in
which
an
application
is
completed
a
copy
of
the
application
and
any
order
issued
pursuant
to
section
229.8,
subsection
3
.
The
advocate
may
attend
the
hospitalization
hearing
of
any
respondent
for
whom
the
advocate
has
received
notice
of
a
hospitalization
hearing.
94
Acts,
ch
1027,
§1
;
2012
Acts,
ch
1120,
§99,
130
;
2015
Acts,
ch
76,
§2
Referred
to
in
§218.92
,
222.7
,
226.31
,
229.19
,
229.21
,
229.22
,
229.24
,
229.26
,
229.38
229.10
Physicians’
or
mental
health
professionals’
e
xamination
—
report.
1.
a.
An
examination
of
the
respondent
shall
be
conducted
by
one
or
more
licensed
physicians
or
mental
health
professionals,
as
required
by
the
court’s
order
,
within
a
reasonable
time.
If
the
respondent
is
detained
pursuant
to
section
229.11,
subsection
1
,
paragraph
“b”
,
the
examination
shall
be
conducted
within
twenty
-four
hours.
If
the
respondent
is
detained
pursuant
to
section
229.11,
subsection
1
,
paragraph
“a”
or
“c”
,
the
examination
shall
be
conducted
within
forty
-eight
hours.
If
the
respondent
so
desires,
the
respondent
shall
be
entitled
to
a
separate
examination
by
a
licensed
physician
or
mental
health
professional
of
the
respondent’s
own
choice.
The
reasonable
cost
of
the
examinations
shall,
if
the
respondent
lacks
sufficient
funds
to
pay
the
cost,
be
paid
by
an
administrative
services
organization
upon
order
of
the
court.
b.
Any
licensed
physician
or
mental
health
professional
conducting
an
examination
pursuant
to
this
section
may
consult
with
or
request
the
participation
in
the
examination
of
any
consulting
mental
health
professional,
and
may
include
with
or
attach
to
the
written
report
of
the
examination
any
findings
or
observations
by
any
consulting
mental
health
professional
who
has
participated
in
the
examination.
c.
If
the
respondent
is
not
taken
into
custody
under
section
229.11
,
but
the
court
is
subsequently
informed
that
the
respondent
has
declined
to
be
examined
by
one
or
more
licensed
physicians
or
mental
health
professionals
pursuant
to
the
court
order
,
the
court
may
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

§229.10,
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS
8
order
such
limited
detention
of
the
respondent
as
is
necessary
to
facilitate
the
examination
of
the
respondent
by
one
or
more
licensed
physicians
or
mental
health
professionals.
2.
A
written
report
of
the
examination
by
one
or
more
court-designated
physicians
or
mental
health
professionals
shall
be
filed
with
the
clerk
prior
to
the
time
set
for
hearing.
A
written
report
of
any
examination
by
a
physician
chosen
by
the
respondent
may
be
similarly
filed.
The
clerk
shall
immediately
do
all
of
the
following:
a.
Cause
the
report
or
reports
to
be
shown
to
the
judge
who
issued
the
order
.
b.
Cause
the
respondent’s
attorney
to
receive
a
copy
of
the
report
or
reports.
3.
If
the
report
of
one
or
more
of
the
court-designated
physicians
or
mental
health
professionals
is
to
the
effect
that
the
individual
is
not
seriously
mentally
impaired,
the
court
shall
without
taking
further
action
terminate
the
proceeding
and
dismiss
the
application
on
its
own
motion
and
without
notice.
4.
If
the
report
of
one
or
more
of
the
court-designated
physicians
or
mental
health
professionals
is
to
the
effect
that
the
respondent
is
seriously
mentally
impaired,
the
court
shall
schedule
a
hearing
on
the
application
as
soon
as
possible.
The
hearing
shall
be
held
not
more
than
forty
-eight
hours
after
the
report
is
filed,
excluding
Saturdays,
Sundays
and
holidays,
unless
an
extension
for
good
cause
is
requested
by
the
respondent,
or
as
soon
thereafter
as
possible
if
the
court
considers
that
sufficient
grounds
exist
for
delaying
the
hearing.
[C77,
79,
81,
§229.10
]
2006
Acts,
ch
1116,
§2
;
2009
Acts,
ch
41,
§224
;
2012
Acts,
ch
1079,
§11
;
2015
Acts,
ch
69,
§62
;
2015
Acts,
ch
138,
§32,
161,
162
;
2017
Acts,
ch
34,
§14
;
2018
Acts,
ch
1056,
§8
;
2024
Acts,
ch
1161,
§78,
137
Referred
to
in
§218.92
,
222.7
,
225.30
,
226.31
,
229.8
,
229.14
,
229.19
,
229.21
,
229.22
,
229.24
,
229.26
,
229.38
2024
amendment
to
subsection
1,
paragraph
a
effective
July
1,
2025;
2024
Acts,
ch
1161,
§137
Subsection
1,
paragraph
a
amended
229.11
Judge
may
order
immediate
custody
.
1.
If
the
applicant
requests
that
the
respondent
be
taken
into
immediate
custody
and
the
judge,
upon
reviewing
the
application
and
accompanying
documentation,
finds
probable
cause
to
believe
that
the
respondent
has
a
serious
mental
impairment
and
is
likely
to
injure
the
respondent
or
other
persons
if
allowed
to
remain
at
liberty
,
the
judge
may
enter
a
written
order
directing
that
the
respondent
be
taken
into
immediate
custody
by
the
sheriff
or
the
sheriff
’s
deputy
and
be
detained
until
the
hospitalization
hearing.
The
hospitalization
hearing
shall
be
held
no
more
than
five
days
after
the
date
of
the
order
,
except
that
if
the
fifth
day
after
the
date
of
the
order
is
a
Saturday
,
Sunday
,
or
a
holiday
,
the
hearing
may
be
held
on
the
next
succeeding
business
day
.
If
the
expenses
of
a
respondent
are
payable
in
whole
or
in
part
by
an
administrative
services
organization,
for
a
placement
in
accordance
with
paragraph
“a”
,
the
judge
shall
give
notice
of
the
placement
to
an
administrative
services
organization,
and
for
a
placement
in
accordance
with
paragraph
“b”
or
“c”
,
the
judge
shall
order
the
placement
in
a
hospital
or
facility
designated
by
an
administrative
services
organization.
The
judge
may
order
the
respondent
detained
for
the
period
of
time
until
the
hearing
is
held,
and
no
longer
,
in
accordance
with
paragraph
“a”
,
if
possible,
and
if
not
then
in
accordance
with
paragraph
“b”
,
or
,
only
if
neither
of
these
alternatives
is
available,
in
accordance
with
paragraph
“c”
.
Detention
may
be
in
any
of
the
following:
a.
In
the
custody
of
a
relative,
friend,
or
other
suitable
person
who
is
willing
to
accept
responsibility
for
supervision
of
the
respondent,
and
the
respondent
may
be
placed
under
such
reasonable
restrictions
as
the
judge
may
order
including
but
not
limited
to
restrictions
on
or
a
prohibition
of
any
expenditure,
encumbrance,
or
disposition
of
the
respondent’s
funds
or
property
.
b.
In
a
suitable
hospital
the
chief
medical
officer
of
which
shall
be
informed
of
the
reasons
why
immediate
custody
has
been
ordered
and
may
provide
treatment
which
is
necessary
to
preserve
the
respondent’s
life,
or
to
appropriately
control
behavior
by
the
respondent
which
is
likely
to
result
in
physical
injury
to
the
respondent
or
to
others
if
allowed
to
continue,
but
may
not
otherwise
provide
treatment
to
the
respondent
without
the
respondent’s
consent.
c.
In
the
nearest
facility
in
the
community
which
is
licensed
to
care
for
persons
with
mental
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

9
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS,
§229.12
illness
or
substance
use
disorder
,
provided
that
detention
in
a
jail
or
other
facility
intended
for
confinement
of
those
accused
or
convicted
of
crime
shall
not
be
ordered.
2.
A
respondent
shall
be
released
from
detention
prior
to
the
hospitalization
hearing
if
a
licensed
physician
or
mental
health
professional
examines
the
respondent
and
determines
the
respondent
no
longer
meets
the
criteria
for
detention
under
subsection
1
and
provides
notification
to
the
court.
3.
If
a
respondent
is
detained
pursuant
to
subsection
1
,
paragraph
“b”
or
“c”
,
the
sheriff
or
the
sheriff
’s
deputy
that
took
the
respondent
into
immediate
custody
may
inform
the
hospital
or
facility
that
an
arrest
warrant
has
been
issued
for
or
charges
are
pending
against
the
respondent
and
may
request
the
hospital
or
facility
to
notify
the
sheriff
or
the
sheriff
’s
deputy
about
the
discharge
of
the
respondent
prior
to
discharge.
4.
The
clerk
shall
furnish
copies
of
any
orders
to
the
respondent
and
to
the
applicant
if
the
applicant
files
a
written
waiver
signed
by
the
respondent.
[C77,
79,
81,
§229.11
]
89
Acts,
ch
275,
§3
;
92
Acts,
ch
1072,
§3
;
92
Acts,
ch
1165,
§2
;
96
Acts,
ch
1183,
§20
;
2004
Acts,
ch
1090,
§33
;
2009
Acts,
ch
41,
§225
;
2015
Acts,
ch
69,
§63
;
2015
Acts,
ch
138,
§33,
161,
162
;
2017
Acts,
ch
109,
§2,
20,
21
;
2018
Acts,
ch
1056,
§9
;
2023
Acts,
ch
19,
§521
;
2024
Acts,
ch
1161,
§79,
137
Referred
to
in
§218.92
,
222.7
,
226.31
,
229.5
,
229.6A
,
229.7
,
229.9
,
229.10
,
229.12
,
229.14
,
229.17
,
229.18
,
229.19
,
229.21
,
229.22
,
229.23
,
229.24
,
229.26
,
229.38
,
229.45
,
331.653
2024
amendment
to
subsection
1,
unnumbered
paragraph
1
effective
July
1,
2025;
2024
Acts,
ch
1161,
§137
Subsection
1,
unnumbered
paragraph
1
amended
229.12
Hearing
procedure.
1.
At
the
hospitalization
hearing,
evidence
in
support
of
the
contentions
made
in
the
application
shall
be
presented
by
the
county
attorney
.
During
the
hearing
the
applicant
and
the
respondent
shall
be
afforded
an
opportunity
to
testify
and
to
present
and
cross-examine
witnesses,
and
the
court
may
receive
the
testimony
of
any
other
interested
person.
The
respondent
has
the
right
to
be
present
at
the
hearing.
If
the
respondent
exercises
that
right
and
has
been
medicated
within
twelve
hours,
or
such
longer
period
of
time
as
the
court
may
designate,
prior
to
the
beginning
of
the
hearing
or
an
adjourned
session
thereof,
the
judge
shall
be
informed
of
that
fact
and
of
the
probable
effects
of
the
medication
upon
convening
of
the
hearing.
2.
All
persons
not
necessary
for
the
conduct
of
the
proceeding
shall
be
excluded,
except
that
the
court
may
admit
persons
having
a
legitimate
interest
in
the
proceeding
and
shall
permit
the
advocate
from
the
county
where
the
respondent
is
located
to
attend
the
hearing.
Upon
motion
of
the
county
attorney
,
the
judge
may
exclude
the
respondent
from
the
hearing
during
the
testimony
of
any
particular
witness
if
the
judge
determines
that
witness’s
testimony
is
likely
to
cause
the
respondent
severe
emotional
trauma.
3.
a.
The
respondent’s
welfare
shall
be
paramount
and
the
hearing
shall
be
conducted
in
as
informal
a
manner
as
may
be
consistent
with
orderly
procedure,
but
consistent
therewith
the
issue
shall
be
tried
as
a
civil
matter
.
The
hearing
may
be
held
by
video
or
telephone
conference
at
the
discretion
of
the
court.
Such
discovery
as
is
permitted
under
the
Iowa
rules
of
civil
procedure
shall
be
available
to
the
respondent.
The
court
shall
receive
all
relevant
and
material
evidence
which
may
be
offered
and
need
not
be
bound
by
the
rules
of
evidence.
There
shall
be
a
presumption
in
favor
of
the
respondent,
and
the
burden
of
evidence
in
support
of
the
contentions
made
in
the
application
shall
be
upon
the
applicant.
b.
The
licensed
physician
or
mental
health
professional
who
examined
the
respondent
shall
be
present
at
the
hearing
unless
the
court
for
good
cause
finds
that
the
licensed
physician
’s
or
mental
health
professional’s
presence
or
testimony
is
not
necessary
.
The
applicant,
respondent,
and
the
respondent’s
attorney
may
waive
the
presence,
televised
appearance,
or
the
telephonic
appearance
of
the
licensed
physician
or
mental
health
professional
who
examined
the
respondent
and
agree
to
submit
as
evidence
the
written
report
of
the
licensed
physician
or
mental
health
professional.
The
respondent’s
attorney
shall
inform
the
court
if
the
respondent’s
attorney
reasonably
believes
that
the
respondent,
due
to
diminished
capacity
,
cannot
make
an
adequately
considered
waiver
decision.
“Good
cause”
for
finding
that
the
testimony
of
the
licensed
physician
or
mental
health
professional
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

§229.12,
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS
10
who
examined
the
respondent
is
not
necessary
may
include
but
is
not
limited
to
such
a
waiver
.
If
the
court
determines
that
the
testimony
of
the
licensed
physician
or
mental
health
professional
is
necessary
,
the
court
may
allow
the
licensed
physician
or
the
mental
health
professional
to
testify
by
telephone
or
televised
means.
c.
If
upon
completion
of
the
hearing
the
court
finds
that
the
contention
that
the
respondent
is
seriously
mentally
impaired
has
not
been
sustained
by
clear
and
convincing
evidence,
it
shall
deny
the
application
and
terminate
the
proceeding.
4.
If
the
respondent
is
not
taken
into
custody
under
section
229.11
,
but
the
court
subsequently
finds
good
cause
to
believe
that
the
respondent
is
about
to
depart
from
the
jurisdiction
of
the
court,
the
court
may
order
such
limited
detention
of
the
respondent
as
is
authorized
by
section
229.11
and
is
necessary
to
insure
that
the
respondent
will
not
depart
from
the
jurisdiction
of
the
court
without
the
court’s
approval
until
the
proceeding
relative
to
the
respondent
has
been
concluded.
5.
The
clerk
shall
furnish
copies
of
any
orders
to
the
respondent
and
to
the
applicant
if
the
applicant
files
a
written
waiver
signed
by
the
respondent.
[R60,
§1480;
C73,
§1400;
C97,
§2265;
C24,
27,
31,
35,
39,
§
3547
;
C46,
50,
54,
58,
62,
66,
71,
73,
75,
§229.4;
C77,
79,
81,
§229.12
]
89
Acts,
ch
275,
§4
;
94
Acts,
ch
1027,
§2
;
2006
Acts,
ch
1116,
§3
;
2006
Acts,
ch
1159,
§31
;
2009
Acts,
ch
41,
§226
;
2012
Acts,
ch
1079,
§12
;
2012
Acts,
ch
1120,
§100,
130
;
2015
Acts,
ch
76,
§3
;
2018
Acts,
ch
1056,
§10
;
2023
Acts,
ch
139,
§3,
4
Referred
to
in
§218.92
,
222.7
,
225.11
,
226.31
,
229.13
,
229.14
,
229.19
,
229.21
,
229.22
,
229.24
,
229.26
,
229.38
,
331.756(40)
,
602.8103
229.13
Evaluation
order
—
treatment
—
unauthorized
departure
or
failure
to
appear
.
1.
If
upon
completion
of
the
hospitalization
hearing
the
court
finds
by
clear
and
convincing
evidence
that
the
respondent
has
a
serious
mental
impairment,
the
court
shall
order
the
respondent
committed
as
expeditiously
as
possible
for
a
complete
psychiatric
evaluation
and
appropriate
treatment
as
follows:
a.
The
court
shall
order
a
respondent
whose
expenses
are
payable
in
whole
or
in
part
by
an
administrative
services
organization
placed
under
the
care
of
an
appropriate
hospital
or
facility
designated
by
an
administrative
services
organization
on
an
inpatient
or
outpatient
basis.
b.
The
court
shall
order
any
other
respondent
placed
under
the
care
of
an
appropriate
hospital
or
facility
licensed
to
care
for
persons
with
mental
illness
or
substance
use
disorder
on
an
inpatient
or
outpatient
basis.
c.
(1)
If
the
court
orders
evaluation
and
treatment
of
the
respondent
on
an
inpatient
basis
under
this
section
,
the
court
may
order
the
respondent
placed
under
the
care
of
an
appropriate
subacute
care
facility
licensed
under
chapter
135G
.
(2)
If
the
court
orders
evaluation
and
treatment
of
a
minor
respondent
on
an
inpatient
basis
under
this
section
,
the
court
may
order
the
minor
respondent
placed
under
the
care
of
an
appropriate
public
hospital.
2.
The
court
shall
provide
notice
to
the
respondent
and
the
respondent’s
attorney
of
the
placement
order
under
subsection
1
.
The
court
shall
advise
the
respondent
and
the
respondent’s
attorney
that
the
respondent
has
a
right
to
request
a
placement
hearing
held
in
accordance
with
the
requirements
of
section
229.14A
.
3.
If
the
respondent
is
ordered
at
a
hearing
to
undergo
outpatient
treatment,
the
outpatient
treatment
provider
must
be
notified
and
agree
to
provide
the
treatment
prior
to
placement
of
the
respondent
under
the
treatment
provider
’s
care.
4.
The
court
shall
furnish
to
the
chief
medical
officer
of
the
hospital
or
facility
at
the
time
the
respondent
arrives
at
the
hospital
or
facility
for
inpatient
or
outpatient
treatment
a
written
finding
of
fact
setting
forth
the
evidence
on
which
the
finding
is
based.
If
the
respondent
is
ordered
to
undergo
outpatient
treatment,
the
order
shall
also
require
the
respondent
to
cooperate
with
the
treatment
provider
and
comply
with
the
course
of
treatment.
5.
a.
(1)
The
chief
medical
officer
of
the
hospital
or
facility
at
which
the
respondent
is
placed
shall
report
to
the
court
and
make
a
recommendation
for
disposition
of
the
matter
no
more
than
fifteen
days
after
the
date
the
respondent
is
placed
at
the
hospital
or
facility
.
(2)
If
the
respondent
is
a
minor
and
is
placed
under
the
care
of
a
public
hospital
pursuant
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

11
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS,
§229.13
to
subsection
1
,
paragraph
“c”
,
subparagraph
(2),
the
chief
medical
officer
of
the
public
hospital
shall
report
to
the
court
and
make
a
recommendation
for
disposition
no
later
than
thirty
calendar
days
after
the
date
the
minor
respondent
is
placed
under
the
care
of
the
public
hospital.
b.
A
copy
of
the
chief
medical
officer
’s
report
shall
be
sent
to
the
respondent’s
attorney
.
c.
(1)
Upon
request,
the
court
may
grant
the
chief
medical
officer
an
extension
of
time,
not
to
exceed
seven
days,
upon
a
showing
of
cause.
The
respondent’s
attorney
may
contest
the
need
for
an
extension
of
time.
(2)
The
court
shall
grant
an
extension
of
time
unless
the
request
is
contested,
in
which
case
the
court
shall
make
such
inquiry
as
it
deems
appropriate
and
may
either
order
the
respondent’s
release
from
the
hospital
or
facility
,
or
grant
an
extension
of
time
for
psychiatric
evaluation.
d.
If
the
chief
medical
officer
fails
to
report
to
the
court
within
the
time
specified
in
paragraph
“a”
,
and
an
extension
of
time
has
not
been
granted,
the
chief
medical
officer
is
guilty
of
contempt
and
shall
be
punished
under
chapter
665
.
The
court
shall
order
a
rehearing
on
the
application
to
determine
whether
the
respondent
should
continue
to
be
detained
at
or
placed
under
the
care
of
the
hospital
or
facility
.
6.
A
hospital
or
facility
’s
chief
medical
officer
shall
inform
the
sheriff
or
a
law
enforcement
agency
if,
after
placement
of
a
respondent
in
or
under
the
care
of
a
hospital
or
other
suitable
facility
for
inpatient
treatment,
the
respondent
departs
from
the
hospital
or
facility
without
authorization
or
fails
to
appear
for
treatment
as
ordered.
The
law
enforcement
agency
shall
exercise
all
due
diligence
to
take
the
respondent
into
custody
for
placement
in
the
appropriate
hospital
or
facility
.
7.
a.
If
the
respondent
is
ordered
to
undergo
outpatient
treatment
and
the
respondent’s
failure
to
comply
with
the
course
of
treatment
results
in
behavior
by
the
respondent
which,
in
the
opinion
of
the
respondent’s
mental
health
professional
acting
within
the
scope
of
the
mental
health
professional’s
practice,
is
likely
to
result
in
physical
injury
to
the
respondent’s
self
or
others
if
allowed
to
continue,
all
of
the
following
shall
occur
:
(1)
The
respondent’s
mental
health
professional
acting
within
the
scope
of
the
mental
health
professional’s
practice
shall
notify
the
committing
court,
with
preference
given
to
the
committing
judge,
if
available,
in
the
appropriate
county
and
the
court
shall
enter
a
written
order
directing
that
the
respondent
be
taken
into
immediate
custody
by
the
appropriate
sheriff
or
sheriff
’s
deputy
.
The
appropriate
sheriff
or
sheriff
’s
deputy
shall
exercise
all
due
diligence
in
taking
the
respondent
into
protective
custody
to
a
hospital
or
other
suitable
facility
.
(2)
Once
in
protective
custody
,
the
respondent
shall
be
given
the
choice
of
being
treated
by
the
appropriate
medication
which
may
include
the
use
of
oral
medicine
or
injectable
antipsychotic
medicine
by
a
mental
health
professional
acting
within
the
scope
of
the
mental
health
professional’s
practice
at
an
outpatient
psychiatric
clinic,
hospital,
or
other
suitable
facility
or
being
placed
for
treatment
under
the
care
of
a
hospital
or
other
suitable
facility
for
inpatient
treatment.
(3)
If
the
respondent
chooses
to
be
treated
by
the
appropriate
medication
which
may
include
the
use
of
oral
medicine
or
injectable
antipsychotic
medicine
but
the
mental
health
professional
acting
within
the
scope
of
the
mental
health
professional’s
practice
at
the
outpatient
psychiatric
clinic,
hospital,
or
other
suitable
facility
determines
that
the
respondent’s
behavior
continues
to
be
likely
to
result
in
physical
injury
to
the
respondent’s
self
or
others
if
allowed
to
continue,
the
mental
health
professional
acting
within
the
scope
of
the
mental
health
professional’s
practice
shall
comply
with
the
provisions
of
subparagraph
(1)
and,
following
notice
and
hearing
held
in
accordance
with
the
procedures
in
section
229.12
,
the
court
may
order
the
respondent
treated
on
an
inpatient
basis
requiring
full-time
custody
,
care,
and
treatment
in
a
hospital
until
such
time
as
the
chief
medical
officer
reports
that
the
respondent
does
not
require
further
treatment
for
serious
mental
impairment
or
has
indicated
the
respondent
is
willing
to
submit
to
treatment
on
another
basis
as
ordered
by
the
court.
b.
An
administrative
services
organization
shall
contract
with
mental
health
professionals
to
provide
the
appropriate
treatment
including
treatment
by
the
use
of
oral
medicine
or
injectable
antipsychotic
medicine
pursuant
to
this
section
.
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

§229.13,
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS
12
8.
A
sheriff
or
peace
officer
shall
have
the
authority
to
take
a
respondent
into
custody
in
any
county
in
which
the
respondent
is
found
for
placement
in
a
hospital
or
facility
in
accordance
with
an
order
entered
pursuant
to
this
section
.
[R60,
§1479;
C73,
§1401;
C97,
§2266;
C24,
27,
31,
35,
39,
§
3552,
3553;
C46,
50,
54,
58,
62,
66,
71,
73,
75,
§229.9,
229.10;
C77,
79,
81,
§229.13
]
90
Acts,
ch
1020,
§3
;
91
Acts,
ch
108,
§5
;
92
Acts,
ch
1165,
§3
;
96
Acts,
ch
1183,
§21
;
2001
Acts,
ch
155,
§30
;
2004
Acts,
ch
1090,
§33
;
2013
Acts,
ch
90,
§52
;
2015
Acts,
ch
61,
§2
;
2015
Acts,
ch
69,
§64
;
2015
Acts,
ch
138,
§34,
161,
162
;
2016
Acts,
ch
1073,
§78
;
2016
Acts,
ch
1094,
§1
;
2016
Acts,
ch
1138,
§23
;
2018
Acts,
ch
1056,
§11
;
2020
Acts,
ch
1063,
§86
;
2023
Acts,
ch
19,
§522
;
2024
Acts,
ch
1161,
§80,
81,
137
;
2025
Acts,
ch
86,
§11,
12
;
2025
Acts,
ch
95,
§4,
5
Referred
to
in
§218.92
,
222.7
,
225.11
,
225.15
,
225.17
,
226.9
,
226.31
,
229.14
,
229.14A
,
229.14B
,
229.17
,
229.18
,
229.19
,
229.21
,
229.22
,
229.23
,
229.24
,
229.26
,
229.27
,
229.38
,
229.44
,
229.45
2024
amendments
to
subsection
1,
paragraph
a
and
subsection
7,
paragraph
b
effective
July
1,
2025;
2024
Acts,
ch
1161,
§137
Subsection
1,
paragraphs
a
and
c
amended
Subsection
5
amended
Subsection
6
stricken
and
rewritten
Subsection
7,
paragraph
b
amended
NEW
subsection
8
229.14
Chief
medical
officer
’s
report.
1.
The
chief
medical
officer
’s
report
to
the
court
on
the
psychiatric
evaluation
of
the
respondent
shall
be
made
not
later
than
the
expiration
of
the
time
specified
in
section
229.13
.
At
least
two
copies
of
the
report
shall
be
filed
with
the
clerk,
who
shall
dispose
of
them
in
the
manner
prescribed
by
section
229.10,
subsection
2
.
The
report
shall
state
one
of
the
four
following
alternative
findings:
a.
That
the
respondent
does
not,
as
of
the
date
of
the
report,
require
further
treatment
for
serious
mental
impairment.
If
the
report
so
states,
the
court
shall
order
the
respondent’s
immediate
release
from
involuntary
hospitalization
and
terminate
the
proceedings.
b.
That
the
respondent
is
seriously
mentally
impaired
and
in
need
of
full-time
custody
,
care
and
inpatient
treatment
in
a
hospital,
and
is
considered
likely
to
benefit
from
treatment.
The
report
shall
include
the
chief
medical
officer
’s
recommendation
for
further
treatment.
c.
That
the
respondent
is
seriously
mentally
impaired
and
in
need
of
treatment,
but
does
not
require
full-time
hospitalization.
If
the
report
so
states,
it
shall
include
the
chief
medical
officer
’s
recommendation
for
treatment
of
the
respondent
on
an
outpatient
or
other
appropriate
basis.
d.
The
respondent
is
seriously
mentally
impaired
and
in
need
of
full-time
custody
and
care,
but
is
unlikely
to
benefit
from
further
inpatient
treatment
in
a
hospital.
The
report
shall
include
the
chief
medical
officer
’s
recommendation
for
an
appropriate
alternative
placement
for
the
respondent.
2.
F
ollowing
receipt
of
the
chief
medical
officer
’s
report
under
subsection
1
,
paragraph
“b”
,
“c”
,
or
“d”
,
the
court
shall
issue
an
order
for
appropriate
treatment
as
follows:
a.
F
or
a
respondent
whose
expenses
are
payable
in
whole
or
in
part
by
an
administrative
services
organization,
placement
as
designated
by
an
administrative
services
organization
in
the
care
of
an
appropriate
hospital
or
facility
on
an
inpatient
or
outpatient
basis,
or
other
appropriate
treatment,
or
in
an
appropriate
alternative
placement.
b.
F
or
any
other
respondent,
placement
in
the
care
of
an
appropriate
hospital
or
facility
on
an
inpatient
or
outpatient
basis,
or
other
appropriate
treatment,
or
an
appropriate
alternative
placement.
c.
F
or
a
respondent
who
is
an
inmate
in
the
custody
of
the
department
of
corrections,
the
court
may
order
the
respondent
to
receive
mental
health
services
in
a
correctional
program.
d.
If
the
court
orders
treatment
of
the
respondent
on
an
outpatient
or
other
appropriate
basis
as
described
in
the
chief
medical
officer
’s
report
pursuant
to
subsection
1
,
paragraph
“c”
,
the
order
shall
provide
that,
should
the
respondent
fail
or
refuse
to
submit
to
treatment
in
accordance
with
the
court’s
order
,
the
court
may
order
that
the
respondent
be
taken
into
immediate
custody
as
provided
by
section
229.11
and,
following
notice
and
hearing
held
in
accordance
with
the
procedures
of
section
229.12
,
may
order
the
respondent
treated
on
an
inpatient
basis
requiring
full-time
custody
,
care,
and
treatment
in
a
hospital
until
such
time
as
the
chief
medical
officer
reports
that
the
respondent
does
not
require
further
treatment
for
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

13
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS,
§229.14A
serious
mental
impairment
or
has
indicated
the
respondent
is
willing
to
submit
to
treatment
on
another
basis
as
ordered
by
the
court.
If
a
patient
is
transferred
for
treatment
to
another
provider
under
this
paragraph,
the
treatment
provider
who
will
be
providing
the
outpatient
or
other
appropriate
treatment
shall
be
provided
with
copies
of
relevant
court
orders
by
the
former
treatment
provider
.
e.
(1)
If
the
court
orders
placement
and
treatment
of
a
respondent
on
an
inpatient
basis
under
this
section
,
the
court
may
order
the
respondent
placed
under
the
care
of
an
appropriate
subacute
care
facility
licensed
under
chapter
135G
.
(2)
If
the
court
orders
placement
and
treatment
of
a
minor
respondent
on
an
inpatient
basis
under
this
section
,
the
court
may
order
the
minor
respondent
placed
under
the
care
of
an
appropriate
public
hospital.
[C77,
79,
81,
§229.14
;
82
Acts,
ch
1228,
§1
]
90
Acts,
ch
1020,
§4
;
91
Acts,
ch
219,
§2
;
92
Acts,
ch
1165,
§4
;
2001
Acts,
ch
155,
§31
;
2002
Acts,
ch
1119,
§32
;
2004
Acts,
ch
1090,
§33
;
2015
Acts,
ch
61,
§3
;
2015
Acts,
ch
69,
§65
;
2015
Acts,
ch
138,
§35,
161,
162
;
2016
Acts,
ch
1073,
§79
;
2024
Acts,
ch
1161,
§82,
137
;
2025
Acts,
ch
86,
§13
Referred
to
in
§218.92
,
222.7
,
225.15
,
225.17
,
225.27
,
226.26
,
226.31
,
226.33
,
229.1
,
229.14A
,
229.14B
,
229.15
,
229.16
,
229.17
,
229.19
,
229.21
,
229.23
,
229.26
,
229.27
,
229.28
,
229.38
,
229.44
2024
amendment
to
subsection
2,
paragraph
a
effective
July
1,
2025;
2024
Acts,
ch
1161,
§137
Subsection
2,
paragraphs
a
and
e
amended
229.14A
Placement
order
—
notice
and
hearing.
1.
W
ith
respect
to
a
chief
medical
officer
’s
report
made
pursuant
to
section
229.14,
subsection
1
,
paragraph
“b”
,
“c”
,
or
“d”
,
or
any
other
provision
of
this
chapter
related
to
involuntary
commitment
for
which
the
court
issues
a
placement
order
or
a
transfer
of
placement
is
authorized,
the
court
shall
provide
notice
to
the
respondent
and
the
respondent’s
attorney
or
mental
health
advocate
pursuant
to
section
229.19
concerning
the
placement
order
and
the
respondent’s
right
to
request
a
placement
hearing
to
determine
if
the
order
for
placement
or
transfer
of
placement
is
appropriate.
2.
The
notice
shall
provide
that
a
request
for
a
placement
hearing
must
be
in
writing
and
filed
with
the
clerk
within
seven
days
of
issuance
of
the
placement
order
.
3.
A
request
for
a
placement
hearing
may
be
signed
by
the
respondent,
the
respondent’s
next
friend,
guardian,
or
attorney
.
4.
The
court,
on
its
own
motion,
may
order
a
placement
hearing
to
be
held.
5.
a.
A
placement
hearing
shall
be
held
no
sooner
than
four
days
and
no
later
than
seven
days
after
the
request
for
the
placement
hearing
is
filed
unless
otherwise
agreed
to
by
the
parties.
b.
The
respondent
may
be
transferred
to
the
placement
designated
by
the
court’s
placement
order
and
receive
treatment
unless
a
request
for
hearing
is
filed
prior
to
the
transfer
.
If
the
request
for
a
placement
hearing
is
filed
prior
to
the
transfer
,
the
court
shall
determine
where
the
respondent
shall
be
detained
and
treated
until
the
date
of
the
hearing.
c.
If
the
respondent’s
attorney
has
withdrawn
pursuant
to
section
229.19
,
the
court
shall
appoint
an
attorney
for
the
respondent
in
the
manner
described
in
section
229.8,
subsection
1
.
6.
Time
periods
shall
be
calculated
for
the
purposes
of
this
section
excluding
weekends
and
official
holidays.
7.
If
a
respondent’s
expenses
are
payable
in
whole
or
in
part
by
an
administrative
services
organization,
notice
of
a
placement
hearing
shall
be
provided
to
the
county
attorney
and
an
administrative
services
organization.
At
the
hearing,
the
county
may
present
evidence
regarding
appropriate
placement.
8.
In
a
placement
hearing,
the
court
shall
determine
a
placement
for
the
respondent
in
accordance
with
the
requirements
of
section
229.23
,
taking
into
consideration
the
evidence
presented
by
all
the
parties.
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

§229.14A
,
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS
14
9.
A
placement
made
pursuant
to
an
order
entered
under
section
229.13
or
229.14
or
this
section
shall
be
considered
to
be
authorized
by
an
administrative
services
organization.
2001
Acts,
ch
155,
§33,
40
;
2004
Acts,
ch
1090,
§33
;
2015
Acts,
ch
69,
§66
;
2015
Acts,
ch
138,
§36,
161,
162
;
2016
Acts,
ch
1073,
§80
;
2024
Acts,
ch
1161,
§83,
137
Referred
to
in
§218.92
,
222.7
,
225.17
,
226.31
,
229.6A
,
229.13
,
229.15
,
229.17
,
229.21
,
229.26
,
229.38
2024
amendment
to
subsections
7
and
9
effective
July
1,
2025;
2024
Acts,
ch
1161,
§137
Subsections
7
and
9
amended
229.14B
Escape
from
custody
.
A
person
who
is
placed
in
a
hospital
or
other
suitable
facility
for
evaluation
under
section
229.13
or
who
is
required
to
remain
hospitalized
for
treatment
under
section
229.14
shall
remain
at
that
hospital
or
facility
unless
discharged
or
otherwise
permitted
to
leave
by
the
court
or
the
chief
medical
officer
of
the
hospital
or
facility
.
If
a
person
placed
at
a
hospital
or
facility
or
required
to
remain
at
a
hospital
or
facility
leaves
the
facility
without
permission
or
without
having
been
discharged,
the
chief
medical
officer
may
notify
a
sheriff
or
law
enforcement
agency
of
the
person
’s
absence
and
the
sheriff
or
law
enforcement
agency
shall
take
the
person
into
custody
and
return
the
person
promptly
to
the
hospital
or
facility
.
92
Acts,
ch
1072,
§4
C93,
§229.14A
2001
Acts,
ch
155,
§32,
40
CS2001,
§229.14B
2025
Acts,
ch
95,
§6
Referred
to
in
§218.92
,
222.7
,
225.17
,
226.31
,
229.17
,
229.21
,
229.26
,
229.38
Section
amended
229.15
P
eriodic
reports
required.
1.
Not
more
than
thirty
days
after
entry
of
an
order
for
continued
hospitalization
of
a
patient
under
section
229.14,
subsection
1
,
paragraph
“b”
,
and
thereafter
at
successive
intervals
of
not
more
than
sixty
days
continuing
so
long
as
involuntary
hospitalization
of
the
patient
continues,
the
chief
medical
officer
of
the
hospital
shall
report
to
the
court
which
entered
the
order
.
The
report
shall
be
submitted
in
the
manner
required
by
section
229.14
,
shall
state
whether
the
patient’s
condition
has
improved,
remains
unchanged,
or
has
deteriorated,
and
shall
indicate
if
possible
the
further
length
of
time
the
patient
will
be
required
to
remain
at
the
hospital.
The
chief
medical
officer
may
at
any
time
report
to
the
court
a
finding
as
stated
in
section
229.14,
subsection
1
,
and
the
court
shall
act
upon
the
finding
as
required
by
section
229.14,
subsection
2
.
2.
Not
more
than
sixty
days
after
the
entry
of
a
court
order
for
treatment
of
a
patient
pursuant
to
a
report
issued
under
section
229.14,
subsection
1
,
paragraph
“c”
,
and
thereafter
at
successive
intervals
as
ordered
by
the
court
but
not
to
exceed
ninety
days
so
long
as
that
court
order
remains
in
effect,
the
medical
director
of
the
facility
or
the
psychiatrist
or
psychiatric
advanced
registered
nurse
practitioner
treating
the
patient
shall
report
to
the
court
which
entered
the
order
.
The
report
shall
state
whether
the
patient’s
condition
has
improved,
remains
unchanged,
or
has
deteriorated,
and
shall
indicate
if
possible
the
further
length
of
time
the
patient
will
require
treatment
by
the
facility
.
If
at
any
time
the
patient
without
good
cause
fails
or
refuses
to
submit
to
treatment
as
ordered
by
the
court,
the
medical
director
shall
at
once
so
notify
the
court,
which
shall
order
the
patient
hospitalized
as
provided
by
section
229.14,
subsection
2
,
paragraph
“d”
,
unless
the
court
finds
that
the
failure
or
refusal
was
with
good
cause
and
that
the
patient
is
willing
to
receive
treatment
as
provided
in
the
court’s
order
,
or
in
a
revised
order
if
the
court
sees
fit
to
enter
one.
If
at
any
time
the
medical
director
reports
to
the
court
that
in
the
director
’s
opinion
the
patient
requires
full-time
custody
,
care,
and
treatment
in
a
hospital,
and
the
patient
is
willing
to
be
admitted
voluntarily
to
the
hospital
for
these
purposes,
the
court
may
enter
an
order
approving
hospitalization
for
appropriate
treatment
upon
consultation
with
the
chief
medical
officer
of
the
hospital
in
which
the
patient
is
to
be
hospitalized.
If
the
patient
is
unwilling
to
be
admitted
voluntarily
to
the
hospital,
the
procedure
for
determining
involuntary
hospitalization,
as
set
out
in
section
229.14,
subsection
2
,
paragraph
“d”
,
shall
be
followed.
3.
a.
A
psychiatric
advanced
registered
nurse
practitioner
treating
a
patient
previously
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

15
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS,
§229.17
hospitalized
under
this
chapter
may
complete
periodic
reports
pursuant
to
this
section
on
the
patient
if
the
patient
has
been
recommended
for
treatment
on
an
outpatient
or
other
appropriate
basis
pursuant
to
section
229.14,
subsection
1
,
paragraph
“c”
.
b.
An
advanced
registered
nurse
practitioner
who
is
not
certified
as
a
psychiatric
advanced
registered
nurse
practitioner
but
who
meets
the
qualifications
set
forth
in
the
definition
of
a
mental
health
professional
in
section
228.1
,
may
complete
periodic
reports
pursuant
to
paragraph
“a”
.
4.
When
a
patient
has
been
placed
in
an
alternative
facility
other
than
a
hospital
pursuant
to
a
report
issued
under
section
229.14,
subsection
1
,
paragraph
“d”
,
a
report
on
the
patient’s
condition
and
prognosis
shall
be
made
to
the
court
which
placed
the
patient,
at
least
once
every
six
months,
unless
the
court
authorizes
annual
reports.
5.
a.
When
in
the
opinion
of
the
chief
medical
officer
the
best
interest
of
a
patient
would
be
served
by
a
convalescent
or
limited
leave,
the
chief
medical
officer
may
authorize
the
leave
and,
if
authorized,
shall
promptly
report
the
leave
to
the
court.
When
in
the
opinion
of
the
chief
medical
officer
the
best
interest
of
a
patient
would
be
served
by
a
transfer
to
a
different
hospital
for
continued
full-time
custody
,
care,
and
treatment,
the
chief
medical
officer
shall
promptly
send
a
report
to
the
court.
The
court
shall
act
upon
the
report
in
accordance
with
section
229.14A
.
b.
This
subsection
shall
not
be
construed
to
add
to
or
restrict
the
authority
otherwise
provided
by
law
for
transfer
of
patients
or
residents
among
various
state
institutions
administered
by
the
department.
If
a
patient
is
transferred
under
this
subsection
,
the
treatment
provider
to
whom
the
patient
is
transferred
shall
be
provided
with
copies
of
relevant
court
orders
by
the
former
treatment
provider
.
6.
Upon
receipt
of
any
report
required
or
authorized
by
this
section
the
court
shall
furnish
a
copy
to
the
patient’s
attorney
,
or
alternatively
to
the
advocate
appointed
as
required
by
section
229.19
.
The
court
shall
examine
the
report
and
take
the
action
thereon
which
it
deems
appropriate.
Should
the
court
fail
to
receive
any
report
required
by
this
section
or
section
229.14
at
the
time
the
report
is
due,
the
court
shall
investigate
the
reason
for
the
failure
to
report
and
take
whatever
action
may
be
necessary
in
the
matter
.
[C77,
79,
81,
§229.15
;
81
Acts,
ch
78,
§20,
37
;
82
Acts,
ch
1228,
§2
]
83
Acts,
ch
96,
§157,
159
;
92
Acts,
ch
1165,
§5
;
2000
Acts,
ch
1112,
§38
;
2001
Acts,
ch
155,
§34,
35
;
2008
Acts,
ch
1082,
§5,
6
;
2009
Acts,
ch
133,
§85
;
2011
Acts,
ch
121,
§53,
62
;
2013
Acts,
ch
90,
§53
;
2023
Acts,
ch
19,
§523
;
2024
Acts,
ch
1161,
§84,
137
Referred
to
in
§218.92
,
222.7
,
225.17
,
226.23
,
226.31
,
229.17
,
229.19
,
229.21
,
229.26
,
229.29
,
229.38
,
229.43
2024
amendment
to
subsection
4
effective
July
1,
2025;
2024
Acts,
ch
1161,
§137
Subsection
4
amended
229.16
Discharge
and
termination
of
proceeding.
When
the
condition
of
a
patient
who
is
hospitalized
pursuant
to
a
report
issued
under
section
229.14,
subsection
1
,
paragraph
“b”
,
or
is
receiving
treatment
pursuant
to
a
report
issued
under
section
229.14,
subsection
1
,
paragraph
“c”
,
or
is
in
full-time
care
and
custody
pursuant
to
a
report
issued
under
section
229.14,
subsection
1
,
paragraph
“d”
,
is
such
that
in
the
opinion
of
the
chief
medical
officer
the
patient
no
longer
requires
treatment
or
care
for
serious
mental
impairment,
the
chief
medical
officer
shall
tentatively
discharge
the
patient
and
immediately
report
that
fact
to
the
court
which
ordered
the
patient’s
hospitalization
or
care
and
custody
.
Upon
receiving
the
report,
the
court
shall
issue
an
order
confirming
the
patient’s
discharge
from
the
hospital
or
from
care
and
custody
,
as
the
case
may
be,
and
shall
terminate
the
proceedings
pursuant
to
which
the
order
was
issued.
Copies
of
the
order
shall
be
sent
by
regular
mail
to
the
hospital,
the
patient,
and
the
applicant
if
the
applicant
has
filed
a
written
waiver
signed
by
the
patient.
[C77,
79,
81,
§229.16
]
89
Acts,
ch
275,
§5
;
99
Acts,
ch
144,
§2
;
2001
Acts,
ch
155,
§36
Referred
to
in
§225.15
,
225.17
,
225.27
,
226.18
,
226.19
,
229.17
,
229.21
,
229.26
229.17
Status
of
respondent
during
appeal.
If
a
respondent
appeals
to
the
supreme
court
from
a
finding
that
the
contention
the
respondent
is
seriously
mentally
impaired
has
been
sustained,
and
the
respondent
was
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

§229.17,
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS
16
previously
ordered
taken
into
immediate
custody
under
section
229.11
or
has
been
hospitalized
for
psychiatric
evaluation
and
appropriate
treatment
under
section
229.13
before
the
court
is
informed
of
intent
to
appeal
its
finding,
the
respondent
shall
remain
in
custody
as
previously
ordered
by
the
court,
the
time
limit
stated
in
section
229.11
notwithstanding,
or
shall
remain
in
the
hospital
subject
to
compliance
by
the
hospital
with
sections
229.13
through
229.16
,
as
the
case
may
be,
unless
the
supreme
court
orders
otherwise.
If
a
respondent
appeals
to
the
supreme
court
regarding
a
placement
order
,
the
respondent
shall
remain
in
placement
unless
the
supreme
court
orders
otherwise.
[C77,
79,
81,
§229.17
]
2001
Acts,
ch
155,
§37
;
2021
Acts,
ch
80,
§120
Referred
to
in
§229.21
,
229.26
229.18
Status
of
respondent
if
hospitalization
is
delayed.
When
the
court
directs
that
a
respondent
who
was
previously
ordered
taken
into
immediate
custody
under
section
229.11
be
placed
in
a
hospital
for
psychiatric
evaluation
and
appropriate
treatment
under
section
229.13
,
and
no
suitable
hospital
can
immediately
admit
the
respondent,
the
respondent
shall
remain
in
custody
as
previously
ordered
by
the
court,
the
time
limit
stated
in
section
229.11
notwithstanding,
until
a
suitable
hospital
can
admit
the
respondent.
The
court
shall
take
appropriate
steps
to
expedite
the
admission
of
the
respondent
to
a
suitable
hospital
at
the
earliest
feasible
time.
[R60,
§1436;
C73,
§1403;
C97,
§2271;
S13,
§2271;
C24,
27,
31,
35,
39,
§
3564;
C46,
50,
54,
58,
62,
66,
71,
73,
75,
§229.24;
C77,
79,
81,
§229.18
]
Referred
to
in
§229.21
,
229.26
229.19
Advocates
—
appointment
—
duties
—
employment
and
compensation.
1.
a.
(1)
The
board
of
supervisors
of
each
county
shall
appoint
an
individual
to
act
as
an
advocate
representing
the
interests
of
patients
involuntarily
hospitalized
by
the
court
in
matters
relating
to
a
patient’s
hospitalization
or
treatment
under
section
229.14
or
229.15
.
The
individual
shall
have
prior
experience
advocating
for
or
promoting
the
welfare
and
rehabilitation
of
persons
with
mental
illness.
(2)
A
person
appointed
under
this
section
shall
not
be
any
of
the
following:
(a)
An
officer
or
employee
of
the
department.
(b)
An
officer
or
employee
of
an
administrative
services
organization.
(c)
An
officer
or
employee
of
an
agency
or
facility
providing
care
or
treatment
to
persons
with
mental
illness.
(d)
An
officer
or
employee
of
a
disability
access
point.
b.
The
committing
court
shall
assign
the
advocate
for
the
county
where
the
patient
is
located.
A
county
may
seek
reimbursement
from
an
administrative
services
organization.
c.
The
advocate’s
responsibility
with
respect
to
any
patient
shall
begin
at
whatever
time
the
attorney
employed
or
appointed
to
represent
that
patient
as
respondent
in
hospitalization
proceedings,
conducted
under
sections
229.6
through
229.13
,
reports
to
the
court
that
the
attorney
’s
services
are
no
longer
required
and
requests
the
court’s
approval
to
withdraw
as
counsel
for
that
patient.
However
,
if
the
patient
is
found
to
be
seriously
mentally
impaired
at
the
hospitalization
hearing,
the
attorney
representing
the
patient
shall
automatically
be
relieved
of
responsibility
in
the
case
and
an
advocate
shall
be
assigned
to
the
patient
at
the
conclusion
of
the
hearing
unless
the
attorney
indicates
an
intent
to
continue
the
attorney
’s
services
and
the
court
so
directs.
If
the
court
directs
the
attorney
to
remain
on
the
case,
the
attorney
shall
assume
all
the
duties
of
an
advocate.
The
clerk
shall
furnish
the
advocate
with
a
copy
of
the
court’s
order
approving
the
withdrawal
and
shall
inform
the
patient
of
the
name
of
the
patient’s
advocate.
d.
W
ith
regard
to
each
patient
whose
interests
the
advocate
is
required
to
represent
pursuant
to
this
section
,
the
advocate’s
duties
shall
include
all
of
the
following:
(1)
T
o
review
each
report
submitted
pursuant
to
sections
229.14
and
229.15
.
(2)
If
the
advocate
is
not
an
attorney
,
to
advise
the
court
at
any
time
it
appears
that
the
services
of
an
attorney
are
required
to
properly
safeguard
the
patient’s
interests.
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

17
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS,
§229.20
(3)
T
o
be
readily
accessible
to
communications
from
the
patient
and
to
originate
communications
with
the
patient
within
five
days
of
the
patient’s
commitment.
(4)
T
o
visit
the
patient
within
fifteen
days
of
the
patient’s
commitment
and
periodically
thereafter
.
(5)
T
o
communicate
with
medical
personnel
treating
the
patient
and
to
review
the
patient’s
medical
records
pursuant
to
section
229.25
.
(6)
T
o
file
with
the
court
reports
as
the
advocate
feels
necessary
or
as
required
by
the
court.
(7)
T
o
utilize
the
related
best
practices
for
the
duties
identified
in
this
paragraph
“d”
.
e.
An
advocate
may
also
be
assigned
pursuant
to
this
section
for
an
individual
who
has
been
diagnosed
with
a
co
-
occurring
mental
illness
and
substance
use
disorder
.
2.
The
hospital
or
facility
to
which
a
patient
is
committed
shall
grant
all
reasonable
requests
of
the
advocate
to
visit
the
patient,
to
communicate
with
medical
personnel
treating
the
patient,
and
to
review
the
patient’s
medical
records
pursuant
to
section
229.25
.
An
advocate
shall
not
disseminate
information
from
a
patient’s
medical
records
to
any
other
person
unless
done
for
official
purposes
in
connection
with
the
advocate’s
duties
pursuant
to
this
chapter
or
when
required
by
law
.
3.
The
county
board
of
supervisors
shall
prescribe
reasonable
compensation
for
the
services
of
the
advocate.
The
compensation
shall
be
based
upon
the
duties
performed
by
the
advocate
and
in
accordance
with
the
personnel
policies
set
forth
by
the
board
for
county
employees.
The
advocate
is
an
employee
of
the
county
,
including
for
purposes
of
chapters
97B
and
670
.
4.
The
department,
in
consultation
with
advocates
and
county
and
judicial
branch
representatives,
shall
adopt
rules
pursuant
to
chapter
17A
relating
to
advocates
that
include
but
are
not
limited
to
all
of
the
following
topics:
a.
Quarterly
and
annual
reports.
b.
Data
collection
requirements.
c.
Juvenile
patient
representation.
d.
Grievance
procedures.
e.
Conflict
of
interest
provisions.
f
.
W
orkforce
coverage.
g.
Confidentiality
.
h.
Minimum
professional
qualifications
and
educational
requirements.
i.
Caseload
criteria.
j.
Caseload
audits.
k.
Quality
assurance
measures.
l.
T
erritory
assignments.
5.
An
advocate
appointed
by
the
chief
judge
of
a
judicial
district
or
by
the
county
board
of
supervisors
prior
to
July
1,
2015,
shall
be
considered
to
be
appointed
by
the
county
board
of
supervisors
on
July
1,
2015,
as
required
in
subsection
1
.
Such
an
advocate
shall
be
compensated
at
a
minimum
at
the
advocate’s
wage
and
benefit
level
in
place
immediately
prior
to
July
1,
2015.
[C77,
79,
81,
§229.19
]
83
Acts,
ch
96,
§157,
159
;
83
Acts,
ch
123,
§85,
209
;
85
Acts,
ch
62,
§1
;
87
Acts,
ch
57,
§1
;
93
Acts,
ch
83,
§1
;
94
Acts,
ch
1173,
§10
;
96
Acts,
ch
1129,
§113
;
99
Acts,
ch
135,
§19
;
2006
Acts,
ch
1030,
§22
;
2007
Acts,
ch
22,
§53,
54
;
2007
Acts,
ch
86,
§3
;
2012
Acts,
ch
1079,
§13,
14
;
2012
Acts,
ch
1120,
§101,
130
;
2015
Acts,
ch
76,
§4
;
2017
Acts,
ch
97,
§1
;
2021
Acts,
ch
80,
§121
;
2023
Acts,
ch
19,
§524
;
2024
Acts,
ch
1104,
§1
;
2024
Acts,
ch
1161,
§85,
86,
137
;
2025
Acts,
ch
135,
§3
Referred
to
in
§226.31
,
229.2
,
229.14A
,
229.15
,
229.21
,
229.26
2024
amendments
to
subsection
1,
paragraph
b
and
subsection
4,
unnumbered
paragraph
1
effective
July
1,
2025;
2024
Acts,
ch
1161,
§137
See
Code
editor
’s
note
on
simple
harmonization
at
the
beginning
of
this
Code
volume
Subsection
1,
paragraphs
a
and
b
amended
Subsection
4,
unnumbered
paragraph
1
amended
229.20
Reserved.
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

§229.21,
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS
18
229.21
Judicial
hospitalization
referee
—
appeals
to
district
court.
1.
The
chief
judge
of
each
judicial
district
may
appoint
at
least
one
judicial
hospitalization
referee
for
each
county
within
the
district.
The
judicial
hospitalization
referee
shall
be
an
attorney
,
licensed
to
practice
law
in
this
state,
who
shall
be
chosen
with
consideration
to
any
training,
experience,
interest,
or
combination
of
those
factors,
which
are
pertinent
to
the
duties
of
the
office.
The
referee
shall
hold
office
at
the
pleasure
of
the
chief
judge
of
the
judicial
district
and
receive
compensation
at
a
rate
fixed
by
the
supreme
court.
If
the
referee
expects
to
be
absent
for
any
significant
length
of
time,
the
referee
shall
inform
the
chief
judge
who
may
appoint
a
temporary
substitute
judicial
hospitalization
referee
having
the
qualifications
set
forth
in
this
subsection
.
2.
When
an
application
for
involuntary
hospitalization
under
section
229.6
or
for
involuntary
commitment
or
treatment
of
persons
with
a
substance
use
disorder
under
section
125.75
is
filed
with
the
clerk
of
the
district
court
in
any
county
for
which
a
judicial
hospitalization
referee
has
been
appointed,
and
no
district
judge,
district
associate
judge,
or
magistrate
who
is
admitted
to
the
practice
of
law
in
this
state
is
accessible,
the
clerk
shall
immediately
notify
the
referee
in
the
manner
required
by
section
229.7
or
section
125.77
.
The
referee
shall
discharge
all
of
the
duties
imposed
upon
the
court
by
sections
229.7
through
229.19
,
this
section
,
and
section
229.22
or
sections
125.75
through
125.94
in
the
proceeding
so
initiated.
Subject
to
the
provisions
of
subsection
4
,
orders
issued
by
a
referee,
in
discharge
of
duties
imposed
under
this
section
,
shall
have
the
same
force
and
effect
as
if
ordered
by
a
district
judge.
However
,
any
commitment
to
a
facility
regulated
and
operated
under
chapter
135C
shall
be
in
accordance
with
section
135C.23
.
3.
a.
Any
respondent
with
respect
to
whom
the
magistrate
or
judicial
hospitalization
referee
has
found
the
contention
that
the
respondent
is
seriously
mentally
impaired
or
a
person
with
a
substance
use
disorder
sustained
by
clear
and
convincing
evidence
presented
at
a
hearing
held
under
section
229.12
or
section
125.82
,
may
appeal
from
the
magistrate’s
or
referee’s
finding
to
a
judge
of
the
district
court
by
giving
the
clerk
notice
in
writing,
within
ten
days
after
the
magistrate’s
or
referee’s
finding
is
made,
that
an
appeal
is
taken.
The
appeal
may
be
signed
by
the
respondent
or
by
the
respondent’s
next
friend,
guardian,
or
attorney
.
b.
An
order
of
a
magistrate
or
judicial
hospitalization
referee
with
a
finding
that
the
respondent
is
seriously
mentally
impaired
or
a
person
with
a
substance
use
disorder
shall
include
the
following
notice,
located
conspicuously
on
the
face
of
the
order
:
NOTE:
The
respondent
may
appeal
from
this
order
to
a
judge
of
the
district
court
by
giving
written
notice
of
the
appeal
to
the
clerk
of
the
district
court
within
ten
days
after
the
date
of
this
order
.
The
appeal
may
be
signed
by
the
respondent
or
by
the
respondent’s
next
friend,
guardian,
or
attorney
.
F
or
a
more
complete
description
of
the
respondent’s
appeal
rights,
consult
section
229.21
of
the
Code
of
Iowa
or
an
attorney
.
c.
When
appealed,
the
matter
shall
stand
for
trial
de
novo
.
Upon
appeal,
the
court
shall
schedule
a
hospitalization
or
commitment
hearing
before
a
district
judge
at
the
earliest
practicable
time.
d.
Any
respondent
with
respect
to
whom
the
magistrate
or
judicial
hospitalization
referee
has
held
a
placement
hearing
and
has
entered
a
placement
order
may
appeal
the
order
to
a
judge
of
the
district
court.
The
request
for
appeal
must
be
given
to
the
clerk
in
writing
within
ten
days
of
the
entry
of
the
magistrate’s
or
referee’s
order
.
The
request
for
appeal
shall
be
signed
by
the
respondent,
or
the
respondent’s
next
friend,
guardian,
or
attorney
.
4.
If
the
appellant
is
in
custody
under
the
jurisdiction
of
the
district
court
at
the
time
of
service
of
the
notice
of
appeal,
the
appellant
shall
be
discharged
from
custody
unless
an
order
that
the
appellant
be
taken
into
immediate
custody
has
previously
been
issued
under
section
229.11
or
section
125.81
,
in
which
case
the
appellant
shall
be
detained
as
provided
in
that
section
until
the
hospitalization
or
commitment
hearing
before
the
district
judge.
If
the
appellant
is
in
the
custody
of
a
hospital
or
facility
at
the
time
of
service
of
the
notice
of
appeal,
the
appellant
shall
be
discharged
from
custody
pending
disposition
of
the
appeal
unless
the
chief
medical
officer
,
not
later
than
the
end
of
the
next
secular
day
on
which
the
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

19
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS,
§229.22
office
of
the
clerk
is
open
and
which
follows
service
of
the
notice
of
appeal,
files
with
the
clerk
a
certification
that
in
the
chief
medical
officer
’s
opinion
the
appellant
is
seriously
mentally
ill
or
a
person
with
a
substance
use
disorder
.
In
that
case,
the
appellant
shall
remain
in
custody
of
the
hospital
or
facility
until
the
hospitalization
or
commitment
hearing
before
the
district
court.
5.
The
hospitalization
or
commitment
hearing
before
the
district
judge
shall
be
held,
and
the
judge’s
finding
shall
be
made
and
an
appropriate
order
entered,
as
prescribed
by
sections
229.12
and
229.13
or
sections
125.82
and
125.83
.
If
the
judge
orders
the
appellant
hospitalized
or
committed
for
a
complete
psychiatric
or
substance
use
disorder
evaluation,
jurisdiction
of
the
matter
shall
revert
to
the
judicial
hospitalization
referee.
[C97,
§2267,
2268;
C24,
27,
31,
35,
39,
§
3560,
3561;
C46,
50,
54,
58,
62,
66,
71,
73,
75,
§229.17,
229.18;
C77,
79,
81,
§229.21
;
82
Acts,
ch
1212,
§27
]
85
Acts,
ch
195,
§25
;
87
Acts,
ch
190,
§2
;
90
Acts,
ch
1085,
§20
;
91
Acts,
ch
108,
§6
;
92
Acts,
ch
1165,
§6
;
98
Acts,
ch
1181,
§23
;
99
Acts,
ch
144,
§3,
4
;
2001
Acts,
ch
155,
§38
;
2011
Acts,
ch
121,
§54
–
56,
62
;
2013
Acts,
ch
130,
§49
;
2014
Acts,
ch
1026,
§47
;
2021
Acts,
ch
80,
§122
;
2023
Acts,
ch
19,
§525
Referred
to
in
§97B.1A
,
125.90
229.22
Hospitalization
—
emergency
procedure.
1.
The
procedure
prescribed
by
this
section
shall
be
used
when
it
appears
that
a
person
should
be
immediately
detained
due
to
serious
mental
impairment,
but
an
application
has
not
been
filed
naming
the
person
as
the
respondent
pursuant
to
section
229.6
,
and
the
person
cannot
be
ordered
into
immediate
custody
and
detained
pursuant
to
section
229.11
.
2.
a.
(1)
In
the
circumstances
described
in
subsection
1
,
any
peace
officer
who
has
reasonable
grounds
to
believe
that
a
person
is
mentally
ill,
and
because
of
that
illness
is
likely
to
physically
injure
the
person
’s
self
or
others
if
not
immediately
detained,
may
without
a
warrant
take
or
cause
that
person
to
be
taken
to
the
nearest
available
facility
or
hospital
as
defined
in
section
229.11,
subsection
1
,
paragraphs
“b”
and
“c”
.
A
person
believed
mentally
ill,
and
likely
to
injure
the
person
’s
self
or
others
if
not
immediately
detained,
may
be
delivered
to
a
facility
or
hospital
by
someone
other
than
a
peace
officer
.
(2)
Upon
delivery
of
the
person
believed
mentally
ill
to
the
facility
or
hospital,
the
examining
physician,
examining
physician
assistant,
examining
mental
health
professional,
or
examining
psychiatric
advanced
registered
nurse
practitioner
may
order
treatment
of
that
person,
including
chemotherapy
,
but
only
to
the
extent
necessary
to
preserve
the
person
’s
life
or
to
appropriately
control
behavior
by
the
person
which
is
likely
to
result
in
physical
injury
to
that
person
or
others
if
allowed
to
continue.
(3)
The
peace
officer
who
took
the
person
into
custody
,
or
other
party
who
brought
the
person
to
the
facility
or
hospital,
shall
describe
the
circumstances
of
the
matter
to
the
examining
physician,
examining
physician
assistant,
examining
mental
health
professional,
or
examining
psychiatric
advanced
registered
nurse
practitioner
.
If
the
person
is
a
peace
officer
,
the
peace
officer
may
do
so
either
in
person
or
by
written
report.
(4)
(a)
If
the
examining
physician,
examining
physician
assistant,
examining
mental
health
professional,
or
examining
psychiatric
advanced
registered
nurse
practitioner
finds
that
there
is
reason
to
believe
that
the
person
is
seriously
mentally
impaired,
and
because
of
that
impairment
is
likely
to
physically
injure
the
person
’s
self
or
others
if
not
immediately
detained,
the
facility
shall
have
the
authority
to
detain
the
person
for
a
period
of
no
longer
than
twelve
hours.
W
ithin
twelve
hours
of
detaining
a
person
pursuant
to
this
section
,
the
examining
physician,
examining
physician
assistant,
examining
mental
health
professional,
or
examining
psychiatric
advanced
registered
nurse
practitioner
shall
communicate
with
the
nearest
available
magistrate.
(b)
Once
contacted
pursuant
to
subparagraph
division
(a),
the
magistrate
shall,
based
upon
the
circumstances
described
by
the
examining
physician,
examining
physician
assistant,
examining
mental
health
professional,
or
examining
psychiatric
advanced
registered
nurse
practitioner
,
give
the
examining
physician,
examining
physician
assistant,
examining
mental
health
professional,
or
examining
psychiatric
advanced
registered
nurse
practitioner
oral
instructions
either
directing
that
the
person
be
released
forthwith
or
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

§229.22,
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS
20
authorizing
the
person
’s
detention
in
an
appropriate
facility
.
A
peace
officer
from
the
law
enforcement
agency
that
took
the
person
into
custody
,
if
available,
during
the
communication
with
the
magistrate,
may
inform
the
magistrate
that
an
arrest
warrant
has
been
issued
for
or
charges
are
pending
against
the
person
and
request
that
any
oral
or
written
order
issued
under
this
subsection
require
the
facility
or
hospital
to
notify
the
law
enforcement
agency
about
the
discharge
of
the
person
prior
to
discharge.
The
magistrate
may
also
give
oral
instructions
and
order
that
the
detained
person
be
transported
to
an
appropriate
facility
.
b.
If
the
magistrate
orders
that
the
person
be
detained,
the
magistrate
shall,
by
the
close
of
business
on
the
next
working
day
,
file
a
written
order
with
the
clerk
in
the
county
where
it
is
anticipated
that
an
application
may
be
filed
under
section
229.6
.
The
order
may
be
filed
by
facsimile
if
necessary
.
A
peace
officer
from
the
law
enforcement
agency
that
took
the
person
into
custody
,
if
no
request
was
made
under
paragraph
“a”
,
may
inform
the
magistrate
that
an
arrest
warrant
has
been
issued
for
or
charges
are
pending
against
the
person
and
request
that
any
written
order
issued
under
this
paragraph
require
the
facility
or
hospital
to
notify
the
law
enforcement
agency
about
the
discharge
of
the
person
prior
to
discharge.
The
order
shall
state
the
circumstances
under
which
the
person
was
taken
into
custody
or
otherwise
brought
to
a
facility
or
hospital,
and
the
grounds
supporting
the
finding
of
probable
cause
to
believe
that
the
person
is
seriously
mentally
impaired
and
likely
to
injure
the
person
’s
self
or
others
if
not
immediately
detained.
The
order
shall
also
include
any
law
enforcement
agency
notification
requirements
if
applicable.
The
order
shall
confirm
the
oral
order
authorizing
the
person
’s
detention
including
any
order
given
to
transport
the
person
to
an
appropriate
facility
or
hospital.
A
peace
officer
from
the
law
enforcement
agency
that
took
the
person
into
custody
may
also
request
an
order
,
separate
from
the
written
order
,
requiring
the
facility
or
hospital
to
notify
the
law
enforcement
agency
about
the
discharge
of
the
person
prior
to
discharge.
The
clerk
shall
provide
a
copy
of
the
written
order
or
any
separate
order
to
the
chief
medical
officer
of
the
facility
or
hospital
to
which
the
person
was
originally
taken,
to
any
subsequent
facility
to
which
the
person
was
transported,
and
to
any
law
enforcement
department,
ambulance
service,
or
transportation
service
under
contract
with
an
administrative
services
organization
that
transported
the
person
pursuant
to
the
magistrate’s
order
.
A
transportation
service
that
contracts
with
an
administrative
services
organization
for
purposes
of
this
paragraph
shall
provide
a
secure
transportation
vehicle
and
shall
employ
staff
that
has
received
or
is
receiving
mental
health
training.
c.
If
an
arrest
warrant
has
been
issued
for
or
charges
are
pending
against
the
person,
but
no
court
order
exists
requiring
notification
to
a
law
enforcement
agency
under
paragraph
“a
”
or
“b”
,
and
if
the
peace
officer
delivers
the
person
to
a
facility
or
hospital
and
the
peace
officer
notifies
the
facility
or
hospital
in
writing
on
a
form
prescribed
by
the
department
of
public
safety
that
the
facility
or
hospital
notify
the
law
enforcement
agency
about
the
discharge
of
the
person
prior
to
discharge,
the
facility
or
hospital
shall
do
all
of
the
following:
(1)
Notify
the
dispatch
of
the
law
enforcement
agency
that
employs
the
peace
officer
by
telephone
prior
to
the
discharge
of
the
person
from
the
facility
or
hospital.
(2)
Notify
the
law
enforcement
agency
that
employs
the
peace
officer
by
electronic
mail
prior
to
the
discharge
of
the
person
from
the
facility
or
hospital.
3.
The
chief
medical
officer
of
the
facility
or
hospital
shall
examine
and
may
detain
and
care
for
the
person
taken
into
custody
under
the
magistrate’s
order
for
a
period
not
to
exceed
forty
-eight
hours
from
the
time
such
order
is
dated,
excluding
Saturdays,
Sundays
and
holidays,
unless
the
order
is
sooner
dismissed
by
a
magistrate.
The
facility
or
hospital
may
provide
treatment
which
is
necessary
to
preserve
the
person
’s
life,
or
to
appropriately
control
behavior
by
the
person
which
is
likely
to
result
in
physical
injury
to
the
person
’s
self
or
others
if
allowed
to
continue,
but
may
not
otherwise
provide
treatment
to
the
person
without
the
person
’s
consent.
The
person
shall
be
discharged
from
the
facility
or
hospital
and
released
from
custody
not
later
than
the
expiration
of
that
period,
unless
an
application
is
sooner
filed
with
the
clerk
pursuant
to
section
229.6
.
P
rior
to
such
discharge
the
facility
or
hospital
shall,
if
required
by
this
section
,
notify
the
law
enforcement
agency
requesting
such
notification
about
the
discharge
of
the
person.
The
law
enforcement
agency
shall
retrieve
the
person
no
later
than
six
hours
after
notification
from
the
facility
or
hospital
but
in
no
circumstances
shall
the
detention
of
the
person
exceed
the
period
of
time
prescribed
for
detention
by
this
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

21
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS,
§229.23
subsection
.
The
detention
of
any
person
by
the
procedure
and
not
in
excess
of
the
period
of
time
prescribed
by
this
section
shall
not
render
the
peace
officer
,
physician,
mental
health
professional,
facility
,
or
hospital
so
detaining
that
person
liable
in
a
criminal
or
civil
action
for
false
arrest
or
false
imprisonment
if
the
peace
officer
,
physician,
mental
health
professional,
facility
,
or
hospital
had
reasonable
grounds
to
believe
the
person
so
detained
was
mentally
ill
and
likely
to
physically
injure
the
person
’s
self
or
others
if
not
immediately
detained,
or
if
the
facility
or
hospital
was
required
to
notify
a
law
enforcement
agency
by
this
section
,
and
the
law
enforcement
agency
requesting
notification
prior
to
discharge
retrieved
the
person
no
later
than
six
hours
after
the
notification,
and
the
detention
prior
to
the
retrieval
of
the
person
did
not
exceed
the
period
of
time
prescribed
for
detention
by
this
subsection
.
4.
The
cost
of
hospitalization
at
a
public
hospital
of
a
person
detained
temporarily
by
the
procedure
prescribed
in
this
section
shall
be
paid
in
the
same
way
as
if
the
person
had
been
admitted
to
the
hospital
by
the
procedure
prescribed
in
sections
229.6
through
229.13
.
5.
The
department
of
public
safety
shall
prescribe
the
form
to
be
used
when
a
law
enforcement
agency
desires
notification
under
this
section
from
a
facility
or
hospital
prior
to
discharge
of
a
person
admitted
to
the
facility
or
hospital
and
for
whom
an
arrest
warrant
has
been
issued
or
against
whom
charges
are
pending.
The
form
shall
be
consistent
with
all
laws,
regulations,
and
rules
relating
to
the
confidentiality
or
privacy
of
personal
information
or
medical
records,
including
but
not
limited
to
the
federal
Health
Insurance
P
ortability
and
Accountability
Act
of
1996,
Pub.
L.
No
.
104-191,
and
regulations
promulgated
in
accordance
with
that
Act
and
published
in
45
C.F
.R
.
pts.
160
–
164
.
6.
A
facility
or
hospital,
which
has
been
notified
by
a
peace
officer
or
a
law
enforcement
agency
by
delivery
of
a
form
as
prescribed
by
the
department
of
public
safety
indicating
that
an
arrest
warrant
has
been
issued
for
or
charges
are
pending
against
a
person
admitted
to
the
facility
or
hospital,
that
does
not
notify
the
law
enforcement
agency
about
the
discharge
of
the
person
as
required
by
subsection
2
,
paragraph
“c”
,
shall
pay
a
civil
penalty
as
provided
in
section
805.8C,
subsection
9
.
[C77,
79,
81,
§229.22
]
95
Acts,
ch
24,
§2
;
2003
Acts,
ch
68,
§3,
4
;
2009
Acts,
ch
41,
§227
;
2010
Acts,
ch
1103,
§1,
2
;
2011
Acts,
ch
34,
§55
;
2012
Acts,
ch
1079,
§15
;
2013
Acts,
ch
90,
§54
;
2013
Acts,
ch
130,
§50,
51
;
2014
Acts,
ch
1092,
§173
;
2015
Acts,
ch
37,
§1
;
2017
Acts,
ch
34,
§15,
16
;
2018
Acts,
ch
1056,
§12
;
2021
Acts,
ch
80,
§123
;
2022
Acts,
ch
1071,
§5
;
2024
Acts,
ch
1161,
§87,
137
Referred
to
in
§229.21
,
229.23
,
229.24
,
331.910
,
602.6405
,
805.8C(9)
2024
amendment
to
subsection
2,
paragraph
b
effective
July
1,
2025;
2024
Acts,
ch
1161,
§137
Subsection
2,
paragraph
b
amended
229.23
Rights
and
privileges
of
hospitalized
persons.
Every
person
who
is
hospitalized
or
detained
under
this
chapter
shall
have
the
right
to
:
1.
P
rompt
evaluation,
necessary
psychiatric
services,
and
additional
care
and
treatment
as
indicated
by
the
patient’s
condition.
A
comprehensive,
individualized
treatment
plan
shall
be
timely
developed
following
issuance
of
the
court
order
requiring
involuntary
hospitalization.
The
plan
shall
be
consistent
with
current
standards
appropriate
to
the
facility
to
which
the
person
has
been
committed
and
with
currently
accepted
standards
for
psychiatric
treatment
of
the
patient’s
condition,
including
chemotherapy
,
psychotherapy
,
counseling
and
other
modalities
as
may
be
appropriate.
2.
The
right
to
refuse
treatment
by
shock
therapy
or
chemotherapy
,
unless
the
use
of
these
treatment
modalities
is
specifically
consented
to
by
the
patient’s
next
of
kin
or
guardian.
The
patient’s
right
to
refuse
treatment
by
chemotherapy
shall
not
apply
during
any
period
of
custody
authorized
by
section
229.4,
subsection
3
,
section
229.11
or
section
229.22
,
but
this
exception
shall
extend
only
to
chemotherapy
treatment
which
is,
in
the
chief
medical
officer
’s
judgment,
necessary
to
preserve
the
patient’s
life
or
to
appropriately
control
behavior
by
the
person
which
is
likely
to
result
in
physical
injury
to
that
person
or
others
if
allowed
to
continue.
The
patient’s
right
to
refuse
treatment
by
chemotherapy
shall
also
not
apply
during
any
period
of
custody
authorized
by
the
court
pursuant
to
section
229.13
or
229.14
.
In
any
other
situation
in
which,
in
the
chief
medical
officer
’s
judgment,
chemotherapy
is
appropriate
for
the
patient
but
the
patient
refuses
to
consent
thereto
and
there
is
no
next
of
kin
or
guardian
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

§229.23,
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS
22
to
give
consent,
the
chief
medical
officer
may
request
an
order
authorizing
treatment
of
the
patient
by
chemotherapy
from
the
district
court
which
ordered
the
patient’s
hospitalization.
3.
In
addition
to
protection
of
the
person
’s
constitutional
rights,
enjoyment
of
other
legal,
medical,
religious,
social,
political,
personal
and
working
rights
and
privileges
which
the
person
would
enjoy
if
the
person
were
not
so
hospitalized
or
detained,
so
far
as
is
possible
consistent
with
effective
treatment
of
that
person
and
of
the
other
patients
of
the
hospital.
If
the
patient’s
rights
are
restricted,
the
physician
’s
or
mental
health
professional’s
direction
to
that
effect
shall
be
noted
on
the
patient’s
record.
The
department
shall,
in
accordance
with
chapter
17A
establish
rules
setting
forth
the
specific
rights
and
privileges
to
which
persons
hospitalized
or
detained
are
entitled
under
this
section
,
and
the
exceptions
provided
by
section
17A
.2,
subsection
11
,
paragraphs
“a”
and
“k”,
shall
not
be
applicable
to
the
rules
established.
The
patient
or
the
patient’s
next
of
kin
or
friend
shall
be
advised
of
these
rules
and
be
provided
a
written
copy
upon
the
patient’s
admission
to
or
arrival
at
the
hospital.
[C77,
79,
81,
§229.23
]
83
Acts,
ch
96,
§157,
159
;
89
Acts,
ch
275,
§6
;
2017
Acts,
ch
34,
§17
;
2023
Acts,
ch
19,
§526
Referred
to
in
§229.14A
229.24
Records
of
involuntar
y
hospitalization
proceeding
to
be
confidential.
1.
All
papers
and
records
pertaining
to
any
involuntary
hospitalization
or
application
pursuant
to
section
229.6
of
any
person
under
this
chapter
,
whether
part
of
the
permanent
record
of
the
court
or
of
a
file
in
the
department,
are
subject
to
inspection
only
upon
an
order
of
the
court
for
good
cause
shown.
2.
If
authorized
in
writing
by
a
person
who
has
been
the
subject
of
any
proceeding
or
report
under
sections
229.6
through
229.13
or
section
229.22
,
or
by
the
parent
or
guardian
of
that
person,
information
regarding
that
person
which
is
confidential
under
subsection
1
may
be
released
to
any
designated
person.
3.
If
all
or
part
of
the
costs
associated
with
hospitalization
of
an
individual
under
this
chapter
are
chargeable
to
an
administrative
services
organization,
the
clerk
of
the
district
court
shall
provide
to
an
administrative
services
organization
the
following
information
pertaining
to
the
individual
which
would
be
confidential
under
subsection
1
:
a.
Administrative
information,
as
defined
in
section
228.1
.
b.
An
evaluation
order
under
this
chapter
and
the
location
of
the
individual’s
placement
under
the
order
.
c.
A
hospitalization
or
placement
order
under
this
chapter
and
the
location
of
the
individual’s
placement
under
the
order
.
d.
The
date,
location,
and
disposition
of
any
hearing
concerning
the
individual
held
under
this
chapter
.
e.
Any
payment
source
available
for
the
costs
of
the
individual’s
care.
4.
This
section
shall
not
prohibit
any
of
the
following:
a.
A
hospital
from
complying
with
the
requirements
of
this
chapter
and
of
chapter
230
relative
to
financial
responsibility
for
the
cost
of
care
and
treatment
provided
a
patient
in
that
hospital
or
from
properly
billing
any
responsible
relative
or
third-party
payer
for
such
care
or
treatment.
b.
A
court
or
the
department
of
public
safety
from
forwarding
to
the
federal
bureau
of
investigation
information
that
a
person
has
been
disqualified
from
possessing,
shipping,
transporting,
or
receiving
a
firearm
pursuant
to
section
724.31
.
[C77,
79,
81,
§229.24
]
83
Acts,
ch
96,
§157,
159
;
95
Acts,
ch
120,
§3
;
96
Acts,
ch
1183,
§22
;
2002
Acts,
ch
1146,
§4
;
2004
Acts,
ch
1090,
§8
;
2010
Acts,
ch
1031,
§362
;
2010
Acts,
ch
1178,
§1,
2,
19
;
2012
Acts,
ch
1120,
§102,
130
;
2013
Acts,
ch
130,
§52
;
2015
Acts,
ch
69,
§67
;
2021
Acts,
ch
80,
§124
;
2023
Acts,
ch
19,
§527
;
2024
Acts,
ch
1161,
§88,
137
Referred
to
in
§228.6
2024
amendment
to
subsection
3,
unnumbered
paragraph
1
effective
July
1,
2025;
2024
Acts,
ch
1161,
§137
Subsection
3,
unnumbered
paragraph
1
amended
229.25
Medical
records
to
be
confidential
—
e
x
ceptions.
1.
a.
The
records
maintained
by
a
hospital
or
other
facility
relating
to
the
examination,
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

23
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS,
§229.27
custody
,
care
and
treatment
of
any
person
in
that
hospital
or
facility
pursuant
to
this
chapter
shall
be
confidential,
except
that
the
chief
medical
officer
shall
release
appropriate
information
under
any
of
the
following
circumstances:
(1)
The
information
is
requested
by
a
licensed
physician
or
mental
health
professional,
attorney
,
or
advocate
who
provides
the
chief
medical
officer
with
a
written
waiver
signed
by
the
person
about
whom
the
information
is
sought.
(2)
The
information
is
sought
by
a
court
order
.
(3)
The
person
who
is
hospitalized
or
that
person
’s
guardian,
if
the
person
is
a
minor
or
is
not
legally
competent
to
do
so
,
signs
an
informed
consent
to
release
information.
Each
signed
consent
shall
designate
specifically
the
person
or
agency
to
whom
the
information
is
to
be
sent,
and
the
information
may
be
sent
only
to
that
person
or
agency
.
b.
Such
records
may
be
released
by
the
chief
medical
officer
when
requested
for
the
purpose
of
research
into
the
causes,
incidence,
nature
and
treatment
of
mental
illness,
however
information
shall
not
be
provided
in
a
way
that
discloses
patients’
names
or
which
otherwise
discloses
any
patient’s
identity
.
2.
When
the
chief
medical
officer
deems
it
to
be
in
the
best
interest
of
the
patient
and
the
patient’s
next
of
kin
to
do
so
,
the
chief
medical
officer
may
release
appropriate
information
during
a
consultation
which
the
hospital
or
facility
shall
arrange
with
the
next
of
kin
of
a
voluntary
or
involuntary
patient,
if
requested
by
the
patient’s
next
of
kin.
[C77,
79,
81,
§229.25
;
82
Acts,
ch
1135,
§1
]
89
Acts,
ch
275,
§7
;
2009
Acts,
ch
41,
§263
;
2017
Acts,
ch
34,
§18
Referred
to
in
§228.6
,
229.19
229.26
Ex
clusive
procedure
for
involuntar
y
hospitalization.
Sections
229.6
through
229.19
constitute
the
exclusive
procedure
for
involuntary
hospitalization
of
persons
by
reason
of
serious
mental
impairment
in
this
state,
except
that
this
chapter
does
not
negate
the
provisions
of
section
904.503
relating
to
transfer
of
prisoners
with
mental
illness
to
state
mental
health
institutes
and
does
not
apply
to
commitments
of
persons
under
chapter
812
or
the
rules
of
criminal
procedure,
Iowa
court
rules,
or
negate
the
provisions
of
section
232.51
relating
to
disposition
of
children
with
mental
illness.
[C77,
79,
81,
§229.26
]
84
Acts,
ch
1323,
§3
;
85
Acts,
ch
21,
§36
;
87
Acts,
ch
90,
§4
;
88
Acts,
ch
1134,
§45
;
96
Acts,
ch
1129,
§58
;
2002
Acts,
ch
1119,
§108
;
2003
Acts,
ch
108,
§125,
132
;
2012
Acts,
ch
1019,
§81
;
2015
Acts,
ch
30,
§72
;
2023
Acts,
ch
19,
§528
229.27
Hospitalization
not
to
equate
with
incompetency
—
procedure
for
finding
incompetency
due
to
mental
illness.
1.
Hospitalization
of
a
person
under
this
chapter
,
either
voluntarily
or
involuntarily
,
does
not
constitute
a
finding
of
nor
equate
with
nor
raise
a
presumption
of
incompetency
,
nor
cause
the
person
so
hospitalized
to
be
deemed
a
person
of
unsound
mind
nor
a
person
under
legal
disability
for
any
purpose,
including
but
not
limited
to
any
circumstances
to
which
sections
6B.15
,
447.7
,
section
488.603,
subsection
6
,
paragraph
“c”
,
sections
488.704
,
597.6
,
600B.21
,
614.8
,
614.19
,
614.22
,
614.24
,
614.27
,
and
633.244
are
applicable.
2.
The
applicant
may
,
in
initiating
a
petition
under
section
229.6
or
at
any
subsequent
time
prior
to
conclusion
of
the
involuntary
hospitalization
proceeding,
also
petition
the
court
for
a
finding
that
the
person
is
incompetent
by
reason
of
mental
illness.
The
test
of
competence
for
the
purpose
of
this
section
shall
be
whether
the
person
possesses
sufficient
mind
to
understand
in
a
reasonable
manner
the
nature
and
effect
of
the
act
in
which
the
person
is
engaged;
the
fact
that
a
person
is
mentally
ill
and
in
need
of
treatment
for
that
illness
but
because
of
the
illness
lacks
sufficient
judgment
to
make
responsible
decisions
with
respect
to
the
person
’s
hospitalization
or
treatment
does
not
necessarily
mean
that
that
person
is
incapable
of
transacting
business
on
any
subject.
3.
A
hearing
limited
to
the
question
of
the
person
’s
competence
and
conducted
in
substantially
the
manner
prescribed
in
sections
633.552
,
633.556
,
633.558
,
and
633.560
shall
be
held
when
any
of
the
following
circumstances
applies:
a.
The
court
is
petitioned
or
proposes
upon
its
own
motion
to
find
incompetent
by
reason
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

§229.27,
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS
24
of
mental
illness
a
person
whose
involuntary
hospitalization
has
been
ordered
under
section
229.13
or
229.14
,
and
who
contends
that
the
person
is
not
incompetent.
b.
A
person
previously
found
incompetent
by
reason
of
mental
illness
under
subsection
2
petitions
the
court
for
a
finding
that
the
person
is
no
longer
incompetent
and,
after
notice
to
the
applicant
who
initiated
the
petition
for
hospitalization
of
the
person
and
to
any
other
party
as
directed
by
the
court,
an
objection
is
filed
with
the
court.
The
court
may
order
a
hearing
on
its
own
motion
before
acting
on
a
petition
filed
under
this
paragraph.
A
petition
by
a
person
for
a
finding
that
the
person
is
no
longer
incompetent
may
be
filed
at
any
time
without
regard
to
whether
the
person
is
at
that
time
hospitalized
for
treatment
of
mental
illness.
4.
Nothing
in
this
chapter
shall
preclude
use
of
any
other
procedure
authorized
by
law
for
declaring
any
person
legally
incompetent
for
reasons
which
may
include
mental
illness,
without
regard
to
whether
that
person
is
or
has
been
hospitalized
for
treatment
of
mental
illness.
[C77,
79,
81,
§229.27
;
82
Acts,
ch
1103,
§1109
]
91
Acts,
ch
93,
§1
;
96
Acts,
ch
1034,
§9
;
98
Acts,
ch
1181,
§24
;
2004
Acts,
ch
1175,
§368,
400
;
2004
Acts,
ch
1021,
§118,
119
;
2004
Acts,
ch
1175,
§369,
400
;
2013
Acts,
ch
130,
§53
;
2019
Acts,
ch
57,
§2,
43,
44
;
2023
Acts,
ch
19,
§529
Referred
to
in
§4.1
,
218.95
,
229.39
229.28
Hospitalization
in
certain
federal
facilities.
1.
When
a
court
finds
that
the
contention
that
a
respondent
is
seriously
mentally
impaired
has
been
sustained
or
proposes
to
order
continued
hospitalization
of
any
person,
or
an
alternative
placement,
as
described
under
section
229.14,
subsection
1
,
paragraph
“b”
or
“d”
,
and
the
court
is
furnished
evidence
that
the
respondent
or
patient
is
eligible
for
care
and
treatment
in
a
facility
operated
by
the
United
States
department
of
veterans
affairs
or
another
agency
of
the
United
States
government
and
that
the
facility
is
willing
to
receive
the
respondent
or
patient,
the
court
may
so
order
.
a.
The
respondent
or
patient,
when
so
hospitalized
or
placed
in
a
facility
operated
by
the
United
States
department
of
veterans
affairs
or
another
agency
of
the
United
States
government
within
or
outside
of
this
state,
shall
be
subject
to
the
rules
of
the
United
States
department
of
veterans
affairs
or
other
agency
,
but
shall
not
thereby
lose
any
procedural
rights
afforded
the
respondent
or
patient
by
this
chapter
.
b.
The
chief
officer
of
the
facility
shall
have,
with
respect
to
the
person
so
hospitalized
or
placed,
the
same
powers
and
duties
as
the
chief
medical
officer
of
a
hospital
in
this
state
would
have
in
regard
to
submission
of
reports
to
the
court,
retention
of
custody
,
transfer
,
convalescent
leave
or
discharge.
2.
Jurisdiction
is
retained
in
the
court
to
maintain
surveillance
of
the
person
’s
treatment
and
care,
and
at
any
time
to
inquire
into
that
person
’s
mental
condition
and
the
need
for
continued
hospitalization
or
care
and
custody
.
[C27,
31,
35,
§3562-b1;
C39,
§
3562.1;
C46,
50,
54,
58,
62,
66,
71,
73,
75,
§229.20;
C77,
79,
81,
§229.28
]
2001
Acts,
ch
155,
§39
;
2009
Acts,
ch
26,
§10
Referred
to
in
§229.30
229.29
T
ransfer
to
certain
federal
facilities.
1.
Upon
receipt
of
a
certificate
stating
that
any
person
involuntarily
hospitalized
under
this
chapter
is
eligible
for
care
and
treatment
in
a
facility
operated
by
the
United
States
department
of
veterans
affairs
or
another
agency
of
the
United
States
government
which
is
willing
to
receive
the
person
without
charge
to
the
state
of
Iowa
or
any
county
in
the
state,
the
chief
medical
officer
may
transfer
the
person
to
that
facility
.
Upon
so
doing,
the
chief
medical
officer
shall
notify
the
court
which
ordered
the
person
’s
hospitalization
in
the
same
manner
as
would
be
required
in
the
case
of
a
transfer
under
section
229.15,
subsection
5
,
and
the
person
transferred
shall
be
entitled
to
the
same
rights
as
the
person
would
have
under
that
subsection.
2.
No
person
shall
be
transferred
under
this
section
who
is
confined
pursuant
to
conviction
of
a
public
offense
or
whose
hospitalization
was
ordered
upon
contention
of
incompetence
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

25
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS,
§229.33
to
stand
trial
by
reason
of
mental
illness,
without
prior
approval
of
the
court
which
ordered
that
person
’s
hospitalization.
[C27,
31,
35,
§3562-b1;
C39,
§
3562.1;
C46,
50,
54,
58,
62,
66,
71,
73,
75,
§229.20;
C77,
79,
81,
§229.29
]
2009
Acts,
ch
26,
§11
229.30
Orders
of
courts
in
other
states.
A
judgment
or
order
of
hospitalization
or
commitment
by
a
court
of
competent
jurisdiction
of
another
state
or
the
District
of
Columbia,
under
which
any
person
is
hospitalized
or
placed
in
a
facility
operated
by
the
United
States
department
of
veterans
affairs
or
another
agency
of
the
United
States
government,
shall
have
the
same
force
and
effect
with
respect
to
that
person
while
the
person
is
in
this
state
as
the
judgment
or
order
would
have
if
the
person
were
in
the
jurisdiction
of
the
court
which
issued
it.
That
court
shall
be
deemed
to
have
retained
jurisdiction
of
the
person
so
hospitalized
or
placed
for
the
purpose
of
inquiring
into
that
person
’s
mental
condition
and
the
need
for
continued
hospitalization
or
care
and
custody
,
as
do
courts
in
this
state
under
section
229.28
.
Consent
is
hereby
given
to
the
application
of
the
law
of
the
state
or
district
in
which
is
situated
the
court
which
issued
the
judgment
or
order
as
regards
authority
of
the
chief
officer
of
any
facility
,
operated
in
this
state
by
the
United
States
department
of
veterans
affairs
or
another
agency
of
the
United
States
government,
to
retain
custody
,
transfer
,
place
on
convalescent
leave
or
discharge
the
person
so
hospitalized
or
committed.
[C27,
31,
35,
§3562-b1;
C39,
§
3562.1;
C46,
50,
54,
58,
62,
66,
71,
73,
75,
§229.20;
C77,
79,
81,
§229.30
]
2009
Acts,
ch
26,
§12
229.31
Commission
of
inquir
y
.
A
sworn
complaint,
alleging
that
a
named
person
is
not
seriously
mentally
impaired
and
is
unjustly
deprived
of
liberty
in
any
hospital
in
the
state,
may
be
filed
by
any
person
with
the
clerk
of
the
district
court
of
the
county
in
which
such
named
person
is
so
confined,
or
of
the
county
in
which
such
named
person
is
a
resident.
Upon
receiving
the
complaint,
a
judge
of
that
court
shall
appoint
a
commission
of
not
more
than
three
persons
to
inquire
into
the
truth
of
the
allegations.
One
of
the
commissioners
shall
be
a
physician
and
if
additional
commissioners
are
appointed,
one
of
the
additional
commissioners
shall
be
a
lawyer
.
[C73,
§1442;
C97,
§2304;
C24,
27,
31,
35,
39,
§
3571;
C46,
50,
54,
58,
62,
66,
71,
73,
75,
77,
79,
81,
§229.31
]
2012
Acts,
ch
1120,
§103,
130
Referred
to
in
§229.36
229.32
Duty
of
commission.
Said
commission
shall
at
once
proceed
to
the
place
where
said
person
is
confined
and
make
a
thorough
and
discreet
examination
for
the
purpose
of
determining
the
truth
of
said
allegations
and
shall
promptly
report
its
findings
to
said
judge
in
writing.
Said
report
shall
be
accompanied
by
a
written
statement
of
the
case
signed
by
the
chief
medical
officer
of
the
hospital
in
which
the
person
is
confined.
[C73,
§1442;
C97,
§2304;
C24,
27,
31,
35,
39,
§
3572;
C46,
50,
54,
58,
62,
66,
71,
73,
75,
77,
79,
81,
§229.32
]
Referred
to
in
§229.36
229.33
Hearing.
If,
on
such
report
and
statement,
and
the
hearing
of
testimony
if
any
is
offered,
the
judge
shall
find
that
such
person
is
not
seriously
mentally
impaired,
the
judge
shall
order
the
person
’s
discharge;
if
the
contrary
,
the
judge
shall
so
state,
and
authorize
the
continued
detention
of
the
person,
subject
to
all
applicable
requirements
of
this
chapter
.
[C73,
§1442;
C97,
§2304;
C24,
27,
31,
35,
39,
§
3573;
C46,
50,
54,
58,
62,
66,
71,
73,
75,
77,
79,
81,
§229.33
]
97
Acts,
ch
23,
§17
Referred
to
in
§229.36
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

§229.34,
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS
26
229.34
F
inding
and
order
filed.
The
finding
and
order
of
the
judge,
with
the
report
and
other
papers,
shall
be
filed
in
the
office
of
the
clerk
of
the
court
where
the
complaint
was
filed.
Said
clerk
shall
enter
a
memorandum
thereof
on
the
appropriate
record,
and
forthwith
notify
the
chief
medical
officer
of
the
hospital
of
the
finding
and
order
of
the
judge,
and
the
chief
medical
officer
shall
carry
out
the
order
.
[C73,
§1442;
C97,
§2304;
C24,
27,
31,
35,
39,
§
3574;
C46,
50,
54,
58,
62,
66,
71,
73,
75,
77,
79,
81,
§229.34
]
Referred
to
in
§229.36
229.35
Compensation
—
payment.
Said
commissioners
shall
be
entitled
to
their
necessary
expenses
and
a
reasonable
compensation,
to
be
allowed
by
the
judge,
who
shall
certify
the
same
to
the
director
of
the
department
of
administrative
services
who
shall
thereupon
draw
the
proper
warrants
on
any
funds
in
the
state
treasury
not
otherwise
appropriated.
The
applicant
shall
pay
said
costs
and
expenses
if
the
judge
shall
so
order
on
a
finding
that
the
complaint
was
filed
without
probable
cause.
[C73,
§1442;
C97,
§2304;
C24,
27,
31,
35,
39,
§
3575;
C46,
50,
54,
58,
62,
66,
71,
73,
75,
77,
79,
81,
§229.35
]
2003
Acts,
ch
145,
§286
Referred
to
in
§229.36
229.36
Limitation
on
proceedings.
The
proceeding
authorized
in
sections
229.31
through
229.35
shall
not
be
had
more
often
than
once
in
six
months
regarding
the
same
person;
nor
regarding
any
patient
within
six
months
after
the
patient’s
admission
to
the
hospital.
[C73,
§1443;
C97,
§2305;
C24,
27,
31,
35,
39,
§
3576;
C46,
50,
54,
58,
62,
66,
71,
73,
75,
77,
79,
81,
§229.36
]
2005
Acts,
ch
3,
§52
;
2020
Acts,
ch
1063,
§87
229.37
Habeas
corpus.
All
persons
confined
as
seriously
mentally
impaired
shall
be
entitled
to
the
benefit
of
the
writ
of
habeas
corpus,
and
the
question
of
serious
mental
impairment
shall
be
decided
at
the
hearing.
If
the
judge
shall
decide
that
the
person
is
seriously
mentally
impaired,
such
decision
shall
be
no
bar
to
the
issuing
of
the
writ
a
second
time,
whenever
it
shall
be
alleged
that
such
person
is
no
longer
seriously
mentally
impaired.
[R60,
§1441;
C73,
§1444;
C97,
§2306;
C24,
27,
31,
35,
39,
§
3577;
C46,
50,
54,
58,
62,
66,
71,
73,
75,
77,
79,
81,
§229.37
]
Constitutional
provision,
Iowa
Constitution,
Art.
I,
§13
Habeas
corpus,
chapter
663
229.38
Cr
uelty
or
official
misconduct.
If
any
person
having
the
care
of
a
person
with
mental
illness
who
has
voluntarily
entered
a
hospital
or
other
facility
for
treatment
or
care,
or
who
is
responsible
for
psychiatric
examination
care,
treatment,
and
maintenance
of
any
person
involuntarily
hospitalized
under
sections
229.6
through
229.15
,
whether
in
a
hospital
or
elsewhere,
with
or
without
proper
authority
,
shall
treat
such
patient
with
unnecessary
severity
,
harshness,
or
cruelty
,
or
in
any
way
abuse
the
patient
or
if
any
person
unlawfully
detains
or
deprives
of
liberty
any
person
with
mental
illness
or
any
person
who
is
alleged
to
have
mental
illness,
or
if
any
officer
required
by
the
provisions
of
this
chapter
and
chapter
226
,
to
perform
any
act
shall
willfully
refuse
or
neglect
to
perform
the
same,
the
offending
person
shall,
unless
otherwise
provided,
be
guilty
of
a
serious
misdemeanor
.
[C73,
§1415,
1416,
1440,
1445;
C97,
§2307;
C24,
27,
31,
35,
39,
§
3578;
C46,
50,
54,
58,
62,
66,
71,
73,
75,
77,
79,
81,
§229.38
]
96
Acts,
ch
1129,
§59
;
2020
Acts,
ch
1063,
§88
;
2024
Acts,
ch
1161,
§89,
137
2024
amendment
effective
July
1,
2025;
2024
Acts,
ch
1161,
§137
Section
amended
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

27
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS,
§229.43
229.39
Status
of
persons
hospitalized
under
former
law
.
1.
Each
person
admitted
or
committed
to
a
hospital
for
treatment
of
mental
illness
on
or
before
December
31,
1975
who
remained
so
hospitalized,
or
was
on
convalescent
leave
or
was
receiving
care
in
another
facility
on
transfer
from
such
hospitalization,
on
or
after
January
1,
1976
shall
be
considered
to
have
been
hospitalized
under
this
chapter
,
and
its
provisions
shall
apply
to
each
such
person
on
and
after
the
effective
date
of
this
section
,
except
as
otherwise
provided
by
subsection
3
.
2.
Hospitalization
of
a
person
for
treatment
of
mental
illness,
either
voluntary
or
involuntary
,
on
or
before
December
31,
1975
does
not
constitute
a
finding
nor
equate
with
nor
raise
a
presumption
of
incompetency
,
nor
cause
the
person
hospitalized
to
be
deemed
a
person
of
unsound
mind
nor
a
person
under
legal
disability
for
any
purpose,
including
but
not
limited
to
the
circumstances
enumerated
in
section
229.27,
subsection
1
.
This
subsection
does
not
invalidate
any
specific
declaration
of
incompetence
of
a
person
hospitalized
if
the
declaration
was
made
pursuant
to
a
separate
procedure
authorized
by
law
for
that
purpose,
and
did
not
result
automatically
from
the
person
’s
hospitalization.
3.
Where
a
person
was
hospitalized
involuntarily
for
treatment
of
mental
illness
on
or
before
December
31,
1975
and
remained
so
hospitalized,
or
was
on
convalescent
leave
or
was
receiving
care
in
another
facility
on
transfer
from
such
hospitalization,
on
or
after
January
1,
1976,
but
was
subsequently
discharged
prior
to
July
1,
1978,
this
section
shall
not
be
construed
to
require:
a.
The
filing
after
July
1,
1978,
of
any
report
relative
to
that
person
’s
status
which
would
have
been
required
to
be
filed
prior
to
said
date
if
that
person
had
initially
been
hospitalized
under
this
chapter
as
amended
by
1975
Iowa
Acts,
ch.
139,
§1
to
30
.
b.
That
legal
proceedings
be
taken
under
this
chapter
,
as
so
amended,
to
clarify
the
status
of
the
person
so
hospitalized,
unless
that
person
or
the
district
court
considers
such
proceedings
necessary
in
a
particular
case
to
appropriately
conclude
the
matter
.
[C79,
81,
§229.39
]
2011
Acts,
ch
34,
§56
;
2014
Acts,
ch
1026,
§143
229.40
Rules
for
proceedings.
P
roceedings
under
this
chapter
are
subject
to
rules
prescribed
by
the
supreme
court
under
section
602.4201
.
[C79,
81,
§229.40
]
83
Acts,
ch
186,
§10053,
10201
R
ules
adopted
by
the
supreme
court
are
published
in
the
compilation
“Iowa
Court
R
ules”
229.41
V
oluntar
y
admission
—
state
mental
health
institute.
P
ersons
making
application
pursuant
to
section
229.2
on
their
own
behalf
or
on
behalf
of
another
person
who
is
under
eighteen
years
of
age,
if
the
person
whose
admission
is
sought
is
received
for
observation
and
treatment
on
the
application,
shall
be
required
to
pay
the
costs
of
hospitalization
at
rates
established
by
the
department.
The
costs
may
be
collected
weekly
in
advance
and
shall
be
payable
to
the
state
mental
health
institute.
The
collections
shall
be
remitted
to
the
department
monthly
to
be
credited
to
the
general
fund
of
the
state.
[C50,
54,
58,
62,
66,
71,
73,
75,
77,
79,
81,
§229.41
]
2000
Acts,
ch
1112,
§39
;
2001
Acts,
ch
155,
§21
;
2023
Acts,
ch
19,
§530
Referred
to
in
§229.2
229.42
Costs
paid
by
county
—
state
mental
health
institute.
Repealed
by
2024
Acts,
ch
1161,
§135,
137
.
2024
repeal
effective
July
1,
2025;
2024
Acts,
ch
1161,
§137
229.43
Nonresident
patients
—
state
mental
health
institutes.
The
department
may
place
patients
of
state
mental
health
institutes
who
are
nonresidents
on
convalescent
leave
to
a
private
sponsor
or
in
a
health
care
facility
licensed
under
chapter
135C
,
when
in
the
opinion
of
the
director
the
placement
is
in
the
best
interests
of
the
patient
and
the
state
of
Iowa.
If
the
patient
was
involuntarily
hospitalized,
the
district
court
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)

§229.43,
HOSPIT
ALIZA
TION
OF
PERS
ONS
WITH
MENT
AL
ILLNESS
28
which
ordered
hospitalization
of
the
patient
shall
be
informed
when
the
patient
is
placed
on
convalescent
leave,
as
required
by
section
229.15,
subsection
5
.
[C24,
27,
31,
35,
39,
§
3446;
C46,
50,
54,
58,
62,
§222.36;
C66,
71,
73,
75,
77,
79,
81,
§229.43
]
2000
Acts,
ch
1112,
§40
;
2012
Acts,
ch
1120,
§105,
130
;
2023
Acts,
ch
19,
§532
229.44
V
enue.
1.
V
enue
for
hospitalization
proceedings
shall
be
in
the
county
where
the
respondent
is
found,
unless
the
matter
is
transferred
pursuant
to
Iowa
court
r
ule
12.15
for
the
involuntary
hospitalization
of
persons
with
mental
illness,
in
which
case
venue
shall
be
in
the
county
where
the
matter
is
transferred
for
hearing.
2.
After
an
order
is
entered
pursuant
to
section
229.13
or
229.14
,
the
court
may
transfer
proceedings
to
the
court
of
any
county
having
venue
at
any
further
stage
in
the
proceeding
as
follows:
a.
When
it
appears
that
the
best
interests
of
the
respondent
or
the
convenience
of
the
parties
will
be
served
by
a
transfer
,
the
court
may
transfer
the
case
to
the
court
of
the
county
of
the
respondent’s
residence.
b.
When
it
appears
that
the
best
interests
of
the
respondent
or
the
convenience
of
the
parties
will
be
served
by
a
transfer
,
the
court
may
transfer
the
case
to
the
court
of
the
county
where
the
respondent
is
found.
3.
If
a
proceeding
is
transferred,
the
court
shall
contact
the
court
in
the
county
which
is
to
be
the
recipient
of
the
transfer
before
entering
the
order
to
transfer
the
case.
The
court
shall
then
transfer
the
case
by
ordering
a
transfer
of
the
matter
to
the
recipient
county
,
by
ordering
a
continuance
of
the
matter
in
the
transferring
county
,
and
by
forwarding
to
the
clerk
of
the
receiving
court
a
certified
copy
of
all
papers
filed,
together
with
the
order
of
transfer
.
The
referee
of
the
receiving
court
may
accept
the
filings
of
the
transferring
court
or
may
direct
the
filing
of
a
new
application
and
may
hear
the
case
anew
.
92
Acts,
ch
1165,
§7
;
96
Acts,
ch
1079,
§9
;
96
Acts,
ch
1129,
§113
229.45
P
rovision
of
summar
y
of
procedures
to
applicant
in
involuntar
y
commitment.
The
department,
in
consultation
with
the
office
of
attorney
general,
shall
develop
a
summary
of
the
procedures
involved
in
an
involuntary
commitment
and
information
concerning
the
participation
of
an
applicant
in
the
proceedings.
The
summary
shall
be
provided
by
the
department,
at
the
department’s
expense,
to
the
clerks
of
the
district
court
who
shall
make
the
summary
available
to
all
applicants
prior
to
the
filing
of
a
verified
application,
or
to
any
other
person
upon
request,
and
who
shall
attach
a
copy
of
the
summary
to
the
notice
of
hearing
which
is
served
upon
the
respondent
under
section
125.77
or
229.7
.
The
summary
may
include,
but
is
not
limited
to
,
the
following:
1.
The
statutory
criteria
for
ordering
that
a
person
be
involuntarily
committed
under
chapter
125
or
sections
229.11
and
229.13
.
2.
A
description
of
the
hearing
process.
3.
An
explanation
of
the
applicant’s
right
to
testify
and
examples
of
the
kinds
of
relevant
information
which
may
be
introduced
at
the
hearing.
4.
An
explanation
of
the
duties
of
the
county
attorney
in
civil
commitment
proceedings.
94
Acts,
ch
1024,
§1
;
2023
Acts,
ch
19,
§533
T
ue
Dec
09
22:21:30
2025
Iowa
Code
2026,
Chapter
229
(47,
1)