Iowa DHS Again fails to protect Iowa’s Youth

August 7, 2017 -Disability Rights Iowa released a report today regarding the failure of the Iowa Department of Human Services to provide appropriate mental health treatment to the youth at the Boys State Training School in Eldora, Iowa.

Disability Rights Iowa (DRI) is a non-profit law center, which has been authorized by Congress to protect and advocate for the rights of Iowans with disabilities and mental illness. Over the past year, DRI has intensively investigated the adequacy of mental health services for youth placed at the Boys State Training School (BSTS), which is a secure juvenile justice facility located in Eldora, Iowa.  BSTS is operated by the Iowa Department of Human Services (DHS).  Approximately 120 youth live there. About two-thirds of them have been diagnosed as having a serious mental illness and are on psychotropic medications.

DRI’s key findings of DRI’s report – entitled “Unlicensed and Unlawful: The Failure to Ensure Safe and Evidence-Based Treatment at the Boys State Training School” are as follows:

  • The BSTS is not providing evidence-based mental health services to residents besides medication management. This is a violation of the statutory mission of the BSTS and a violation of the constitutional rights of the residents at BSTS.
  • There is an overreliance on the use of restraint and seclusion, which disproportionately affects African American youth and youth with disabilities.
  • There are no regulations that govern the use of restraint and seclusion and provisions of mental health care and education at the BSTS. This is an anomaly in the juvenile justice system in Iowa.
  • There is no independent State licensure and oversight of the BSTS. This is an anomaly in the juvenile justice system in Iowa.

DRI recommends several forms of relief for the residents at the BSTS, which include but are not limited to, the following:

  • Transfer of all youth with mental illness to appropriate placements where appropriate mental health services can be provided, including adding to Iowa’s continuum of care if there are no services that can currently be provided for the youth who are transferred.
  • Implement all recommendations found in the mental health services audit at the BSTS.
  • Provide additional training to staff in multiple areas of need identified in this report and implement data collecting and reporting procedures for the reduction of restraint and seclusion and the reduction of the disproportionate punishment of African American youth.
  • Eliminate the use of room confinement for minor rule violations and the use of the “wrap”.
  • Provide State regulations for the BSTS that adhere to Juvenile Detention Alternatives Initiative (JDAI) Juvenile Detention Standards.
  • Provide licensure and oversight by an independent State entity.

DRI is open and will to meet with state officials to discuss its findings and recommendations.  However, DRI will take all appropriate and necessary action, up to and including filing a lawsuit in federal court against the Governor, the DHS Director and other state officials, if they do not remedy the problems that DRI has identified in this report and taken appropriate corrective action.

Full Boys State Training School Public Report

Appendix A

Appendix B

Appendix C

Appendix D

Appendix E

Appendix F

Press Contact:  Nathan Kirstein, J.D.,



Disability Rights Iowa Board of Directors Openings!

Disability Rights Iowa Board of Directors Openings

Disability Rights Iowa is currently seeking applications to fill upcoming openings on our Board of Directors. Disability Rights Iowa is a private, non-profit, legally-based disability advocacy organization whose mission is to defend and promote the human and legal rights of Iowans who have disabilities and mental illness.

The volunteer Board of Directors meets at least quarterly throughout the fiscal year (October 1 through September 30) and is responsible for the governance and fiscal oversight of the agency. The Board sets the Areas of Focus which direct the agency’s work each fiscal year. The Board is a working board and members are expected to attend meetings and serve on committees, as necessary, to carry out the board’s responsibilities.  Board members may serve a four year term.

If you are interested, please complete the Disability Rights Iowa Board of Directors application.   Completed applications or any questions may be emailed to  All applications are reviewed by the Board Governance Committee.

How to Be Your Own Best Advocate: Guide to Navigating Managed Care in Iowa.

The Managed Care Ombudsman Program has just released a new resource for Medicaid members and their support system. The How to be Your Own Best Advocate Guide is intended to assist members and their loved ones with navigating the managed care system. The link to the guide can be found below. This guide was developed in collaboration with Disability Rights Iowa and the Iowa Developmental Disabilities Council.




Iowans Challenge State’s Termination of Critical Health Care Services

Six Iowans with significant disabilities filed a class action lawsuit in federal court to stop Governor Kim Reynolds and Department of Human Services Director Charles Palmer from arbitrarily terminating or reducing the Medicaid services they depend on to stay in their homes in the community.  If it were not for these services, the Plaintiffs and others like them would be confined in hospitals, nursing facilities or intermediate care facilities.

Find out everything you need to know about the class action lawsuit challenging the arbitrary termination of HCBS services here. Click the following link for the Press Release . You can also click the following link to see pleadings and related documents.



Response to the Iowa Girls Justice Initiative Recommendations: “Serious, Violent, and Chronic Juvenile Female Offenders: Service and System Recommendations for Iowa” dated February 2017.




A Response to Iowa Girls Justice Initiative Recommendations: “Serious, Violent, and Chronic Juvenile Female Offenders: Service and System Recommendations for Iowa” dated February 2017.  (See   The IGJI recommendations begin by noting that serious, violent, and chronic juvenile female offenders are at the center of a system and service crisis in juvenile justice in Iowa.  The authors of this report offer a different way to look at this “crisis”.  We do not believe this “crisis” is caused by the lack of a locked or staff-secure facility for “Serious, Chronic, and Violent” girls in Iowa, as the IGJI recommendations would have you believe.  Rather, we believe the “crisis” is caused by a lack of female-responsive, culturally competent, trauma-informed, treatment-oriented, developmentally appropriate services for girls across the continuum of services for ALL girls involved with the juvenile justice system.

The authors of this response recommend that one way out of this “crisis” is to provide a level of community-based services here in Iowa that is not currently a part of Iowa’s juvenile justice continuum.  One such organization that provides such services would be Youth Advocacy Programs (YAP).  They serve similarly situated youth quite successfully in other states that have used this organization as an alternative to the use of locked facilities.  If these girls cannot be served by these community-based services at home, then the authors recommend the use of these community-based services in a therapeutic foster home or regionally based group home for the youth.  These services should be properly funded by the State of Iowa.

Read the Response to Iowa Girls Justice Initiative Recommendations February 2017



Nathan Kirstein

Staff Attorney

515-278-2502 Ext. 25





DRI publishes report examining the troubling systemic issue of individuals with mental illness who end up in Iowa’s county jails.


In honor of Human Rights Day this past weekend, DRI is proud to release our most recent publication “In Jail and Out of Options: An Examination of the Systemic Issues affecting the Housing and Treatment of Iowans with Mental Illness in County Jails.” This report, comprised of three parts, describes how individuals with mental illness have come to end up in county jails, how they are treated while they are incarcerated in these facilities, and what community stakeholders around Iowa are doing to combat this problem.

Click here for the FULL REPORT, “In Jail and Out of Options: An Examination of the Systemic Issues affecting the Housing and Treatment of Iowans with Mental Illness in County Jails.”

Only interested in one part? Use the links below to navigate to the part you want to retrieve:

Part I: Transinstitutionalization of Individuals with Mental Illness from Hospitals to Jails — How Iowa’s County Jails are Responding

Part II: Mental Health Treatment and Medications in Iowa’s County Jails

Part III: Systemic Solutions




Disability Rights Iowa files amicus brief in workplace discrimination case.

Judicial Building

On August 31st, DRI filed an amicus (friend-of-the-court) brief with the Iowa Supreme Court in support of an employee with mental illness.  The case is about licensed mental health professionals, who worked for Magellan, directing hatred and ridicule towards another coworker who was suffering from major depression, the same type of serious mental illnesses for which their member-patients needed their help. They created a hostile environment when she tried to return to work after taking medical leave to cope with and recover from her depression. The brief deals with the stigma of mental illness in the workplace and society at large.


Click here for the Full Amicus brief.