On June 30, 2024, Glenwood Resource Center closed its doors.[1] Glenwood Resource Center was originally an orphan asylum during the Civil War. In 1876, the asylum became a state psychiatric hospital. In 2000, it transformed into a mental health institution for individuals with severe intellectual disabilities, often with a dual diagnosis of mental illness.[2] Glenwood Resource Center provided medical care and social services to individuals with intellectual disabilities and co-occurring conditions.[3] Those most impacted by Glenwood’s closure are the former patients now displaced and their family members who must travel farther to the only state-run psychiatric facility that is still open in the state – Woodward Resource Center. [4] Their only alternatives are to travel to neighboring states for care or approach the for-profit facilities remaining in Iowa, both of which are incredibly expensive in comparison to state-run institutions. 

Even when individuals are provided access to public psychiatric care, the results can be dangerous and even life-threatening. For example, at Glenwood Resource Center, staff abused and mistreated the residents through unethical experimentation and inadequate behavioral and physical medical care. [5] In 2020, the U.S. Department of Justice launched an investigation into Glenwood Resource Center and held that the State violated the 14th amendment by exposing “Glenwood residents to unreasonable harm and serious risk of harm by . . . deficient safety and oversight mechanisms.”[6] The DOJ ultimately entered a decree requiring the State to comply with strict oversight guidelines.[7] In addition, in 2021, the DOJ discovered that Iowa was unnecessarily institutionalizing intellectually disabled individuals at the Glenwood and Woodward Resource Centers when the residents were capable of community-based living.[8] Iowa violated Title II of the Americans with Disabilities Act (ADA) because it failed to “provide programs and services in an integrated setting” to residents capable of more independent living. [9]

Ideally, the state should build and operate more local care facilities that follow the ADA and the DOJ decree standards to meet the needs of intellectually disabled Iowans. Without proper enforcement and oversight, the State could run into the same issues Glenwood Resource Center faced and risk violating residents’ constitutional rights. 

The DOJ decree set the proper oversight procedures for these care facilities to increase transparency through public reporting and stakeholder engagement. These new protocols focus on improving staffing and training, prohibiting unethical experiments, and limiting restraint use and seclusion to ensure residents’ best interests are protected.[10] Most importantly, the state will not be the sole monitor of their compliance. An independent monitor will be appointed by the DOJ to assess state compliance and will provide public care facility oversight.[11] This independent party’s role is to ensure residents are in the “most integrated setting consistent with their informed choice, needs and preferences, with the appropriate services and supports in place. [12]  These guidelines align with ADA standards and should be used to provide adequate medical care for the intellectually disabled in care facilities. The DOJ has investigated mistreatment and abuse extensively at Glenwood Resource Center, so utilizing their protocols as preventative measures will help ensure no abuse or mistreatment occurs in care facilities in the future. 

The closure of Glenwood Resource Center signifies a great decline in state-run in-patient treatment for the intellectually disabled. These in-patient facilities are still vital for Iowans, so closures forcing patients into home or community-based care may not meet the high level of care that some intellectually disabled individuals require. These closures may not directly affect a majority of the Iowan population, but that is no excuse for Iowa legislators to ignore the basic human necessities of intellectually disabled Iowans. The state should create more care facilities that are local, properly staffed, and regulated, so patients receive adequate medical care, avoid mistreatment and abuse, and families may see their inpatient loved ones more often.