Opinion ID: 1958490
Heading Depth: 1
Heading Rank: 3

Heading: Applicability of Chapters 229A and 229.

Text: A. Standard of review. We review Betsworth's claims regarding the interpretation of chapter 229A and chapter 229 for the correction of errors of law. See In re Detention of Cubbage, 671 N.W.2d 442, 444 (Iowa 2003). In interpreting these statutes, our primary goal is to give effect to the intent of the legislature. See State v. Iowa Dist. Ct. for Black Hawk County, 616 N.W.2d 575, 578 (Iowa 2000). That intent is gleaned from the language of `the statute as a whole, not from a particular part only.' State v. Iowa Dist. Ct. for Monroe County, 630 N.W.2d 778, 781 (Iowa 2001) (citation omitted); accord In re Detention of Swanson, 668 N.W.2d 570, 574 (Iowa 2003). Because we presume the legislature intends  `[a] just and reasonable result,' we interpret statutes to avoid impractical or absurd results. Iowa Dist. Ct. for Black Hawk County, 616 N.W.2d at 578 (citation omitted); accord In re Detention of Swanson, 668 N.W.2d at 574. B. Evidentiary record. Before we discuss the applicability of the civil commitment procedures set forth in chapters 229A and 229, we review the testimony at trial concerning the nature of Betsworth's mental condition and the prospects for treatment. The State presented the testimony of Dr. Dennis Doren, a licensed psychologist with extensive experience working with sex offenders. Based on a short interview with the respondent and a review of the respondent's records, Dr. Doren concluded Betsworth suffered from an organically based problem, in other words, a physiological abnormality of the brain. Although Dr. Doren found it difficult to place a label on Betsworth's condition, the doctor was certain it was real. The witness opined Betsworth's condition was acquired or congenital or both. Dr. Doren believed Betsworth's symptoms revealed very, very significant volitional and emotional capacity problems. He explained the term volitional capacity has to do with the process of making decisions about one's behavior. Emotional capacity refers to the ability to demonstrate a concern for others. Due to these problems, Betsworth would have serious difficulty controlling his behavior, according to this witness. Dr. Doren also believed Betsworth's condition predisposed him to commit sexually violent offenses. Finally, the doctor discussed his risk assessment of Betsworth. Dr. Doren employed three actuarial assessments in which Betsworth scored in the high-risk category on two and in the moderate-risk category on the third. The witness noted Betsworth had not participated in a sex offender treatment program, and the treatment the respondent had been receiving under his chapter 229 commitment had not been successful in lowering the risk of another offense. The final circumstance considered by the doctor was the fact that despite Betsworth's institutionalization, the respondent continued to offend within a controlled environment. Based upon all these factors, Dr. Doren opined that Betsworth was at a high risk to reoffend. A staff member who had been assaulted twice by the respondent also testified. She said that on both occasions, Betsworth laughed and showed no remorse for his actions. A correctional counselor from the Newton Correctional Facility, where Betsworth was confined at the time of trial, gave similar testimony. This witness testified the respondent could be disciplined every day for sexually inappropriate comments or for exposing himself, but it's gotten to the point where nobody takes any disciplinary action on him because it doesn't mean anything. Instead, Betsworth has been placed in lock-up, and his contact with female staff members has been limited due to his inability to control himself. Betsworth called Dr. Jason Smith, the administrator for the civil commitment unit for sexual offenders in Cherokee, to testify. Dr. Smith described the various treatment modalities available at the facility, including cognitive therapy, relapse prevention, individual therapy, and medication management. The witness acknowledged that, from the record, it appeared the respondent would probably not benefit greatly from traditional cognitive therapy. Therefore, he concluded, [w]e would probably use more of the behavioral components in treating Betsworth. Dr. Smith acknowledged it seemed the respondent would have difficulty in group therapy, but stated he could not say for sure until he actually saw how the respondent would manifest his symptoms in that setting. Finally, Dr. Smith stated that all treatment, including medication management, would be individualized for the respondent. C. Applicability of chapter 229A. Betsworth claims chapter 229A does not apply to a person who suffers from a physiological mental defect and is not amenable to sex offender treatment. We begin with a brief review of the pertinent provisions of chapter 229A. Iowa Code chapter 229A sets up a civil commitment procedure for the long-term care and treatment of the sexually violent predator. Iowa Code § 229A.1, para. 2. The statute defines a sexually violent predator as a person who has been convicted of or charged with a sexually violent offense and who suffers from a mental abnormality which makes the person likely to engage in predatory acts constituting sexually violent offenses, if not confined in a secure facility. Id. § 229A.2(11). A mental abnormality is a congenital or acquired condition affecting the emotional or volitional capacity of a person and predisposing that person to commit sexually violent offenses to a degree which would constitute a menace to the health and safety of others. Id. § 229A.2(5). This definition places no limitation on the nature of the condition that may qualify as a mental abnormality. See In re Detention of Barnes, 689 N.W.2d 455, 458-59 (Iowa 2004) (holding the types of conditions that can serve to establish a `mental abnormality' are not limited to certain recognized diagnoses). Thus, the term mental abnormality appears to include an organic condition such as that from which Betsworth suffers, provided the condition meets the other requirements of the statutory definition of mental abnormality. See id. (What is important is that the statute requires the condition to be congenital or acquired and to affect the emotional or volitional capacity of the person subject to commitment.). Betsworth claims, however, that the definition of mental abnormality cannot be read so broadly. He relies on section 229A.1, which states in part: The general assembly finds that a small but extremely dangerous group of sexually violent predators exists which is made up of persons who do not have a mental disease or defect that renders them appropriate for involuntary treatment pursuant to the treatment provisions for mentally ill persons under chapter 229, since that chapter is intended to provide short-term treatment to persons with serious mental disorders and then return them to the community. In contrast to persons appropriate for civil commitment under chapter 229, sexually violent predators generally have antisocial personality features that are unamenable to existing mental illness treatment modalities and that render them likely to engage in sexually violent behavior. Iowa Code § 229A.1, para. 1 (emphasis added). Based on these legislative findings, the respondent contends that persons who have a mental disease or defect that causes their behavior are appropriate for commitment under chapter 229, whereas offenders who have antisocial personality features and a mental abnormality that influence their behavior are appropriately committed under chapter 229A. The rationale for this distinction, according to Betsworth, is that persons who have a mental disease or defect cannot appreciate the wrongfulness of their conduct, and consequently, cannot meaningfully participate in, or benefit from, cognitive behavioral therapy. In contrast, sexually violent predators, he claims, are fully aware that what they have done is wrong, and can fully and meaningfully participate in and benefit from cognitive behavioral treatment. We are not persuaded the distinction suggested by the respondent was intended by the legislature. In adopting chapter 229A, the legislature was not concerned with persons who do not have a mental disease or defect, but with persons who do not have a mental disease or defect that renders them appropriate for involuntary treatment pursuant to [chapter 229]. Id. § 229A.1, para. 1 (emphasis added). In other words, the sexually violent predator was viewed as a person who has a mental disease or defect but who could benefit from a more specialized treatment program than usually found in institutions treating the general population of mentally ill persons. Moreover, the legislature did not find that all sexually violent predators have a mental disorder with antisocial personality features; it said, sexually violent predators generally have antisocial personality features. Id. (emphasis added). Thus, the definition of mental abnormality, which does not exclude organic conditions and which does not require the condition to include antisocial personality features, is fully consistent with the legislative findings. Consequently, the district court did not err in relying on the plain meaning of the statutory definitions in concluding chapter 229A encompasses a condition such as that exhibited by the respondent. We also disagree with the respondent's thought that chapter 229A requires that the person committed be amenable to the long-term cognitive behavioral treatment principally used to treat sex offenders. It is true the legislative findings refer to the treatment modalities for the sexually violent predator being very different from the traditional treatment modalities available. . . for persons appropriate for commitment under chapter 229. See id. § 229A.1, para. 2. The legislature also stated that [t]he procedures . . . should . . . provid[e] treatment services designed to benefit sexually violent predators who are civilly committed [and][t]he procedures should . . . encourage full, meaningful participation of sexually violent predators in treatment programs. Id. But the legislature did not limit the types of treatment modalities or programs that should or could be provided to persons committed under chapter 229A. See id. § 229A.7(4) (stating the respondent shall be committed to the custody of the director . . . for control, care, and treatment). Thus, the State is free to provide individualized treatment for sexually violent predators. Such treatment may or may not include cognitive behavioral therapy and may or may not include treatment that would also be available under chapter 229. We conclude, therefore, that chapter 229A encompasses sexually violent predators who, like Betsworth, will not benefit greatly from cognitive behavioral therapy and must instead be treated with other modalities. D. Exclusivity of chapter 229. Betsworth also argues the civil commitment statute for the mentally ill, chapter 229, provides the exclusive procedure for the involuntary commitment of mentally ill persons. He relies on section 229.26, which states in pertinent part: Sections 229.6 through 229.19 constitute the exclusive procedure for involuntary hospitalization of persons by reason of serious mental impairment in this state, with certain exceptions not implicated here. Id. § 229.26 (emphasis added). Betsworth points out that although the legislature excluded certain proceedings from the procedural requirements of chapter 229, chapter 229A commitment proceedings were not among the exceptions. Persons who are seriously mentally impaired, as defined in section 229.1(15), may be involuntarily hospitalized under chapter 229. Id. § 229.13(1). Sections 229.6 through 229.19 set forth the procedural steps that must be followed for an involuntary commitment under chapter 229. Thus, the statement in section 229.26 upon which the respondent relies simply means that these procedures must be followed, with certain exceptions, in order to involuntarily hospitalize a person based on the person's serious mental impairment. But Betsworth is not being committed because he has a serious mental impairment; his commitment rests on a mental abnormality that predisposes him to commit sexually violent offenses, as defined in chapter 229A. Chapter 229A has its own procedures for commitment. Thus, the exclusive procedures of chapter 229 are simply not applicable to a commitment pursued under chapter 229A.