Title: Waupaca County v. K.E.K.

State: wisconsin

Issuer: Wisconsin Supreme Court

Document:

2021 WI 9 
 
SUPREME COURT OF WISCONSIN 
 
 
 
 
 
CASE NO.: 
2018AP1887 
 
 
 
COMPLETE TITLE: 
In the matter of the mental commitment of 
K.E.K.: 
 
Waupaca County, 
          Petitioner-Respondent, 
     v. 
K.E.K., 
          Respondent-Appellant-Petitioner. 
 
 
 
 
 
REVIEW OF DECISION OF THE COURT OF APPEALS 
Reported at 389 Wis. 2d 104,936 N.W.2d 405 
(2019 – unpublished) 
 
 
OPINION FILED: 
February 9, 2021   
SUBMITTED ON BRIEFS: 
        
ORAL ARGUMENT: 
November 17, 2020   
 
 
SOURCE OF APPEAL: 
 
 
COURT: 
Circuit   
 
COUNTY: 
Waupaca   
 
JUDGE: 
Vicki L. Clussman   
 
 
 
JUSTICES: 
 
ZIEGLER, J., delivered the majority opinion of the Court, in 
which ROGGENSACK, C.J., ANN WALSH BRADLEY, REBECCA GRASSL 
BRADLEY, and HAGEDORN, JJ., joined.  DALLET, J., filed a 
dissenting opinion, in which KAROFSKY, J., joined 
NOT PARTICIPATING: 
        
 
 
 
ATTORNEYS: 
 
For the respondent-appellant-petitioner, there were briefs 
filed by Colleen D. Ball, assistant state public defender. There 
was an oral argument by Colleen D. Ball. 
 
For the petitioner-respondent, there was a brief filed by 
David G. Been, Waupaca corporation counsel. There was an oral 
argument by David G. Been. 
2021 WI 9 
 
NOTICE 
This opinion is subject to further 
editing and modification.  The final 
version will appear in the bound 
volume of the official reports.   
No.   2018AP1887 
(L.C. No. 
2017ME44) 
STATE OF WISCONSIN  
 
 
   : 
IN SUPREME COURT 
 
 
In the matter of the mental commitment of 
K.E.K.: 
 
Waupaca County, 
 
          Petitioner-Respondent, 
 
     v. 
 
K.E.K., 
 
          Respondent-Appellant-Petitioner. 
 
FILED 
 
FEB 9, 2021 
 
Sheila T. Reiff 
Clerk of Supreme Court 
 
 
 
 
ZIEGLER, J., delivered the majority opinion of the Court, in 
which ROGGENSACK, C.J., ANN WALSH BRADLEY, REBECCA GRASSL 
BRADLEY, and HAGEDORN, JJ., joined.  DALLET, J., filed a 
dissenting opinion, in which KAROFSKY, J., joined. 
 
 
REVIEW of a decision of the Court of Appeals.  Affirmed.   
 
¶1 
ANNETTE KINGSLAND ZIEGLER, J.   This is a review of an 
unpublished decision of the court of appeals, Waupaca Cnty. v. 
K.E.K., No. 2018AP1887, unpublished slip op. (Wis. Ct. App. 
Sept. 26, 2020), affirming the Waupaca County circuit court's1 
                                                 
1 The Honorable Vicki L. Clussman presided. 
No. 
2018AP1887   
 
2 
 
order extending K.E.K.'s involuntary commitment2 pursuant to Wis. 
Stat. § 51.20(13)(g)3. (2017-18).3   
¶2 
K.E.K. challenges the commitment extension arguing 
that Wis. Stat. § 51.20(1)(am), the statute upon which the 
County relied to prove K.E.K.'s dangerousness, is both facially 
unconstitutional and unconstitutional as applied to this case 
because the statute does not require a sufficient showing of 
current 
dangerousness 
as 
exhibited 
by 
recent 
acts 
of 
dangerousness.4  Specifically, she claims that the standard under 
                                                 
2 Wisconsin Stat. § 51.20, as well as the case law, uses 
"recommitment" and "extension of a commitment" interchangeably, 
and we do as well.  See Portage Cnty. v. J.W.K., 2019 WI 54, ¶1 
n.1, 386 Wis. 2d 672, 927 N.W.2d 509; see also Wis. Stat. 
§§ 51.20(13)(g)2r., 3.   
3 All subsequent references to the Wisconsin Statutes are to 
the 2017-18 version unless otherwise indicated. 
4 We note that K.E.K.'s petition for review also included a 
question involving the circuit court's competency to exercise 
subject matter jurisdiction over K.E.K.'s extension proceeding.  
However, K.E.K. did not develop, nor discuss in any way, this 
argument in her briefs.  Accordingly, we will not consider it.  
See Serv. Emp. Int'l Union, Loc. 1 v. Vos, 2020 WI 67, ¶24, 393 
Wis. 2d 38, 946 N.W.2d 35 ("We do not step out of our neutral 
role to develop or construct arguments for parties; it is up to 
them to make their case.").   
No. 
2018AP1887   
 
3 
 
§ 51.20(1)(am) violates due process5 and equal protection of the 
laws6 and is thus unconstitutional on its face and as applied.7   
¶3 
However, 
similar 
to 
an 
initial 
commitment, 
a 
recommitment requires a showing of mental illness and current 
dangerousness.  A recommitment petition must "establish the same 
elements with the same quantum of proof" as an initial 
commitment.  Waukesha Cnty. v. J.W.J., 2017 WI 57, ¶20, 375 
                                                 
5 K.E.K. specifically alleges that Wis. Stat. § 51.20(1)(am) 
violates substantive due process.  Substantive due process 
derives from the Fifth and Fourteenth Amendments to the United 
States Constitution.  See U.S. Const. amend. V ("No person 
shall . . . be deprived of life, liberty, or property, without 
due process of law."); amend. XIV, § 1 ("[N]or shall any State 
deprive any person of life, liberty, or property, without due 
process of law.").  "Substantive due process provides protection 
from 'certain arbitrary, wrongful government actions.'"  State 
ex rel. Greer v. Wiedenhoeft, 2014 WI 19, ¶57, 353 Wis. 2d 307, 
845 N.W.2d 373 (quoting State v. Schulpius, 2006 WI 1, ¶33, 287 
Wis. 2d 44, 707 N.W.2d 495).   
6 The right to equal protection of the laws arises from the 
Fourteenth Amendment to the United States Constitution.  See 
U.S. Const. amend. XIV, § 1 ("No State shall . . . deny to any 
person within its jurisdiction the equal protection of the 
laws.").  
7 K.E.K. 
also 
asserts 
that 
Wis. 
Stat. 
§ 51.20(1)(am) 
violates the Privileges or Immunities Clause of the Fourteenth 
Amendment.  The Privileges or Immunities Clause provides, "No 
State shall make or enforce any law which shall abridge the 
privileges or immunities of citizens of the United States."  
U.S. Const. amend. XIV, § 1.  K.E.K. asserts that "when [her] 
brief invokes substantive due process, she is also invoking the 
Privileges 
or 
Immunities 
Clause." 
 
Beyond 
this 
cursory 
statement, she does not develop her argument based on the text 
and 
history 
of 
the 
Privileges 
or 
Immunities 
Clause.  
Accordingly, we will not develop this argument and decline to 
entertain K.E.K.'s Privileges or Immunities Clause claims.  See 
Vos, 393 Wis. 2d 38, ¶24. 
No. 
2018AP1887   
 
4 
 
Wis. 2d 542, 895 N.W.2d 783.  The initial commitment requires 
proof that the individual is mentally ill, a proper subject for 
treatment, and currently dangerous.  See Wis. Stat. § 51.20(1); 
Portage Cnty. v. J.W.K., 2019 WI 54, ¶16, 386 Wis. 2d 672, 927 
N.W.2d 509.  Section 51.20(1)(am) provides an alternative path 
to 
prove 
current 
dangerousness 
provided 
the 
evidence 
demonstrates "a substantial likelihood, based on the subject 
individual's treatment record, that the individual would be a 
proper subject for commitment if treatment were withdrawn."  
§ 51.20(1)(am).   
¶4 
Accordingly, we conclude that K.E.K. is unable to 
prove that Wis. Stat. § 51.20(1)(am) cannot be enforced under 
any circumstances because due process and the statute both 
require a showing of mental illness and current dangerousness.  
As such, K.E.K.'s facial due process challenge fails.  
¶5 
Moreover, 
Wis. 
Stat. 
§ 51.20(1)(am) 
creates 
an 
alternative path to give counties a more realistic basis by 
which to prove current dangerousness when it is likely the 
committed individual would discontinue treatment if no longer 
committed.  Thus, the state has a rational basis for treating 
those recommitted under § 51.20(1)(am) and those committed under 
§ 51.20(1)(a)2.e. differently.  
¶6 
Finally, K.E.K.'s as-applied constitutional challenges 
are disguised sufficiency of the evidence challenges.  Her 
argument is that she does not meet the statutory standard for 
dangerousness, 
not 
that 
Wis. 
Stat. 
§ 51.20(1)(am) 
is 
unconstitutional when applied to K.E.K.'s specific facts.  
No. 
2018AP1887   
 
5 
 
¶7 
Therefore, we conclude that Wis. Stat. § 51.20(1)(am) 
is 
facially 
constitutional 
and 
that 
K.E.K.'s 
as-applied 
constitutional challenges fail.  Accordingly, we affirm the 
decision of the court of appeals.    
 
I.  FACTUAL BACKGROUND AND PROCEDURAL POSTURE 
¶8 
On November 22, 2017, Waupaca County (the County) 
filed an initial petition seeking to commit K.E.K. under Wis. 
Stat. § 51.20(1)(a)2.e., the "fifth standard."8  On December 8, 
                                                 
8 The "fifth standard" provides that "an individual, other 
than an individual who is alleged to be drug dependent or 
developmentally disabled," is considered "dangerous" if: 
after 
the 
advantages 
and 
disadvantages 
of 
and 
alternatives to accepting a particular medication or 
treatment have been explained to him or her and 
because 
of 
mental 
illness, 
evidences 
either 
incapability of expressing an understanding of the 
advantages and disadvantages of accepting medication 
or treatment and the alternatives, or substantial 
incapability of applying an understanding of the 
advantages, disadvantages, and alternatives to his or 
her mental illness in order to make an informed choice 
as to whether to accept or refuse medication or 
treatment; and evidences a substantial probability, as 
demonstrated 
by 
both 
the 
individual's 
treatment 
history and his or her recent acts or omissions, that 
the individual needs care or treatment to prevent 
further disability or deterioration and a substantial 
probability that he or she will, if left untreated, 
lack services necessary for his or her health or 
safety and suffer severe mental, emotional or physical 
harm that will result in the loss of the individual's 
ability to function independently in the community or 
the loss of cognitive or volitional control over his 
or her thoughts or actions.  The probability of 
suffering severe mental, emotional or physical harm is 
not substantial under this subd.2.e. if reasonable 
provision for the individual's care or treatment is 
available in the community and there is a reasonable 
No. 
2018AP1887   
 
6 
 
2017, the circuit court held a jury trial on the County's 
petition for initial commitment.  The jury entered the verdict 
that K.E.K. was mentally ill, a danger to herself and others, 
and a proper subject for treatment.  On the basis of this jury 
verdict, the circuit court entered an Order of Commitment, 
committing K.E.K. for six months.   
¶9 
On May 22, 2018, the County filed a petition seeking 
to extend K.E.K.'s commitment.  The petition alleged: (1) K.E.K. 
was "currently under an order of commitment"; (2) K.E.K. was 
"mentally ill, developmentally disabled or drug dependent, and a 
proper subject for treatment"; (3) K.E.K. was "dangerous because 
there [was] a substantial likelihood, based on [K.E.K.'s] 
treatment record, that [K.E.K.] would be a proper subject for 
commitment if treatment were withdrawn"; and (4) that "a 
recommitment 
of 
[K.E.K. 
was] 
recommended . . . for 
the 
protection of society, [K.E.K.], or both."  Attached to the 
petition was an evaluation conducted by K.E.K.'s case manager.  
                                                                                                                                                             
probability that the individual will avail himself or 
herself of these services or if the individual is 
appropriate for protective placement under ch. 55. 
Food, shelter or other care that is provided to an 
individual who is substantially incapable of obtaining 
food, shelter or other care for himself or herself by 
any person other than a treatment facility does not 
constitute reasonable provision for the individual's 
care 
or 
treatment 
in 
the 
community 
under 
this 
subd.2.e.  The individual's status as a minor does not 
automatically establish a substantial probability of 
suffering severe mental, emotional, or physical harm 
under this subd.2.e. 
Wis. Stat. § 51.20(1)(a)2.e. 
No. 
2018AP1887   
 
7 
 
In this evaluation, K.E.K.'s case manager states, in part, "[A]t 
this time, this worker believes that without a commitment, 
[K.E.K.] would leave the facility she is living at, stop taking 
her medications, and repeat all behaviors that were the cause of 
the filing for the commitment in 2017."   
¶10 The circuit court held a hearing on the extension 
petition on June 6, 2018.9   At the hearing, the court heard from 
the County's psychiatrist, who testified that K.E.K. "suffers 
from schizophrenia, paranoid type."  He further opined about 
K.E.K.'s actions if K.E.K. were no longer committed: 
Well, I've explained I do believe she's improved 
with her current treatment interventions care and safe 
keeping at this group home, Evergreen and with 
medications.  But she has distinctive lack of insight 
into her mental illness and that impedes her treatment 
in general. 
And so if she is off commitment or if treatment 
is 
withdrawn, 
she 
will, 
in 
my 
opinion, 
almost 
certainly stop her medications, she will almost 
certainly leave Evergreen.  She mentioned to me that 
she would live with family in Illinois, but her mother 
cited advancing age, and just being uncomfortable with 
the stress of this, due to her mother's age.  So I 
don't think she has any kind of set housing set-up.  
And I'm concerned that off mediations, which I believe 
she would stop them, and without stable housing, she 
would decompensate and become a proper subject for 
commitment, in my opinion, again. 
The court also heard from K.E.K.'s case manager.  She testified 
that she believed "an extension is warranted because without the 
treatment 
and 
care 
that 
[K.E.K.'s] 
receiving 
                                                 
9 The day before the extension hearing, K.E.K. waived her 
right to a jury trial, instead opting for a bench trial.  
No. 
2018AP1887   
 
8 
 
currently, . . . [K.E.K.] will no longer take her medications, 
become more unstable, and potentially [sic] a danger to herself 
as a result of that."  The court also heard from the manager of 
K.E.K.'s group home and K.E.K. herself.   
¶11 At the conclusion of the testimony, the circuit court 
found that K.E.K. would be a proper subject for recommitment.  
The court specifically found that "the county has met its 
burdens in showing that if treatment were withdrawn, that 
[K.E.K.] would be a proper subject for a commitment."  Relying 
on the recommitment standard from Wis. Stat. § 51.20(1)(am), the 
court found that K.E.K. was currently dangerous and ordered her 
commitment be extended for 12 months.   
¶12 K.E.K. 
appealed 
the 
circuit 
court's 
commitment 
extension order, challenging the constitutionality of Wis. Stat. 
§ 51.20(1)(am).  On September 26, 2019, the court of appeals 
affirmed, holding, in relevant part, that § 51.20(1)(am) does 
not violate due process facially nor as applied to K.E.K.  
K.E.K., No. 2018AP1887, ¶¶33-40, 46-50.  
¶13 On October 30, 2019, K.E.K. petitioned this court for 
review.  We held the petition in abeyance pending resolution of 
Winnebago County v. C.S., 2020 WI 33, 391 Wis. 2d 35, 940 
N.W.2d 875.  After this court's decision in C.S., K.E.K. filed a 
motion to amend her petition for review.  Her new petition 
alleged that Wis. Stat. § 51.20(1)(am) violated due process, the 
No. 
2018AP1887   
 
9 
 
Fourteenth Amendment's Privileges or Immunities Clause,10 and the 
Equal Protection Clause.  We granted K.E.K.'s motion to amend 
her petition and granted review.  
 
II.  STANDARD OF REVIEW 
¶14 K.E.K. brings facial and as-applied constitutional 
challenges to Wis. Stat. § 51.20(1)(am).  A facial challenge 
claims the law is "unconstitutional on its face."  League of 
Women Voters of Wis. Educ. Network, Inc. v. Walker, 2014 WI 97, 
¶13, 357 Wis. 2d 360, 851 N.W.2d 302 (quoting State v. Wood, 
2010 WI 17, ¶13, 323 Wis. 2d 321, 780 N.W.2d 63).  "Under a 
facial challenge, the challenger must show that the law cannot 
be enforced under any circumstances."  C.S., 391 Wis. 2d 35, ¶14 
(quoting Winnebago Cnty. v. Christopher S., 2016 WI 1, ¶34, 366 
Wis. 2d 1, 878 N.W.2d 109).  A statute under review is presumed 
constitutional when challenged facially.11  Id. 
                                                 
10 As we stated above, K.E.K. did not develop this argument, 
and we do not address her Privileges or Immunities Clause claim.  
See supra, ¶2 n.7.  
11 The parties dispute what burden of proof must be shown to 
prove a statute is unconstitutional.  Relying on this court's 
precedent, the County argues that K.E.K. must prove the statute 
is unconstitutional beyond a reasonable doubt.  See Winnebago 
Cnty. v. C.S., 2020 WI 33, ¶14, 391 Wis. 2d 35, 940 N.W.2d 875; 
Mayo v. Wis. Injured Patients & Families Comp. Fund, 2018 WI 78, 
¶27, 
383 
Wis. 2d 1, 
914 
N.W.2d 67. 
 
Relying 
on 
federal 
precedent, K.E.K. counters and argues that she must only make a 
"plain showing" or "clearly demonstrate" that the law violates 
the federal Constitution.  See United States v. Morrison, 529 
U.S. 598, 607 (2000); Nat'l Fed'n of Indep. Bus. v. Sebelius, 
567 U.S. 519, 538 (2012).  We need not resolve this dispute in 
this case because the law is constitutional under either 
standard.  
No. 
2018AP1887   
 
10 
 
¶15 "In contrast, in an as-applied challenge, we assess 
the merits of the challenge by considering the facts of the 
particular case in front of us 'not hypothetical facts in other 
situations.'"  League of Women Voters, 357 Wis. 2d 360, ¶13 
(quoting Wood, 323 Wis. 2d 321, ¶13).  "[W]hile we presume the 
statute is constitutional, 'we do not presume that the State 
applies statutes in a constitutional manner.'"  Mayo v. Wis. 
Injured Patients & Families Comp. Fund, 2018 WI 78, ¶56, 383 
Wis. 2d  1, 914 N.W.2d 678 (quoting Tammy W-G. v. Jacob T., 2011 
WI 30, ¶48, 333 Wis. 2d 273, 797 N.W.2d 854).   
¶16 Under either type of challenge, "the constitutionality 
of a statute is a question of law we review de novo."  C.S., 391 
Wis. 2d 35, ¶13.   
¶17 K.E.K.'s argument requires us to interpret Wis. Stat. 
§ 51.20(1)(am).  "[S]tatutory interpretation is a question of 
law we review de novo."  J.W.K., 386 Wis. 2d 672, ¶10.  However, 
we have already interpreted § 51.20(1)(am).  See id., ¶¶19, 23-
24.  "[W]here a statute has been authoritatively interpreted by 
this court, the party challenging that interpretation must 
establish 
that 
our 
prior 
interpretation 
was 
'objectively 
wrong.'"  State v. Breitzman, 2017 WI 100, ¶5 n.4, 378 
Wis. 2d 431, 904 N.W.2d 93; see also Johnson Controls, Inc. v. 
Emp'rs Ins. of Wausau, 2003 WI 108, ¶94, 264 Wis. 2d 60, 665 
N.W.2d 257; Progressive N. Ins. Co. v. Romanshek, 2005 WI 67, 
¶45, 281 Wis. 2d 300, 697 N.W.2d 417.   
 
No. 
2018AP1887   
 
11 
 
III.  ANALYSIS 
¶18 K.E.K. is challenging her recommitment on the basis 
that Wis. Stat. § 51.20(1)(am) is unconstitutional facially and 
as 
applied. 
 
Section 
51.20 
"governs 
involuntary 
civil 
commitments for mental health treatment."  State v. Dennis H., 
2002 WI 104, ¶14, 255 Wis. 2d 359, 647 N.W.2d 851.  The statute 
"contains 
five 
different 
definitions 
or 
standards 
of 
dangerousness for purposes" of an initial commitment.  Id.; 
see also § 51.20(1)(a)2.a.-e.  After an initial commitment, a 
county can seek an extension of a commitment for "a period not 
to exceed one year."  § 51.20(13)(g)1., 3.  At a recommitment 
proceeding, a county may prove current dangerousness under 
either 
the 
five 
standards 
of 
dangerousness 
under 
§ 51.20(1)(a)2.a.-e. 
or 
under 
those 
five 
standards 
in 
combination with § 51.20(1)(am).  J.W.K., 386 Wis. 2d 672, ¶18; 
Langlade Cnty. v. D.J.W., 2020 WI 41, ¶50, 391 Wis. 2d 231, 942 
N.W.2d 277.  Pursuant to § 51.20(1)(am), a county has an 
alternative avenue for proving dangerousness at an extension 
proceeding: 
If the individual has been the subject of inpatient 
treatment for mental illness . . . immediately prior 
to commencement of the proceedings as a result 
of . . . a commitment or protective placement ordered 
by a court under this section . . . the requirements 
of a recent overt act, attempt or threat to act under 
par. (a)2.a. or b., pattern of recent acts or 
omissions under par. (a)2.c. or e., or recent behavior 
under par. (a)2. d. may be satisfied by a showing that 
there is a substantial likelihood, based on the 
subject 
individual's 
treatment 
record, 
that 
the 
individual would be a proper subject for commitment if 
treatment were withdrawn. 
No. 
2018AP1887   
 
12 
 
Wis. Stat. § 51.20(1)(am).   
¶19 We 
later 
explained 
that 
this 
section 
works 
in 
combination 
with 
the 
five 
standards 
of 
dangerousness, 
specifically focusing on the standard set forth in Wis. Stat. 
§ 51.20(1)(a)2.d.: 
[W]e focus on whether the introduced testimony meets 
the standard for dangerousness set by Wis. Stat. 
§ 51.20(1)(a)2.d., as viewed through the lens of 
§ 51.20(1)(am).  That is, the testimony must provide 
sufficient evidence to support the conclusion that 
D.J.W. would be "unable to satisfy basic needs for 
nourishment, medical care, shelter or safety without 
prompt and adequate treatment so that a substantial 
probability 
exists 
that 
death, 
serious 
physical 
injury, serious physical debilitation, or serious 
physical 
disease 
will 
imminently 
ensue[,]" 
§ 51.20(1)(a)2.d., 
if 
treatment 
were 
withdrawn. 
§ 51.20(1)(am). 
D.J.W., 
391 
Wis. 2d 231, 
¶50. 
 
Accordingly, 
Wis. 
Stat. 
§ 51.20(1)(am) works in combination with the five standards to 
provide 
counties 
with 
an 
alternative 
avenue 
for 
proving 
dangerousness.   
¶20 K.E.K. 
argues 
that 
her 
recommitment 
is 
unconstitutional 
because 
Wis. 
Stat. 
§ 51.20(1)(am):  (A) 
violates her right to due process by allowing her to be 
committed without a showing of current dangerousness; (B) 
violates her right to equal protection of the law by allowing 
commitment under circumstances different than those existing 
under the fifth standard of dangerousness;12 and (C) is 
                                                 
12 This court discussed the requirements for the fifth 
standard in Dennis H., stating:  
No. 
2018AP1887   
 
13 
 
unconstitutional as applied to the specific facts of her case.  
We disagree and uphold the statute against her due process, 
equal protection, and as-applied challenges.  
A.  Due Process 
¶21 K.E.K. argues that Wis. Stat. § 51.20(1)(am) violates 
her constitutional right to due process.  K.E.K. asserts that 
§ 51.20(1)(am) 
does 
not 
require 
a 
showing 
of 
current 
dangerousness because it does not require the government to 
prove recent acts or omissions.  However, this position 
misconstrues what § 51.20(1)(am) and due process require.  
Section 51.20(1)(am) is facially constitutional because it 
requires a showing of mental illness and current dangerousness, 
as due process demands.  Accordingly, K.E.K. cannot show that 
§ 51.20(1)(am) "cannot be enforced under any circumstances." 
                                                                                                                                                             
The fifth standard permits commitment only when a 
mentally ill person needs care or treatment to prevent 
deterioration but is unable to make an informed choice 
to accept it.  This must be "demonstrated by both the 
individual's treatment history" and by the person's 
"recent 
acts 
or 
omissions." 
 
Wis. 
Stat. 
§ 51.20(1)(a)2.e. [(1999-2000).]  It must also be 
substantially probable that if left untreated, the 
person "will suffer severe mental, emotional or 
physical harm" resulting in the loss of the "ability 
to function independently in the community" or in the 
loss of "cognitive or volitional control."  Id.  Only 
then may the individual be found "dangerous" under the 
fifth standard. 
State v. Dennis H., 2002 WI 104, ¶39, 255 Wis. 2d 359, 647 
N.W.2d 851. 
No. 
2018AP1887   
 
14 
 
1.  Wisconsin Stat. § 51.20(1)(am) requirements 
¶22 Statutory interpretation "begins with the language of 
the statute."  State ex rel. Kalal v. Circuit Court for Dane 
Cnty., 2004 WI 58, ¶45, 271 Wis. 2d 633, 681 N.W.2d 110 
(internal quotations omitted).  If its meaning is plain, then 
our inquiry ends.  Id.  We give statutory language "its common, 
ordinary, and accepted meaning."  Id.  We give "technical or 
specially-defined words or phrases" their "technical or special 
definitional meaning."  Id.  "Context is important to meaning."  
Id., ¶46.  Accordingly, we interpret statutory language "not in 
isolation but as part of a whole."  Id.  For the whole statute 
to have meaning, we must "give reasonable effect to every word" 
and "avoid surplusage."  Id.   
¶23 However, 
when 
we 
have 
already 
authoritatively 
interpreted 
a 
statute, 
we 
are 
bound 
to 
follow 
that 
interpretation unless there is a special justification to depart 
from our earlier interpretation.  See Johnson Controls, 264 
Wis. 2d 60, ¶94; Progressive N. Ins. Co., 281 Wis. 2d 300, ¶45.  
Because we already interpreted Wis. Stat. § 51.20(1)(am) in 
J.W.K., 
we 
must 
follow 
our 
previous 
interpretation 
of 
§ 51.20(1)(am).   
¶24 As we stated in J.W.K., at a recommitment proceeding, 
"the County may, as an alternative to the options outlined in 
§ 51.20(1)(a)2.a.-e., 
prove 
dangerousness 
by 
showing 
'a 
substantial likelihood, based on the subject individual's 
treatment record, that the individual would be a proper subject 
for commitment if treatment were withdrawn.'"  J.W.K., 386 
No. 
2018AP1887   
 
15 
 
Wis. 2d 672, ¶19.  "[P]aragraph (am) functions as an alternative 
evidentiary 
path, 
reflecting 
a 
change 
in 
circumstances 
occasioned by an individual's commitment and treatment."  Id.   
¶25 However, each recommitment, including those where the 
County utilizes Wis. Stat. § 51.20(1)(am), "requires the County 
to prove the same elements with the same quantum of proof 
required for the initial commitment."  Id., ¶24.  An initial 
commitment requires a county to prove that the individual is 
mentally ill, a proper subject for commitment, and currently 
dangerous.  See § 51.20(1); J.W.K., 386 Wis. 2d 672, ¶16.  We 
explained that: 
The dangerousness standard is not more or less onerous 
during an extension proceeding; the constitutional 
mandate that the County prove an individual is both 
mentally ill and dangerous by clear and convincing 
evidence remains unaltered.  Each extension hearing 
requires proof of current dangerousness.  It is not 
enough that the individual was at one point a proper 
subject for commitment.  The County must prove the 
individual "is dangerous."  The alternate avenue of 
showing dangerousness under paragraph (am) does not 
change the elements or quantum of proof required.  It 
merely acknowledges that an individual may still be 
dangerous 
despite 
the 
absence 
of 
recent 
acts, 
omissions, 
or 
behaviors 
exhibiting 
dangerousness 
outlined in § 51.20(1)(a)2.a.-e. 
J.W.K., 386 Wis. 2d 672, ¶24 (citations omitted).  
¶26 Accordingly, 
as 
we 
authoritatively 
determined 
in 
J.W.K., Wis. Stat. § 51.20(1)(am) merely provides an alternative 
path for the County to prove current dangerousness——it does not 
change the requirement that the County prove, by clear and 
convincing evidence, that the individual is mentally ill, a 
No. 
2018AP1887   
 
16 
 
proper subject for treatment, and currently dangerous.  Id.  We 
reaffirm that determination.  
2.  Due process and commitment proceedings 
¶27 The 
Constitution 
forbids 
the 
government 
from 
"depriv[ing] any person of life, liberty, or property, without 
due process of law."  U.S. Const. amend. V (applying the 
prohibition 
to 
the 
federal 
government); 
amend. 
XIV, 
§ 1 
(applying the same to the States).  "[C]ommitment for any 
purpose constitutes a significant deprivation of liberty that 
requires due process protection."  J.W.K., 386 Wis. 2d 672, ¶16.  
As we stated last term, "in a civil commitment case, due process 
requires the [government] to prove by clear and convincing 
evidence 
that 
the 
individual 
is 
both 
mentally 
ill 
and 
dangerous."  Marathon Cnty. v. D.K., 2020 WI 8, ¶29, 390 
Wis. 2d 50, 937 N.W.2d 901.   
¶28 The United States Supreme Court established that, 
before the government can commit someone and deprive that person 
of liberty, "the [government] must prove by clear and convincing 
evidence that [the individual] is demonstrably dangerous to the 
community."  Foucha v. Louisiana, 504 U.S. 71, 81 (1992).  
K.E.K. asserts that this means the County must use recent acts 
or omissions to prove she is "demonstrably dangerous."  However, 
no such requirement appears in Foucha, nor has the Court ever 
required 
a 
specific 
type 
of 
evidence 
to 
prove 
current 
dangerousness.  Indeed, "[i]n this complicated and difficult 
area, the Supreme Court 'has wisely left the job of creating 
statutory definitions to the legislators who draft state laws.'"  
No. 
2018AP1887   
 
17 
 
Dennis H., 255 Wis. 2d 359, ¶38 (quoting State v. Post, 197 
Wis. 2d 279, 304, 541 N.W.2d 115 (1995)).  As such, we decline 
to create, from whole-cloth, a constitutional requirement that a 
county use recent acts or omissions at a commitment extension 
proceeding.  Instead, we rely on the options the legislature 
provided to the counties to prove current dangerousness——the 
five standards from Wis. Stat. § 51.20(1)(a)2.a.-e. and the 
alternative evidentiary path from § 51.20(1)(am).  It is the 
definitions and requirements the legislature chose that must 
comport with due process, not the novel requirement that K.E.K. 
proposes.  
3.  Wisconsin Stat. § 51.20(1)(am) satisfies due process. 
¶29 To satisfy due process, the government must prove that 
the individual is both mentally ill and currently dangerous by 
clear and convincing evidence.  See Foucha, 504 U.S. at 81.  We 
have held that, at a recommitment proceeding, a county must meet 
this due process standard.  J.W.K., 386 Wis. 2d 672, ¶24.  Thus, 
to succeed on a due process claim here, K.E.K. must prove that 
Wis. Stat. § 51.20(1)(am) does not require a showing of current 
dangerousness.  K.E.K. cannot do so because, as this court 
unanimously recognized, § 51.20(1)(am) creates an alternative 
No. 
2018AP1887   
 
18 
 
evidentiary path to prove current dangerousness.  See J.W.K., 
386 Wis. 2d 672, ¶¶24, 34.13   
¶30 Therefore, because Wis. Stat. § 51.20(1)(am) requires 
proof of current dangerousness, it satisfies the Due Process 
Clause's requirements.  Accordingly, K.E.K. cannot show that 
§ 51.20(1)(am) violates Due Process in all applications, so her 
facial challenge fails.  
B.  Equal Protection 
¶31 K.E.K. also alleges that Wis. Stat. § 51.20(1)(am) 
violates her constitutional right to equal protection of the 
laws by allowing for commitment under different standards than a 
commitment under the fifth standard, § 51.20(1)(a)2.e.  However, 
the state14 has a rational basis for allowing these different 
evidentiary standards.  Accordingly, K.E.K.'s facial equal 
protection claim fails.  
¶32 K.E.K. claims that those recommitted under Wis. Stat. 
§ 51.20(1)(am) and those committed under the fifth standard are 
similarly situated, but that a county may commit someone under 
                                                 
13 The majority opinion in J.W.K. stated that "[e]ach 
extension 
hearing 
requires 
proof 
of 
current 
dangerousness . . . . The County must prove the individual 'is 
dangerous.'  The alternate avenue of showing dangerousness under 
paragraph (am) does not change the elements or quantum of proof 
required."  J.W.K., 386 Wis. 2d 672, ¶24 (citations omitted).  
Similarly, the dissent described Wis. Stat. § 51.20(1)(am) as 
"creating 
an 
alternative 
path 
to 
prove 
current 
dangerousness . . . ."  Id., ¶35 (Dallet, J., dissenting).  
14 Although it is the counties who file petitions under Wis. 
Stat. § 51.20, the state created the commitment scheme via 
statute.  Accordingly, the state must possess a rational basis 
for any differential treatment, not the counties.  
No. 
2018AP1887   
 
19 
 
§ 51.20(1)(am) without proving the elements that we held are 
necessary for a commitment under the fifth standard.15  K.E.K. 
argues that the state does not have a rational basis for 
requiring these elements for an initial commitment under the 
fifth standard and a recommitment under § 51.20(1)(am).  Thus, 
she 
asserts, 
§ 51.20(1)(am) 
violates 
her 
right 
to 
equal 
protection of the laws.  
¶33 "To prove an equal protection clause violation, the 
party challenging a statute's constitutionality must show that 
'the state unconstitutionally treats members of similarly 
situated classes differently.'"  State v. West, 2011 WI 83, ¶90, 
336 Wis. 2d 578, 800 N.W.2d 929 (quoting Post, 197 Wis. 2d at 
318).  However, "[t]he right to equal protection does not 
require 
that 
such 
similarly 
situated 
classes 
be 
treated 
identically, but rather requires that the distinction made in 
treatment 
have 
some 
relevance 
to 
the 
purpose 
for 
which 
                                                 
15 We described these necessary elements for a commitment 
under the fifth standard in Dennis H.: 
The fifth standard permits commitment only when a 
mentally ill person needs care or treatment to prevent 
deterioration but is unable to make an informed choice 
to accept it.  This must be "demonstrated by both the 
individual's treatment history" and by the person's 
"recent 
acts 
or 
omissions." 
 
It 
must 
also 
be 
substantially probable that if left untreated, the 
person "will suffer severe mental, emotional or 
physical harm" resulting in the loss of the "ability 
to function independently in the community" or in the 
loss of "cognitive or volitional control." 
Dennis H., 255 Wis. 2d 359, ¶39 (citation omitted).  
No. 
2018AP1887   
 
20 
 
classification of the classes is made."  Id.  Thus, the first 
step in an equal protection claim is to identify similarly 
situated, yet differently treated individuals.  See Dennis H., 
255 Wis. 2d 359, ¶31; Post, 197 Wis. 2d at 318-19.  The second 
step is to determine if the government has an appropriate basis 
for the different classifications and treatment.  See Dennis H., 
255 Wis. 2d 359, ¶31.   
¶34 Those committed under Wis. Stat. § 51.20(1)(am) and 
those committed under the fifth standard are similarly situated.  
A county, under either § 51.20(1)(am) or the fifth standard, 
must prove exactly the same underlying elements with the same 
quantum of proof required for commitment.  See J.W.K., 386 
Wis. 2d 672, ¶24 ("The alternate avenue of showing dangerousness 
under paragraph (am) does not change the elements or quantum of 
proof required.  It merely acknowledges that an individual may 
still 
be 
dangerous 
despite 
the 
absence 
of 
recent 
acts, 
omissions, or behaviors exhibiting dangerousness outlined in 
§ 51.20(1)(a)2.a.-e."). 
 
Moreover, 
when 
a 
county 
uses 
§ 51.20(1)(am), it does so in combination with the five 
standards, including when a county commits someone under the 
fifth standard through the lens of § 51.20(1)(am).  See D.J.W., 
391 Wis. 2d 231, ¶50.  That is, the two statutes work in concert 
with each other, so those committed under either section face 
nearly identical elements and restraints.  Accordingly, a person 
facing a commitment under the fifth standard and a person facing 
an extension of a commitment under § 51.20(1)(am) are similarly 
situated.  Cf. Post, 197 Wis. 2d at 318-19 (holding that 
No. 
2018AP1887   
 
21 
 
"persons committed under chapters 51 and 980 are similarly 
situated for purposes of an equal protection comparison").  
¶35 Because 
those 
committed 
under 
Wis. 
Stat. 
§ 51.20(1)(am) and those committed under the fifth standard are 
similarly situated, we must evaluate whether the "statutorily 
distinctive mechanisms for dealing with the two classes was 
proper in light of the difference between the classifications."  
West, 336 Wis. 2d 578, ¶92.  "Whether a legislative distinction 
between otherwise similarly situated persons violates equal 
protection depends upon whether there is a reasonable basis to 
support it."  Dennis H., 255 Wis. 2d 359, ¶31.  "Where the 
classification 
does 
not 
involve 
a 
suspect 
class, 
equal 
protection is denied only if the legislature has made an 
irrational or arbitrary classification."  Id. (quoting State ex 
rel. Jones v. Gerhardstein, 141 Wis. 2d 710, 733, 416 N.W.2d 883 
(1987)).  Describing the power of the state to create different 
classifications, we have stated: 
"[T]he state retains broad discretion to create 
classifications so long as the classifications have a 
reasonable basis."  Under the rational basis test, a 
statutory classification is presumed to be proper.  It 
will be sustained if the reviewing court can identify 
any reasonable basis to support it.  Any doubt must be 
resolved in favor of the reasonableness of the 
classification 
and 
the 
constitutionality 
of 
the 
statute in which it is made.  A "legislative enactment 
must be sustained unless it is 'patently arbitrary' 
and bears no rational relationship to a legitimate 
government interest." 
Dennis 
H., 
255 
Wis. 2d 359, 
¶32 
(citations 
omitted).  
Accordingly, we apply a rational basis level of scrutiny to Wis. 
No. 
2018AP1887   
 
22 
 
Stat. § 51.20(1)(am) and will sustain it if we can identify "any 
reasonable basis to support" the different classifications. 
¶36 We determine that the state has a reasonable basis for 
treating those committed under the fifth standard and those 
committed under Wis. Stat. § 51.20(1)(am) differently.  The 
purpose of § 51.20(1)(am) "is to allow extension of a commitment 
when the patient's condition has not improved enough to warrant 
discharge.  Because of the therapy received, evidence of recent 
action 
exhibiting 
'dangerousness' 
is 
often 
nonexistent. 
Therefore, the emphasis is on the attendant consequence to the 
patient should treatment be discontinued."  M.J. v. Milwaukee 
Cnty. Combined Cmty. Servs. Bd., 122 Wis. 2d 525, 530-31, 362 
N.W.2d 190 (Ct. App. 1984); see also J.W.K., 386 Wis. 2d 672, 
¶23.  Thus, unlike the fifth standard, § 51.20(1)(am) applies 
only to patients that are already receiving treatment.  By 
enacting this alternative means of showing dangerousness, the 
legislature conceivably could have wanted——and likely did want——
to give counties a more realistic basis by which to prove 
current dangerousness when it is likely the committed individual 
would discontinue treatment if no longer committed.  See J.W.K., 
386 Wis. 2d 672, ¶24 ("[Wisconsin Stat. § 51.20(1)(am)] merely 
acknowledges that an individual may still be dangerous despite 
the absence of recent acts, omissions, or behaviors exhibiting 
dangerousness outlined in § 51.20(1)(a)2.a.-e.").  As the court 
of appeals previously explained: 
 
No. 
2018AP1887   
 
23 
 
The clear intent of the legislature in amending [Wis. 
Stat. § 51.20(1)(am)] was to avoid the "revolving 
door" phenomena whereby there must be proof of a 
recent overt act to extend the commitment but because 
the patient was still under treatment, no overt acts 
occurred and the patient was released from treatment 
only to commit a dangerous act and be recommitted.  
The result was a vicious circle of treatment, release, 
overt act, recommitment.  The legislature recognized 
the danger to the patients and others of not only 
allowing 
for, 
but 
requiring, 
overt 
acts 
as 
a 
prerequisite for further treatment. 
State v. W.R.B., 140 Wis. 2d 347, 351, 411 N.W.2d 142 (Ct. App. 
1987).  Accordingly, we hold that addressing the "revolving 
door" phenomena is a reasonable basis for the different 
evidentiary avenues of § 51.20(1)(am) and the fifth standard.  
¶37 Accordingly, K.E.K. is unable to prove that the state 
impermissibly 
treats 
those 
committed 
under 
Wis. 
Stat. 
§ 51.20(1)(am) and those committed under the fifth standard 
differently.  Therefore, the statute does not violate K.E.K.'s 
right to equal protection of the laws.  
C.  As Applied 
¶38 K.E.K. also challenges Wis. Stat. § 51.20(1)(am)'s 
constitutionality as applied to her.  She claims that, based on 
the specifics of her case, § 51.20(1)(am) violates due process, 
the Privileges or Immunities Clause, and the Equal Protection 
Clause.  She argues that, because she was not dangerous to 
herself or others, "§ 51.20(1)(am) plainly, clearly, and beyond 
a reasonable doubt violates the 14th Amendment as applied to the 
facts of [her] case."  This argument, however, advances an 
evidentiary sufficiency challenge under the guise of as-applied 
constitutional challenges.  Accordingly, K.E.K.'s as-applied 
No. 
2018AP1887   
 
24 
 
constitutional challenges to § 51.20(1)(am) fail because they 
are sufficiency of the evidence challenges, not constitutional 
challenges.  
¶39 A claim that a statute is unconstitutional as applied 
is "a claim that a statute is unconstitutional on the facts of a 
particular case or to a particular party."  Voters with Facts v. 
City of Eau Claire, 2018 WI 63, ¶60, 382 Wis. 2d 1, 913 
N.W.2d 131 (quoting Olson v. Town of Cottage Grove, 2008 WI 51, 
¶44 n.9, 309 Wis. 2d 365, 749 N.W.2d 211).  Although these 
claims operate on the basis of the "facts of a particular case," 
it does not transform the as-applied constitutional challenge 
into an alternative means to attack the sufficiency of the 
evidence.  
¶40 K.E.K. asserts that "[i]t is undisputed that [she] 
posed no danger to herself or others during her commitment."  
This is not a challenge to the constitutionality of the statute 
as applied to K.E.K.'s facts; it challenges the application of 
the statute to the facts of this case.  The statute has no 
application, constitutional or otherwise, against those who are 
not currently dangerous.  See, e.g., D.J.W., 391 Wis. 2d 231, 
¶59 (concluding the evidence was insufficient at a recommitment 
hearing to prove dangerousness under Wis. Stat. § 51.20(1)(am)).  
If K.E.K. is not currently dangerous, the County has no power to 
commit her under the statute.  If the evidence is insufficient, 
it does not mean the statute is unconstitutional——it merely 
means that the County violated the statute.   
No. 
2018AP1887   
 
25 
 
¶41 Accordingly, 
K.E.K.'s 
as-applied 
constitutional 
challenges fail.  Her dispute is with the sufficiency of the 
evidence, 
not 
with 
the 
constitutionality 
of 
Wis. 
Stat. 
§ 51.20(1)(am).   
 
IV.  CONCLUSION 
¶42 We conclude that K.E.K. is unable to prove that Wis. 
Stat. § 51.20(1)(am) cannot be enforced under any circumstances 
because due process and the statute both require a showing of 
mental illness and current dangerousness.  As such, K.E.K.'s 
facial due process challenge fails. 
¶43 Moreover, 
Wis. 
Stat. 
§ 51.20(1)(am) 
creates 
an 
alternative path to give counties a more realistic basis by 
which to prove current dangerousness when it is likely the 
committed individual would discontinue treatment if no longer 
committed.  Thus, the state has a rational basis for treating 
those recommitted under § 51.20(1)(am) and those committed under 
§ 51.20(1)(a)2.e. differently.  
¶44 Finally, K.E.K.'s as-applied constitutional challenges 
are disguised sufficiency of the evidence challenges.  Her 
argument is that she does not meet the statutory standard for 
dangerousness, 
not 
that 
Wis. 
Stat. 
§ 51.20(1)(am) 
is 
unconstitutional when applied to K.E.K.'s specific facts.  
¶45 Therefore, we conclude that Wis. Stat. § 51.20(1)(am) 
is 
facially 
constitutional 
and 
that 
K.E.K.'s 
as-applied 
constitutional challenges fail.  Accordingly, we affirm the 
decision of the court of appeals.    
No. 
2018AP1887   
 
26 
 
By the Court.—The decision of the court of appeals is 
affirmed. 
No.  2018AP1887.rfd 
 
1 
 
¶46 REBECCA 
FRANK 
DALLET, 
J.   (dissenting). 
 
The 
Fourteenth Amendment to the United States Constitution prohibits 
the government from involuntarily confining a person with a 
mental illness unless it can prove that person is currently 
dangerous.  K.E.K. argues that Wis. Stat. § 51.20(1)(am) 
(2017-18)1 is unconstitutional because it allows the government 
to extend her commitment based not on her recent acts or 
omissions but on a treatment record detailing past behaviors and 
on predictions that, if no longer committed, she might behave 
dangerously in the future.  In the face of that constitutional 
challenge, the majority fails to engage in any real analysis of 
whether 
this 
type 
of 
"alternative" 
evidence 
passes 
constitutional muster.  It does not.  Section 51.20(1)(am) is 
facially 
unconstitutional 
because 
it 
eliminates 
the 
constitutionally required showing of current dangerousness in 
favor of "alternative" evidence that shows only that a person 
was or might become dangerous.  Therefore, I respectfully 
dissent. 
                                                 
1 K.E.K.'s challenge implicates only the first of the three 
sentences in Wis. Stat. § 51.20(1)(am).  If successful, her 
challenge would void only that sentence because the other two 
are distinct, separable, and not dependent on the first.  See 
State v. Hezzie R., 219 Wis. 2d 848, 863, 580 N.W.2d 660 (1998) 
("[P]art of a statute may be unconstitutional, and the remainder 
may still have effect, provided the two parts are distinct and 
separable and are not dependent upon each other." (quoting 
Muench v. PSC, 261 Wis. 492, 515, 55 N.W.2d 40 (1952))).  
Therefore, when I refer to § 51.20(1)(am), I refer only to its 
first sentence. 
No.  2018AP1887.rfd 
 
2 
 
I 
¶47 The civil commitment of persons diagnosed with a 
mental illness constitutes a government exercise of either its 
parens patriae power to care for citizens unable to care for 
themselves or its police power to prevent harm to the community.  
See Addington v. Texas, 441 U.S. 418, 426 (1979).  While both 
are legitimate government interests, neither is boundless.  
Involuntary mental health commitments are, after all, "a 
significant deprivation of liberty."  Id.; Vitek v. Jones, 445 
U.S. 480, 491–92 (1980).  They deprive persons of their most 
basic and fundamental freedom "to go unimpeded about [their] 
affairs" and to make decisions regarding their health.  Lessard 
v. Schmidt, 349 F. Supp. 1078, 1084 (E.D. Wis. 1972), vacated 
and 
remanded 
on 
other 
grounds, 
421 
U.S. 957 
(1975), 
reinstated, 413 F. Supp. 1318 (E.D. Wis. 1976). 
¶48 The 
Fourteenth 
Amendment 
to 
the 
United 
States 
Constitution guarantees that no citizen may be involuntarily 
committed without due process.  See Vitek, 445 U.S. at 491–92 
("[C]ommitment . . . produces 
'a 
massive 
curtailment 
of 
liberty,' and in consequence 'requires due process protection.'" 
(quoted 
sources 
omitted)). 
 
Thus, 
an 
individual 
facing 
commitment must have a meaningful opportunity to contest the 
evidence against her.  State v. Hanson, 98 Wis. 2d 80, 86, 295 
N.W.2d 209 
(Ct. 
App. 
1980), 
aff'd, 
100 
Wis. 2d 549, 
302 
N.W.2d 452 (1981).  And because an involuntary mental health 
commitment is premised on either an individual's inability to 
care for herself or her danger to the public, due process 
No.  2018AP1887.rfd 
 
3 
 
dictates that the government must demonstrate, by clear and 
convincing evidence, that the person is both mentally ill and 
dangerous to herself or others.2  Marathon Cnty. v. D.K., 2020 
WI 8, ¶¶27-28, 390 Wis. 2d 50, 937 N.W.2d 901 (citing O'Connor 
v. Donaldson, 422 U.S. 563, 576 (1975) and Addington, 441 U.S. 
at 432-33).  As we recently held, the government must prove that 
an individual is "current[ly] dangerousness"; "it is not enough 
that 
the 
individual 
was" 
dangerous. 
 
Portage 
Cnty. 
v. 
J.W.K., 2019 WI 54, ¶24, 386 Wis. 2d 672, 927 N.W.2d 509. 
                                                 
2 There is no dispute that the Fourteenth Amendment 
substantively protects the basic liberty of non-dangerous 
individuals against the government's attempts to deprive them of 
that liberty.  See O'Connor v. Donaldson, 422 U.S. 563, 575-76 
(1975); Vitek v. Jones, 445 U.S. 480, 491–92 (1980).  There is 
some debate, however, about whether it is the Fourteenth 
Amendment's Due Process Clause or its Privileges or Immunities 
Clause that prevents states from infringing on an individual's 
inherent right to liberty.  See, e.g., Planned Parenthood of Se. 
Penn. v. Casey, 505 U.S. 833, 847-48 (1992) (explaining that the 
Due Process Clause protects "a realm of personal liberty which 
the government may not enter"); Winnebago Cnty. v. C.S., 2020 
WI 33, ¶¶47-70, 391 Wis. 2d 35, 940 N.W.2d 875 (Rebecca Grassl 
Bradley, J., dissenting) (concluding that "liberty interests may 
be vindicated under the Privileges or Immunities Clause"); Josh 
Blackman 
& 
Ilya 
Shapiro, 
Keeping 
Pandora's 
Box 
Sealed:  
Privileges or Immunities, the Constitution in 2020, and Properly 
Extending the Right to Keep and Bear Arms to the States, 8 Geo. 
J.L. & Pub. Pol'y 1, 64 (2010) ("The Privileges or Immunities 
Clause is about individual liberty.").  This academic debate has 
no bearing on K.E.K.'s challenge.  After all, this court has 
already held that, based on the United States Supreme Court's 
"due process" jurisprudence, the government must prove current 
dangerousness.  See Marathon Cnty. v. D.K., 2020 WI 8, ¶¶26-27, 
390 Wis. 2d 50, 937 N.W.2d 901 (citing O'Connor, 422 U.S. 
at 576).  Support for this basic liberty may also be found in 
the 
Wisconsin 
Constitution's 
protection 
of 
the 
people's 
"inherent right[]" to "liberty."  Wis. Const. art. I, § 1. 
No.  2018AP1887.rfd 
 
4 
 
¶49 These constitutional due process protections, however, 
have not always been the law in Wisconsin, and vestiges of our 
troubling history in this area remain.  In the early 1970s, 
Wisconsin became the epicenter of civil commitment reform 
following a class-action lawsuit that contested Wisconsin's 
mental 
health 
commitment 
procedures. 
 
See 
Lessard, 
349 
F. Supp. 1078.  There, a three-judge federal panel enjoined 
Wisconsin's commitment laws because Alberta Lessard, like many 
committed before her, was denied a series of key procedural 
protections: 
 adequate notice of the proceedings against her; 
 a 
prompt 
probable-cause 
hearing, 
despite 
being 
detained; 
 the 
ability 
to 
invoke 
her 
right 
against 
self-
incrimination or object to hearsay evidence; 
 a heightened burden of proof commensurate with the 
deprivation of her liberty; and 
 her right to counsel. 
Id. at 1090-1103.  Lessard's victory led to certain procedural 
changes, but our pre-Lessard ghosts continue to haunt us.  
Indeed, as of 2015, Wisconsin involuntarily commits its citizens 
diagnosed with mental illnesses at a higher rate than any other 
state.3  Although we presume that the State's current mental 
                                                 
3 Wisconsin involuntarily commits roughly 44 of every 1,000 
persons diagnosed with a serious mental health disorder, far 
exceeding the average rate of other states (9 per 1,000).  
Substance Abuse & Mental Health Servs. Admin., Civil Commitment 
and the Mental Health Care Continuum:  Historical Trends and 
Principles for Law and Practice 12 (2019). 
No.  2018AP1887.rfd 
 
5 
 
health commitment scheme is constitutional, we cannot ignore its 
history to the contrary.  See Winnebago Cnty. v. C.S., 2020 
WI 33, ¶14, 391 Wis. 2d 35, 940 N.W.2d 875. 
¶50 Today, mental health commitments begin with a six-
month initial commitment once the criteria set forth in Wis. 
Stat. § 51.20(1)(a) are met.  See § 51.20(13)(g)1. (limiting the 
initial commitment period to not more than six months).  As 
discussed above, the government must show that the person is 
both mentally ill and currently dangerous.  § 51.20(1)(a); 
D.K., 390 Wis. 2d 50, ¶27.  The government may prove the latter 
requirement if it can show, by clear and convincing evidence, 
that there is a substantial probability that, based on recent 
acts or omissions, the person will cause physical harm to 
herself 
or 
others 
in 
at 
least 
one 
of 
four 
ways.  
§ 51.20(1)(a)2.a.-d.  A fifth standard allows the government to 
prove current dangerousness by showing a substantial probability 
that, without treatment, an individual who has demonstrated an 
"inability to make informed treatment decisions" will "further 
decompensat[e]" to the extent that she cannot independently care 
for herself, "as demonstrated by both the individual's treatment 
history 
and 
his 
or 
her 
recent 
acts 
or 
omissions."  
§ 51.20(1)(a)2.e.; State v. Dennis H., 2002 WI 104, ¶¶20-24, 255 
Wis. 2d 359, 647 N.W.2d 851. 
¶51 After the initial six-month commitment period, the 
government may extend the commitment for up to one year at a 
time.  See § 51.20(13)(g)1. & 3.  At each extension hearing, the 
government must again demonstrate both mental illness and 
No.  2018AP1887.rfd 
 
6 
 
current 
dangerousness. 
 
§ 51.20(13)(g)3.; 
J.W.K., 
386 
Wis. 2d 672, ¶21.  The evidence of current dangerousness must be 
"independent[]" of that introduced at the initial commitment 
proceeding.  J.W.K., 386 Wis. 2d 672, ¶¶21, 24.  Just as in the 
initial commitment proceedings, § 51.20(1)(a)2. governs the type 
of 
evidence 
the 
government 
can 
use 
to 
show 
current 
dangerousness. 
¶52 But 
§ 51.20(1)(am) 
provides 
an 
"alternative" 
evidentiary path.  Under that provision, the government may 
"satisf[y]" the respective recent-act-or-omission requirements 
in each of the five dangerousness standards "by a showing that 
there is a substantial likelihood, based on the subject 
individual's treatment record, that the individual would be a 
proper subject for commitment if treatment were withdrawn."  
(Emphases added.)  Thus, by its plain language, § 51.20(1)(am) 
permits the government to extend an individual's commitment 
based not upon evidence that an individual is dangerous but upon 
a prediction that she might become dangerous in one of the ways 
defined in § 51.20(1)(a)2. 
¶53 That is the route Waupaca County took here.  The 
circuit court extended K.E.K's commitment under the fifth 
standard of dangerousness, § 51.20(1)(a)2.e., by way of the 
§ 51.20(1)(am) 
"alternative," 
basing 
its 
order 
on 
the 
predictions of two mental health professionals.  Those witnesses 
forecasted that K.E.K., based on her treatment record, would 
become a proper subject for commitment under the fifth standard 
if treatment were withdrawn. 
No.  2018AP1887.rfd 
 
7 
 
¶54 K.E.K. argues that extending her commitment based on 
this "alternative" to evidence of recent acts or omissions 
contravenes her Fourteenth Amendment rights in that it allows 
the government to extend her commitment without providing any 
evidence that she is currently dangerous.  In rejecting her 
challenge, the majority opinion sidesteps the constitutional 
question, instead misinterpreting and improperly relying on 
J.W.K.  A careful constitutional analysis of § 51.20(1)(am), 
however, reveals that it is facially unconstitutional. 
II 
¶55 The majority opinion errs in its premise that we 
"authoritatively 
determined" 
in 
J.W.K. 
that 
Wis. 
Stat. 
§ 51.20(1)(am) is constitutional.  See majority op., ¶26.  
There, however, we interpreted the language of § 51.20(1)(am) 
only to determine whether J.W.K.'s appeal challenging the 
sufficiency of the evidence was moot.  We made no pronouncement 
either way about its constitutionality——an unsurprising result 
given that J.W.K. did not raise a constitutional challenge. 
¶56 To 
the 
extent 
that 
J.W.K. 
addresses 
current 
dangerousness, its reasoning undercuts the majority's conclusion 
rather 
than 
supports 
it. 
 
The 
majority 
claims 
that 
§ 51.20(1)(am) is constitutional because, per J.W.K., it allows 
the government to use "alternative" evidence to show that an 
individual "may still be dangerous despite the absence of recent 
acts, 
omissions, 
or 
behaviors 
exhibiting 
dangerousness."  
Id., ¶36 (quoting J.W.K., 386 Wis. 2d 672, ¶24).  That is, the 
majority opinion accepts as "current" the dangerous behavior 
No.  2018AP1887.rfd 
 
8 
 
that led to the individual's initial commitment, based on 
conjecture that this same behavior might manifest itself again 
if treatment is withdrawn.  But J.W.K. rejected that very 
argument, explaining that the government may not extend an 
individual's commitment by resting solely on the evidence used 
to initially commit her.  J.W.K., 386 Wis. 2d 672, ¶24 ("It is 
not enough that the individual was at one point a proper subject 
for commitment.").  Simply put, J.W.K. provides no basis for a 
constitutional analysis of § 51.20(1)(am); it instead bolsters 
K.E.K.'s position that whatever evidence of dangerousness 
supported 
her 
initial 
commitment 
cannot 
satisfy 
the 
constitutional requirement that the government demonstrate she 
is dangerous right now.  The majority opinion's mistaken 
reliance on and misinterpretation of J.W.K. stunts any actual 
constitutional analysis of § 51.20(1)(am). 
¶57 A 
proper 
examination 
of 
the 
plain 
language 
of 
§ 51.20(1)(am) reveals that it is facially unconstitutional 
because it allows the government to involuntarily commit someone 
who 
is 
not 
currently 
dangerous. 
 
Section 
51.20(1)(am) 
substitutes 
the 
recent-act-or-omission 
requirements 
of 
§ 51.20(1)(a)2. with a showing that there is a "substantial 
likelihood," based on the subject individual's treatment record, 
that the individual "would be a proper subject for commitment if 
treatment were withdrawn."  (Emphases added.)  The use of "would 
be" in tandem with an "if" clause forms a "future unreal 
conditional."  As the label implies, such sentences deal with 
hypothetical futures based on some condition not currently 
No.  2018AP1887.rfd 
 
9 
 
present.  This phrasing redefines "is dangerous" to mean "might 
be dangerous if some future conditions are met." 
¶58 The problem with relying on the future conditional 
language in § 51.20(1)(am) is compounded by the fact that the 
five standards of dangerousness are already predictions about 
future behavior.  Each standard is based on a "substantial 
probability" that harm will occur.  What saves the five 
standards from being unconstitutional in the initial commitment 
context is that each requires evidence of a recent act or 
omission that evinces dangerousness.  
See § 51.20(1)(a)2.  
Section 51.20(a)(am) dispenses entirely with that recent-act-or-
omission requirement, allowing it to be "satisfied" with future 
speculation, thus layering uncertainty on top of uncertainty 
while never proving that an individual is in fact dangerous 
right now. 
¶59 Section 51.20(1)(am)'s reliance on an individual's 
treatment record likewise does not establish proof of current 
dangerousness.  An individual's treatment record will always 
include some past event of dangerous behavior; otherwise the 
individual could not have been committed in the first place.  
But in the commitment extension context, if the government's 
only evidence of dangerousness is that which led to the initial 
commitment, then it has no evidence of current dangerousness.  
See J.W.K., 386 Wis. 2d 672, ¶24.  And without evidence of 
current dangerousness, an individual cannot be involuntarily 
committed. 
 
J.W.K., 
386 
Wis. 2d 672, ¶21; 
Foucha 
v. 
Louisiana, 504 U.S. 71, 77-78 (1992). 
No.  2018AP1887.rfd 
 
10 
 
¶60 K.E.K.'s commitment extension illustrates just how 
divorced predictions about future dangerousness are from current 
dangerousness.  Both the County's psychiatrist, Dr. Marshall 
Bales, and K.E.K.'s behavioral health case manager, Heather Van 
Kooy, confirmed that K.E.K was stable in an outpatient facility.  
They explained that K.E.K. was responding to treatment, that she 
had been taking her medication, and that she had committed no 
recent violent or threatening acts.  Dr. Bales pointedly stated 
that K.E.K. had "not been dangerous over the last number of 
months."  Although he noted that K.E.K. lacked insight into her 
mental illness and that she still talked and giggled to herself, 
he 
acknowledged 
that 
those 
symptoms 
are 
not 
necessarily 
dangerous behaviors.  Ms. Van Kooy agreed that K.E.K.'s symptoms 
had not manifested in any dangerous behaviors or threats of harm 
to herself or others.  Far from showing that K.E.K. was 
currently dangerous, Dr. Bales's and Ms. Van Kooy's testimony 
exemplify the disconnect between predictions about future 
dangerousness permitted under § 51.20(1)(am) and actual evidence 
of current dangerousness required by the Constitution and our 
precedent. 
B 
¶61 Failing to grapple with that disconnect, the majority 
opinion offers two last-ditch, but unavailing, arguments for 
upholding 
Wis. 
Stat. 
§ 51.20(1)(am). 
 
First, 
it 
upholds 
§ 51.20(1)(am) on the grounds that it "give[s] counties a more 
realistic basis by which to prove dangerousness."  Majority 
op., ¶36. 
 
More 
realistic 
than 
what 
is 
unclear.  
No.  2018AP1887.rfd 
 
11 
 
Notwithstanding, there is nothing unrealistic about a standard 
of proof that requires evidence of current dangerous behavior to 
show that someone is currently dangerous.  If the government has 
no such evidence, perhaps the committed individual is, in fact, 
not currently dangerous. 
¶62 To that, the majority opinion responds with its second 
defense of § 51.20(1)(am):  the "revolving door" phenomena.  
This 
justification 
posits 
that 
without 
the 
"alternative" 
evidence permitted under § 51.20(1)(am), committed individuals 
will enter a "vicious circle of treatment, release, overt act, 
recommitment."  Majority op., ¶36 (quoting State v. W.R.B., 140 
Wis. 2d 347, 351, 411 N.W.2d 142 (Ct. App. 1987)).  Setting 
aside the fact that this judicially crafted rationale lacks any 
basis in the text or legislative history of § 51.20(1)(am), it 
does 
nothing 
to 
address 
the 
fact 
that 
§ 51.20(1)(am) 
impermissibly redefines "currently dangerous."  Instead, it 
assumes the truth of the constitutional violation——that the 
individual is not presently dangerous——while excusing that 
violation because the previously committed individual may meet 
the commitment requirements again. 
¶63 I 
understand, 
to 
a 
point, 
the 
policy 
concerns 
underlying this revolving door reality for some.  I recognize 
that an individual released from a mental health commitment may 
at some point cease treatment and again become a proper subject 
for commitment.  I also recognize that simply extending an 
individual's commitment may be more expedient than having to 
No.  2018AP1887.rfd 
 
12 
 
start the commitment process anew should an individual's 
condition significantly deteriorate. 
¶64 The Constitution, however, yields to neither good 
intentions nor expediency.  Its protections are all the more 
important 
when 
faced 
with 
well-intentioned 
and 
efficient 
practices 
that 
ultimately 
amount 
to 
a 
violation 
of 
an 
individual's fundamental liberty.  See Bonnett v. Vallier, 136 
Wis. 193, 200, 116 N.W. 885 (1908) ("Good intentions in the 
passage of a law or a praiseworthy end sought to be attained 
thereby cannot save the enactment if it transcends in the 
judgment of the court the limitations which the Constitution has 
placed upon legislative power."); Kiley v. Chi., Milwaukee & St. 
Paul Ry. Co., 138 Wis. 215, 256, 119 N.W. 309 (1909) ("The 
Constitution was made to guard the people against the dangers of 
good intentions as well as bad intentions and mistakes.  The 
former may excuse a void enactment, but never justify it.").  
Therefore, as concerning as the revolving door phenomenon may 
be, it cannot justify depriving individuals of their liberty 
without due process. 
III 
¶65 The government may constitutionally commit someone 
against her will only if she is mentally ill and currently 
dangerous.  By its plain terms, Wis. Stat. § 51.20(1)(am) swaps 
the latter requirement for evidence of an individual's past 
conduct and uncertain predictions about her potential future 
dangerousness.  Under no set of facts, however, can past records 
or speculative predictions, on their own, demonstrate current 
No.  2018AP1887.rfd 
 
13 
 
dangerousness.  Accordingly, I conclude that § 51.20(1)(am) 
facially violates the Fourteenth Amendment to the United States 
Constitution. 
¶66 I therefore respectfully dissent. 
¶67 I am authorized to state that Justice JILL J. KAROFSKY 
joins this dissent. 
 
No.  2018AP1887.rfd 
 
 
 
1