Title: Garcia v. Commonwealth

State: massachusetts

Issuer: Massachusetts Supreme Court

Document:

NOTICE:  All slip opinions and orders are subject to formal 
revision and are superseded by the advance sheets and bound 
volumes of the Official Reports.  If you find a typographical 
error or other formal error, please notify the Reporter of 
Decisions, Supreme Judicial Court, John Adams Courthouse, 1 
Pemberton Square, Suite 2500, Boston, MA, 02108-1750; (617) 557-
1030; SJCReporter@sjc.state.ma.us 
 
SJC-12863 
 
MARCOS GARCIA  vs.  COMMONWEALTH. 
 
 
 
Suffolk.     December 7, 2020. - March 22, 2021. 
 
Present:  Budd, C.J., Gaziano, Lowy, Cypher, & Wendlandt, JJ. 
 
 
Practice, Civil, Civil commitment, Moot case.  Moot Question.  
Due Process of Law, Commitment, Substantive rights. 
 
 
 
Civil action commenced in the Supreme Judicial Court for 
the county of Suffolk on October 16, 2019. 
 
The case was considered by Kafker, J. 
 
 
 
Elizabeth Hugetz, Committee for Public Counsel Services, 
for the petitioner. 
 
Ryan J. Rall, Assistant District Attorney, for the 
Commonwealth. 
 
 
 
LOWY, J.  After a defendant has been found not criminally 
responsible by reason of mental illness, G. L. c. 123, § 16 (a), 
allows the trial judge to order that the defendant be 
hospitalized "at a facility" for forty days for observation and 
2 
 
examination.1  If the defendant is male and the judge determines 
"that the failure to retain him in strict security would create 
a likelihood of serious harm by reason of mental illness, or 
other mental defect," the judge may order that the 
hospitalization occur at the Bridgewater State Hospital 
(Bridgewater).  Id.  Yet for defendants sent to a facility other 
than Bridgewater, § 16 (a) does not provide a standard to guide 
the judge's determination whether to temporarily commit for an 
examination. 
 
After a jury-waived trial in October 2019, the defendant, 
Marcos Garcia,2 was found not criminally responsible by reason of 
mental illness based on a February 2018 incident.3  Immediately 
 
 
1 If the defendant was hospitalized before trial under G. L. 
c. 123, § 15 (b), for an assessment of competency to stand trial 
or criminal responsibility, the combined periods of 
hospitalization under §§ 15 (b) and 16 (a) must not exceed fifty 
days.  G. L. c. 123, § 16 (a). 
 
 
2 Although Garcia commenced this action by filing a petition 
in the county court, for convenience we refer to him as "the 
defendant." 
 
 
3 Although § 16 (a) refers to defendants found "not guilty 
by reason of mental illness or mental defect," we employ the 
terminology from our cases, which use variations of the term 
"not criminally responsible."  See, e.g., Commonwealth v. 
DiPadova, 460 Mass. 424, 431 n.9 (2011) ("We use 'lacks criminal 
responsibility,' or 'criminal irresponsibility,' terms that 
derive from Commonwealth v. McHoul, 352 Mass. 544, 555 [1967] 
[McHoul], at times in this opinion as a shorthand for the more 
cumbersome text of the formal McHoul standard [i.e., 'as a 
result of mental disease or defect (lacking) substantial 
capacity either to appreciate the criminality (wrongfulness) of 
 
3 
 
after the trial concluded, and despite a lack of evidence that 
at the time of trial the defendant presented a risk of harm to 
himself or others, the judge nevertheless ordered him to be 
hospitalized pursuant to § 16 (a) at a facility for forty days 
for observation and examination. 
 
For the reasons that follow, we conclude that the 
defendant's substantive due process rights were violated.  
Specifically, we hold that the clause of § 16 (a) referring to 
hospitalization "at a facility" (first clause) is 
unconstitutional when applied to the defendant, where he was 
found not criminally responsible and where there was 
insufficient evidence that he posed a current likelihood of 
serious harm.4 
 
Background.  The essential facts are uncontested.  On 
February 28, 2018, the defendant was arrested following an 
incident occurring after he crashed his van while driving on 
Interstate Highway 495.  When a passerby stopped to help, the 
defendant approached the passerby's car with a pickaxe and 
 
his conduct or to conform his conduct to the requirements of 
law']"). 
 
 
4 We decide this case based on the narrow facts before us, 
where there is insufficient evidence in the record that would 
support a conclusion that the defendant posed a likelihood of 
serious harm.  We therefore do not reach the issue of whether 
the statute also violates procedural due process.  We are 
cognizant, though, that the statute raises procedural due 
process concerns.  See part 3.b, infra. 
4 
 
attempted to enter the vehicle but was thwarted.  When another 
driver stopped and got out of her Chevrolet Equinox, the 
defendant entered that vehicle and drove away.  The defendant 
then struck the rear of a tow truck, as well as two additional 
vehicles, but continued driving.  About five to seven miles down 
the road, the defendant crashed the vehicle and came to a stop.  
A nurse who was driving by stopped to assist the defendant, who 
was visibly injured.  The defendant tried to kiss her hand and 
grabbed the door handle of her minivan, but he relented when she 
said her children were inside.  The defendant then entered one 
of the cars involved in the crash and tried to drive away, but 
the car would not move.  Officers arrived at the scene and 
eventually placed the defendant under arrest after firing a stun 
gun at him nine times.  The pickaxe was recovered from inside 
the Chevrolet Equinox that the defendant had taken. 
 
While in an ambulance en route to the hospital to treat his 
injuries, the defendant's demeanor changed.  He became visibly 
upset and remorseful.  He told the State police trooper who was 
accompanying him that he had been having mental health issues 
and had been living in the parking lot of the treatment center 
where he had been receiving help.  He also told the trooper that 
he was driving because he thought someone was trying to kill 
him. 
5 
 
 
In August 2018, a Middlesex County grand jury returned a 
twelve-count indictment charging the defendant with two counts 
of armed carjacking and multiple related charges.5  The defendant 
was held on bail from his arrest until his bail was reduced in 
December 2018, and he was released with the requirement that he 
wear a global positioning system monitoring bracelet.  He 
remained out of custody until trial without issue.  Once 
released, he participated in a nonresidential mental health 
program until the program closed in April 2019.  At the time of 
trial, the defendant was on two different waiting lists to 
continue outpatient treatment, although he had not been able to 
access care due to long waiting lists at providers that accepted 
his insurance. 
 
Before trial, the defendant was evaluated by two forensic 
psychologists.  At the jury-waived trial on October 1, 2019, Dr. 
John Daignault testified for the defendant, and Dr. Andrea 
Buonaugurio testified on behalf of the Commonwealth.  Both 
experts also submitted written reports to the court.  Both 
 
 
5 Specifically, the defendant was charged with two counts of 
armed carjacking, G. L. c. 265, § 21A; two counts of carjacking, 
G. L. c. 265, § 21A; one count of assault by means of a 
dangerous weapon, G. L. c. 265, § 15B (b); one count of larceny 
of motor vehicle, G. L. c. 266, § 28; three counts of attempted  
larceny of a motor vehicle, G. L. c. 274, § 6; one count of 
leaving the scene after causing property damage, G. L. c. 90, 
§ 24 (2) (a); one count of operating a motor vehicle to 
endanger, G. L. c. 90, § 24 (2) (a); and one count of resisting 
arrest, G. L. c. 268, § 32B. 
6 
 
experts opined that at the time of the incident, the defendant 
lacked criminal responsibility.  At the conclusion of the trial, 
the judge found the defendant not guilty for lack of criminal 
responsibility. 
 
Following that finding, the Commonwealth moved that the 
defendant be hospitalized for evaluation pursuant to G. L. 
c. 123, § 16 (a), and stated that depending on the results of 
that evaluation, it might move for a six-month commitment under 
§ 16 (b).  In anticipation that the defendant would be found not 
criminally responsible, the Commonwealth's expert, Dr. 
Buonaugurio, had testified at trial on the issue of 
"hospitalization" under § 16 (a).6  Buonaugurio testified that 
the defendant did not currently present an "imminent risk of 
 
 
6 Although the language of § 16 (a) does not require a 
hearing regarding hospitalization before a judge temporarily 
commits someone, the judge here allowed testimony and argument 
concerning whether the defendant should be hospitalized under 
§ 16 (a).  Because the findings of both experts showed that a 
verdict that the defendant was not criminally responsible was 
likely, the judge allowed the evidence regarding hospitalization 
for purposes of § 16 (a) to be introduced during the criminal 
trial, instead of after the verdict.  The defendant and the 
Commonwealth both assented to this procedure. 
 
 
The defendant's expert, Dr. Daignault, did not testify on 
the issue of hospitalization, as he had not evaluated the 
defendant since April and June of 2018, whereas Dr. 
Buonaugurio's evaluation had occurred more recently, in July and 
August of 2019. 
7 
 
harm" to himself or others.7  The judge did not explicitly 
discredit this conclusion, and it is unclear from the record 
exactly what he determined regarding the defendant's risk of 
future harm.  He said, "[T]here's nothing in the record that 
gives me any comfort that this won't happen again," and "sooner 
or later, the combination of [a] lack of treatment and serious 
mental . . . illness [could lead] to a . . . horrendous 
situation with criminal conduct."  The judge's findings appear 
to be based on Buonaugurio's testimony that the defendant was 
currently unmedicated and out of treatment, which were similar 
to the preconditions leading to his criminal conduct.  The 
judge, over the defendant's objection, ordered that the 
defendant be hospitalized at a facility for forty days for 
observation and examination pursuant to § 16 (a). 
 
The defendant filed a petition pursuant to G. L. c. 211, 
§ 3, requesting relief from confinement.  While the petition was 
pending, he was released from hospitalization because the 
§ 16 (a) period had expired.  The facility's forensic 
psychologist concluded that the defendant did not meet the 
 
 
7 Dr. Buonaugurio stated that, although the provision of 
§ 16 (a) referring to "a facility" does not contain a standard, 
the practice was to import the standard from § 16 (b) requiring 
a likelihood of serious harm. 
8 
 
requirements for involuntary commitment.  In total, the 
defendant was confined for forty-two days.8 
 
Following his discharge, the defendant filed a motion to 
modify the relief sought in his petition, maintaining that he 
had an ongoing interest in the merits.  A single justice of this 
court denied the defendant's petition, stating that the judge's 
hospitalization order under § 16 (a) did "not constitute an 
error of law or abuse of discretion."  The defendant filed a 
timely notice of appeal, and his appeal was entered in this 
court. 
 
Discussion.  1.  Review under G. L. c. 211, § 3.  A single 
justice faced with a G. L. c. 211, § 3, petition first decides 
whether, in his or her discretion, to review the substantive 
merits of the petition, and then if so, issues a decision on the 
merits.  Commonwealth v. Fontanez, 482 Mass. 22, 24, 28 (2019).  
Here, the single justice exercised his discretion to reach the 
merits, holding that the trial judge's hospitalization order 
pursuant to § 16 (a) did not constitute an error of law or abuse 
of discretion.  In reviewing the single justice's decision, we 
look to whether "the single justice abused his or her discretion 
or made a clear error of law" (citation omitted).  Commonwealth 
 
 
8 It is not clear why the defendant was hospitalized for 
forty-two days; § 16 (a) allows hospitalization only for a 
period of forty days. 
9 
 
v. Ruiz, 480 Mass. 683, 685 (2018).  Because the defendant 
raises an issue of law, we review the single justice's decision 
de novo.9  See id. 
 
2.  Mootness.  "Ordinarily, litigation is considered moot 
when the party who claimed to be aggrieved ceases to have a 
personal stake in its outcome."  Matter of a Minor, 484 Mass. 
295, 299 (2020), quoting Commonwealth v. Dotson, 462 Mass. 96, 
98 (2012).  Because individuals temporarily committed under 
§ 16 (a) have a personal stake in litigating a wrongful 
temporary commitment, even after release from confinement, we 
conclude that appeals from an order pursuant to § 16 (a) are not 
moot. 
 
"When considering other statutory provisions that allow 
involuntary civil commitment, we have determined that the 
continuing stigma of a potentially wrongful commitment alone 
sufficed to defeat a claim of mootness."  Matter of a Minor, 484 
Mass. at 299 (appeals from commitment orders under G. L. c. 123 
§ 35).  See Pembroke Hosp. v. D.L., 482 Mass. 346, 351 (2019) 
 
 
9 The Commonwealth contends that the defendant's claim is 
not properly before this court because there is an adequate 
alternative remedy under G. L. c. 278, § 28, and because the 
defendant did not comply with the requirements of S.J.C. Rule 
2:21, as amended, 434 Mass. 1301 (2001), after his appeal was 
entered in the full court.  Because it is doubtful that the 
statute applies in these circumstances, and because in any event 
the single justice exercised his discretion to reach the merits 
of the petition, we do not address these contentions. 
10 
 
(same for appeals challenging involuntary commitment orders 
under G. L. c. 123, § 12); Matter of M.C., 481 Mass. 336, 343 
(2019) (same for appeals challenging extensions of commitment 
orders under G. L. c. 123, § 16 [b]).  A temporary commitment 
under § 16 (a), like other civil commitments, carries with it a 
stigma.  Thus, the defendant has a surviving interest in the 
matter. 
 
Moreover, even absent the defendant's surviving interest, 
"it is well established that cases involving the confinement of 
mentally ill persons present classic examples of issues that are 
capable of repetition, yet evading review, which thus warrant 
appellate review even after the confinement ends" (quotations 
and citation omitted).  Pembroke Hosp., 482 Mass. at 351.  Thus, 
we reach the merits of the case. 
 
3.  Due process.  At the heart of this case is whether the 
defendant's involuntary hospitalization at a facility other than 
Bridgewater, as permitted by the first clause of G. L. c. 123, 
§ 16 (a), violates due process.10  There is no doubt that this 
 
 
10 We do not address the portion of § 16 (a) that allows a 
temporary commitment to Bridgewater, because that does contain a 
standard requiring a finding of present dangerousness ("failure 
to retain him in strict security would create a likelihood of 
serious harm by reason of mental illness, or other mental 
defect").  We also do not address the portion of § 16 (a) 
allowing temporary commitments of incompetent defendants, 
because such circumstances present different compelling 
interests.  See Commonwealth v. Calvaire, 476 Mass. 242, 246 
 
11 
 
clause raises due process concerns.  "The right of an individual 
to be free from physical restraint is a paradigmatic fundamental 
right."  Matter of E.C., 479 Mass. 113, 119 (2018), quoting 
Commonwealth v. Knapp, 441 Mass. 157, 164 (2004).  We have 
previously described a temporary hospitalization as short as 
three days under G. L. c. 123, § 12, as a "massive curtailment" 
of liberty (citation omitted).  Newton-Wellesley Hosp. v. 
Magrini, 451 Mass. 777, 784 (2008) (patient involuntarily 
confined for eleven days was entitled to emergency hearing).  
Permitting a forty-day involuntary hospitalization, § 16 (a) 
necessarily implicates a fundamental right. 
 
a.  Strict scrutiny.  The question, then, is whether the 
defendant's temporary commitment was narrowly tailored to a 
compelling government interest to satisfy strict scrutiny.  See 
Knapp, 441 Mass. at 164 (when government action impairs 
fundamental right, that action must be "narrowly tailored to 
further a legitimate and compelling governmental interest"). 
 
We have held that certain temporary detentions satisfy due 
process when justified by compelling government interests such 
as protecting the public from harm, securing a defendant's 
 
(2017) (confinement of incompetent defendants under § 16 [f] 
"narrowly tailored to allow the Commonwealth some time to pursue 
the legitimate and proper purpose of prosecuting charged crimes, 
but not for a period of time longer than is reasonably necessary 
to ascertain the defendant's chances of regaining competency"). 
12 
 
presence in court, or preserving the integrity of the judicial 
process.  See, e.g., Knapp, 441 Mass. at 164-165 (temporary 
confinement before G. L. c. 123A sexually dangerous person 
commitment trial is narrowly tailored to compelling interest of 
protecting public from harm by persons likely to be sexually 
dangerous); Querubin v. Commonwealth, 440 Mass. 108, 114 (2003) 
(detention without bail of defendant who poses serious risk of 
flight permissible because securing defendant's presence at 
trial is "of fundamental importance to the basic functioning of 
the judiciary"); Paquette v. Commonwealth, 440 Mass. 121, 131 
(2003), cert. denied, 540 U.S. 1150 (2004) (bail revocation 
following charge of crime committed while on release "narrowly 
tailored to further the Commonwealth's legitimate and compelling 
interests in assuring compliance with its laws[] and in 
preserving the integrity of the judicial process"); Mendonza v. 
Commonwealth, 423 Mass. 771, 780-781 (1996) (pretrial detention 
based on dangerousness under G. L. c. 276, § 58A, satisfies due 
process). 
 
In the mental health context, it is unconstitutional to 
confine a nondangerous person against his or her will merely to 
provide treatment.  See O'Connor v. Donaldson, 422 U.S. 563, 575 
(1975) ("there is still no constitutional basis for confining 
such persons involuntarily if they are dangerous to no one and 
can live safely in freedom"); Williams v. Steward Health Care 
13 
 
Sys., LLC, 480 Mass. 286, 293 (2018).  That a person may benefit 
from mental health treatment is not alone a sufficient basis to 
restrict his or her liberty.  See O'Connor, supra.  With this in 
mind, we conclude that the only potential compelling government 
interest justifying a temporary commitment under § 16 (a) of a 
person found not criminally responsible is to protect the 
individual and the community from harm. 
 
Although the United States Supreme Court has noted that a 
not guilty by reason of insanity verdict11 "certainly indicates 
dangerousness," Jones v. United States, 463 U.S. 354, 364 
(1983), a "'not guilty by reason of insanity' verdict is 
backward-looking, focusing on one moment in the past, while 
commitment requires a judgment as to the present and future."  
Id. at 377 (Brennan, J., dissenting).  Thus, the constitutional 
basis to detain an insanity acquittee evaporates when he or she 
is no longer dangerous.  Foucha v. Louisiana, 504 U.S. 71, 77-78 
(1992).12 
 
 
11 When discussing United States Supreme Court cases, we use 
the terminology it employed, such as "not guilty by reason of 
insanity." 
 
 
12 We acknowledge that the United States Supreme Court has 
noted in dicta that "insanity acquittees may be initially held 
without complying with the procedures applicable to civil 
committees," Foucha, 504 U.S. at 76 n.4, even though the 
"acquittee is entitled to release when he . . . is no longer 
dangerous" (citation omitted), id. at 77.  See Jones, 463 U.S. 
at 366 (hearing within fifty days of commitment after insanity 
 
14 
 
 
In this case, there was no constitutionally adequate 
justification to temporarily commit the defendant under 
§ 16 (a).  Because a fundamental right was implicated triggering 
strict scrutiny, the Commonwealth bears the burden of showing 
the restriction of liberty was narrowly tailored to a compelling 
government interest.  Commonwealth v. Weston W., 455 Mass. 24, 
26 (2009).  Yet the Commonwealth's own expert testified that the 
defendant presented no risk of imminent harm at the time of 
trial.  Moreover, prior to trial, the defendant had been at 
liberty for more than ten months without any issues. 
 
While the judge did not explicitly reject the expert's 
conclusion, he appeared to think there was at least some 
likelihood of future harm, albeit a very nebulous one.13  This 
conclusion appears to be based on the Commonwealth's expert's 
testimony that the defendant's current status of being 
 
acquittal assures acquittee "has prompt opportunity to obtain 
release if he [or she] has recovered").  We need not determine 
whether the defendant's temporary commitment was justified under 
Federal law in these circumstances.  We base our holding on the 
"more emphatic" due process guarantees in arts. 1, 10, and 14 of 
the Massachusetts Declaration of Rights.  See Mendonza, 423 
Mass. at 780 (text and structure of arts. 1, 10, and 14 indicate 
they provide "more emphatic" due process protection than Federal 
Constitution). 
 
 
13 Specifically, the judge said, "sooner or later, the 
combination of [a] lack of treatment and serious mental . . . 
illness [could lead] to a . . . horrendous situation with 
criminal conduct." 
15 
 
unmedicated and out of treatment was similar to his 
circumstances prior to his criminal conduct. 
 
Even if it was reasonable for the judge to reject the 
Commonwealth's own expert's uncontroverted testimony,14 the 
paltry evidence of the defendant's likelihood of future 
dangerousness does not satisfy the Commonwealth's burden of 
showing a compelling government interest.  See Commonwealth v. 
Bruno, 432 Mass. 489, 502-504 (2000) (temporary commitment under 
G. L. c. 123A, § 12 [e], constitutional because it was not based 
solely on prior criminal conduct, but rather on "sufficient 
showing" of "evidence before the court" that person was likely 
to commit future harm).  Cf. Sharris v. Commonwealth, 480 Mass. 
586, 602 (2018) ("A statute is not narrowly tailored to achieve 
a compelling government interest where the stated interest is 
not at stake").  The mere fact that the defendant was 
unmedicated and out of treatment, combined with prior criminal 
conduct, was not sufficient to show that he posed a likelihood 
of harm to himself or others sufficient to justify a massive 
 
 
14 We leave for another day whether expert testimony is 
required in § 16 (a) hearings.  We note, however, that we have 
held that expert testimony is required for temporary commitments 
under G. L. c. 123A, § 12 (e), because "the predictive 
behavioral question of the likelihood that a person suffering 
from such a condition will commit a sexual offense, [is a 
matter] beyond the range of ordinary experience and require[s] 
expert testimony."  Commonwealth v. Bruno, 432 Mass. 489, 511 
(2000). 
16 
 
curtailment of his liberty.  The judge's concern for the 
defendant and the community -- encapsulated by the statement "I 
don't feel comfortable letting him [go]" -- though 
understandable given the lack of guidance provided by the 
statute, is not a constitutionally adequate basis to restrict a 
defendant's liberty for forty days.  Cf. Foucha, 504 U.S. at 82 
(expert's testimony that "I don't think I would feel comfortable 
in certifying that he would not be a danger to himself or to 
other people" not constitutionally adequate basis for long-term 
commitment). 
 
"[C]onfinement without legal justification is never 
innocuous" (citation omitted).  Commonwealth v. G.F., 479 Mass. 
180, 196 (2018).  Thus, because there was not a constitutionally 
adequate finding of likelihood of future dangerousness, the 
defendant's substantive due process rights were violated.15 
 
 
15 Nothing in our holding today is intended to affect the 
statutory scheme in G. L. c. 123, § 15.  Under that section, a 
judge may order an evaluation of a defendant by a court 
clinician before trial if the judge doubts whether the defendant 
is competent to stand trial or criminally responsible by reason 
of mental illness (§ 15 [a] evaluation).  That examination is 
typically brief and takes place in the court house or in a place 
where the defendant is being detained before trial.  There is no 
separate and independent detention of the defendant for that 
purpose.  After the § 15 (a) evaluation, the judge may then 
order that the person be involuntarily hospitalized for up to 
twenty days, for observation and a more detailed examination, 
if, based on the court clinician's evaluation, the court "has 
reason to believe that such observation and further examination 
are necessary in order to determine whether mental illness or 
 
17 
 
 
b.  Looking forward.  We decide the defendant's case based 
only on the narrow facts before us, where there was insufficient 
evidence to support a conclusion that the defendant posed a 
present likelihood of serious harm.  Yet he has called our 
attention to a problem with broader implications:  the first 
clause of § 16 (a) contains no standard.  The Commonwealth asks 
us to read in a standard from other portions of the statute, 
while the defendant asks us to strike down the first clause of 
§ 16 (a) entirely.  We doubt whether our tools of statutory 
interpretation would allow us to follow the Commonwealth's 
proposed course, especially where legislative history suggests 
that the Legislature might not have intended to include a 
 
mental defect have so affected a person that he is not competent 
to stand trial or not criminally responsible."  G. L. c. 123 
§ 15 (b). 
 
 
Hospitalization under § 15 (b) is distinguishable from that 
under § 16 (a) for two reasons.  First, it is narrowly tailored.  
By the time a hospitalization is ordered under § 15 (b), there 
already has been an initial evaluation under § 15 (a) and a 
determination based on it that the hospitalization is needed.  
Thus, only defendants for whom a longer period of observation 
and examination is needed will be hospitalized against their 
will.  Second, there is a compelling government interest.  
Because the criminal case is ongoing, an evaluation under § 15 
to determine the defendant's competency or lack of criminal 
responsibility is designed help ensure that a defendant is not 
tried while incompetent or found guilty when he or she lacks 
criminal responsibility.  See Commonwealth v. Robidoux, 450 
Mass. 144, 152 (2007) (subjecting incompetent defendant to trial 
would violate due process rights). 
 
18 
 
standard at all.16  See Aime v. Commonwealth, 414 Mass. 667, 683-
684 (1993) (declining to engage in "massive rewriting" of bail 
statute, especially where doing so would infringe on apparent 
legislative intent).  These concerns loom over § 16 (a). 
 
The Legislature may wish to address this point by amending 
§ 16 (a) to include a legal standard to guide judges as to when 
they can order a temporary commitment for observation after a 
verdict of not criminally responsible.  To satisfy substantive 
due process concerns, any change would need to reflect a 
compelling government interest, narrowly tailored.  See Knapp, 
 
 
16 The language in § 16 (a) has remained essentially 
unchanged since it was first enacted in the predecessor to the 
current G. L. c. 123 as part of the mental health reform act of 
1970 (Reform Act).  See St. 1970, c. 888, § 4.  Prior to the 
Reform Act, defendants who were acquitted as not guilty by 
reason of insanity were subject to automatic indefinite civil 
commitments.  Walker, Mental Health Law Reform in Massachusetts, 
53 B.U. L. Rev. 986, 1008 (1973).  In the years before the 
Reform Act, we issued two decisions calling into question the 
constitutionality of the prior law.  See Commonwealth v. Druken, 
356 Mass. 503 (1969); Rohrer, petitioner, 353 Mass. 282 (1967).  
In Rohrer, petitioner, supra at 285-286, we distinguished 
indefinite commitments from "temporary commitments for 
observation and diagnosis," implying that the latter did not 
necessarily require notice and a hearing to satisfy due process.  
See Druken, supra at 508. 
 
 
"The Legislature is presumed to be aware of the prior state 
of the law as explicated by the decisions of this court" 
(citation omitted).  Commonwealth v. Montarvo, 486 Mass. 535, 
541 (2020).  Thus, when the Legislature enacted the Reform Act, 
it may well have thought that a temporary commitment for 
observation and examination need not include the same due 
process protections as a longer-term commitment.  The absence of 
a standard in the first clause of § 16 (a), then, may have been 
intentional. 
19 
 
441 Mass. at 164.  Focusing on a present or future likelihood of 
serious harm -- and not solely the conduct that gave rise to the 
criminal charges -- would ensure that a genuine compelling 
government interest is at stake.  Our substantive due process 
cases also detail a requirement that judges consider less 
restrictive means.  See Matter of a Minor, 484 Mass. at 308-311 
(requiring judge to find, by clear and convincing evidence, that 
there is no appropriate less restrictive alternative before 
granting G. L. c. 123, § 35, petition for substance use 
commitment). 
 
Further, although we do not reach the issue of procedural 
due process, we note that any change to the statute would need 
to satisfy procedural due process as well.  "'Procedural due 
process' requires that a statute or governmental action that has 
survived substantive due process scrutiny be implemented in a 
fair manner."  Aime, 441 Mass. at 674, citing United States v. 
Salerno, 481 U.S. 739, 746 (1987).  See Mathews v. Eldridge, 424 
U.S. 319, 335 (1976).  Aime is instructive.  There, we noted 
that certain amendments to the bail statute did not contain 
procedures designed to "further the accuracy" of a judge's 
determination of dangerousness and thus "essentially grant[ed] 
the judicial officer unbridled discretion."  Aime, supra at 682, 
20 
 
quoting Salerno, supra at 751.17  Section 16 (a), as presently 
written, similarly appears to grant unfettered discretion to 
judges considering defendants who fall within the ambit of its 
first clause. 
 
Conclusion.  The matter is remanded to the county court for 
entry of a judgment allowing the defendant's petition pursuant 
to G. L. c. 211, § 3, and ordering that the Superior Court 
judge's order hospitalizing the defendant under § 16 (a) be 
vacated. 
 
 
 
 
 
 
 
So ordered. 
 
 
17 Among other absent procedural safeguards, the statute at 
issue in Aime, 414 Mass. at 681-682, did not state a required 
quantum of proof for the showing that an arrestee's release 
would endanger the community.  If the Legislature were to choose 
to amend § 16 (a), it appears that clear and convincing evidence 
would satisfy the appropriate quantum of proof.  We have 
condoned its use for other short-term detentions.  See, e.g., 
Matter of G.P., 473 Mass. 112, 119-120 (2015) (G. L. c. 123, 
§ 35, short-term substance use commitment); Mendonza, 423 Mass. 
at 784 (pretrial detention under G. L. c. 276, § 58A).  Because 
"the length of time an involuntary commitment may last is key 
among the factors that may bear on the determination of what 
standard applies," Matter of G.P., supra at 119, the quantum of 
proof beyond a reasonable doubt required for longer-term 
commitments may not be necessary.  See Commonwealth v. Nassar, 
380 Mass. 908, 916 (1980) (G.L. c. 123, § 16 [b], commitments); 
Superintendent of Worcester State Hosp. v. Hagberg, 374 Mass. 
271, 275-277 (1978) (G.L. c. 123, §§ 7, 8, commitments).  
Because either of these two standards appears to satisfy the 
Declaration of Rights, the choice is a quintessential 
legislative prerogative.