United States Court of Appeals

For the Eighth Circuit

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No. 11-2251

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Timothy Green

lllllllllllllllllllll Plaintiff - Appellant

v.

Dave Dormire; Arthur Wood; Bill Galloway; Dr. Robert E. Holland; Kay Redding,

Dept. of Mental Health; Department of Mental Health of the State of Missouri;

Greg Boyt, Dept. of Mental Health; Sally Taylor, Dept. of Mental Health; Allen

Heald, Dept. of Mental Health; Jim Bennett, Dept. of Mental Health; Mariann

Atwell; Missouri Department of Corrections; Jerry Doty; Ellis McSwain; William

Eikermann; Mark W. Schmitz; Dr. Felix Vincenz; Joe Mangini; Bruce Harry;

StephanieScott; KaySmith; JeanneHenry;DebraLewis;DavidStephens;A.E.Daniels

lllllllllllllllllllll Defendants - Appellees

Ed Cullumber; Dr. Gulley; Dr. Loehr; Dr. Rawlani; Shelley Moore

lllllllllllllllllllll Defendants

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 Appeal from United States District Court 

for the Western District of Missouri - Jefferson City

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 Submitted: June 15, 2012

 Filed: September 4, 2012 

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Before LOKEN, GRUENDER, and BENTON, Circuit Judges.

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BENTON, Circuit Judge. 

Timothy Green, an inmate of the Missouri Department of Corrections, was

transferred from the Jefferson City Correctional Center (JCCC) to the Biggs

Correctional Treatment Unit at the Fulton State Hospital (Biggs). There, he was

involuntarily medicated. Green sued under 42 U.S.C. § 1983, alleging that his

transfer, detention, and involuntary medication violated his Due Process rights. The

district court granted summary judgment to the defendant prison officials and

1

doctors. Having jurisdiction under 28 U.S.C. § 1291, this court affirms.

In September 2003, Green was placed in the administrative segregation unit at

JCCC for two weeks. Released from administrative segregation, he began to exhibit

delusional behaviors based on his belief that a device had been planted in his

television, allowing celebrities to watch and communicate with him and to wear

fashions he designed without his permission. This belief led him to write multiple

lettersto various celebrities. Dr. Robert E. Holland diagnosed Green with Delusional

Disorder and prescribed medication to treat it. Green refused to take the medication

because he did not believe he had delusions. 

Due to his refusal to take medication, Green was moved from JCCC to Biggs,

which isjointly operated by the Missouri Department ofCorrections and the Missouri

Department of Mental Health. Defendant Dave Dormire, the chief administrative

officer of JCCC, did not certify, before the transfer, that Green needed treatment. 

Green was at Biggs for 33 days. He saw a number of mental health

professionals who evaluated him and created treatment plans. One week after his

arrival at Biggs, the mental health staff, at a treatment hearing that Green attended, 

The Honorable Nanette K. Laughrey, United States District Court for the

1

Western District of Missouri. 

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outlined his treatment goals and objectives. At that meeting, a consulting

psychologist recommended that Green take antipsychoticmedication. Green refused. 2

Two days later, another hearing convened to determine whether Green should

be involuntarily medicated. Attending were a consulting psychiatrist, a psychologist,

a physician, a social worker, a regional manager of Mental Health Services, an

associate superintendent, and Green’s two lay advocates. Green spoke during the

hearing. Other attendees asked him questions and expressed their opinions about his 

mental health. 

At the conclusion of the hearing, a committee composed of the consulting

psychiatrist, the associate superintendent, and the regional manager of Mental Health

Services determined that Green was gravely disabled and not able to function in

prison orin the general population without control of his Delusional Disorder through

medication. Thus, the committee determined that Green required involuntary

medication. 

Green appealed. The Chief of Mental Health Services, after reviewing the

hearing record and Green’s progress notes, found it clinically necessary to administer

involuntary medication. Green was forcibly medicated for seven months.

Green sued, arguing that his federal Due Process rights were violated when he

was (1) moved from JCCC to Biggs without certification by the warden and retained

for more than 96 hours without judicial certification (in alleged violation of a state

statute), and (2) was forcibly medicated. Green renews these arguments on appeal.

Antipsychotic drugs, also known as “neuroleptics” or “psychotropic drugs,” 2

are commonly used to treat mental disorders, but can have “serious, even fatal, side

effects.” Washington v. Harper, 494 U.S. 210, 229 (1990).

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This court reviews de novo the district court’s grant of summary judgment,

viewing all evidence and drawing all reasonable inferences in favor of the nonmoving party. Crawford v. Van Buren County, Ark., 678 F.3d 666, 669 (8th Cir.

2012). Summary judgment is proper if there is no genuine issue of material fact and

the moving party is entitled to judgment as a matter of law. Fed. R. Civ. P. 56(a). 

I.

The district court ruled that Green’s transfer did not violate section 552.050.1

RSMo, which provides: 3

If the chief administrative officer of any correctional facility has

reasonable cause to believe that any offender needs care in a mental

hospital, he shall so certify to the division of classification and

treatment, which shall then transfer the offender to a state mental

hospital for custody, care and treatment. The hospital may detain and

treat the offender for a period of time not to exceed ninety-six hours.

After the 96-hour period ends, “the offender shall be returned to a correctionalfacility

designated by the department of corrections unless the individual admits himself as

a voluntary patient or the mental health coordinator or head of the facility files for

involuntary detention and treatment . . . .” § 552.050.1 RSMo. Any continued

involuntary detention must complywith section 632.330 RSMo,which grants specific

rights to the detainee. The district court found that Green was not transferred to a

state mental hospital because he “remained in a correctional facility at all times,” and

thus that the Missouri statutes “never came into play.” At issue, however, is not

whether the statutes were violated but rather whether the minimum requirements of

Due Process are satisfied. 

RSMo refers to the Missouri Revised Statutes, 2000, as amended. 3

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Green argues that his relocation to and detention at Biggs violated a Statecreated liberty interest. “[S]tate statutes may create liberty interests that are entitled

to the procedural protections of the Due Process Clause of the Fourteenth

Amendment.” Vitek v. Jones, 445 U.S. 480, 488 (1980) (“[O]nce a State grants a

prisoner [a] conditional liberty properly dependent on the observance of special . . .

restrictions, due process protections attach.”). When a liberty interest is present, the

minimum requirements of Due Process are established by federal law, not by state

statute. Id. at 491.

Temporary transfers to mental-health facilities for evaluation do not give rise

to the liberty interest protected in Vitek. United States v. Jones, 811 F.2d 444, 448

(8th Cir. 1987); Gay v. Turner, 994 F.2d 425, 427 (8th Cir. 1993) (per curiam);

Trapnell v. Ralston, 819 F.2d 182, 184-85 (8th Cir. 1987). Vitek addressed a statute

authorizing the “indefinite commitment” of an inmate to a mental-health facility. 

Jones, 811 F.2d at 448. “Thus, the court’s reliance on the stigma attached to a

commitment and the behavioral modification procedures utilized at the facility, on

which the court substantially relied in finding a protected liberty interest, has no

application to [a case concerning a temporary transfer for evaluation].” Id. Other

circuits follow this court’s precedent. See, e.g., Fortune v. Bitner, 285 F. Appx. 947,

950 (3d Cir. 2008) (per curiam) (unpublished); Fant v. Fed. Bureau of Prisons, No.

93-5059, 1993 WL 318888, at *1 (D.C. Cir. 1993) (per curiam) (order).

Green argues that he wastransferred for treatment and not evaluation. Green’s

behavior required some sort of segregation, and prison officials transferred him to

Biggs. A temporary transfer to a mental-health facility for evaluation does not burden

an inmate any more than a prison transfer for administrative purposes. See Jones,

811 F.2d at 448 (discussing the great leeway given to prison officials to transfer

inmates – even into more restrictive conditions – without implicating a liberty

interest). After being evaluated, Green received sufficient process (including a

treatment hearing) within seven days of arriving, and before any involuntary 

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medication. The district court properly granted the defendants’ motion for summary

judgment as to Green’s transfer.

II.

Green claims that his involuntary medication violated his substantive Due

Process rights. Prisoners possess “a significant liberty interest in avoiding the

unwanted administration of antipsychotic drugs under the Due Process Clause of the

Fourteenth Amendment.” Washington v. Harper, 494 U.S. 210, 222 (1990). 

A.

Green argues that, as a general proposition, the Due Process Clause requires

that he be found dangerous before he may be involuntarily medicated. The committee

assembled for the Due Process hearing concluded that Green was “gravely disabled

to the extent he would not be able to function in prison or in the population upon

release without control of his delusional disorder.” Citing United States v.

McAllister, 969 F. Supp. 1200, 1207-08 (D. Minn. 1997), Green argues that “[i]f the

‘gravely disabled’ language in the [Policy] were not read to require a showing of

dangerousness within the institution, the [Policy] would be unconstitutional under the

Due Process Clause.” True, Harper’s specific holding is that Due Process allows an

inmate to be treated “if [he] is dangerous to himself or others” and (2) when “the

treatment is in the inmate’s medical interest.” Harper, 494 U.S. at 227. The Harper

opinion does not make these criteria the only basis for involuntary medication. See

id. at 227 (holding that the “Due Process Clause permits the State to treat a prison

inmate . . . with antipsychotic drugs against his will” under certain circumstances,

while not limiting treatment to those circumstances). The Supreme Court has

explained that an “overriding justification and a determination of medical

appropriateness” may justify the forced administration of “antipsychotic drugs on a

convicted prisoner.” Riggins v. Nevada, 504 U.S. 127, 135 (1992) (involuntary

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medication during trial is permissible where “medically appropriate and, considering

less intrusive alternatives, essential for the sake of [a defendant’s] own safety or the

safety of others” (emphasis added)).

In Harper, the Supreme Court also held that Washington’s policy for the

involuntary medication of inmates comported with the requirements of Due Process. 

Harper, 494 U.S. at 227. That policy allowed an inmate to be subjected to

involuntary medication “if he (1) suffers from a ‘mental disorder’ and (2) is ‘gravely

disabled’ or poses a ‘likelihood ofserious harm’ to himself, others, or their property.” 

Id. at 215 (emphasis added). The disjunctive demonstrates that “gravely disabled”

does not include dangerousness. Washington’s definition confirms this; someone

who is “gravely disabled” may“manifest[ ] severe deterioration in routine functioning

evidenced by repeated and escalating loss of cognitive or volitional control over his

or her actions and is not receiving such care as is essential for his or her health or

safety.” Id. at 215 n.3. 

Like Washington’s policy, Missouri’s Policy allows involuntary medication

when an inmate’s “mental illness interferes with [his] functioning in the institution,

yet no immediate danger exists. This includesthose who are gravely disabled or pose

a future likelihood of harm to self or others if treatment is not instituted.” (Emphasis

added). Under Missouri’s Policy, the gravely disabled include those who, like Green,

are “the psychotic offender who evidences delusions, hallucinations or other thought

disturbances” and those who suffer from “severely diminished institutional

adjustment.” Green need only be found gravely disabled before he may be

involuntarily medicated. 

4

While dangerousness is not required to comply with Harper, Green’s 4

dangerousness was the focus of the committee’s discussion when it made its

determination. Although committee members believed Green was not an imminent

danger, they felt that his “delusional system will feed to that at a later time,” that he

“could become a stalker,” and that he was beginning to project his sense of loss of

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B.

Green contendsthat his liberty interest in avoiding involuntary medication was

expanded by Missouri Department of Corrections Policy IS12-6.1, and that this

substantive right was violated. Green claims that Policy IS12-6.1 allows the

involuntary administration of antipsychotic medication only when, based upon the

opinion of a psychiatrist or a physician in conjunction with another mental health

profession, (1) an inmate’s symptoms “are determined to be a clinical emergency,”

and (2) alternative methods are not sufficient or suitable. As defined by Policy IS12-

6.1, a “clinical emergency” is limited to “cases where an offender is demonstrating

symptoms of acute mental disorder resulting in the offender being considered

imminently dangerous to self or others.” Green argues that, because neither the

committee assembled for his Due Process hearing nor the chief of mental health

services found that a clinical emergency existed, his treatment violates Policy IS12-

6.1. 

To the contrary, the Policy does not limit involuntary medication to a “clinical

emergency.” The Policy also allows involuntary medication in cases of “clinical

necessity.” A “clinical necessity” occurs when “mental illness interferes with [an

inmate’s] functioning in the institution, yet no immediate danger exists. This includes

those who are gravely disabled or pose a future likelihood of harm to self or others

if treatment is not instituted” and includes inmates who evidence “delusions,

hallucinations or other thought disturbances.” “Clinical necessity” was the basis for

Green’s involuntary medication. 

Green interprets the Policy’s language to require a “clinical emergency” before

a “clinical necessity” allows forced medication. He relies on the structure of the

control on others, a sign that a loss of control “is likely to happen at some time.” See

Harper, 494 U.S. at 232 (a court should not second-guess the findings of trained

medical professionals). 

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Policy, which outlines the two standards, places clinical emergency before clinical

necessity, and states: “When the continued involuntary administration of

[antipsychotic] medication is a clinical necessity, a clinical due process hearing

should occur.” According to Green, the word “continued” implies an uninterrupted

administration of medication from a previous emergency. 

Green’s interpretation is incorrect. The Policy sets forth two independent

avenues for involuntary medication. A clinical emergency occurs when an inmate

poses an imminent threat to himself or others, and immediate action is required. The

Policy allows prison officials immediately to medicate the inmate, without a due

process hearing (based on the opinion of a psychiatrist or a physician in conjunction

with another mental health professional). See Hogan v. Carter, 85 F.3d 1113, 1117-

18 (4th Cir. 1996) (en banc) (holding that Harper allows prison officials to dispense

with minimumDue Process requirements during emergencies in order to involuntarily

administer antipsychotic drugs). According to Missouri’s Policy, once the

“emergency has abated, [if] the psychiatrist or physician believes that involuntary

medication is still warranted, a clinical due process hearing should be arranged.” 

The Policy has an alternative avenue for involuntary medication: clinical

necessity. The Due Process Clause does not require that an inmate’s mental state

become an emergency before involuntary treatment may be imposed. See Riggins,

504 U.S. at 135 (holding that inmates may be involuntarily medicated when there is

an overriding justification). The “clinical necessity” applies to non-emergency

situations. These two standards reflect the Government’s legitimate interest “in

treating [Green] where medically appropriate for the purpose of reducing the danger

he poses,” Harper, 494 U.S. at 226, and the idea that “[t]he extent of a prisoner’s

right under the [Due Process] Clause to avoid the unwanted administration of

antipsychotic drugs must be defined in the context of the inmate’s confinement,” id.

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at 222. Green’s involuntary medication for a clinical necessity did not violate Policy

IS12-6.1, or his Fourteenth Amendment Due Process rights. 

III.

Green’s right to avoid involuntary medication is protected by minimum

procedural Due Process requirements. See Harper, 494 U.S. at 228. In Washington

v. Harper, the Supreme Court held that the procedural protections in Washington’s

policy for the involuntary administration of antipsychotic drugs met the requirements

of Due Process. Id. at 228. That policy included: (1) a hearing ; (2) a neutral and

detached trier of fact; (3) notice; (4) the inmate’s right to be present at the adversarial

hearing; (5) the inmate’s right to cross-examine witnesses; and, (6) the right to

appeal. Id. at 228, 231, 235. 

Green’s procedural rights were not violated. The Department of Corrections’

policy for the involuntary administration of antipsychotic drugs, Policy IS12-6.1

closely follows Washington’s policy approved in Harper. Before his forced

treatment, Green was given notice of his Due Process hearing, was present at it, and

was permitted to cross-examine witnesses. A neutral decisionmaker made the

decision, which Green appealed. 

IV.

In view of the discussion above, this court need not address Green’s arguments

that the district court should have appointed counsel for him, or that qualified

immunity does not apply in this case. 

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The judgment of the district court is affirmed.

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