IN THE

ARIZONA COURT OF APPEALS

DIVISION TWO

IN RE PIMA COUNTY MENTAL HEALTH NO. MH20130801

No. 2 CA-MH 2014-0006

Filed April 24, 2015

Appeal from the Superior Court in Pima County

No. MH20130801

The Honorable Peter W. Hochuli, Judge Pro Tempore

ORDER VACATED

COUNSEL

Mental Health Defender’s Office, Tucson

By Sarah Medley

Counsel for Appellant

Community Partnership of Southern Arizona, Tucson

By Ryan J. Thomsen

Counsel for Appellee 

OPINION

Judge Howard authored the opinion of the Court, in which 

Presiding Judge Kelly and Judge Vásquez concurred.

H O W A R D, Judge:

¶1 Appellant S.A. challenges the trial court’s signed 

minute entry granting a petition for continued court-ordered mental 

health treatment, filed by the Community Partnership of Southern 

Arizona (CPSA) pursuant to A.R.S. § 36-543(F). He argues the trial 
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2

court’s order should be vacated because the psychiatric examination 

performed by Dr. Robin Ross did not comply with statutory 

requirements for continuation of court-ordered treatment, as set 

forth in § 36-543(D) and (E), and because CPSA failed to establish, by 

clear and convincing evidence, that he has a “[p]ersistent or acute 

disability” as defined in A.R.S. § 36-501(31). For the following 

reasons, we vacate the court’s order.

Background

¶2 The underlying facts are undisputed. At all times 

relevant to these proceedings, S.A. was incarcerated in the Pima

County Adult Detention Center (PCADC). In October 2013, a 

PCADC employee applied for an involuntary evaluation of S.A.

pursuant to A.R.S. § 36-520, alleging in the application that S.A. had 

not been taking care of his personal hygiene, had smeared feces on 

himself and the wall of his cell, had been in a physical altercation 

while in custody, and had exhibited other aggressive and 

threatening behavior necessitating his removal from the PCADC 

general population. The applicant further alleged that S.A. had been 

uncooperative with PCADC staff, was in denial about his mental 

health problems, refused to speak with PCADC clinicians, and 

refused medications. 

¶3 The trial court ordered an evaluation, and two PCADC 

psychiatrists reported that S.A. had refused to take prescribed 

psychiatric medication and had been uncooperative when they 

attempted to evaluate him, telling one of the psychiatrists, “I refuse 

to talk with you due to the crimes committed against me.” The chief 

psychiatrist for PCADC filed a petition for court-ordered treatment 

pursuant to A.R.S. §§ 36-531(B), 36-533. Appointed counsel moved 

for a hearing on the petition, but S.A. refused to participate.

¶4 After finding S.A. had knowingly, voluntarily, and 

intelligently waived his presence, the court proceeded in S.A.’s 

absence. The court then granted the petition, finding S.A. was, as a 

result of a mental disorder, persistently or acutely disabled, a danger 

to others, and in need of psychiatric treatment. The court entered an 

order authorizing his involuntary mental health treatment, effective 

for one year.
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¶5 Pursuant to the trial court’s order, S.A. was enrolled for 

services with CPSA and assigned to Cope Community Services 

(COPE), an outpatient provider, even though he remained 

incarcerated.1 In September 2014, Ross, COPE’s medical director, 

conducted an annual review, as required by § 36-543(D), “to 

determine whether the continuation of [S.A.’s] court-ordered 

treatment [was] appropriate.” Pursuant to the same statute, she 

then appointed herself “to carry out a psychiatric examination of 

[S.A.].” Id. In accordance with § 36-543(F), the results of her

psychiatric examination were filed with CPSA’s petition seeking 

continuation of S.A.’s court-ordered treatment.

¶6 In the report of her psychiatric examination, Ross wrote

that, because S.A. had “been incarcerated since the time of his court 

ordered treatment,” all of his “appointments” had been “completed 

by chart review and reports by the jail psychiatrist,” and he had 

“never been seen by a C[OPE] psychiatrist.” She thus explained that 

S.A.’s “rollover appointment” “was completed per chart review due 

to [his] being incarcerated.” Ross opined that S.A. remained 

persistently or acutely disabled and in need of court-ordered 

treatment because he “ha[d] a history of not taking his prescribed 

psychiatric medications when he is not ordered by the courts to do 

so.” She also concluded he lacked insight into his mental illness

because “he wants off of all of his medications.”

¶7 At the hearing that followed, S.A., through counsel, 

moved to dismiss the petition, arguing Ross’s psychiatric 

examination was legally insufficient under § 36-543(D) and (E)

because she had never had personal contact with S.A. or an 

 

1In its answering brief, CPSA describes itself as the “Regional 

Behavioral Health Authority for Pima County,” under contract with 

the Arizona Department of Health Services “to administer the 

publicly-funded behavioral health care system in Pima County.” It 

further explains that COPE “is a Comprehensive Service Provider 

(CSP) under contract with CPSA to provide services to CPSAenrolled members” like S.A., and that “CPSA provides legal 

representation to its CSPs such as COPE” in matters related to CPSA 

members who are receiving court-ordered treatment. 
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opportunity to talk with him about his medication or to ask whether 

he would agree to voluntary treatment. The trial court denied the 

motion and received testimony on the petition from Ross and S.A.

¶8 Ross explained that “all information” she has about 

S.A.’s mental health treatment at PCADC “is [obtained] through” 

progress notes prepared by a COPE court liaison, whose notes, in 

turn, are derived from “talking directly to [S.A.] and from talking to 

the clinical staff at the jail.” Based on the court liaison’s notes, Ross 

said S.A. had “maintained well” on a long-acting, injectable, 

anti-psychotic medication he receives every two weeks. She also 

stated that, although the first injection was administered forcibly, 

S.A. had since submitted to the injections. According to Ross, 

PCADC clinical staff told COPE’s court liaison that S.A. had “been 

willing to take his injection” but “does not want to take the 

medication and has limited insight into [his] mental illness.” But 

Ross could not answer whether PCADC clinical staff otherwise had 

been having difficulty engaging S.A. in treatment, because she had 

“not read anything about” that issue in the court liaison’s progress 

notes.

¶9 When asked the basis for her recommendation that 

court-ordered treatment be continued, Ross stated that “what was 

most notable” was S.A.’s “presentation prior to starting medication.” 

She said she did not know his diagnosis, but he was “being treated 

. . . for a psychotic disorder . . . [for] symptoms that are consistent 

with psychosis [and] that cleared upon using an antipsychotic.” She

testified there was a “substantial probability” S.A. would “suffer 

severe and abnormal mental or physical or emotional harm” without 

treatment, noting that he had “display[ed] . . . pretty significant 

psychotic symptoms” before treatment began. 

¶10 S.A. testified that he believed his pre-treatment 

behavior had been caused by his “trying to get comfortable with 

[his] environment” at PCADC. He stated, “I was angry and I was 

scared so I was lashing out at some point.” He said the medication 

had caused him “[d]ozens of side effects like cold sweats, the shakes, 

lack of sleep, [and] lack of motivation.” He confirmed that he does 

not believe he has a mental illness; that he has consistently said, 

since involuntary treatment was ordered, that he did not want to 
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5

take the prescribed medications; that he was submitting to the 

injections because of the court’s order; and that, if the trial court did 

not order continued, involuntary treatment, he would stop taking 

the medication.

¶11 At the close of the hearing, the trial court granted 

CPSA’s petition, finding, by clear and convincing evidence, that S.A. 

“remain[ed], as a result of a mental disorder persistently or acutely 

disabled and in need of further court-ordered mental health 

treatment.” The court further found that, although S.A. “at times 

may be able and willing to comply with treatment on a voluntar[y]

basis, there are clearly periodic episodes wherein [he] is unable or 

unwilling to comply with treatment on a voluntar[y] basis.” This 

appeal followed.

Discussion

¶12 S.A. first argues the trial court erred in denying his 

motion to dismiss the petition for continued treatment prior to the 

hearing. He asserts that CPSA had failed to comply with 

§ 36-543(D) and (E) and that those provisions “require a face-to-face 

examination by the appointed psychiatrist.” In the alternative, he 

argues the court erred in finding clear and convincing evidence that 

the advantages, disadvantages, and alternatives to treatment had 

been explained to him, as required to support a determination that 

he remained “persistently or acutely disabled.”

¶13 “Because a person’s involuntary commitment ‘may 

result in a serious deprivation of liberty,’ strict compliance with the 

applicable statutes is required.” In re Pima Cnty. Mental Health No. 

MH-2010-0047, 228 Ariz. 94, ¶ 7, 263 P.3d 643, 645 (App. 2011), 

quoting In re Coconino Cnty. Mental Health No. MH 1425, 181 Ariz. 

290, 293, 889 P.2d 1088, 1091 (1995). When statutory requirements 

are not strictly met, we are required to vacate an involuntary 

treatment order. In re Pinal Cnty. Mental Health No. MH-201000076, 

226 Ariz. 131, ¶ 5, 244 P.3d 568, 569 (App. 2010). We address S.A.’s 

arguments in turn.
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Motion to Dismiss 

¶14 On appeal, we will review “any intermediate orders 

involving the merits of the action.” A.R.S. § 12-2102(A). Accordingly,

“[a]ppeal after entry of judgment typically is the proper method to 

challenge the denial of a motion to dismiss.” Sanchez v. Coxon, 175 

Ariz. 93, 94, 854 P.2d 126, 127 (1993); see Pima Cnty. No. MH-2010-0047, 

228 Ariz. 94, ¶¶ 5, 7, 263 P.3d at 644-45 (reviewing denial of motion 

to dismiss on appeal after final judgment). “Although we generally 

review [a] trial court’s denial of a motion to dismiss for an abuse of 

discretion,” we review de novo an issue of statutory interpretation.

Edonna v. Heckman, 227 Ariz. 108, ¶ 8, 253 P.3d 627, 628 (App. 2011). 

¶15 A trial court may order involuntary mental health 

treatment only upon finding, by clear and convincing evidence,

“that the proposed patient, as a result of mental disorder, is a danger 

to self, is a danger to others, has a persistent or acute disability or a 

grave disability and [is] in need of treatment, and is either unwilling 

or unable to accept voluntary treatment.” A.R.S. § 36-540(A). When 

a court orders involuntary mental health treatment through an 

“outpatient” program, as the court did here in October 2013, the 

duration of the order “shall not exceed three hundred sixty-five 

days.” § 36-540(D); see also A.R.S. § 36-542(A) (patient in courtordered treatment discharged at expiration of order unless patent 

accepts treatment voluntarily or “new petition is filed”).

¶16 Pursuant to § 36-543(D), within ninety days before a 

treatment order expires, the medical director of the supervising 

treatment agency “shall conduct an annual review . . . to determine 

whether the continuation of court-ordered treatment is appropriate.” 

If, after annual review of “the mental health treatment and clinical 

records contained in the patient’s treatment file,” the medical 

director believes continuation of court-ordered treatment is 

appropriate, he or she “shall appoint one or more psychiatrists to 

carry out a psychiatric examination of the patient.” Id. 

¶17 A psychiatrist appointed to participate in such an

examination “must consider, along with all other evidence, the 

patient’s history before and during the current period of courtordered treatment, the patient’s compliance with recommended 
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treatment[,] and any other evidence relevant to the patient’s ability 

and willingness to follow recommended treatment with or without a 

court order.” § 36-543(E). An examining psychiatrist must then 

provide, in a report to the medical director, “opinions as to whether 

the patient continues to have a grave disability or a persistent or 

acute disability as the result of a mental disorder” and is “in need of 

continued court-ordered treatment.” Id.

¶18 After completion of this process, the medical director 

may file an application for continued court-ordered treatment “and 

shall file simultaneously with the application any psychiatric 

examination conducted as part of the annual review.” § 36-543(F). 

If a hearing is requested, the applicant must prove, by clear and 

convincing evidence, (1) “[t]he patient continues to have a mental 

disorder and, as a result of that disorder, has either a persistent or 

acute disability or a grave disability”; (2) “[t]he patient is in need of 

continued court-ordered treatment”; and (3) “[t]he patient is either 

unwilling or unable to accept treatment voluntarily.” § 36-543(H).

¶19 In large part, the parties dispute the meaning of the 

“psychiatric examination” required to support a petition for 

continued court-ordered treatment. S.A. maintains this provision 

“means an examination of the person, not of his record,” and he 

argues the petition should have been dismissed because Ross, acting 

as an appointed examining psychiatrist under § 36-543(D), failed to 

comply with this statutory requirement.

¶20 Without addressing S.A.’s argument that the statute’s 

reference to “examination of the patient” requires a psychiatrist to 

observe or communicate with the patient, CPSA contrasts the 

provisions of § 36-543(D) and (E), which it argues do not “provide or 

suggest that personal observations are a necessary component of a 

psychiatric examination” for purposes of continued treatment, with 

A.R.S. § 36-539(B), which requires that a hearing on an original 

petition for treatment must include testimony regarding the 

evaluating physicians’ personal observations. According to CPSA, 

“The Arizona legislature knew how to require a psychiatric 

examination to include personal observations . . . but chose not to” 

and, therefore, § 36-543 “clearly and unambiguously does not 

require a psychiatric examination to be based on personal 
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observations.” CPSA also points out that, in 2012, the legislature 

“amended [title 36, chapter 5] to clarify the evaluation and 

examination requirements for purposes of Court-Ordered 

Treatment,” and, in doing so, “removed the definition of 

‘examination’ from § 36-501.” See 2012 Ariz. Sess. Laws, ch. 334, § 1. 

¶21 We agree with CPSA that some of the recent 

amendments to title 36, chapter 5, were intended to clarify that a 

psychiatrist’s opinions regarding initial court-ordered treatment 

could be based on “remote observations by interactive audiovisual 

media,” § 36-501(12), in response to this court’s determination that 

such observations were insufficient to meet the statute’s previous

requirement that physicians “personally conduct a physical 

examination of [the] patient,” In re Pinal Cnty. Mental Health No. 

MH-201000029, 225 Ariz. 500, ¶ 21, 240 P.3d 1262, 1268 (App. 2010). 

But in contemporaneous amendments, the legislature also 

substantially revised the procedure to be followed to continue courtordered treatment for patients initially found to be suffering from a 

persistent or acute disability.

¶22 Before 2005, § 36-543 only addressed continued courtordered treatment for those patients initially found to have a grave 

disability. See 1999 Ariz. Sess. Laws, ch. 83, § 11. The statute was 

then amended to provide for continued involuntary treatment of a 

patient initially found to be persistently or acutely disabled, but only 

after “the medical director of the mental health treatment agency 

determine[d] that the patient has been substantially noncompliant 

with treatment during the period of the court order” and “an annual 

examination and review” was conducted, with a psychiatrist 

appointed “to carry out the examination.” 2005 Ariz. Sess. Laws, 

ch. 291, § 2.

¶23 In 2011, the legislature amended this provision, striking 

“examination” from the statute and requiring only that an appointed 

psychiatrist conduct “an annual review.” 2011 Ariz. Sess. Laws, 

ch. 19, § 4; see also Senate Fact Sheet, H.B. 2635, 50th Leg., 1st Reg. 

Sess. (Ariz. Apr. 8, 2011) (stating revision “[e]liminate[d] the 

requirement to conduct a physical examination of a patient as a 

component of the annual review of . . . court-ordered treatment”).
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¶24 But in 2012, the legislature enacted more substantial 

changes to § 36-543, as reflected in the current statute. It eliminated

the requirement that a patient be found substantially non-compliant 

with treatment before the court order could be continued, but it 

required the medical director, within newly specified time frames, to 

personally “review” treatment records and, if that review suggested 

continued court-ordered treatment was appropriate, to appoint a

psychiatrist to “carry out a psychiatric examination of the patient.” 

2012 Ariz. Sess. Laws, ch. 334, § 6. Thus, having eliminated the 

requirement for a psychiatric examination in 2011, the legislature 

reinstated it in 2012. In light of the legislature’s recent distinction 

between “review” and “examination,” see id.; 2011 Ariz. Sess. Laws, 

ch. 219, § 4, we cannot conclude it intended the two terms to be 

synonymous, as CPSA seems to suggest.

¶25 We agree with S.A. that the legislature contemplated a 

two-step process that has not occurred here. Ross, as medical 

director, reviewed the treatment records and concluded additional 

treatment was necessary. But there was no evidence anyone

performed an additional “psychiatric examination,” which 

presumably would have provided firsthand information on S.A.’s 

current condition.2 

¶26 “Generally, we will vacate a treatment order absent 

strict compliance with the applicable statutory provisions.” Pima 

 

2 We find persuasive S.A.’s argument that a “psychiatric 

examination of the patient” must, at a minimum, include a 

psychiatrist’s observations of him. See In re MH 2008-000438, 220 

Ariz. 277, ¶ 14 & n.3, 205 P.3d 1124, 1127 & n.3 (App. 2009) (“[A] 

psychiatric examination . . . includes observing the patient’s 

demeanor and physical presentation, and can aid in diagnosis.”). 

But because the facts here do not support a conclusion that any 

examination was conducted after the medical director’s initial 

review of records, we need not determine the scope of the 

examination required by § 36-543(E). S.A. does not argue that Ross 

was prohibited from appointing herself as an examining psychiatrist 

pursuant to § 36-543(D), and we do not consider the issue.
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Cnty. No. MH-2010-0047, 228 Ariz. 94, ¶ 7, 263 P.3d at 645. We 

conclude we must do so here.

Evidence of Persistent or Acute Disability

¶27 Although CPSA’s failure to strictly comply with 

§ 36-543 requires us to vacate the trial court’s order for continued 

treatment, we address S.A.’s second argument because of the 

importance of the liberty interests at stake and because “the merits 

of this issue potentially evade our review.” Coconino Cnty. No. 1425, 

181 Ariz. at 292, 889 P.2d at 1090 (notwithstanding mootness, 

considering “significant” involuntary treatment procedural issue 

that may evade review due to “statutory time limits on commitment 

orders and the delays inherent in the appellate process”); see also In 

re Maricopa Cnty. Mental Health No. MH 90-00566, 173 Ariz. 177, 180, 

840 P.2d 1042, 1045 (App. 1992) (noting “involuntary commitment 

order affects important liberty interest” in deciding to address moot 

issue that may evade review). “We view the facts in the light most 

favorable to sustaining the trial court’s judgment,” In re MH

2008-001188, 221 Ariz. 177, ¶ 14, 211 P.3d 1161, 1163 (App. 2009), and 

we will not reverse an involuntary treatment order for insufficient 

evidence “unless it is ‘clearly erroneous or unsupported by any 

credible evidence,’” In re MH 2008-000438, 220 Ariz. 277, ¶ 6, 205 

P.3d 1124, 1125 (App. 2009), quoting In re Maricopa Cnty. Mental 

Health Case No. MH 94-00592, 182 Ariz. 440, 443, 897 P.2d 742, 745 

(App. 1995). However, we review de novo the application and 

interpretation of statutes involving involuntary mental health 

treatment. Id.

¶28 To prevail on its petition to renew court-ordered 

treatment, CPSA was required to prove, by clear and convincing 

evidence, that S.A. “continues to have a mental disorder and, as a 

result of that disorder, has . . . a persistent or acute disability.” 

§ 36-543(H). And, to establish S.A. has a persistent or acute 

disability, CPSA was required to prove, inter alia, that he has 

a severe mental disorder that . . . causes 

[him] to be incapable of understanding and 

expressing an understanding of the 

advantages and disadvantages of accepting 
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treatment and understanding and 

expressing an understanding of the 

alternatives to the particular treatment 

offered after the advantages, disadvantages 

and alternatives are explained to [him]. 

§ 36-501(31)(b).

¶29 Construing this statutory language, we held that “as a 

predicate to [the court] determining whether a mentally-ill person is 

capable of engaging in a rational decision-making process” 

concerning treatment, “the doctors must explain the advantages and 

disadvantages of accepting treatment[] and . . . the alternatives to 

such treatment and the advantages and disadvantages of such 

alternatives.” In re Maricopa Cnty. Mental Health No. MH 91-00558, 

175 Ariz. 221, 225, 854 P.2d 1207, 1211 (App. 1993). “Unless the 

doctors have explained these matters to the mentally-ill person, the 

applicant cannot establish that such person’s capacity to make an 

informed decision is impaired.” Id.

¶30 We also have observed that this requirement may be 

excused upon “clear and convincing [evidence] that it was 

impracticable” to explain the advantages and disadvantages of 

treatment alternatives to the patient, such as when a patient engages 

in “excessive verbal abuse, physical abuse, repeatedly walking away 

when the physicians attempt to discuss the matters, or 

nonresponsiveness.” Maricopa Cnty. No. MH 94-00592, 182 Ariz. at

446, 897 P.2d at 748. Thus, “we do not believe that mental health 

officials must engage in a confrontation with a mentally ill patient or 

have the patient physically restrained in order to fulfill the letter of 

the requirement.” In re Pima Cnty. Mental Health No. MH-1140-6-93, 

176 Ariz. 565, 567-68, 863 P.2d 284, 286-87 (App. 1993).

¶31 Before the initial order for treatment, S.A. refused to 

discuss treatment, as shown by a psychiatrist’s detailed explanation 

that when he attempted to engage S.A. in such discussion, S.A. 

became increasingly agitated and eventually said, in a raised voice, 

“Please leave my cell front.” But when Ross was asked about more 

recent attempts to engage S.A. about his treatment, she said that he 

had “been willing to take his injection[s]” and that “[t]he [PCADC] 
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clinical team would tell our liaison that there is a lack of insight into 

his psychosis and the need for treatment,” but that “in terms of any 

other engagement [she] ha[d] not read anything about it.” When 

asked whether S.A.’s mental illness substantially impaired his 

capacity to make an informed decision about treatment, Ross 

answered, “I would say yes it does[,] but again that is a bit of a 

stretch, based on what I’ve read in the chart.” Similarly, when asked 

whether she believed S.A. was “capable of understanding and 

expressing an understanding of the advantages and disadvantages 

of treatment,” she relied on his initial refusal of treatment in the fall 

of 2013, stating this was “[t]he only thing” she “really ha[d] to go on 

in the records.” 

¶32 Although CPSA acknowledges that § 36-543 requires a 

petitioner to show the patient presently remains persistently or 

acutely disabled, it attempts to distinguish Maricopa County No. MH 

91-00558 on the basis that the physicians in that case had performed 

evaluations in support of an initial order for treatment pursuant to 

§ 36-533(B), not examinations pursuant to § 36-543(B). It argues that, 

in contrast to those physicians, Ross “ha[d] the benefit of [a] year[’s]

worth of clinical records to aid in the decision-making process [and] 

. . . was able to form a reasoned opinion” about S.A.’s capacity to 

understand the advantages and disadvantages of treatment, after 

those matters had been explained to him, “without personally 

interviewing him.”

¶33 S.A. testified he did not think he had a mental disorder 

and was only taking the medications because of the court order. But 

there was no evidence that anyone had attempted to engage him

about the advantages and disadvantages of treatment after his courtordered treatment began in the fall of 2013, and no evidence that 

S.A. had ever resisted such discussion. 

¶34 Section 36-501(31)(b) requires more than evidence that a 

patient wishes to decline treatment, see Maricopa Cnty. No.

MH-90-00566, 173 Ariz. at 184, 840 P.2d at 1049, and it “requires 

more than a physician’s opinion that [he] suffers from a mental 

disorder that impairs [his] ability to make an informed decision 

about treatment,” Maricopa Cnty. No. MH 91-00558, 175 Ariz. at 225, 

854 P.2d at 1211. The statute “focuses on the mentally-ill 
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individual’s decision-making process rather than on the content of 

the decision,” and, pursuant to the statute, that process may be 

found inadequate only after the advantages, disadvantages, and 

alternatives to treatment have been explained. Maricopa Cnty. No. 

MH-90-00566, 173 Ariz. at 184, 840 P.2d at 1049; see also In re Maricopa 

Cnty. Mental Health No. MH 2007-001236, 220 Ariz. 160, ¶ 29, 204 

P.3d 418, 427 (App. 2008) (to support involuntary treatment order, 

physician’s opinion must be “expressed to a reasonable degree of 

medical certainty”). 

¶35 This court has recognized that “many patients who 

respond favorably to treatment need not be subjected to continued 

court-ordered treatment.” Maricopa Cnty. No. MH 94-00592, 182 

Ariz. at 445, 897 P.2d at 747. In this case, Ross acknowledged that 

S.A.’s psychotic symptoms had “cleared” after his treatment began 

and testified that “[u]sually insight is progressive and the length of 

time someone is stable the more insight they gain.” Before an order 

for treatment may be extended beyond its original term, a petitioner 

must present evidence of some recent testing of a patient’s 

incapacity “to make an informed decision regarding treatment . . .

after the advantages, disadvantages and alternatives are explained.” 

§ 36-501(31)(b). Although PCADC clinical staff may have engaged 

S.A. in discussions about his treatment, there is no evidence in the

record that such an exchange occurred, and CPSA therefore failed to 

prove, by clear and convincing evidence, that S.A. remained 

persistently and acutely disabled.

Disposition

¶36 For the foregoing reasons, we vacate the trial court’s 

order continuing S.A.’s involuntary mental health treatment 

pursuant to § 36-543.