Notice: This opinion is subject to correction before publication in the PACIFIC REPORTER. 

Readers are requested to bring errors to the attention of the Clerk of the Appellate Courts, 

303 K Street, Anchorage, Alaska 99501, phone (907) 264-0608, fax (907) 264-0878, email 

corrections@akcourts.gov.

THE SUPREME COURT OF THE STATE OF ALASKA

NATIVE VILLAGE OF 

KWINHAGAK, 

 Appellant, 

v. 

STATE OF ALASKA, DEPARTMEN

OF HEALTH & SOCIAL SERVICES,

OFFICE OF CHILDREN’S 

SERVICES; MIRA J.; and ELAINE G.

T 

,

 Appellees. 

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Supreme Court No. S-18481

uperior Court No. 4BE-19-00046 CN

 P I N I O N

o. 7684 – February 9, 2024

S

O

N

Appeal from the Superior Court of the State of Alaska, 

Fourth Judicial District, Bethel, Terrence P. Haas, Judge.

Appearances: Pearl E. Pickett, Alaska Legal Services 

Corporation, Anchorage, for Appellant. Laura Fox, Senior 

Assistant Attorney General, Anchorage, and Treg R. Taylor,

Attorney General, Juneau, for State of Alaska. Katie 

Stephenson, Assistant Public Advocate, and James Stinson, 

Public Advocate, Anchorage, for Mira J. Justin Gillette, 

Assistant Public Defender, and Samantha Cherot, Public 

Defender, Anchorage, for Elaine G.

Before: Maassen, Chief Justice, and Carney, Borghesan, 

Henderson, and Pate, Justices. 

BORGHESAN, Justice. 
-2- 7684

INTRODUCTION

This case is about the legal process that applies when the Office of 

Children’s Services (OCS) seeks to admit a child in its custody to the hospital for 

psychiatric care. The teenaged child at the center of this case was hospitalized 

continuously for 46 days — first at a local hospital, then at North Star Hospital, an acute 

psychiatric hospital for minors — before the court held a hearing to decide whether her

hospitalization was justified. 

The statutes governing child in need of aid (CINA) proceedings give OCS 

the duty and authority to seek emergency medical care for the children in its custody. 

One statute in particular, AS 47.10.087, requires judicial review when OCS seeks to 

place a child at a secure residential psychiatric treatment facility. But the facilities to 

which OCS brought the child in this case do not meet that definition. And there is no 

other provision of the CINA statutes that limits OCS’s authority to seek admission of 

children to the hospital for psychiatric care. OCS is subject only to an injunction that 

requires an “AS 47.10.087-type hearing” to be held within 30 days after it admits a 

child to North Star. 

The child’s tribe argues that a different statutory framework governed the 

child’s hospitalization: the civil commitment statutes. The Tribe also argues, in the 

alternative, that the constitution did not permit OCS to hospitalize a child for such a 

long time without a court hearing to determine whether the hospitalization was justified. 

We reject the Tribe’s statutory argument. OCS was not required to follow 

the civil commitment statutes when admitting the child to either hospital. However, 

when OCS sought to admit the child to the hospital for psychiatric care, the due process 

clause of the Alaska Constitution required OCS to promptly notify the parties to the 

CINA case. Due process also required the court to hold a hearing as soon as reasonably 

possible to determine whether the hospitalization was justified. The 46-day wait 

between the child’s first admission to the hospital and the hearing held in this case was 
-3- 7684

far too long to satisfy due process. We therefore reverse the court’s order authorizing 

the child’s continued hospitalization. 

FACTS AND PROCEEDINGS

A. Mira’s Hospitalization

 Mira J., a member of the Native Village of Kwinhagak (the Tribe), was 

adjudicated a child in need of aid and placed in OCS custody in late 2019.1

 She was 14 

years old at the time. The Tribe intervened as a party in the CINA case. OCS placed 

Mira in foster care in Sitka. 

 Mira’s foster parent brought her to Sitka Community Hospital (Sitka) on 

December 3, 2021, after Mira consumed alcohol and her foster parent’s prescription 

medication. Ten days later OCS issued a “delayed notice of change of placement” to 

the parties to the CINA case to inform them that it had “placed” Mira at Sitka. 

 Within a few hours of Mira’s admission to Sitka, a clinician advised that 

Mira did not require “24/7 supervision[,] just ongoing counseling and support.” But 

Mira’s previous foster family refused to accept her back into their home due to her 

behaviors. While OCS looked for another foster home, Mira “opened up about her past 

trauma” to the Sitka clinician and experienced ataxia2 symptoms and a panic attack that 

caused her to struggle “to move her limbs and to breathe.” These events caused the 

clinician to recommend “acute residential treatment,” and OCS transferred Mira to 

North Star Hospital (North Star), a psychiatric hospital in Anchorage. The record does 

not specify when the Sitka clinician changed her recommendation, although OCS 

1

 A pseudonym is used to protect her privacy.

2 “An inability to coordinate muscle activity during voluntary movement; 

most often results from disorders of the cerebellum or the posterior columns of the 

spinal cord; may involve the limbs, head, or trunk.” Ataxia, STEDMAN’S MEDICAL 

DICTIONARY, Westlaw (database updated Nov. 2014).
-4- 7684

apparently decided to transfer Mira to North Star by December 14.3 Mira was moved 

directly from Sitka to North Star on December 20 or 21. OCS notified the parties on 

December 22 that Mira had been moved to North Star, only after the Tribe requested 

an update on Mira’s status. 

B. Legal Proceedings

 On December 22 the Tribe moved for a hearing and expedited 

consideration under the civil commitment statutes (AS 47.30.700 – 47.30.815). This 

was the first request for judicial review of Mira’s inpatient psychiatric treatment by any 

party. OCS did not oppose the Tribe’s request for a hearing or expedited consideration, 

but OCS did not agree that the superior court should apply the civil commitment 

statutes. The superior court issued an order appointing counsel for Mira and scheduling 

a hearing for December 30, 2021 — 27 days after Mira had first been hospitalized and 

8 days after OCS had transferred her to North Star. 

 The superior court repeatedly rescheduled that hearing to ensure that 

counsel could represent Mira and that a key witness from North Star could attend. The 

court finally considered the Tribe’s motion at a hearing on January 18, 2021 — 46 days 

after Mira had been initially hospitalized at Sitka and 29 days after OCS transferred her 

to North Star. 

 During these proceedings the parties advanced different positions on the 

legal framework applicable to Mira’s case. OCS asserted that because it had legal 

custody of Mira under the CINA statutes, it had authority to admit her to the hospital 

for psychiatric care, subject only to a permanent injunction issued by the superior court 

in Native Village of Hooper Bay v. Lawton.

4

 In that case the superior court considered 

3

 The assigned OCS caseworker was on leave when Mira’s foster parent 

brought her to Sitka and was not part of the decision to transfer Mira to North Star. The 

decision to transfer Mira to North Star had already been made by the time the 

caseworker returned to the office on December 14. 

4

 No. 3AN-14-5238 CI (Alaska Super., Feb. 12, 2015). 
-5- 7684

whether AS 47.10.087, which governs OCS’s authority to place children in its custody 

in a “secure residential psychiatric treatment center,” applied to North Star.5

 The court 

held that North Star did not meet the statutory definition, so the standards of 

AS 47.10.087 were not directly applicable.6 But it concluded that the constitution 

required some judicial oversight of OCS’s decision to admit a child to an acute 

psychiatric hospital like North Star.7 Accordingly the court enjoined OCS “from 

holding any child under the care of OCS for longer than 30 days at North Star Hospital 

without conducting an AS 47.10.087-type of hearing.”8 In the January hearing 

regarding Mira’s hospitalization, OCS maintained that the Hooper Bay injunction 

established the correct procedure for Mira’s admission to North Star. 

 The Tribe countered that the court must instead review Mira’s 

hospitalization according to the civil commitment statutes. Those statutes authorize 

any person to petition for the evaluation and involuntary psychiatric hospitalization of 

an adult or minor.9 When a petition for civil commitment is filed, the court’s 

5 Id. at 7.

6 Id. at 9-10.

7 Id. at 16-18.

8 Under AS 47.10.087, OCS may place a child in its custody in a “secure 

residential psychiatric treatment center” if a court finds, “based on the testimony of a 

mental health professional, that (1) the child is gravely disabled or is suffering from 

mental illness and, as a result, is likely to cause serious harm to the child or to another 

person; (2) there is no reasonably available, appropriate, and less restrictive alternative 

for the child’s treatment or that less restrictive alternatives have been tried and have 

failed; and (3) there is reason to believe that the child’s mental condition could be 

improved by the course of treatment or would deteriorate if untreated.” 

9 AS 47.30.700 (authorizing “any adult” to petition for screening 

investigation and judicial determination within 48 hours whether “there is probable 

cause to believe the respondent is mentally ill and that condition causes the respondent 

to be gravely disabled or to present a likelihood of serious harm to self or others”); see 

also AS 47.30.705 and AS 47.30.707(a) (authorizing peace officer, mental health 
-6- 7684

involvement is triggered almost immediately, and a contested hearing must be held 

within a matter of days to review whether involuntary hospitalization is justified.

10

 The parties also disagreed over whether the evidence justified Mira’s 

hospitalization under either legal framework. OCS and Mira’s guardian ad litem (GAL)

argued, pursuant to AS 47.10.087, that Mira suffered from mental illness, was likely to 

cause serious harm to herself or others, and should remain at North Star until accepted 

into a less restrictive facility. OCS presented the testimony of North Star’s clinical 

director. The director testified that Mira’s psychiatrist had diagnosed her with various 

mental health conditions. The director opined that those conditions, paired with Mira’s 

verbal aggression toward peers and suicidal thoughts, suggested that Mira would 

deteriorate if untreated and was likely to harm herself or others. Under crossexamination, the director recounted an episode in which Mira had consumed hand 

sanitizer. When asked about less restrictive alternatives, the director explained that she 

had sent referrals to several in-state residential facilities a week prior and had not yet 

heard back from any of them. OCS also presented testimony by the assigned 

caseworker, who confirmed that Mira had “very clearly stated that she is not happy 

being there, that she does not want to be at North Star.” 

Mira and her mother argued that OCS did not prove that Mira was likely 

to harm herself or others and that OCS had not met its burden to show that there was 

no less restrictive alternative to her placement at North Star. The Tribe joined these 

arguments, adding that OCS had transferred Mira to North Star “without giving [Mira] 

any sort of hope of due process.” The Tribe also asked the court to “rule on whether or 

not this is, in fact, an [AS 47.10.087] proceeding” or “a continuation of a civil 

commitment that should have been initiated at the beginning of December.” 

officer, or other medical professional to take person into custody for evaluation starting 

within 24 hours of arrival).

10 See AS 47.30.700-.730.
-7- 7684

 The superior court entered an oral ruling. It ruled that AS 47.10.087 

applied to Mira’s proceedings and that the civil commitment statutes did not (the court 

did not mention the Hooper Bay injunction). Yet the court expressed ambivalence 

about its decision. It drew comparisons between Mira’s case and our decision in In re 

Hospitalization of April S., which concerned OCS’s attempt to rely on the civil 

commitment statutes to admit a minor to a state-run psychiatric facility.

11 The court 

stated that in both cases, “you have a child who’s been admitted to a facility, whether 

it’s admitted with [or without] consent of a parent, and then it’s . . . at the hands of OCS 

to, if it’s under a .087, to get the ball rolling to find a less restrictive facility.” But the 

court observed that if the minor’s admission was pursuant to the civil commitment 

statutes, “much more rights are entitled to the minor.” The court questioned “why 

somebody in OCS custody would be entitled to less rights,” but concluded “that’s 

clearly what 47.10.087 does.” Although the court determined that AS 47.10.087 

applied to Mira’s proceedings, it expressed reservations about this result and suggested

that parties’ actual practice should be closer to what is required by civil commitment 

statues, which the court opined were “not a great burden on anybody.” 

 The court then found that the criteria of AS 47.10.087 had been met. It 

determined that although Mira was “not intending to overdose” on the substances that 

brought her to Sitka, she was “getting close to that, an attempt to kill herself.” The hand 

sanitizer incident suggested to the court that “she’s continuing to engage in this type of 

behavior.” The court therefore concluded that Mira was suffering from mental illness 

“and as a result, is likely to cause serious harm to herself.” 

 The superior court rebuked North Star and OCS for failing to apply to less 

restrictive facilities until a few days before the hearing, characterizing this failure as “a 

lack of planning and foresight.” But it nonetheless found that no less restrictive 

11 499 P.3d 1011, 1012 (Alaska 2021).
-8- 7684

alternative was available at that time. Finally, the court expressed skepticism that 

Mira’s condition would improve at North Star, but found that “her condition would 

deteriorate if . . . untreated.” The court authorized Mira’s continued placement at North 

Star for 90 days12 but set another hearing three weeks later to review placement options. 

 The Tribe appeals. It challenges the superior court’s ruling on the 

applicable legal framework but not the court’s factual findings. 

STANDARDS OF REVIEW

 Because the Tribe asks this court only to interpret statutes and the Alaska 

Constitution, de novo review applies.13 We adopt the rule of law that is most persuasive 

in light of precedent, reason, and policy.14

 Questions of standing and mootness “are questions of law involving 

matters of judicial policy,” so we use our independent judgment when answering 

them.15

 We review issues raised for the first time on appeal for plain error.16 Plain 

error exists if an “obvious mistake”17 is “so prejudicial that failure to correct it will 

perpetuate a manifest injustice.”18 

12 See AS 47.10.087 (instructing courts to review placements made under 

the statute “at least once every 90 days”).

13 Petrolane Inc. v. Robles, 154 P.3d 1014, 1018 (Alaska 2007).

14 Id.

15 Fairbanks Fire Fighters Ass’n, Loc. 1324 v. City of Fairbanks, 48 P.3d 

1165, 1167 (Alaska 2002). 

16 In re Hospitalization of Connor J., 440 P.3d 159, 163 (Alaska 2019).

17 In re Hospitalization of Gabriel C., 324 P.3d 835, 838 (Alaska 2014).

18 Donahue v. Ledgends, Inc., 331 P.3d 342, 356 n.75 (Alaska 2014) 

(quoting Forshee v. Forshee, 145 P.3d 492, 500 n.36 (Alaska 2006)). Although the 

Tribe argues that the plain error standard is more permissive in the constitutional 

context, the case it cites discusses the criminal plain error rule, which arises from Alaska 
-9- 7684

DISCUSSION

A. We Consider Most Issues Raised By The Tribe Under The Public 

Interest Exception To The Mootness Doctrine.

 This case presents several statutory and constitutional questions: (1) 

whether OCS must follow civil commitment procedures when admitting children in its 

custody to a hospital for psychiatric treatment; (2) whether the Tribe has standing to 

assert Mira’s constitutional rights; and (3) whether the lengthy period that Mira was 

hospitalized at OCS’s direction before a hearing was held satisfies Alaska’s 

constitutional guarantees of equal protection and due process. All of these questions 

are moot because Mira was discharged from psychiatric hospitalization long ago. But 

with one exception, we decide these issues under the public interest exception to the 

mootness doctrine. 

 We consider three factors when deciding to apply the public interest 

exception to the mootness doctrine: “(1) whether the disputed issues are capable of 

repetition, (2) whether the mootness doctrine, if applied, may cause review of the issues 

to be repeatedly circumvented, and (3) whether the issues presented are so important to 

the public interest as to justify overriding the mootness doctrine.”19 

These factors support addressing most of the issues raised by the Tribe. 

Although the superior court’s order has long expired, the State concedes that most 

issues the Tribe raises will recur and, due to the typically short periods of 

hospitalization, will repeatedly evade review. Clarifying the legal protections for a 

Criminal Rule 47(b) and does not apply here. See Adams v. State, 261 P.3d 758, 770-

71 (Alaska 2011). 

19 Blythe P. v. State, Dep’t of Health & Soc. Servs., Off. of Child.’s Servs., 

524 P.3d 238, 244 (Alaska 2023) (quoting In re Off. of Pub. Advoc., 514 P.3d 1281, 

1285 (Alaska 2022)); id. (noting “no one factor is dispositive”).
-10- 7684

vulnerable population of children in state custody is of utmost public importance.

20 We 

must therefore determine which statutory framework governs the acute psychiatric 

hospitalization of minors in OCS custody and whether that framework satisfies 

constitutional requirements. 

 However, we agree with the State that the public interest exception to the 

mootness doctrine does not extend to one aspect of the Tribe’s statutory argument: the 

definition of “evaluation facilities.” In the period following Mira’s hospitalization the

legislature modified the statutory definition of “evaluation facility” so that it no longer 

includes “a medical facility licensed under AS 47.32” — the language that seemingly 

included both Sitka and North Star.21 Whether these facilities were “evaluation 

facilities” under an old version of the statute, and whether their status as “evaluation 

facilities” required the superior court to apply AS 47.30.700 et seq., are no longer issues 

that could recur in future cases.22 We decline to consider this moot issue. 

B. The Civil Commitment Statutes Did Not Apply To Mira’s 

Hospitalization. 

The parties disagree over the correct statutory framework governing 

OCS’s authority to admit Mira to a hospital for inpatient psychiatric care. In our recent 

decision in Tuluksak Native Community v. Department of Health & Social Services, we 

held that the superior court did not err by applying AS 47.10.087 to evaluate a child’s 

admission to North Star, rejecting a different tribe’s argument that that the admission 

20 See, e.g., id. (citing Jennifer L. v. State, Dep’t of Health & Soc. Servs., 357 

P.3d 110, 114 (Alaska 2015); Peter A. v. State, Dep’t of Health & Soc. Servs., Off. of 

Child.’s Servs., 146 P.3d 991, 996 & n.30 (Alaska 2006)).

21 See Ch. 41 § 28, SLA 2002. 

22 Cf. Akpik v. State, Off. of Mgmt. & Budget, 115 P.3d 532, 535 (Alaska 

2005) (declining to apply the public interest exception to mootness where the relevant 

statutes had been changed). 
-11- 7684

was subject to the civil commitment statutes.23 But the issues in that case were framed 

differently than they are in this case, so that decision does not control our analysis 

here.24 

In this case the Tribe argues that OCS was required to petition for Mira’s 

involuntary commitment under AS 47.30.700 and that the superior court erred by not 

applying the strict timelines and procedural safeguards of the commitment statutes to 

Mira’s hospitalization. If those statutes applied, OCS would have had to petition for 

Mira’s hospitalization when it took her to Sitka, and the superior court would have had 

to hold a hearing on whether Mira’s hospitalization was justified within just a few 

days.25 

OCS counters that it had authority by virtue of its legal custody under the 

CINA statutes to bring Mira to the hospital to receive psychiatric care. OCS takes the 

position that because it has this separate source of authority, it did not have to petition 

for Mira’s involuntary commitment, and therefore was not subject to the procedures 

that apply to petitions for involuntary commitment. We agree with OCS’s interpretation 

of the statutory framework. 

23 530 P.3d 359, 368-69 (Alaska 2023).

24 For example, in Tuluksak the parties did not take the position that North 

Star is not a secure residential psychiatric treatment facility admission for purposes of 

AS 47.10.087. 

25 AS 47.30.700 (authorizing “any adult” to petition for screening 

investigation and judicial determination within 48 whether “there is probable cause to 

believe the respondent is mentally ill and that condition causes the respondent to be 

gravely disabled or to present a likelihood of serious harm to self or others”); see also

AS 47.30.705 (authorizing peace officer, mental health officer, or other medical 

professional to take person into custody for evaluation starting within 24 hours of 

arrival); AS 47.30.715 (setting forth procedures for evaluation facilities to conduct 

evaluations following receipt of evaluation orders, as well as procedures for court to set 

30-day commitment hearing); AS 47.30.730 (establishing procedural and substantive 

requirements for petition for 30-day commitment). 
-12- 7684

OCS has the power to take a child to the hospital in a medical emergency. 

When a child is placed in OCS’s custody, “a relationship of legal custody exists” that 

gives OCS authority and responsibility to make decisions about the child’s welfare.26 

This authority includes, among other things, “the duty of providing the child with food, 

shelter, education, and medical care.”27 In this way OCS stands largely in the shoes of 

the child’s parent. Like a parent, OCS can seek treatment for psychiatric emergencies. 

Of course, OCS’s authority is more limited than that of a parent. OCS has 

the power to decide “where and with whom the child shall live,”28 but a parent can ask 

the superior court to review OCS’s decision.29 Although OCS has a duty to provide 

medical care to a child in its custody, the child’s parent still retains the right to consent, 

or to withhold consent, to “major medical treatment.”30 And though OCS may seek to 

place a child in a “secure residential psychiatric treatment facility,” it must prove to the 

court by clear and convincing evidence that the child’s condition is serious enough and 

that the treatment is likely to help the child or prevent the child’s condition from getting 

worse.31 

None of those limits on OCS authority applied in this case. The Tribe and 

OCS agree that AS 47.10.087, which limits OCS’s authority to place children at “secure 

residential psychiatric treatment centers,” does not apply to Mira’s hospitalizations 

26 AS 47.10.084(a). 

27 Id.

28 Id.

29 AS 47.10.080(s) (providing for judicial review of OCS decision to transfer 

child from one placement to another). 

30 AS 47.10.084(c).

31 AS 47.10.087; Tuluksak Native Cmty. v. State, Dep’t of Health & Soc. 

Servs., 530 P.3d 359, 373 (Alaska 2023) (holding that a court’s findings under 

AS 47.10.087 “must be made by clear and convincing evidence”).
-13- 7684

because neither Sitka nor North Star meets the definition for such a facility.32 Nor has 

any party argued that inpatient psychiatric hospitalization alone, without involuntary 

medication, is “major medical treatment” that requires parental consent under the CINA 

statutes.33 In short, nothing in the CINA statutes prohibited OCS from taking Mira to

Sitka or North Star to receive inpatient psychiatric care. Doing so was consistent with 

its “duty of providing the child with . . . medical care” required by AS 47.10.084.34

Although the Tribe argues that OCS cannot exercise this authority without 

invoking the civil commitment statutes, those statutes do not purport to limit OCS’s 

legal custody and authority under AS 47.10.084. The civil commitment statutes (with 

one exception we will address shortly) do not mention those with parental or other legal 

authority over others. They do not mention children in state custody or reference 

AS 47.10 at all. The civil commitment statutes create a legal mechanism for “any adult” 

— relative, colleague, neighbor — to have another person committed to a state-run or 

state-designated psychiatric hospital.35 When this mechanism is used, the attendant 

protections apply. But OCS does not have to use this mechanism. It has a separate 

basis of authority under the CINA statutes to seek emergency medical care, including 

32 See AS 47.32.900 (defining “secure residential psychiatric treatment 

center” as “a secure or semi-secure facility, or an inpatient program in another facility, 

that provides, under the direction of a physician, psychiatric diagnostic, evaluation, and 

treatment services on a 24-hour-a-day basis to children with severe emotional or 

behavioral disorders”). 

33 See AS 47.10.084(b)-(c) (describing residual rights of parents of children 

in OCS custody, including “consenting to major medical treatment” and defining 

“major medical treatment” to include “administration of medication used to treat a 

mental health disorder”); cf. Kiva O. v. State, Dep’t of Health & Soc. Servs., Off. of 

Child.’s Servs., 408 P.3d 1181 (Alaska 2018) (establishing standard for overruling 

parent’s unwillingness to give consent for involuntary medication of child in OCS 

custody).

34 AS 47.10.084(a).

35 AS 47.30.700. 
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psychiatric care, for the children in its custody. This authority is not expressly subject 

to the procedures in the civil commitment statutes. 

The Tribe argues that the legislature could not have intended OCS to be 

exempt from oversight when admitting children in its custody to a psychiatric hospital. 

This argument rests largely on two statutes. First, the Tribe points to AS 47.10.087’s 

judicial review process when OCS seeks to place children in secure residential 

psychiatric treatment facilities. The Tribe contends that it would be inconsistent with 

the legislature’s protective intent to allow OCS to admit children to other, more acute 

psychiatric facilities without oversight. Second, the Tribe argues that under 

AS 47.30.690 the legislature has limited even parents’ authority to admit their own

children to a psychiatric hospital. Therefore, the Tribe argues, it would be absurd to 

interpret the law so that OCS has more authority to hospitalize a child than parents

possess. The Tribe bolsters its argument under AS 47.30.690 by pointing to our 

decision in In re April S., which held that OCS cannot rely on that statute to admit a 

child to a psychiatric hospital.36 We stated in that case that OCS could instead petition 

for the child’s involuntary commitment under AS 47.30.700.37 The Tribe argues it 

would be inconsistent with April S. to hold that OCS was not required to petition for 

Mira’s involuntary commitment to Sitka and North Star. 

The problem with the Tribe’s first argument is that we cannot interpret 

statutes to include things the legislature has failed to include.

38 Under AS 47.10.087, 

OCS’s decision to place a child in a “secure residential psychiatric treatment facility” 

36 499 P.3d 1011, 1019-20 (Alaska 2021).

37 Id. at 1020.

38 See State v. Fyfe, 370 P.3d 1092, 1100 (Alaska 2016) (explaining that we 

must assume “the legislature chose its words deliberately, avoided redundancies, and 

omitted words it intended to omit”); State, Div. of Workers’ Comp. v. Titan Enters., 

LLC, 338 P.3d 316, 321 (Alaska 2014) (“We do not rewrite statutes even when the 

legislative history suggests that the legislature may have made a mistake in drafting.”).
-15- 7684

is subject to judicial review.

39 The superior court may permit this placement only if 

OCS proves by clear and convincing evidence that the severity of the child’s condition 

warrants it.40 This requirement does not apply to other classes of psychiatric facilities. 

The Tribe argues it would be absurd not to subject OCS’s decision to admit a child in 

its custody to a psychiatric hospital (rather than a secure residential psychiatric 

treatment facility) to the same kind of judicial review. But the legislature could 

plausibly have intended to allow judicial review for long-term “residential placements” 

of youth in OCS custody but not for admission to a psychiatric hospital for acute care, 

which is often of much shorter duration.41 More fundamentally, we as a court cannot 

rewrite the law to include what the legislature has omitted.42 

The Tribe’s second argument rests on a mistaken premise. The law does 

not limit parents’ authority to admit children to all psychiatric hospitals, only to those 

designated by the State to hold people involuntarily. Under AS 47.30.690, a parent or 

guardian may sign a child into a “designated treatment facility” for psychiatric care if 

the child meets the criteria for admission, but the admission is limited to 30 days, and 

the child is assigned a GAL who can seek judicial review of the admission.43 A 

“designated treatment facility” is defined as “a hospital, clinic, institution, center, or 

39 AS 47.10.087(a).

40 Tuluksak Native Cmty. v. State, Dep’t of Health & Soc. Servs., 530 P.3d 

359, 373 (Alaska 2023). 

41 See AS 47.10.087(b) (providing that court shall review placement at 

secure residential psychiatric treatment facility every 90 days).

42 “The separation of powers doctrine ‘prohibits this court from enacting 

legislation or redrafting defective statutes.’ ” Alaska Airlines, Inc. v. Darrow, 403 P.3d 

1116, 1131 (Alaska 2017) (quoting State v. Campbell, 536 P.2d 105, 111 (Alaska 1975) 

(citing Alaska Const. art. II, § 1, & art. IV, § 1), overruled on other grounds by 

Kimoktoak v. State, 584 P.2d 25 (Alaska 1978)). 

43 AS 47.30.690(a)-(b).
-16- 7684

other health care facility that has been designated by the department for the treatment 

or rehabilitation of mentally ill persons under AS 47.30.670 – 47.30.915.”44 

In other words, a parent’s authority to admit a child for psychiatric care at 

a state-designated facility is subject to the statutory restrictions detailed above. But the 

statute does not apply when a parent takes a child to a psychiatric hospital that is not 

designated for the purpose of involuntarily hospitalizing patients under AS 47.30.45 

Therefore a parent may admit their child to a non-designated psychiatric hospital for 

inpatient care free from the restrictions of AS 47.30.690. Because the legislature did 

not restrict parents’ authority to admit their children to non-designated psychiatric

facilities, the absurdity posited by the Tribe — parents being subject to more restrictions 

than OCS — does not exist. 

44 AS 47.30.915 (emphasis added).

45 At first blush, it seems strange that the legislature would create procedures 

for judicial review when a parent admits a child to a psychiatric hospital but extend that 

protection only to some psychiatric hospitals. The Tribe argues this reading of 

AS 47.30.690 creates an absurd and glaring gap in the statute, undermining the apparent 

legislative goal of protecting children’s liberty from their parents’ decisions. But the 

Tribe may be misreading the underlying legislative policy of AS 47.30.690. Because 

the statute applies only to hospitalization at facilities designated by the State to 

involuntarily hold someone, it appears that the legislative purpose was not to restrict 

parents’ ability to obtain medical care that they believe their children need. Instead the 

apparent purpose was to provide the due process that the U.S. Supreme Court held is

constitutionally required when a state operates or designates a facility to restrain a 

minor’s liberty at the direction of a parent. See Parham v. J.R., 442 U.S. 584, 591, 600

(1979) (examining whether Georgia statute authorizing child’s admission to state-run 

mental hospital at parent’s behest so long as staff physician found child met admission 

criteria satisfied due process because “the state’s involvement in the commitment 

decision constitutes state action under the Fourteenth Amendment”); id. at 633-34

(Brennan, J., concurring in part and dissenting in part) (maintaining that due process 

entitles child who objects to hospitalization to a “reasonably prompt” post-admission 

judicial hearing). For that reason, it is not absurd that the statute’s protections apply 

only to facilities “designated by the department.” AS 47.30.690; AS 47.30.915(7).
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Neither Sitka nor North Star was a “designated treatment facility” at the 

time of Mira’s admission, so the restrictions in AS 47.30.690 did not apply. The Tribe

maintains that these facilities were designated. Its argument relies on a Department of 

Health Care Services regulation, 7 Alaska Administrative Code 12.215(d)(2), which 

provides that “[a] psychiatric hospital must have policies and procedures which require 

that it admit and discharge patients in accordance with AS 47.30.” The Tribe argues 

that because a licensed psychiatric hospital (which includes North Star) must have 

policies and procedures that comply with AS 47.30, all such hospitals are “designated 

by the department for the treatment or rehabilitation of mentally ill persons under 

AS 47.30.670 – 47.30.915.” This argument has two problems. First, undisputed 

evidence establishes that the State has not designated Sitka or North Star for this 

purpose.46 Second, a different set of regulations expressly describes the process for

designating treatment facilities for civil commitment purposes.

47 For example, 

7 AAC 72.040 describes the Department’s procedure for reviewing designation 

applications,

48 and 7 AAC 72.050 describes the reporting obligations that designated 

facilities incur.49 Therefore the Tribe’s argument that North Star and Sitka were 

“designated” by operation of 7 AAC 12.215 is unavailing. 

Finally, the Tribe’s reliance on April S. is unavailing too. That case 

presented a different question than the one currently before us. There the child was 

hospitalized at Alaska Psychiatric Institute (API),50 a “designated treatment facility” for 

46 In the superior court the State presented an affidavit from a Department of 

Health Care Services official identifying Fairbanks Memorial Hospital, Bartlett 

Regional Hospital, Mat-Su Regional Health Center, and Alaska Psychiatric Institute 

(API) as the only designated treatment facilities in Alaska. 

47 7 Alaska Administrative Code 72.012-.070.

48 7 AAC 72.040.

49 7 AAC 72.050.

50 In re Hospitalization of April S., 499 P.3d 1011, 1012-13 (Alaska 2021).
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purposes of AS 47.30.690 because it is state-run.51 OCS argued that it was a “guardian” 

for purposes of AS 47.30.690, and therefore eligible to “voluntarily” admit a child to 

API under that statute’s procedures. Analyzing the statutory definition of the term 

“guardian” in the CINA and civil commitment statutes, we held that OCS was not the 

child’s guardian and therefore could not admit the child to API without filing a petition 

for civil commitment.52 But we were not presented with the question of OCS’s 

authority to admit a child to a hospital that is not a “designated treatment facility” for 

purposes of AS 47.30.690.53 The April S. decision focused on the narrow issue of 

whether OCS could use AS 47.30.690. It did not resolve broader questions of OCS’s 

authority to provide emergency medical care to children in its custody. 

To summarize: OCS has authority under AS 47.10.084 to seek emergency 

medical care, including acute psychiatric care, for children in its legal custody. The 

civil commitment statutes under AS 47.30 create a separate authority for any person to 

petition to have another person admitted to a psychiatric hospital for evaluation and 

treatment, but these statutes do not expressly limit OCS’s authority under AS 47.10. 

Although the legislature did limit OCS’s authority to place a child in a secure residential 

psychiatric treatment facility, the statute contains no similar limitation on OCS’s ability 

to admit a child to a psychiatric hospital for acute care, and the legislature could 

plausibly have intended that distinction. And although the legislature restricted parents’ 

ability to admit their children to psychiatric hospitals that have been designated by the 

State to involuntarily detain people, it did not restrict parents’ authority to admit their 

children to other psychiatric hospitals. There is nothing absurd about a statutory scheme 

that gives OCS the same authority as a parent when OCS has legal custody of a child, 

51 AS 47.30.915(7). The affidavit mentioned above, supra note 46, attests

that API is a designated treatment facility. 

52 April S., 499 P.3d at 1019-20.

53 Id.
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so we cannot assume the legislature meant to impose restrictions on OCS that it did not 

set forth in statute. For these reasons, we conclude that OCS was not required by statute 

to use the civil commitment procedures outlined in AS 47.30 to have Mira admitted to 

Sitka and North Star (which are not designated treatment facilities for purposes of civil 

commitment) for inpatient psychiatric care. 

The Tribe’s core concern that the statutory scheme has a gap in oversight 

is not unfounded. OCS candidly acknowledges that “the statutes contain what might 

be perceived as a gap because they restrict OCS’s ability to admit a child to a 

‘designated treatment facility’ under AS 47.30 or a ‘secure residential psychiatric 

treatment center’ under AS 47.10.087, but place no explicit restrictions for a nondesignated acute psychiatric hospital like North Star that is neither of these things.” It 

is this seeming gap that led the superior court to issue an injunction in the Hooper Bay

case. The court ordered that, as a matter of procedural due process, OCS may not hold 

a child for longer than 30 days at North Star without “conducting an AS 47.10.087-type 

of hearing.” That order is not before us on appeal, and we do not directly review it. 

But we agree with that court’s conclusion that due process requires some kind of 

procedural oversight of OCS’s decision to admit a child to a psychiatric hospital for a 

lengthy period of time. We address the requirements of procedural due process in more 

detail below. 

Nevertheless, when interpreting statutes, we are bound to give effect to 

the legislative intent discerned from the text, legislative history, and underlying 

statutory purpose.54 Those factors lead us to conclude that the legislature did not intend 

to restrict OCS from admitting a child in its custody to a psychiatric hospital that is not 

designated for purposes of involuntary hospitalization — either for specific policy 

54 State v. Planned Parenthood of the Great Nw., 436 P.3d 984, 992 (Alaska 

2019) (quoting Alyeska Pipeline Serv. Co. v. DeShong, 77 P.3d 1227, 1234 (Alaska 

2003)).
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reasons or because the legislature simply did not consider the scenario. Whether the 

statutory “gap” is due to intention or oversight, we have no authority to rewrite 

statutes.55 The legislature is the branch of government with the authority to fill gaps in 

a statutory scheme.56

C. Mira’s Constitutional Rights Were Violated By The Lack Of Timely 

Notice And Hearing. 

 The Tribe argues that the superior court violated Mira’s rights to equal 

protection, substantive due process, and procedural due process by permitting her 

prolonged hospitalization without a prompt hearing on whether the hospitalization was 

justified. The Tribe argues that the Alaska Constitution requires the courts to apply the 

civil commitment procedures (or their substantial equivalent) whenever OCS seeks 

inpatient psychiatric hospitalization for a child in its care. As threshold matters, we

first determine that (1) the Tribe has standing to raise these constitutional arguments on 

Mira’s behalf and (2) the Tribe’s constitutional arguments must be reviewed for plain 

error because they were not adequately raised below. 

1. The Tribe has standing to assert Mira’s constitutional rights

under the parens patriae doctrine. 

 The State concedes that the Tribe has standing to challenge the proper 

statutory framework for Mira’s placement because it was a party to the CINA case. But 

55 State, Div. of Workers’ Comp. v. Titan Enters., LLC, 338 P.3d 316, 321 

(Alaska 2014). 

56 “The Alaska Constitution vests legislative power in the legislature; 

executive power in the governor; and judicial power in the supreme court, the superior 

court, and additional courts as established by the legislature. The separation of powers 

doctrine limits the authority of each branch to interfere in the powers that have been 

delegated to the other branches. The purposes of the separation of powers doctrine are 

to preclude the exercise of arbitrary power and to safeguard the independence of each 

branch of the government.” Alaska Pub. Int. Rsch. Grp. v. State, 167 P.3d 27, 35 

(Alaska 2007).
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the State also points out that the Tribe’s status as a CINA intervenor does not establish 

standing with respect to all issues. 

“Standing is a ‘rule of judicial self-restraint based on the principle that 

courts should not resolve abstract questions or issue advisory opinions.’ ”57 Because 

we may not issue advisory opinions, we cannot allow a parent to raise constitutional 

arguments on behalf of a child in a CINA case absent a “persuasive showing of potential 

prejudice to [the parent].”58 

However, the Tribe asserts that the parens patriae doctrine permits it to 

bring constitutional claims on Mira’s behalf. 59 The parens patriae doctrine allows a 

sovereign “to bring suit to protect its interest in matters of public concern.”60 We

distinguish sovereign, non-sovereign, and quasi-sovereign interests; only quasisovereign interests may form the basis for parens patriae claims.61 “Sovereign interests 

include ‘the exercise of sovereign power over individuals and entities within the 

relevant jurisdiction,’ as well as ‘the demand for recognition from other sovereigns.’ ”62 

“Non-sovereign interests include a [sovereign’s] proprietary interests as well as the 

57 See Native Vill. of Chignik Lagoon v. State, Dep’t of Health & Soc. Servs., 

Off. of Child.’s Servs., 518 P.3d 708, 717 (Alaska 2022) (quoting Keller v. French, 205 

P.3d 299, 302 (Alaska 2009)).

58 R.J.M. v. State, 946 P.2d 855, 871 (Alaska 1997). 

59 In Tuluksak Native Cmty. v. State, Dep’t of Health & Soc. Servs. we ruled 

that a tribe lacked standing to assert a minor’s constitutional rights because that tribe 

failed to make any arguments establishing its standing. 530 P.3d 359, 380 (Alaska 

2023). But in this case the Tribe thoroughly explains its standing argument and presents 

an opportunity for this court to address the issue. 

60 State, Dep’t of Health & Soc. Servs., Div. of Fam. & Youth Servs. v. Native 

Vill. of Curyung, 151 P.3d 388, 399 (Alaska 2006) (citing Georgia v. Pa. R. Co., 324 

U.S. 439, 449-51 (1945)).

61 Id. (citing Alfred L. Snapp & Son, Inc. v. Puerto Rico, 458 U.S. 592, 600-

02 (1982)). 

62 Id. (quoting Snapp, 458 U.S. at 601-02).
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interests a [sovereign] protects when, acting as ‘no more than a nominal party,’ it seeks 

to protect the interests of private parties in court.”63

 Quasi-sovereign interests, which may form the basis for parens patriae

actions, are a sovereign’s interests in “the well-being of its populace.”64 A sovereign 

may not create a parens patriae claim by aggregating the claims of its citizens.65 

Rather, the sovereign must “articulate an injury to the well-being of the [sovereign] as 

a whole or to a sufficiently large segment of its population, and the overall injury must 

be more than the mere sum of its parts.”66 “[T]he fact that individual parties could have 

brought suit to vindicate their rights does not deprive a [sovereign] of parens patriae 

standing”;67 “[i]n such actions, the [sovereign] merely asserts that in addition to 

harming its citizens individually, the offending party has harmed the overall interests 

of the [sovereign].”68

 In State v. Native Village of Curyung, the Native Village of Kwinhagak 

(and several other tribes) sought to enforce the rights of its children in OCS custody 

under the due process clauses of the federal and state constitutions.

69 We held that the 

Tribes’ quasi-sovereign interests formed the basis for valid parens patriae claims 

because “the villages’ interest in their children and in preserving their traditions through 

those children was ‘inherently linked to the health, safety, and welfare of the Village’s 

63 Id. (quoting Snapp, 458 U.S. at 601-02).

64 Id. (quoting Snapp, 458 U.S. at 602).

65 Id.

66 Id.

67 Id. at 399-400 (citing People v. Peter & John’s Pump House, Inc., 914 F. 

Supp. 809, 813 (N.D.N.Y. 1996)).

68 Id. at 400.

69 Id. at 392. 
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members.’ ”70 Although OCS’s actions directly impacted a relatively small number of 

children, we determined that “the well-being of individual families and children is 

inextricably bound up with the villages’ ability to maintain their integrity, which is 

‘something that can only occur through the children of the Village.’ ”71 

 The same principle applies here. Mira is not the only tribal child in OCS 

custody at risk of unnecessary or overly lengthy psychiatric hospitalization. The Tribe 

has an undeniable quasi-sovereign interest in ensuring that its children are not 

needlessly institutionalized — a traumatic experience that may have long-term 

consequences for the child and her community. The parens patriae doctrine gives the 

Tribe standing to assert constitutional claims on Mira’s behalf. 

2. We review the Tribe’s constitutional arguments for plain error 

because it did not clearly raise these arguments in superior 

court. 

 The Tribe concedes that it did not raise Mira’s equal protection rights 

before the superior court. The parties agree that we should review the Tribe’s equal 

protection argument for plain error. 

 But the Tribe maintains that it preserved its due process arguments by 

mentioning “due process” three times over the course of the continued hearings. During 

the January 7 hearing, the Tribe criticized OCS for failing to provide updates on Mira’s 

status and suggested that doing so “would ensure at least that the CINA proceedings 

would provide her with some level of support and due process.” This statement did not 

preserve the Tribe’s argument on appeal that the due process clause of the Alaska 

Constitution required the court to apply the civil commitment statutes to review Mira’s 

hospitalization. 

70 Id. at 393 (approvingly quoting the superior court).

71 Id. at 402.
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 During the final hearing on January 18, the Tribe expressed frustration 

that OCS and North Star had sent referral applications to less restrictive environments 

only a week prior and had not asked Mira which residential facilities she would be 

willing to accept. The Tribe characterized OCS’s unilateral decision to transfer Mira 

from Sitka to North Star as a failure to give Mira any “hope of due process, without . . . 

any sort of sense of advocacy on her behalf.” The Tribe went on to ask the court to rule 

on whether the hearing would proceed under the AS 47.10.087 framework or the 

AS 47.30.700 et seq. procedures, stating that “[t]he civil commitment statutes require, 

at the very least, that a facility explore with the subject of the petition what they might 

be willing to engage in, not just because of due process rights, but because that’s the 

way to actually get individuals healthy, to have them be willing to engage in a treatment 

program. [Mira] hasn’t been given that opportunity to date.”72 

 Although these statements suggest that the Tribe harbored due process 

concerns during the superior court hearings, they are not clear enough to preserve this 

argument for appeal. A “terse and undeveloped mention of due process in the superior 

court” does not preserve the argument for appeal.

73 In this case the Tribe’s brief 

mention of due process failed to alert the superior court that the Tribe intended to 

present a constitutional challenge to the statutory scheme. We therefore review the 

Tribe’s constitutional arguments for plain error. Plain error exists when there is an 

72 See AS 47.30.825(b) (“The patient . . . [is] entitled to participate in 

formulating the patient’s individualized treatment plan and to participate in the 

evaluation process as much as possible, at minimum to the extent of requesting specific 

forms of therapy, inquiring why specific therapies are or are not included in the 

treatment program, and being informed as to the patient’s present medical and 

psychological condition and prognosis . . . .”). 

73 Best v. Fairbanks North Star Borough, 493 P.3d 868, 876 (Alaska 2021). 
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“obvious mistake”74 that is “so prejudicial that failure to correct it will perpetuate a 

manifest injustice.”75 

3. The superior court did not plainly violate Mira’s right to equal 

protection by declining to apply the civil commitment statutes 

to her hospitalization. 

 The Tribe did not raise an equal protection argument before the superior 

court, and the superior court did not issue an equal protection ruling. But the court did 

contemplate that foster children receive different treatment during involuntary 

hospitalization than children not in OCS custody. “I don’t know why somebody in OCS 

custody would be entitled to less rights,” the superior court stated, “but that’s clearly 

what 47.10.087 does.” The Tribe adopts this position on appeal, arguing that children 

in OCS custody are given fewer protections than children in their parents’ custody. But 

this is not so. Under the statutory scheme described above, foster children in OCS 

custody receive no fewer protections than children in the custody of their parents. 

 The Alaska Constitution provides that “all persons are . . . entitled to equal 

rights, opportunities, and protection under the law.”76 This clause protects “those 

similarly situated from disparate treatment.”77 When assessing equal protection claims, 

we generally “decide which classes are to be compared and determine whether those 

classes are similarly situated or whether differences between the classes justify different 

treatment.”78 

74 In re Hospitalization of Gabriel C., 324 P.3d 835, 838 (Alaska 2014). 

75 Donahue v. Ledgends, Inc., 331 P.3d 342, 356 n.75 (Alaska 2014) 

(quoting Forshee v. Forshee, 145 P.3d 492, 500 n.36 (Alaska 2006)). 

76 Alaska Const. art. I, § 1. 

77 Premera Blue Cross v. State, Dep’t of Com., Cmty. & Econ. Dev., Div. of 

Ins., 171 P.3d 1110, 1121 (Alaska 2007). 

78 State v. Schmidt, 323 P.3d 647, 660 (Alaska 2014). 
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 The Tribe’s equal protection claim fails at the first step because there is 

no unequal treatment. The Tribe has not shown that children in OCS custody receive 

less protection than children in the custody of their parents. The Tribe’s argument rests 

on the idea that when parents admit their child to Sitka or North Star, the protections of 

AS 47.30.690 apply. But these protections, which include limiting admission to 

30 days and appointing a GAL to seek judicial review, do not apply in those scenarios

because neither hospital is a “designated treatment facility” under AS 47.30.690 for the 

reasons explained above. Therefore the statute does not give children admitted to Sitka 

by their parents any more process than children admitted to that hospital by OCS. The 

same is true of admission to North Star.79 Because the statutory scheme does not give 

children in OCS custody fewer rights than children in their parents’ custody, the Tribe’s 

equal protection claim fails. 

4. Mira’s extended stay at Sitka Community Hospital and North 

Star Hospital did not plainly violate her right to substantive due 

process. 

 Substantive due process “ ‘focuses on the result of governmental action, 

not its procedures,’ meaning that it ‘imposes limits on what a state may do regardless 

of what procedural protection is provided.’ ”80 Under both the state and federal 

constitutions, substantive due process “requires that the nature and duration of 

commitment bear some reasonable relation to the purpose for which the individual is 

committed.”81 The parties agree that the nature and duration of Mira’s hospital stays 

should bear a reasonable relation to the purposes for which she was there. Because 

79 In fact, because of the Hooper Bay injunction, children in OCS custody 

who are admitted to North Star receive more procedural protection — an 

“AS 47.10.087-type of hearing” within 30 days of admission — than children whose 

parents admit them to North Star. 

80 In re Hospitalization of Mabel B., 485 P.3d 1018, 1024 (Alaska 2021)

(quoting 16C C.J.S. Constitutional Law § 1821 (2020)). 

81 Id. at 1025 (quoting Jackson v. Indiana, 406 U.S. 715, 738 (1972)).
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Mira’s 18-day stay at Sitka and her 29-day stay at North Star had different purposes, 

we analyze them separately. We conclude that it was not plain error for the superior 

court to find no substantive due process violations in Mira’s detentions at Sitka or North 

Star. 

 Sitka. Mira’s foster parent brought her to Sitka for medical care after 

Mira consumed alcohol and prescription drugs. A clinician cleared Mira for discharge 

after a few hours of observation and stated that Mira did not need “24/7 supervision[,] 

just ongoing counseling and support.” Yet Mira remained at Sitka for many more days, 

not because she was receiving care, but because OCS struggled to find another foster 

home for her.

82 During this time Mira “opened up about her past trauma” to a clinician 

at Sitka and experienced ataxia symptoms and a panic attack. These events caused the 

clinician to recommend acute psychiatric care, and Mira waited at Sitka for additional 

time before OCS transferred her to North Star. 

 Mira’s experience bears some similarity to the facts of another case: In re 

Hospitalization of Mabel B. In that case we held that the State violated the substantive 

due process rights of two women who experienced lengthy detentions at the preevaluation stage of involuntary civil commitment procedures. Although judges had 

issued orders authorizing their “immediate delivery” to API for 72-hour evaluations, 

the women were detained at medical hospitals for more than two weeks before beds 

became available at API.

83 We held that the lack of capacity at API was an “insufficient 

justification” for detaining the women against their will: “[l]ack of funds, staff, or 

facilities cannot justify the State’s failure to provide [such persons] with [the] treatment 

82 The record does not specify when the Sitka clinician changed her 

recommendation, although OCS apparently decided to transfer Mira to North Star by 

December 14. 

83 In re Mabel B., 485 P.3d at 1026. 
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necessary for rehabilitation.”84 Similarly, in this case OCS kept Mira at a hospital that 

was not adequate for her needs for more than two weeks, largely because it struggled 

to find a place for her to go.

85 

 But gaps in the record lead us to conclude the superior court did not plainly 

err by failing to find a substantive due process violation. There were three distinct 

purposes for Mira’s stay at Sitka: (1) acute medical treatment for an alcohol and drug 

overdose; (2) OCS’s search for a new foster home; and (3) awaiting transfer to North 

Star for acute psychiatric care. We know that Mira’s emergency medical treatment at 

Sitka concluded within a few hours. But the record does not tell us how long Mira 

waited at Sitka for a new foster home before it was determined she needed to go to 

North Star. Because we do not know how long Mira waited for each reason, we cannot 

evaluate whether there was a reasonable relation between the length of Mira’s stay at 

Sitka and her reasons for being there. The lengths of time that Mira spent waiting for a 

new foster home and a transfer to North Star may have each been shorter than the 

unacceptable detention period in Mabel B. And because there was no argument before 

the superior court on this matter, we lack the facts necessary to determine the length of 

time required for OCS to complete either task. 

84 Id. at 1026, n.56 (quoting Or. Advoc. Ctr. v. Mink, 322 F.3d 1101, 1121 

(9th Cir. 2003)). In another recent case we held that a four-day confinement before a 

72-hour evaluation does not necessarily violate a detainee’s substantive due process 

rights. In re Hospitalization of Vern H., 486 P.3d 1123, 1132 (Alaska 2021) (“Vern 

was held awaiting transport for approximately four days, and we see no substantive due 

process violation under the facts and circumstances of his detention.”).

85 The record does not explicitly state that Mira objected to her detainment 

at Sitka. But OCS did not promptly notify the parties of Mira’s hospitalization and 

Mira did not have access to her own attorney who could have helped her express her 

desire to leave. We therefore place no weight on Mira’s failure to affirmatively object 

to her confinement.
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 OCS’s poor communication with the parties is largely responsible for this 

gap in the record. But given the inadequate record, we cannot conclude that Mira’s 

extended stay at Sitka was an “obvious” substantive due process violation. 

 North Star. In Mabel B. we ruled there was a substantive due process 

violation when two women were detained for weeks, receiving only limited preliminary

treatment while awaiting evaluation at API.

86 By contrast, Mira did receive psychiatric 

care at North Star. Mira had the opportunity there to participate in individual and group 

therapy, although she sometimes refused this care. The civil commitment statues 

contemplate an initial stay of 30 days, which suggests that the Alaska legislature 

considers a stay of that length to be appropriate for psychiatric treatment.87 Keeping 

Mira at North Star for 29 days was therefore reasonably related to the purpose of 

providing her with acute psychiatric care. 

5. Mira’s hospitalization for emergency psychiatric care for 

46 days without timely notice and a hearing plainly violated her 

right to procedural due process. 

 The Tribe argues that Mira’s extended hospitalization without a hearing 

violated her right to procedural due process. Procedural due process “requires that 

adequate and fair procedures be employed when state action threatens protected life, 

liberty, or property interests.”88 Involuntarily confining an adult to a hospital 

“implicates Alaska’s constitutional guarantees of individual liberty and privacy and 

therefore entitles [that person] to due process protections.”89 Mira’s case requires us to 

86 In re Mabel B., 485 P.3d at 1026.

87 See AS 47.30.730(a) (permitting an initial commitment period of 30 days).

88 In re 2021 Redistricting Cases, 528 P.3d 40, 58 (Alaska 2023) (quoting

Doe v. State, Dep’t of Pub. Safety, 444 P.3d 116, 124 (Alaska 2019)). 

89 Wetherhorn v. Alaska Psychiatric Inst., 156 P.3d 371, 379 (Alaska 2007) 

(citing Foucha v. Louisiana, 504 U.S. 71, 80 (1992)), overruled on other grounds by In 
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determine what protections apply when OCS admits a child in its custody to the hospital 

for psychiatric care. 

 The U.S. Supreme Court considered similar issues in Parham v. J.R.

90 

The Court held that Georgia laws authorizing parents to admit their children to a staterun mental hospital satisfied due process under the federal constitution, even though the 

statute did not provide for judicial review of the parents’ decision.91 The Court 

reasoned that “the risk of error inherent in the parental decision to have a child 

institutionalized for mental health care is sufficiently great that some kind of inquiry 

should be made by a ‘neutral factfinder’ to determine whether the statutory 

requirements for admission are satisfied.”92 It concluded that the Georgia system met 

this standard because it required a clinical team to make an informed diagnosis before 

admitting a child and because it provided for periodic review of the child’s need for 

hospitalization by an independent medical group.93 Particularly relevant to Mira’s case, 

the Court reasoned that “the determination of what process is due varies somewhat 

when the state, rather than a natural parent, makes the request for a commitment.”94 It 

suggested, but did not decide, that “[i]t is possible that the procedures required in 

re Hospitalization of Naomi B., 435 P.3d 918 (Alaska 2019); see also id. at 379 n.48 

(“Freedom from bodily restraint has always been at the core of the liberty protected by 

the Due Process Clause from arbitrary governmental action. It is clear that commitment 

for any purpose constitutes a deprivation of liberty that requires due process protection.” 

(quoting Foucha, 504 U.S. at 80)).

90 442 U.S. 584 (1979).

91 Id.

92 Id. at 606.

93 Id. at 614-16.

94 Id. at 617. 
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reviewing a ward’s need for continuing care should be different from those used to 

review the need of a child with natural parents.”95 

 The State argues that the procedural protections alluded to in Parham are 

satisfied by compliance with the Hooper Bay injunction, which requires an 

“AS 47.10.087-type hearing” within 30 days of a child’s arrival at North Star. The 

Tribe emphasizes that Alaska’s constitution is often more protective of liberty and 

privacy than the federal constitution.96 Accordingly it argues that due process required 

OCS and the superior court to essentially apply the procedures contained in the civil 

commitment statutes to Mira’s hospitalization. 

To evaluate these procedural due process arguments, we use the Mathews 

v. Eldridge test,97 which requires balancing three factors: 

First, the private interest that will be affected by the official 

action; second, the risk of an erroneous deprivation of such 

interest through the procedures used, and the probable value, 

if any, of additional or substitute procedural safeguards; and 

finally, the Government’s interest, including the function 

involved and the fiscal and administrative burdens that the 

additional or substitute procedural requirement would 

entail.[98]

Because the Alaska Constitution’s guarantee of due process is more protective than that 

of the federal constitution, we are guided by, but not tethered to, the Parham decision.

95 Id. at 619.

96 Myers v. Alaska Psychiatric Inst., 138 P.3d 238, 245 (Alaska 2006). 

97 Patrick v. Mun. of Anchorage, Anchorage Transp. Comm’n, 305 P.3d 292, 

299 (Alaska 2013) (“We look to the test set forth by the United States Supreme Court 

in Mathews v. Eldridge to determine the requirements of due process.”).

98 Mathews v. Eldridge, 424 U.S. 319, 334-35 (1976). 
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a. Private interest

 We first consider the strength of minors’ liberty interest in being free from 

forced hospitalization.99 For adults, involuntary hospitalization is “a ‘massive 

curtailment of liberty’ that cannot be accomplished without due process of law.”100 

Adults therefore have “an interest in an accurate and expedited emergency evaluation 

and prompt judicial review of . . . emergency detention and evaluation.”101 

 The U.S. Supreme Court held in Parham that “a child, in common with 

adults, has a substantial liberty interest in not being confined unnecessarily for medical 

treatment.”102 It reasoned that unnecessary commitment may also produce “adverse 

social consequences for the child because of the reaction of some to the discovery that 

the child has received psychiatric care.”103 The Court acknowledged that “[m]ost 

children, even in adolescence, simply are not able to make sound judgments concerning 

99 In In re Hospitalization of April S. we cited an earlier decision, In re 

Hospitalization of Daniel G., for the proposition that held that minors have a strong 

liberty interest. 499 P.3d 1011, 1017 (Alaska 2021) (citing In re Daniel G., 320 P.3d 

262, 271-72 (Alaska 2014)). But our reliance on Daniel G. was mistaken: the 

respondent in that case was not a minor, and his case did not specifically address the 

standards governing minors. See In re Daniel G., 320 P.3d at 264-65, 271-73 

(evaluating respondent’s procedural due process rights in the context of involuntary 

civil commitment procedures initiated by his father, rather than “voluntary” parental 

commitment procedures that would have applied under AS 47.30.690 had the 

respondent been a minor). Therefore we consider the strength of a minor’s liberty 

interest in this context as a matter of first impression. 

100 Wetherhorn v. Alaska Psychiatric Inst., 156 P.3d 371, 375 (Alaska 2007) 

(quoting Humphrey v. Cady, 405 U.S. 504, 509 (1972)). 

101 In re Daniel G., 320 P.3d at 272.

102 442 U.S. 584, 600 (1979) (citing Addington v. Texas, 441 U.S. 418, 425

(1979)). 

103 Id.; see also Wetherhorn, 156 P.3d at 378 (explaining that the level of 

incapacity justifying an AS 47.30 civil commitment order “must be such so as to justify 

the social stigma that affects the social position and job prospects of persons who have 

been committed because of mental illness”). 
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many decisions, including their need for medical care and treatment.”104 But it 

concluded that a child “has a protectible interest not only in being free of unnecessary 

bodily restraints but also in not being labeled erroneously by some persons because of 

an improper decision” by a diagnosing clinician.105 

 The State points out that children do not have the same presumption of 

complete autonomy as adults, and that caregivers — whether parents or OCS — must 

protect children from errors in judgment.106 That is true, but minors’ interest in bodily 

autonomy is still significant and entitled to great weight. We agree with the State that 

caregivers are entitled to deference in caring for children, but our deference to parental

authority does not wholly extend to the State. “The rule in favor of deference to parental 

authority is designed to shield parental control of child rearing from state 

interference.”107 Therefore “[t]he rule cannot be invoked . . . to immunize from review 

the decisions of state social workers.”108 Parents have a special right to “direct the 

upbringing” of their children that warrants protection from judicial scrutiny.

109 OCS 

does not have the same right. 

104 Parham, 442 U.S. at 603; see also Bellotti v. Baird, 443 U.S. 622, 634 

(1979) (listing “three reasons justifying the conclusion that the constitutional rights of 

children cannot be equated with those of adults: the peculiar vulnerability of children; 

their inability to make critical decisions in an informed, mature manner; and the 

importance of the parental role in child rearing”). 

105 Parham, 442 U.S. at 601.

106 See also id. at 602 (“The law’s concept of the family rests on a 

presumption that parents possess what a child lacks in maturity, experience, and 

capacity for judgment required for making life’s difficult decisions.”).

107 Parham, 442 U.S. 584 at 637 (Brennan, J., concurring in part and 

dissenting in part).

108 Id.

109 Pierce v. Soc’y of the Sisters of the Holy Names of Jesus & Mary, 268 U.S. 

510, 534-35 (1925).
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b. Risk of erroneous deprivation and value of additional 

procedural safeguards 

 It is important that all children, including those in OCS custody, receive 

the care that they need. But it is also important to protect children from being placed 

in a psychiatric hospital when they do not need to be. That kind of experience can cause 

harm too.

There is no doubt that children in OCS custody are at substantial risk of 

being hospitalized for longer than they need, or when they do not need to be hospitalized 

at all. Mira’s case is an example. The lack of available foster homes meant that Mira 

was forced to stay at Sitka for well over a week after she had been cleared to leave. 

Because OCS caseworkers manage large caseloads, children are at risk of falling 

through the cracks, and the people who care about them are at risk of being left in the 

dark. The assigned caseworker was out of the office for part of the time that Mira was 

at Sitka. The parties to the case were notified of Mira’s initial hospitalization ten days 

after it happened. They were told of the plan to transfer Mira to North Star only after 

she had been transferred, even though the decision to move her had apparently been 

made days earlier. And the assigned OCS caseworkers and North Star staff failed to 

apply to less restrictive facilities that would better serve Mira’s needs until a few days 

before the superior court hearing — weeks after Mira was first hospitalized at North 

Star. Overall, Mira spent 46 days in a hospital, and the record indicates that for much 

of that time she was not in a setting that was appropriate for her needs. 

The Tribe argues that when OCS seeks to hospitalize a child for 

psychiatric treatment, the constitution requires something akin to the protections 

contained in the civil commitment statutes. Under the civil commitment framework, 

OCS would first have to file a petition to have the child screened to determine if she 

should be taken to the hospital for evaluation,110 or perhaps have a peace officer 

110 AS 47.30.700.
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transport the child to a medical facility for evaluation.111 The applicable statutes 

anticipate fairly immediate initiation and completion of the evaluation to determine 

whether the child meets the criteria for civil commitment.

112 A court hearing would 

have to be held within 72 hours of the child’s arrival to determine whether the child 

should be hospitalized for treatment.

113 

Adopting these procedures would certainly protect more children in OCS 

custody from unnecessary hospitalization. But the key question is whether adopting

these procedures would do more harm than good: in other words, whether such rigorous 

procedures would result in children not getting the psychiatric care they need in a timely 

manner. We must carefully weigh that risk to decide whether the Tribe’s proposal to 

apply civil-commitment-like procedures to hospitalization of children in OCS custody 

strikes the right constitutional balance. 

c. The State’s interest and the burden of more stringent 

procedures

OCS is entrusted with caring for some of the most vulnerable people in 

Alaska: children whose parents are unable to care for them. Many of these children 

have mental health needs as a result of traumatic events they have gone through. It is 

OCS’s duty to get treatment for them.114 

OCS argues that this duty would be frustrated by applying the civil 

commitment statutes to govern psychiatric hospitalization of the children in its custody. 

Although the civil commitment statutes can be applied to children, the typical 

111 AS 47.30.705(a).

112 AS 47.30.710; AS 47.30.715.

113 AS 47.30.725; AS 47.30.730; AS 47.30.735.

114 AS 47.10.084(a). 
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respondent is an adult.115 As noted previously, adults enjoy a strong presumption of 

autonomy and are generally held responsible for their own welfare.116 Those societal 

values are reflected in the civil commitment statutes’ stringent protections against 

involuntary hospitalization.117 OCS argues that the calculus should be different for 

children. Children are generally not responsible for their own welfare, and they enjoy 

fewer freedoms than adults.118 Accordingly OCS argues that applying the civil 

commitment statutes would strike the wrong balance for children: the extensive 

procedures would unduly delay or prevent OCS from getting children the care they 

need. OCS maintains that the Hooper Bay injunction, which requires an 

“AS 47.10.087-type of hearing” within 30 days of a child’s admission to North Star, 

strikes the right balance. 

115 Because most minors are in the custody of a parent or guardian, it is 

usually not necessary to file a petition for involuntary commitment to admit a minor to 

a psychiatric hospital, even against the minor’s will. The “voluntary” admission 

process under AS 47.30.690 applies. 

116 See Myers v. Alaska Psychiatric Inst., 138 P.3d 238, 247 n.61 (Alaska 

2006) (“It is a firmly established principle of the common law of New York that every 

individual ‘of adult years and sound mind has a right to determine what shall be done 

with his own body’ and to control the course of his medical treatment.” (citing Rivers 

v. Katz, 495 N.E.2d 337, 341 (N.Y. 1986))). 

117 See, e.g., AS 47.30.700(a) (requiring — upon petition by adult to have

person involuntarily committed — immediate screening by judge or state-employed 

mental health professional, as well as issuance of ex parte order showing probable cause

that respondent has mental health condition that makes respondent “gravely disabled or 

. . . present[s] a likelihood of serious harm to self or others” within 48 hours of 

completing such investigation); see also AS 47.30.707 (“[W]hen a crisis stabilization 

center admits a respondent under AS 47.30.705[] the crisis stabilization center may hold 

the respondent at the center for a period not to exceed 23 hours and 59 minutes. A 

mental health professional shall examine the respondent within three hours after the 

respondent arrives at the center.”).

118 See Bellotti v. Baird, 443 U.S. 622, 634 (1979).
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It is important to note that the parties disagree only about procedure. They 

do not appear to disagree about the substantive standards for psychiatric hospitalization 

of minors. The civil commitment statutes favored by the Tribe and the standards from 

AS 47.10.087 incorporated in the Hooper Bay injunction both require the same proof 

by clear and convincing evidence: mental illness; grave disability or risk of harm to 

self or others; lack of less restrictive alternatives; and the possibility of improvement or 

the risk of deterioration without treatment.119 Where the parties disagree is on the 

timing and procedural mechanisms applicable to the minor’s hospitalization. 

We conclude that the constitutionally required approach falls between the 

parties’ positions. Although the civil commitment statutes are not the measure of what 

due process requires, the process that Mira received in this case fell below the 

constitutional line. 

 On the one hand, we agree with the State that the civil commitment 

statutes are not the right framework to govern admission of minors in OCS custody to 

a psychiatric hospital. Courts will struggle to hold a hearing to review a child’s 

hospitalization within the time required by the civil commitment statutes. Unlike civil 

commitment cases, which involve only the petitioner and the respondent, CINA cases 

often involve many parties: the child, OCS, one or two parents, a GAL, and sometimes 

a tribe. Each of these parties is entitled to present evidence and be heard on the child’s 

hospitalization.120 Holding a meaningful hearing within the time required by the civil 

119 AS 47.10.087(a); AS 47.30.730(a); Tuluksak Native Cmty. v. State, Dep’t 

of Health & Soc. Servs., 530 P.3d 359, 373 (Alaska 2023). Under the civil commitment 

framework, the petitioner need only show the possibility of improvement if the 

respondent is alleged to be gravely disabled, not when the respondent is alleged to be a 

danger to self or others. AS 47.30.730(a).

120 In these proceedings, most children will have their own attorney to 

advocate for the child’s desires. CINA Rule 12.1(b) (“The court shall appoint an 

attorney for a child who is 10 years of age or older . . . [and] does not consent to 

placement in a psychiatric hospital or residential treatment center.”).
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commitment statutes will be challenging, as Mira’s case shows. The superior court 

repeatedly rescheduled Mira’s hearing in part to ensure that a key witness from North 

Star could attend. If witnesses and parties cannot be made to appear within the 72-hour 

period set in the civil commitment statutes, the respondent must be released from the 

hospital.121 Although this strict result may be appropriate when the respondent is an 

adult, society’s greater interest in providing care for minors demands a more flexible 

process. 

On the other hand, we agree with the Tribe that the Hooper Bay injunction 

does not afford all the process that is due to minors in OCS custody. That order enjoins 

OCS “from holding any child under the care of OCS for longer than 30 days at North 

Star Hospital without conducting an AS 47.10.087-type of hearing.” It does not cover 

other facilities. As a result, the injunction did not prevent OCS from keeping Mira at 

Sitka for over two weeks and then at North Star for almost 30 days before a hearing 

was held to determine whether her hospitalization was justified. When the State, acting

as a child’s custodian, seeks the child’s admission to a hospital for psychiatric care, 

forty-six days is far too long for the child to be held without judicial review. 

The Hooper Bay injunction is also silent on OCS’s obligation to notify the 

child’s parents, GAL, and tribe, if any. But the State must provide notice when it 

proposes to restrain a person’s liberty.122 We agree with the U.S. Supreme Court’s 

decision in Parham that the court need not hold a hearing before the child can be 

121 See AS 47.30.715 (“When an evaluation facility receives a proper order 

for evaluation, it shall accept the order and the respondent for an evaluation period not 

to exceed 72 hours.”); see also AS 47.30.720 (“If at any time in the course of the 72-

hour period the mental health professionals conducting the evaluation determine that 

the respondent does not meet the standards for commitment . . ., the respondent shall be 

discharged from the facility or the place of evaluation.”).

122 Wetherhorn v. Alaska Psychiatric Inst., 156 P.3d 371, 380 (Alaska 2007) 

(quoting Huntley v. N.C. State Bd. of Educ., 493 F.2d 1016, 1019 (4th Cir. 1974)). 
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admitted to the hospital for psychiatric care.123 Society’s interest in ensuring proper 

treatment for children’s psychiatric emergencies permits OCS to first take the child to 

the hospital, then notify the child’s parents and the other parties to the CINA case who 

have a role in advocating for the child’s best interests, and then present evidence at a 

hearing to determine whether the hospitalization is justified. But notice should be given 

at the earliest possible moment. Requiring immediate notice places little burden on 

OCS and reduces the risk that a child will spend a long time in a psychiatric hospital 

when it is not the appropriate place for her. 

In this case, OCS’s failure to timely notify the parties of Mira’s admission 

to the hospital worsened the deprivation of Mira’s rights. It delayed appointment of 

counsel to advocate for Mira. It likely contributed to the ultimate delay in holding the 

hearing. And it may have delayed the search for less restrictive treatment alternatives. 

Mira languished at North Star for over three weeks before OCS applied for her 

admission to less restrictive programs. Unsurprisingly, she had not yet been admitted 

to any residential programs at the time of the hearing, so the superior court was forced 

to approve her continued stay at North Star because there were no less restrictive 

alternatives available at that moment. The limited record in this case does not tell us 

why OCS waited over three weeks after Mira’s arrival at North Star before it began 

submitting applications for less restrictive facilities. Yet it stands to reason that 

notifying the parties earlier would have resulted in an earlier search for solutions. The 

untimely notice and 46-day wait for a hearing violated Mira’s right to due process.

Without a more developed record, we are unable to fully define the 

contours of the process Mira was due. But we identify the following violations of 

123 Parham v. J.R., 442 U.S. 584 at 620-21 (1979) (holding that Georgia’s 

“medical factfinding processes [were] reasonable and consistent with constitutional 

guarantees,” when state’s voluntary admission statutes did not require hearing before 

parent admitted child to psychiatric hospital). 
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Mira’s procedural due process rights: (1) OCS’s failure to immediately notify the 

parties to the CINA case that Mira was being held at Sitka for mental health reasons;

(2) OCS’s failure to immediately notify the parties that it had decided to admit her to 

North Star; and (3) the superior court’s failure to hold a hearing before Mira’s 46th day

of continuous hospitalization. We conclude that the superior court’s failure to hold an 

earlier hearing, at which time OCS’s notice failures could have been recognized and 

corrected, was plain error.124

CONCLUSION

 We REVERSE the superior court’s order authorizing Mira’s continued 

placement at North Star.

124 Because we reject the Tribe’s argument that due process requires 

adherence to the civil commitment statutes, and because we hold that the 46-day period 

Mira went without a hearing did not satisfy due process, we need not decide whether 

the 30-day hearing deadline contained in Hooper Bay is constitutionally adequate. We 

observe only that the superior court set the 30-day deadline as an outer limit for holding 

a hearing, and that children’s interests are best served by holding a hearing promptly 

after their admission to the hospital to confirm that the hospitalization is justified.