Opinion ID: 2069196
Heading Depth: 1
Heading Rank: 5

Heading: Appellants' Due Process Challenge

Text: Appellants challenge, as contrary to due process requirements, the procedures used by the Hospital in detaining them as inpatients after their release from the Hospital on indefinite outpatient status pursuant to court order. The government concedes that appellants had a liberty interest implicating the protections of due process. See Reese, supra, 614 A.2d at 510 (citations omitted); see also Plummer, supra, 608 A.2d at 744 (citations omitted). The question is what process is due, or in this case, what procedural constraints are imposed upon the government before it can deprive an insanity acquittee of his conditional liberty interest. Due process is flexible and calls for such procedural protections as the particular situation demands. Morrissey, supra, 408 U.S. at 481, 92 S.Ct. at 2600. Determination of whether procedures are constitutionally sufficient generally require consideration of 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. Mathews v. Eldridge, 424 U.S. 319, 334-35, 96 S.Ct. 893, 903, 47 L.Ed.2d 18 (1976). We consider each of these factors in turn.
For purposes of the analysis in this case, it is not disputed that appellants have a conditional liberty interest in remaining in the community when placed on conditional release by court order. However, as discussed in Part III of this opinion, insanity acquittees are subject to different and more restrictive procedures than civil committees for purposes of release and conditional release. Such disparities are deemed to be justified because the acquittee's mental illness has already manifested itself in criminal conduct, and therefore more stringent procedures are required to insure the public safety. See Reese, supra, 614 A.2d at 511. Thus, the nature of the private interest to be free of confinement is somewhat more limited than the interest of civil committees with whom appellants seek to compare themselves. See Sanderlin v. United States, 254 U.S.App. D.C. 18, 23, 794 F.2d 727, 732 (1986) (A civilly committed person is afforded greater protections against unwarranted confinement than an insanity acquittee.).
The involuntary rehospitalization of a committed outpatient results in a temporary loss of liberty. Procedural due process serves to minimize the risk of the erroneous deprivation of that liberty. Richardson, supra, 481 A.2d at 482 (citing Greenholtz v. Inmates of Neb. Penal & Correctional Complex, 442 U.S. 1, 13, 99 S.Ct. 2100, 2106-07, 60 L.Ed.2d 668 (1979)). However, the Due Process Clause `does not mandate that all governmental decision making comply with standards that assure perfect, error-free determinations.' Id. (quoting Mackey v. Montrym, 443 U.S. 1, 13, 99 S.Ct. 2612, 2618-19, 61 L.Ed.2d 321 (1979)). At a minimum, due process requires notice and an opportunity to be heard at a meaningful time and in a meaningful manner. Id. at 481 (citing Mathews, supra, 424 U.S. at 333, 96 S.Ct. at 902). The Hospital's procedures, if followed, together with statutory hearing rights for insanity acquittees meet due process requirements. Those procedures include a preliminary determination by mental health professionals that circumstances involving the patient's condition warrant at least temporary inpatient examination and care of the patient, consistent with the terms of the conditional release order. We have recognized the court's power to include in its order authorization to the Hospital to return a patient summarily for observation and treatment under certain circumstances. Richardson, supra, 481 A.2d at 481. The Hospital's procedure of providing notice to the court and the patient's counsel, generally within five days of the patient's return, which set forth the reason therefor, along with the right of the patient to move for a judicial hearing pursuant to D.C.Code § 24-301(k) meet the demands of due process.
The third factor in considering the constitutionality of the process involved is the government's interest and the extent to which it will be impeded by the use of additional safeguards. Richardson, supra, 481 A.2d at 482 (citing Mathews, supra, 424 U.S. at 334-35, 96 S.Ct. at 902-03). Appellants contend that the government's interest is the same whether the case involves an insanity acquittee or a civil committee. In both situations, the government has an interest in evaluating and stabilizing the patient and in protecting the patient and the community. Yet, as we have outlined in Part III of this opinion, there is a stronger focus on assuring public safety when an acquittee is involved because of the demonstrated dangerousness manifested in criminal conduct. See Ecker, supra, 177 U.S.App. D.C. at 37, 543 F.2d at 184. This concern forms a rational basis for utilizing different procedures for criminal acquittees than for patients whose illnesses have not resulted in criminal activity. Overholser, supra, 103 U.S.App. D.C. at 291-92, 257 F.2d at 669-70. In a case involving a civil committee, we observed that mental illness is a dynamic condition, and speedy intervention is frequently necessary to prevent rapid deterioration of the patients' condition and behavior as well as preserve the advances made towards rehabilitation. Richardson, 481 A.2d at 483. Greater safety concerns associated with criminal acquittees may justify even swifter intervention. Appellants contend that the government's interest in expeditious rehospitalization of the patient when it appears that his condition has deteriorated can be met by application of the Richardson procedures. The Richardson procedures require the superintendent of the Hospital to file an affidavit within twenty-four hours setting forth facts which support probable cause for the patient's rehospitalization and release of the patient after the fifth day of institutional care and observation unless the Hospital moves for an adversary judicial hearing seeking permanent revocation. [7] Richardson, supra, 481 A.2d at 480-81. The government argues persuasively that an extension of Richardson procedures to insanity acquittees would impose a rigid timetable upon the difficult process of medically assessing and treating insanity acquittees which would not be in the best interest of the patient or the community. The patient's return to institutional care is not an infrequent occurrence. The requirement of a motion and hearing each time the Hospital deems it necessary to extend treatment beyond five days may hinder the Hospital's ability to respond to the acquittee's changing condition and to meet the goal of assuring public safety. Moreover, the statute governing the hospitalization and treatment for insanity acquittees provides a mechanism for the acquittee to petition for, and to obtain, a judicial hearing if he or she objects to rehospitalization. See D.C.Code § 24-301(k). In light of this legislatively-created procedure which is adequate to meet due process concerns, there is no reason for an additional judicially-imposed procedure which does not enhance in any significant way the protection of the patient's interest.