Opinion ID: 1355643
Heading Depth: 1
Heading Rank: 4

Heading: The power of the district court to commit mentally ill persons outside this state.

Text: The statutory involuntary commitment process, [6] as invoked by application of W.S. XX-XX-XXX, has provisions for emergency detention, W.S. XX-XX-XXX; preliminary hearing, W.S. XX-XX-XXX(h); and general commitment hearing, W.S. XX-XX-XXX(f). In addition to dismissal, disposition options statutorily available in W.S. XX-XX-XXX(j) to the district judge include: (i) Order his hospitalization; (ii) Assign him to a hospital; (iii) Send to the hospital, with the patient a certified copy of the findings of fact and order and a copy of the examiner's report; (iv) Specify where he will be detained pending transportation to the hospital. Only during an extreme emergency shall a person be detained in a nonmedical facility used for detention of persons charged with or convicted of penal offenses. As defined in W.S. XX-XX-XXX(a)(v), `Hospital' means a facility designated pursuant to W.S. XX-XX-XXX or the state hospital; with further definition of State Hospital afforded in W.S. XX-XX-XXX(a)(xi) which means the Wyoming state hospital at Evanston, Wyoming. W.S. XX-XX-XXX outlines D-PASS's duties to hospitals other than the State Hospital. [7] At present, Wyoming has no psychiatric halfway houses, and there is no other domiciliary care facility approved in accord with W.S. XX-XX-XXX. The county is responsible for initial detention and maintenance expenses, W.S. XX-XX-XXX, with hospitalization financial responsibility thereafter assigned to either the State Board of Charities and Reform for care provided in the State Hospital or D-PASS if care is provided elsewhere. It is in this source of responsibility for providing medical care and the availability and expense of costs to be required that the practical legislative-administrative agency responsibilities become entangled. Realistically, the difference between the district court and the commissioner in this case was whether the more conservative budgetary approach was justified, appropriate or permitted. Clearly, nothing statutorily stated confines the district court to accept the out-of-state institution alternative with the probable singularly higher cost involvement. The real issue, lacking mandatory statute, is whether the state constitution, the Fourteenth Amendment to the United States Constitution, or other federally preemptive criteria require the district court to provide a standard of care allegedly not available within the State Hospital. [8] Essentially, K.C. is advocating that she is denied her right to treatment [9] because she is not receiving the best treatment for her illness since she is not being treated in a psychiatric halfway house. [10] We disagree with K.C.'s broad characterization of the right to treatment and her implications. Even Judge Bazelon in Rouse, 373 F.2d at 456-57, while first enunciating such a right, recognized the limits of it: The hospital need not show that the treatment will cure or improve him but only that there is a bona fide effort to do so. This requires the hospital to show that initial and periodic inquiries are made into the needs and conditions of the patient with a view to providing suitable treatment for him, and that the program provided is suited to his particular needs.    The effort should be to provide treatment which is adequate in light of present knowledge.    [T]he possibility of better treatment does not necessarily prove that the one provided is unsuitable or inadequate. [Emphasis added & footnotes omitted.] The Circuit Court of Appeals for the District of Columbia further clarified and honed this right in Tribby, 379 F.2d at 105: We do not suggest that the court should or can decide what particular treatment this patient requires. The court's function here resembles ours when we review agency action. We do not decide whether the agency has made the best decision, but only make sure that it has made a permissible and reasonable decision in view of the relevant information and within a broad range of discretion. [Emphasis added.] Consequently, our review of the dilemma faced by the district court in placement decision [11] centers simply on whether the district court abused its discretion by disregarding either statutory or constitutional law in not requiring a more preferable level of care. We find no abuse of the district court's discretion in choosing placement at the State Hospital. This resolution is confined to our statutory system as provided by our legislature. As Dr. Birnbaum has astutely recognized: [T]he state legislature rather than the judiciary, seems the proper instrumentality to take the lead in establishing and enforcing a right to adequate treatment. Only the legislature has the means to set up a comprehensive scheme and to coordinate it with necessary legislative appropriations; the judiciary is limited to a case-by-case development. Birnbaum, A Rationale for the Right, 57 Geo.L.J. 752, 765 (1969). See also Bazelon, Implementing the Right to Treatment, 36 U. of Chi.L.Rev. 742, 745 (1969). With neither the Wyoming Constitution nor the United States Constitution mandating a greater degree of care than what the legislative branch has funded and the executive branch has provided through facilities within this state, we find no abuse of discretion in the district court's placement of K.C. at the State Hospital. Affirmed.