Court Opinion

ID: 9894794
Source: CourtListenerOpinion
Date Created: 2023-11-02 21:08:12.965462+00
Date Added: 2024-06-11T09:10:39.127589
License: Public Domain

FILED
                                                                      IN THE OFFICE OF THE
                                                                   CLERK OF SUPREME COURT
                                                                        OCTOBER 26, 2023
                                                                    STATE OF NORTH DAKOTA

                   IN THE SUPREME COURT
                   STATE OF NORTH DAKOTA

                                2023 ND 203

In the Interest of A.I.

Catholic Charities,                                 Petitioner and Appellee
        v.
A.I.,                                            Respondent and Appellant

                                No. 20230311

Appeal from the District Court of Burleigh County, South Central Judicial
District, the Honorable James S. Hill, Judge.

AFFIRMED IN PART AND VACATED IN PART.

Opinion of the Court by Jensen, Chief Justice.

Omid Kardoust, Assistant State’s Attorney, Bismarck, ND, for petitioner and
appellee.

William Woodworth, Bismarck, ND, for respondent and appellant.
                                 Interest of A.I.
                                  No. 20230311

Jensen, Chief Justice.

[¶1] A.I. appeals the district court’s order continuing her commitment to the
North Dakota State Hospital (“NDSH”) for a period not to exceed 180 days. She
argues the court erred in not ordering a less restrictive alternative treatment
as testimony supported A.I.’s needs could be met with a lower level of care.
Secondly, A.I. asserts the entry of an order, that indicated a waiver of the
continuing treatment hearing filed after a hearing was held, was clearly
erroneous. We conclude the court’s order to continue her hospitalization was
not clearly erroneous, and the court’s order following waiver of treatment or
continuing treatment hearing, as conceded by both parties, was entered in
error. We affirm the court’s order for continued treatment and vacate the
superfluous order entered in the record at docket entry 43.

                                         I

[¶2] In May 2023, A.I.’s guardian, Catholic Charities of North Dakota filed a
petition for the involuntary commitment of A.I., alleging A.I. was mentally ill
and a person requiring treatment. The district court held a treatment hearing
and determined A.I. was mentally ill and ordered A.I. to undergo treatment at
the NDSH not to exceed 90 days. The order was set to expire on August 22,
2023.

[¶3] On August 4, 2023, a petition for continuing treatment was filed, alleging
A.I. was a person requiring further treatment and that although her needs
could be met with a lower level of care, no placement had accepted her. A
continuing treatment hearing was held on August 21, 2023. The psychologist
who assessed A.I., and a representative from Catholic Charities provided
testimony.

[¶4] At the conclusion of the hearing, the district court issued two orders. The
first, located in the record as docket entry 42, titled findings of fact, conclusions
of law, and order following treatment or continuing treatment hearing, in
which the court ordered A.I. to continue treatment at the NDSH for a period

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not exceeding 180 days. The court’s findings indicate concerns that placing her
in a less restrictive environment could place A.I., others, or property at risk for
harm. To support its findings, the court referenced A.I.’s history of
nonadherence to medical treatment, impulsive behavior, and past incidents
that required the assistance of multiple staff to get compliance. The court
further found that although a less restrictive program could meet A.I.’s needs,
no such program was available.

[¶5] The second order, order following waiver of treatment or continuing
treatment hearing, was provided to the district court as a proposed order before
the start of the hearing. This order also committed A.I. to the NDSH for a
period not to exceed 180 days in addition to indicating “having received an
application and order for waiver of hearing . . . .” The State concedes no waiver
was filed. At oral argument, the parties agreed the order is duplicative of the
order issued in docket entry 42, appears to have been entered in error, and
should be vacated.

                                        II

[¶6] When a person is found to be a person in need of treatment, they have
the right to the least restrictive conditions necessary to achieve the purposes
of the treatment. N.D.C.C. § 25-03.1-21. This Court has determined:

      To comply with the requirements of N.D.C.C. § 25-03.1-21(1), the
      district court is required to make a two-part inquiry: (1) whether a
      treatment program other than hospitalization is adequate to meet
      the individual’s treatment needs, and (2) whether an alternative
      treatment program is sufficient to prevent harm or injuries which
      an individual may inflict on himself or others. The court must find
      by clear and convincing evidence that alternative treatment is not
      adequate or hospitalization is the least restrictive alternative. In
      some cases, a reporting doctor may reasonably conclude that less
      restrictive alternatives to hospitalization simply do not exist. . . .
      We will not set aside the district court’s findings of fact unless they
      are clearly erroneous. A district court’s finding of fact is clearly
      erroneous if it is induced by an erroneous view of the law, if there
      is no evidence to support it, or if, although there is some evidence

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      to support it, on the entire evidence this Court is left with a definite
      and firm conviction a mistake has been made.

In re J.S., 2006 ND 143, ¶ 6, 717 N.W.2d 598 (cleaned up).

[¶7] A.I. asserts since there is a less restrictive alternative to her continued
placement at the NDSH, the district court determination to extend her
commitment was clearly erroneous. Although A.I. could have been placed in a
less restrictive facility, the court received testimony that no such facility had
accepted A.I. for placement.

[¶8] In Interest of J.S., 545 N.W.2d 145 (N.D. 1996), this Court affirmed a
similar district court’s finding. In J.S., the court determined there were no
appropriate alternative programs presently available and continued J.S.’s
treatment at the NDSH. Id. at 148. In J.S., the court was presented with
evidence that placement in a less restrictive alternative to hospitalization was
a potential option, but that such a placement was not currently available. Id.
at 147. Finally, the record in J.S. reflected that a search for a less restrictive
placement was continuing. Id. at 148.

[¶9] Here, the district court heard testimony from the psychologist who
assessed that A.I. could be released to a supervised apartment or transitional
home, but that no such place was currently available. Additional testimony
indicated A.I. had been evaluated for independent living with supportive
services and it was determined A.I. was not ready for such a reduced level of
care. The psychologist also testified that since no transitional facility was
available, A.I. requires continued care with the NDSH until a place with fewer
restrictions accepts her. The representative from Catholic Charities testified
they have been working to find A.I. a placement since the first month she
arrived at the NDSH and are continuing to search for an alternative
placement. At the time of the hearing, no alternative treatment option had
accepted A.I. for placement. Under these circumstances, the court’s finding
that a less restrictive alternative to placement at the NDSH was not available
is supported by evidence in the record, was not a misapplication of the law, and
we are not left with a definite and firm conviction a mistake has been made.

                                         3
We conclude the finding a less restrictive alternative placement is not available
is not clearly erroneous.

[¶10] Secondly, A.I. asserts the district court’s findings as to why an
alternative program was insufficient to prevent harm or injury was not
supported by clear and convincing evidence. Specifically, A.I. argues the court’s
findings related to A.I.’s anxiety and depressed mood, suicidal statements, her
belief that events will happen when no events exist, and an inability to care for
herself were not supported by sufficient testimony. In summary, she argues she
should have been placed into an independent living setting.

[¶11] During the hearing, the psychologist who assessed A.I. testified A.I. was
being treated for borderline personality disorder and adjustment disorder with
mixed anxiety and depressed mood. He testified staff reported A.I. requires
additional treatment to be accepted to a less restrictive treatment setting, in
addition to her being “at high risk for seriously harming herself or others if
discharged at this time.” This report also outlines specific instances in which
her behavior would not be suited for a less restrictive treatment setting:
“Recent incidents include yelling at staff, throwing her walker at staff, not
following basic instructions, and agitation to the point of requiring involuntary
intramuscular injections of sedating medication.”

[¶12] The psychologist who assessed A.I. also testified concern regarding A.I.’s
continued belief in things that are unlikely to happen and indicated A.I. was
not to a level where she could live independently. On this record, the district
court’s finding that a less restrictive alternative to placement at the NDSH was
not available, including independent living, is supported by evidence in the
record, was not a misapplication of the law, and we are not left with a definite
and firm conviction a mistake has been made. We conclude the finding that a
less restrictive alternative placement, including independent living, is not
available is not clearly erroneous.

                                      III

[¶13] The district court’s finding that no less restrictive alternative treatments
were available was not clearly erroneous. Additionally, both parties concede

                                        4
the entry of the superfluous order, order following waiver of treatment or
continuing treatment hearing, located as docket number 43, was done in error.
We affirm the district court’s order for continued treatment and vacate the
superfluous order located at docket number 43.

[¶14] Jon J. Jensen, C.J.
      Daniel J. Crothers
      Lisa Fair McEvers
      Jerod E. Tufte
      Douglas A. Bahr

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