Court Opinion

ID: 9713212
Source: CourtListenerOpinion
Date Created: 2023-08-26 05:10:58.398971+00
Date Added: 2024-06-11T18:23:17.563376
License: Public Domain

*803Liacos, C.J.
(dissenting). The court today strikes down a preliminary injunction which protected Christopher David McKnight (David), a profoundly retarded, autistic young man, from the violent consequences of his own self-destructive behavior. In so doing, the court ignores significant portions of the record, defers to an agency found to have acted in bad faith in the proceedings below, and fails to accord the findings of the Probate Court judge the deference demanded by past decisions of this court. I dissent.
1. Facts. I find it necessary to recite those facts not mentioned by the court regarding the actions of the Department of Mental Retardation (department) and the evidence presented at the proceedings below, which I consider crucial to a proper evaluation of the preliminary injunction.
In response to the request of David’s father that the department provide services to David, the department sent a psychologist, Dr. William Packard, to evaluate David and to determine his eligibility for services. Based on Packard’s report, the department made an immediate determination that David was eligible for services and that the most appropriate placement for David would be a twenty-four hour intensively staffed apartment for autistic adults. Despite this determination, the department initially proposed that David be returned to the care of his father to live in a trailer which lacked adequate heat and had no running water for part of the year. This proposal was later dropped and has been unanimously criticized by those clinicians who testified in the preliminary injunction proceedings.
After abandoning its home-care proposal, the department identified two facilities, Amego Residential Facility (Amego) and the Kennedy Donovan Program (Kennedy), as potential providers of emergency short-term services to David until a permanent placement could be arranged. A representative of the department testified that it did not consider the Behavior Research Institute, Inc. (BRI), program as an alternative to provide emergency service because BRI would want to be paid for rendering service, and because the need for short-term emergency service would not arise unless BRI had al*804ready discharged David for nonpayment,, as was threatened. The Probate Court judge found that the department’s rationale for not considering BRI was “illogical,” “absurd,” and “pure sophistry,” concluding that “it is inexplicable that BRI would not even be contacted by a state agency purportedly undertaking a good faith effort to give equal consideration to providers competent to minister to [David].”
During the preliminary injunction proceedings, the department submitted to the Probate Court a document entitled “Residential Priority One Waiting List” in an effort to demonstrate that there were five “first priority” clients more in need of services than David. The department argued that an order requiring special relief for David would displace these individuals. The Probate Court judge found this document to be “deceptive and misleading” in that it did not contain “up-to-date, current, accurate information,” and, contrary to statements made by the department, the document was prepared specifically for the preliminary injunction proceedings. Also, the department stated in its brief to the Probate Court that no money was available for the provision of residential services for David. In fact, the department was aware of at least $20,000 which was earmarked for David’s care. The Probate Court judge found that the department had “knowingly attempted to mislead the court” through its initial assertion that no funds were available.
Five treatment facilities at which David might be placed were discussed during the preliminary injunction proceedings: (1) BRI, (2) Samoset House, (3) Amego, (4) Kennedy, and (5) South Shore Mental Health Center (South Shore). Of these five facilities, Amego and Kennedy were unable to negotiate a suitable fee arrangement with the department for the provision of services to David, and were dropped from consideration.
During the preliminary injunction proceedings, the director of the inpatient unit at South Shore, Dr. Michael Dorsey, testified that South Shore would not be an appropriate facility at which to treat David. Dr. Dorsey also testified that David would be subject to harm due to self-injury if he were *805placed at Samoset House. Nevertheless, the department proposed to the Probate Court judge that David be placed at Samoset House. Assistant commissioner Jeffrey Keilson and regional director of the department Richard O’Mera, testified to the ability of Samoset House to care adequately for David. However, the Probate Court judge discounted Keilson’s and O’Mera’s testimony because they were administrators, not clinicians, and lacked sufficient expertise to testify to the appropriateness of a Samoset House placement for David. At the close of the preliminary injunction proceedings, the Probate Court judge found that “[n]o clinical support was provided to support [the Samoset House] placement,” and that “David’s placement in Samoset House, according to the unanimous clinical opinions presented to the Court, would most likely lead to a substantial increase in his self-abuse.” Furthermore, the Probate Court judge found that the department’s attempts to support a Samoset House placement “could have been mislead[ing],” “lack[ed] credibility,” and contradicted affidavits submitted to the court by the department.
The court-appointed monitor, Dr. John Daignault, a licensed psychologist, testified that BRI had successfully treated David, and that BRI was an appropriate facility at which to place David. The executive director of BRI, Dr. Matthew Israel, also a licensed psychologist, testified to BRI’s skill in treating David. Ruth Ellen Carpenter, a certified special education teacher who had known David for eleven years, testified that David had made significant progress in controlling his self-injurious behaviors during his time at BRI. In addition, a psychologist employed by the department, Dr. Packard, authored a report entered in evidence which indicated that discontinuing all aversive therapy procedures would lead to a dramatic escalation of David’s self-destructive behavior.
BRI is experienced in the use of aversive therapy, while Samoset House does not utilize aversive procedures. Dr. Daignault and Dr. Israel both testified that the precipitous *806removal of aversive therapy could cause David to suffer a profound regression and lead to an increase in his self-abuse.
Finally, the Probate Court judge found that local service center director Harold Berberick told David’s father that BRI “is not a politically acceptable placement,” and that regional director Richard O’Mera said that a BRI placement is “not the best way to win friends within the Department of Mental Retardation.” In light of this evidence, the Probate Court judge concluded that the department’s failure to consider BRI as an alternative treatment facility “was influenced by improper motivations, if not bad faith.”
2. The Preliminary Injunction. The court recognizes ‘that the Probate Court in this case enjoyed “broad powers to act in the best interests of David by fashioning equitable remedies,” ante at 791, and states that “[t]he judge would have been warranted in entering an injunction (a) directing the department to provide care and protective services to David and (b) defining the level of care and protective services that the department was obligated to furnish David.” Ante at 798. The court then narrows the remaining contested issues to whether the judge could order (1) that David remain at BRI and (2) that aversive therapy be available to prevent David from regressing.
The court, citing the well-established rule that a judge cannot order a public agency to act in a particular manner unless there is but one avenue through which that agency can fulfil its legal obligations, concludes that the record does not support a finding that only by placing David at BRI can the department fulfil its legal obligations. The court states that “[t]he injunction should have left the determination of where David is to be treated in the discretion of the department without requiring it to return to the court for approval of some other provider before David could be moved from BRI.” Ante at 798. Similarly, the court concludes that David has not proven that “the department, acting on the judgment of qualified professionals, could not reasonably deny the continued availability and use of aversives, when necessary.” Ante at 801. Thus, the court remands this case to the Pro*807bate Court where, presumably, another preliminary injunction hearing will be held on the need for aversives in David’s treatment.
The court’s reasoning and conclusions seem to me to be based on sophistry that unnecessarily prolongs these proceedings. In the circumstances of this case, the court’s deference to the expertise of the department is misplaced, and its remand of the case for another hearing is unnecessary.
It is true that judicial deference to the expertise of public agencies is a vital characteristic of our constitutional government, one which invokes the principle of separation of powers contained in art. 30 of the Massachusetts Declaration of Rights. American Family Life Assurance Co. v. Commissioner of Ins., 388 Mass. 468, 480 (1983). The tradition of judicial deference to agency decision making represents an important social policy decision that public agencies are generally in a better position than courts to make particular technical decisions. However, this policy rests on an assumption that public agencies will act properly when making their decisions.
Where agencies have been shown to have acted improperly in the execution of their regulatory, statutory, or constitutional duties, this court has been willing to uphold the exercise of judicial oversight of agency functions. Perez v. Boston Hous. Auth., 379 Mass. 703 (1980). Blaney v. Commissioner of Correction, 374 Mass. 337 (1978).
The rule that a court will not order an agency to act in a particular way, unless there are no other methods by which the agency may fulfil its legal obligations, is drawn directly from the policy of judicial deference to agency expertise. This rule is not absolute; it gives way in the face of agency misbehavior. For example, in the case of Bradley v. Commissioner of Mental Health, 386 Mass. 363, 366 (1982), we stated that “[ajt least until it is demonstrated that the [agency] is unable or unwilling to provide the level of security necessary for the plaintiff’s confinement in some [agency] facility, no order should be entered directing the [agency] to fulfil its statutory obligations in any particular way” (empha*808sis added). In the present case, the Probate Court judge’s findings that the department acted in bad faith, knowingly misled the court, considered improper political motivations in making its decision, and failed to provide any competent clinical evidence to support its proposal to place David at Samoset House certainly warranted a conclusion that the department had abandoned its proper role in this case. Therefore, the Probate Court judge’s decision to require the department to keep David at BRI did not violate the rule against improper judicial interference in agency decisions.
The judge’s conclusion also finds support in the case of Attorney Gen. v. Sheriff of Suffolk County, 394 Mass. 624 (1985). In that case, we did not look solely to whether there were any alternative avenues open to the agency; rather, we looked to the factual context of the case to determine whether there were any feasible alternatives which the agency might choose. Id. at 628, 630. “[I]t is implied in the judge’s findings and in the circumstances presented that there was only one means by which the public officials could carry out their statutory duty, that is, by the construction of a seventeen story jail. The only suitable plan was the seventeen story proposal” (emphasis added). Id. at 630. “[The single justice] concluded that the only feasible plan in the light of costs and time was the seventeen story plan” (emphasis added). Id. at 628.
In the present case, the bulk of the clinical testimony presented at the preliminary injunction proceedings suggested that David would be safe at BRI. The judge, exercising his prerogative to evaluate the evidence, accepted the credibility of this expert testimony. Additionally, he accepted the clinical testimony regarding the propriety of a Samoset House placement which indicated that David would most likely regress and suffer self-inflicted injuries were he to be placed in that facility. The court fails to show that these findings were clearly erroneous.
A Probate Court’s authority over matters relating to guardianship is limited to fashioning relief “in the best interest of [the person] under [its] jurisdiction.” Guardianship of *809Anthony, 402 Mass. 723, 726 (1988), quoting Matter of Moe, 385 Mass. 555, 561 (1982). “The court’s power is ‘to be exercised with an eye single to the welfare of the ward.’ ” Guardianship of Anthony, supra at 726, quoting King v. Dolan, 255 Mass. 236, 237 (1926). Given the fact that the other placement facilities presented as alternative placements at the preliminary injunction proceedings were either unavailable or unable to properly care for David, BRI represented the only feasible treatment facility presented to the Probate Court by any of the parties. In my opinion, the Probate Court judge was bound by his obligation of care for David’s interests to order that David remain at BRI.
The court states that “[i]n legal and practical effect, the injunction is . . . permanent, not . . . preliminary.” Ante at 792. However, by its terms, the injunction allows the department to move to vacate the injunction “at any time . . . upon the submission and upon approval by the Court of a reasonably-conceived, competently-defined clinical habilitation program sufficient to provide for Christopher David McKnight’s safety, habilitation and care, and which shall not cause him harm.” If the department, exercising the expertise alluded to in the court’s opinion, presents a suitable treatment plan to the Probate Court, the injunction will be dissolved. I fail to see how this injunction can realistically be characterized as “permanent.”
When faced with a challenge to a preliminary injunction, the task for this court is to determine whether the lower court abused its discretion in issuing the injunction. Packaging Indus. Group, Inc. v. Cheney, 380 Mass. 609, 615 (1980). Planned Parenthood League of Mass., Inc. v. Operation Rescue, ante 701 (1990). “An appellate court’s role is to decide whether the [trial] court applied proper legal standards and whether there was reasonable support for its evaluation of factual questions.” Packaging Indus. Group, Inc. v. Cheney, supra at 615, quoting Hochstadt v. Worcester Found, for Experimental Biology, 545 F.2d 222, 229 (1st Cir. 1976). I have little doubt but that the record below provided “reasonable support” for the Probate Court judge’s *810finding that David risked irreparable harm if the injunction did not issue and David was subsequently removed from BRI. See Packaging Indus. Group, Inc., supra at 616. The testimony of at least three licensed psychologists suggested that David would risk grievous bodily harm if he were removed from BRI to Samoset House. The department presented no clinical testimony to rebut this suggestion. Quite apart from the evidence of the department’s improper actions, this lack of clinical evidence to the contrary provides strong support for the judge’s finding of irreparable harm.
A remand for further hearings is unnecessary. This court is not faced with a situation where the department has been unable to make its position clear or has not been allowed to present evidence in support of its position. The department has had ample opportunity to state its case. Any wrong which the department feels it suffered at the hands of the Probate Court judge arises, not out of any institutional or procedural infirmity in the proceedings below, but out of the fact that the department failed to present a professionally tenable position to the Probate Court. To remand this case to the Probate Court so that the department can now attempt to produce evidence of “accepted professional practice” to support its position, where scarce effort was made before, allows the department a second chance where none is deserved. The injunction should stand. I dissent.