Court Opinion

ID: 9693707
Source: CourtListenerOpinion
Date Created: 2023-08-25 16:57:53.765728+00
Date Added: 2024-06-11T12:08:17.504078
License: Public Domain

ROGERS, Chief Judge,
concurring:
I write separately because our prior decisions make clear that appellant’s other contentions are equally persuasive. The court order revoking appellant’s outpatient status was invalid because (1) the Hospital failed to file a timely revocation petition, and (2) the Hospital failed to demonstrate at the hearing that indefinite inpatient treatment was the least restrictive alternative. The liberty interests at stake are too precious to allow the Hospital to avoid the statutory and constitutional protections of a citizen otherwise entitled to be left alone by the government.
I
The District of Columbia Hospitalization of the Mentally Ill Act reflects a “profound congressional concern for the liberties of the mentally ill.” In re DeLoatch, 532 A.2d 1343, 1345 (D.C.1987) (quoting Covington v. Harris, 136 U.S.App.D.C. 35, 41, 419 F.2d 617, 623 (1969)). The court has thus construed the Act with the understanding that it “was designed with a view to securing at last the civil and constitutional rights of [a] long-neglected group.” In re Lomax, 386 A.2d 1185, 1188 (D.C.1978) (citing various opinions of the U.S. Court of Appeals for the District of Columbia Circuit and the legislative history of the Act). The Act assures that a person suffering from a mental illness will receive the least restrictive treatment. Covington v. Harris, supra, 136 U.S.App.D.C. at 41, 419 F.2d at 623. It further makes clear a preference for voluntary commitment for treatment. See In re Blair, 510 A.2d 1048, 1050 (D.C.1986) (“Congress ... recognized that voluntary hospitalization was preferable to emergency, involuntary detention”); see also Lake v. Cameron, 124 U.S.App.D.C. 264, 268, 364 F.2d 657, 661 (1966) (en banc) (“Every effort should be made to find a course of treatment which [the patient] might be willing to accept”). “We therefore construe the Act narrowly where its application results in the curtailment of an individual’s liberty.” In re Reed, 571 A.2d 801, 802 (D.C.1990) (citing Lomax, supra, 386 A.2d at 1187-88).
The Act “provides ‘an explicit and expedited timetable’ for involuntary hospitalization procedures.” Reed, supra, 571 A.2d at 802 (quoting Lomax, supra, 386 A.2d at 1188). In In re Richardson, 481 A.2d 473 (D.C.1984), the court held that when the Hospital returns an outpatient to institutional care, it “must either release him after the fifth day of institutional care and observation, or thereafter move for a prompt adversary judicial hearing seeking the permanent revocation of his outpatient status.” Id. at 481 (emphasis added). Appellant’s original 1983 outpatient commitment order contained similar language:
[T]he hospital may return respondent to inpatient status at the hospital for a temporary period not to exceed five days .... At the expiration of five days, the hospital shall again release [appellant] to outpatient status unless within that period the hospital has recommended to the Court in writing that the order of outpatient commitment be revoked, with [appellant] having the right to a prompt hearing before the Court to contest the recommended change in status. [Emphasis added].
Appellant was returned to the Hospital on October 28, 1986. The Hospital was therefore obliged by November 4, 1986,1 *747either to release appellant or to file a petition for a revocation hearing. The Hospital took neither action, however, and did not file a petition until November 6, 1986. The Hospital thus properly conceded at oral argument that it failed to comply with the procedural time limit established by both Richardson and appellant’s outpatient order. The Hospital’s contention — that its failure to comply with the time limit should not invalidate the ultimate judicial determination that appellant’s outpatient commitment be revoked — has been rejected by the court on several occasions.
Thus, in DeLoatch, supra, 532 A.2d 1343, a patient had demanded a hearing pursuant to D.C.Code § 21-525 (1981) to challenge the trial court’s ex parte order authorizing his detention for up to seven days. The patient did not receive a hearing within twenty-four hours of his request, as required by the statute. The court rejected the Hospital’s argument that “the trial court’s ultimate determination that probable cause existed to continue detention cured any error of noncompliance with the statutory time limitation.” Id. at 1345. Because the patient “was held without independent judicial review beyond the time limitations set forth by statute,” subsequent judicial action could not cure the fundamental defect. Id. Similarly, in In re Feenster, 561 A.2d 997 (D.C.1989), a patient was held for ten days before the Hospital filed a notice of hospitalization which should have been filed within twenty-four hours of the patient’s return. The court held that neither a subsequent probable cause order nor the eventual adversarial revocation hearing could “cure [the patient’s] illegal detention for ten days.... ” Id. at 999. Finally, in Reed, supra, 571 A.2d 801, the Hospital failed to file a petition for judicial hospitalization within seven days, as required by D.C.Code § 21-523. Despite the fact that the Hospital missed the deadline by only one day, the court held that “subsequent judicial review cannot cure a failure to meet a statutory deadline.” Id. at 804. In so holding, the court has recognized that the Act provides important safeguards to persons who are institutionalized against their will, and that a fundamental error at an early stage of the commitment process can never be cured by subsequent judicial action. See, e.g., DeLoatch, supra, 532 A.2d at 1345.
The Hospital nevertheless attempts to distinguish these cases by stressing that the notice of rehospitalization was filed promptly, and “unlike the notice of Rehos-pitalization, the filing of the revocation petition, the only document which appellant alleges was late, does not trigger any immediate judicial review.” The Hospital fails to acknowledge, however, that in Reed, the relevant procedural violation concerned a late filing of a petition for hospitalization, which also would not trigger immediate judicial review. Moreover, the Hospital’s timely notice of rehospitalization itself stated that “[t]he Hospital must either release the above-named patient after the fifth day of hospitalization or move for a judicial hearing seeking revocation of his outpatient commitment.” Indeed, even its November 6th petition to revoke referenced the five day period, representing that the Hospital had determined that appellant required hospitalization beyond “the authorized five day period.”
The Hospital’s attempt to analogize its error to those procedural violations which may be cured by subsequent judicial action, see, e.g., In re Rosell, 547 A.2d 180 (D.C.1988) (involving an affidavit improperly submitted by someone who was not a “physician of the person”),2 must fail. As Feen-ster made clear, “a procedural error which ... result[s] in a patient’s detention beyond the statutory time limits” can never be cured. 561 A.2d at 999. Although the Hospital’s failure to file a timely revocation petition in the instant case did not violate a statutory deadline, it resulted in appellant’s detention beyond the time limit proscribed *748by (1) the original 1983 outpatient order, (2) the notice of rehospitalization filed by the Hospital, and (3) our decision in Richardson, supra. These time limits are of no less significance than the time limits proscribed by the Act. Accordingly, “the revocation of appellant’s outpatient commitment order was rendered invalid by the illegal detention that preceded it.” Feenster, supra, 561 A.2d at 999-1000.3
II
Even if the Hospital had filed a timely revocation petition, the trial judge erred nonetheless in ordering appellant’s indeterminate inpatient commitment. When the Hospital moves to revoke a patient’s outpatient commitment, it has the burden of “establishing] that inpatient therapy is ... the least restrictive alternative compatible with the ends of rehabilitation.” Richardson, supra, 481 A.2d at 479 n. 4; see also In re James, 507 A.2d 155, 158 (D.C.1986); In re Stokes, 546 A.2d 356, 363 (D.C.1988). Moreover, in a revocation proceeding “the trial court [must] inquire into ‘such alternative courses of treatment’ ” which may be available to meet the needs of the patient and the public. Id. (quoting Lake v. Cameron, supra, 124 U.S.App.D.C. at 268, 364 F.2d at 661). Thus, “the trial court’s decision to revoke an outpatient commitment ... must abide by the least restrictive treatment principle, and be supported by an explicit finding that the proposed treatment is the least restrictive alternative.” Id. at 158.
Although the trial judge found that “involuntary inpatient hospitalization is now the least restrictive alternative,” the record does not support the trial judge’s ultimate conclusion that committing appellant as an inpatient “for an indefinite period” is consistent with the least restrictive treatment principle. The Hospital presented one expert at the revocation hearing, who testified that for a period of approximately three years appellant had functioned successfully as an outpatient, requiring occasional periods of inpatient treatment at the Hospital. The expert further explained that appellant, in his current condition, required only a temporary stay in the Hospital:
Q. Do you have an opinion as to whether [appellant] needs to remain at the Hospital at this time?
A. Yes. I think [appellant] needs some more time, at least a couple of months or so, in an — hopefully in an intensive ward where they can work on more insight [into his mental illness].
Q. ... [D]o you have an opinion as to whether [appellant] could function in any other setting other than [the Hospital] at this time?
A. Not at this time. He’s not stable _ [He] is not stable at this point to go back into the community today.
The trial judge credited this expert testimony, adding that “I would guarantee you [i.e., appellant] would be out of there in eight weeks or a little bit more, as the doctor said, perhaps, because of the setback the last couple of weeks, and you’d be through with it.” The judge nonetheless revoked appellant’s outpatient commitment and ordered that he be committed as an inpatient for an indefinite period of time, concluding that “at this time I have no choice ... based on the evidence in this case as I have heard it, but to revoke the outpatient commitment at this time and send you back to the Hospital.”
*749The trial judge thus ordered indefinite inpatient commitment even though his view of the evidence showed that appellant needed only “eight weeks or a little bit more” of intensive inpatient treatment. As in Stokes, supra, 546 A.2d at 363 (opinion of Mack, J., announcing the judgment of the court), “[t]he Hospital failed to explain why temporary revocation was not a satisfactory alternative” in appellant’s case. As the court noted in In re Mills, 467 A.2d 971, 974-75 (D.C.1983) (citations omitted) (emphasis in original):
The statutory scheme in this jurisdiction does not limit the court in a commitment proceeding to a polarized choice between indefinite hospitalization and unconditional release.... It has been construed to impose a duty upon the courts to explore alternatives both within the mental hospital ... and outside the hospital, ... and to require that the courts select' the least restrictive alternative which would serve the purposes of the commitment.
The Hospital’s position that “[gjiven [appellant’s refusal] to remain in the hospital even for a short period of time and [his demand for] immediate release, the court was compelled to revoke his outpatient commitment and order inpatient care” for an indefinite time, is simply contrary to the law. The principle of least restrictive treatment incorporated in the Act requires the trial court to craft an order that is minimally intrusive of the patient’s liberty. James, supra, 507 A.2d at 158; Stokes, supra, 546 A.2d at 361 (opinion of Mack, J., announcing the judgment of the court). Because the evidence indicated that appellant needed only temporary inpatient treatment, the judge could only temporarily revoke appellant’s outpatient commitment and order him committed as an inpatient for a limited period of two to three months. The Hospital’s expert opinion was that no more time was required, based on experience with appellant over many years. The judge therefore erred in ordering appellant’s commitment as an inpatient for an indefinite period.

. For purposes of this appeal, I accept appellant’s concession that the relevant deadline was November 4, 1986, seven days after the rehospi-talization, since the intervening Saturday and Sunday were to be "excluded in the computa*747tion” of the deadline. See Super.Ct.Ment.H.R. 12(a) (1990).

. The court in Rosell noted that it was bound by prior cases holding similar errors to be harmless. 547 A.2d at 182. But see id., 547 A.2d at 183-85 (Rogers, J., concurring) (expressing concern over the vitiation of the statutory requirements).

. The Hospital contends that by failing to object in the trial court to the Hospital’s late filing, appellant has waived the issue. Although ordinarily this court “will not consider in a civil case arguments made for the first time on appeal," Henderson v. District of Columbia, 493 A.2d 982, 995 (D.C.1985), "jurisdictional issues may always be raised.” Clay v. Faison, 583 A.2d 1388, 1390 n. 2 (D.C.1990); In re Allegations of Misconduct Against Juveniles Detained at and Committed at Cedar Knoll Inst., Dep't of Human Resources, 430 A.2d 1087, 1100 (Ferren, J., dissenting); 5A C. Wright & A. Miller, Federal Practice and Procedure § 1393 at 773 (2d ed. 1990). Because the trial court was without power to consider the Hospital’s late revocation petition, appellant’s challenge is best characterized as jurisdictional, properly raised on appeal. Indeed, our decision in Feenster, supra, 561 A.2d 997, made no reference to whether the patient had contended in the trial court that the Hospital’s notification was untimely.