Matter of D.L.B.

2017 MT 106, 394 P.3d 169, 387 Mont. 323, 2017 Mont. LEXIS 293, 2017 WL 1833449
Montana Supreme Court·Decided May 8, 2017·No. 16-0281·Published

Opinion

05/08/2017

DA 16-0281 Case Number: DA 16-0281

IN THE SUPREME COURT OF THE STATE OF MONTANA 2017 MT 106

IN THE MATTER OF:

D.L.B.,

Respondent and Appellant.

APPEAL FROM: District Court of the Tenth Judicial District, In and For the County of Fergus, Cause No. DI 15-11 Honorable Jon A. Oldenburg, Presiding Judge

COUNSEL OF RECORD:

For Appellant:

Chad Wright, Chief Appellate Defender, Kristen L. Peterson, Assistant Appellate Defender, Helena, Montana

For Appellee:

Timothy C. Fox, Montana Attorney General, Katie F. Schulz, Assistant Attorney General, Helena, Montana

Thomas P. Meissner, Fergus County Attorney, Craig R. Buehler, Special Deputy County Attorney, Lewistown, Montana

Submitted on Briefs: March 1, 2017

Decided: May 8, 2017

Filed:

__________________________________________ Clerk Justice Dirk M. Sandefur delivered the Opinion of the Court.

¶1 D.L.B. appeals the order of the Tenth Judicial District Court, Fergus County,

recommitting him to the Montana Mental Health Nursing Care Center (Nursing Care

Center) for a period of up to one year. We conclude the order’s factual findings are

deficient and remand for entry of an amended order in compliance with the express

requirements of §§ 53-21-127 and -128(1)(d), MCA.

Did the District Court’s findings of fact meet the statutory requirements regarding alternative placement options?

BACKGROUND

¶2 D.L.B. has suffered from paranoid schizophrenia since his diagnosis at age 22

following a psychotic break. Now 76 years old, D.L.B.’s long history of mental illness

includes numerous involuntarily psychiatric hospitalizations in Washington and Montana.

When his disorder was not well managed by medication, D.L.B. became unable to meet

and maintain his most basic needs of food, clothing, shelter, health, and safety.

¶3 On March 24, 2015, D.L.B. was transferred to the Nursing Care Center from the

Montana State Hospital (MSH). Within 90 days of the transfer, certified mental health

professional Susan Stevens, M.S., L.M.F.T., petitioned to extend D.L.B.’s commitment.

Following an evidentiary hearing, the District Court recommitted D.L.B. to the Nursing

Care Center for up to six months. D.L.B. appealed and this Court affirmed. In re D.L.B.

(D.L.B. I), 2017 MT 1, ¶ 20, 386 Mont. 180, 389 P.3d 227.

¶4 On December 18, 2015, Stevens petitioned for a second extended commitment on

the ground that D.L.B. continued to suffer from a mental disorder requiring evaluation and 2 treatment. The District Court appointed counsel and designated D.L.B.’s sister as his

court-appointed “friend.” At a contested hearing on January 22, 2016, Stacie Klemo,

registered nurse supervisor at the Nursing Care Center, testified at length regarding

D.L.B.’s mental disorder, daily assistance needs, and general treatment plan.

¶5 Susan Stevens evaluated D.L.B.’s condition at the time of the hearing as declining,

depressed, and delusional. Stevens testified that D.L.B.’s history of medication

noncompliance reflected his near total lack of insight regarding his mental illness. Stevens

described a recurring pattern where D.L.B.’s psychiatric condition would stabilize during

an involuntary hospitalization but then destabilize upon discharge due to medication

noncompliance. Without daily medication, D.L.B.’s disorder would spiral out of control,

causing rapid decompensation and renewed need for involuntary inpatient treatment.

Stevens analyzed the alternative placements available and testified that, while D.L.B.

experienced a serious and chronic mental illness, he did not require the acute level of care

provided at MSH. However, according to Stevens, D.L.B.’s history demonstrated an

inability to successfully manage in a community placement, even with extensive support

services. Stevens further ruled out nursing home care due to D.L.B.’s active psychosis and

because nursing homes cannot administer involuntary medication when needed. Stevens

thus concluded that the Nursing Care Center was the least restrictive placement for

effective treatment of D.L.B. At the hearing, D.L.B. contrarily stated he would rather live

in a nursing home than remain at the Nursing Care Center.

3 ¶6 At the close of the hearing, the District Court entered oral findings of fact from the

bench that D.L.B. required recommitment, the Nursing Care Center was the least restrictive

placement for effective treatment, and involuntary administration of necessary medication

was in his best interest. On February 9, 2016, the Court entered written findings of fact,

conclusions of law, and an order recommitting D.L.B. for involuntary mental health

treatment at the Nursing Care Center.

STANDARD OF REVIEW

¶7 We review involuntary civil commitment orders to determine whether the district

court’s findings of fact are clearly erroneous and its conclusions of law are correct. In re

S.M., 2014 MT 309, ¶ 13, 377 Mont. 133, 339 P.3d 23. Upon review of involuntary

commitment proceedings, we review the evidence in the light most favorable to the

prevailing party. In re G.M., 2007 MT 100, ¶ 12, 337 Mont. 116, 157 P.3d 687 (citation

omitted). Whether a district court’s findings of fact satisfy statutory requirements is a

question of law reviewed for correctness. S.M., ¶ 13; In re Mental Health of E.P.B., 2007

MT 224, ¶ 5, 339 Mont. 107, 168 P.3d 662.

DISCUSSION

Did the District Court’s findings of fact meet the statutory requirements regarding alternative placement options?

¶8 Title 53, chapter 21, MCA, sets forth specific procedural and substantive

requirements for involuntary civil commitment proceedings. No later than two weeks

before an involuntary commitment expires, the responsible professional may petition the

court to extend commitment upon a specified showing of need for the extension. Section 4 53-21-128(1)(a), MCA. Except for the right to a jury trial, the extension procedure “must

be the same in all respects as the procedure” required for an initial mental health

commitment. Section 53-21-128(1)(c), MCA.

¶9 If the court finds on hearing that the respondent “continues to suffer from a mental

disorder and to require commitment” under any of the substantive criteria of

§ 53-21-126(1), MCA, then “the court shall order commitment” in accordance with

§ 53-21-127, MCA. Section 53-21-128(1)(d), MCA. At a separate dispositional hearing,

the court must determine the least restrictive placement for effective treatment from the

alternatives specified in § 53-21-127(3), MCA. Sections 53-21-127(5) and -128(1)(d),

MCA. The selected placement alternative must be based on a “comprehensive

individualized plan of treatment.” Section 53-21-128(1)(d), MCA.

¶10 Whether “stated on the record” or by written “opinion or memorandum of decision,”

district courts must generally make findings of fact and conclusions of law stating the

factual and legal bases for decisions in civil matters. M. R. Civ. P. 52(a)(1). In extending

a prior involuntary mental health commitment, district courts must make specific findings

of fact:

(1) stating in detail “the facts upon which the court found the respondent to be suffering from a mental disorder and requiring commitment” under the commitment criteria of §§ 53-21-126, -127(8)(a), and -128(1)(d), MCA;

(2) describing “what alternatives for treatment of the [respondent] are available,” §§ 53-21-127(8)(c) and -128(1)(d), MCA;

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Matter of D.L.B., 2017 MT 106, 394 P.3d 169, 387 Mont. 323, 2017 Mont. LEXIS 293, 2017 WL 1833449 (Mo. 2017).

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