Opinion
No. A04-1908.
Filed March 15, 2005.
Appeal from the District Court, Chisago County, File No. PX-04-1402.
Timothy T. Ryan, Joslin Ryan Berry Law Offices P.A., (for appellant Jeremy Douglas Glem).
Katherine M. Johnson, Chisago County Attorney, Susan E. Drabek, Assistant County Attorney, (for respondent Chisago County).
Considered and decided by Lansing, Presiding Judge; Willis, Judge; and Stoneburner, Judge.
This opinion will be unpublished and may not be cited except as provided by Minn. Stat. § 480A.08, subd. 3 (2004).
UNPUBLISHED OPINION
Jeremy Glem appeals from an order committing him as mentally ill and a companion order authorizing involuntary administration of neuroleptic medication. We reject Glem's claims that the hearing procedures were improper, that the medical-examiner's report lacked an adequate foundation, and that the proceedings violated his due-process rights. But we agree that the findings and conclusions do not satisfy the statutory requirement of stating the conduct that is the basis for the commitment, and we remand for further consideration.
FACTS
Chisago County detained Jeremy Glem in the county jail pending felony charges for failure to comply with sex-offender-registration requirements. Based on Glem's conduct during detention, the district court ordered a mental-health evaluation under Minn. R. Crim. P. 20.01 and Minn. R. Crim. P. 20.02. A forensic psychologist on the staff of the St. Peter Regional Treatment Center evaluated Glem and concluded that he is mentally ill and a danger to himself. Responding to this report, the district court ordered Glem's transport to the Cambridge Medical Center for further evaluation.
Chisago County Health and Human Services filed a petition for Glem's commitment as mentally ill. A subsequent petition requested authorization to impose treatment. The district court conducted a hearing on both petitions at the Cambridge Medical Center. The court-appointed medical examiner testified that he reviewed Glem's medical records and personally interviewed Glem. Based on the information that the examiner obtained from the records and the interview, he diagnosed Glem as suffering from chronic paranoid schizophrenia and observed that he was currently in an active psychotic state with delusions and auditory hallucinations. The examiner, consistent with the evaluation of the forensic psychologist at the St. Peter Regional Treatment Center, concluded that Glem represents an imminent risk of serious danger to himself and others in his acutely psychotic condition. He further noted that Glem's disorder prevents him from seeking and obtaining the necessary medical care to treat his mental illness. A psychiatric social worker at the Cambridge Medical Center testified to Glem's conduct that conformed to this diagnosis. Glem testified on his own behalf and denied that he was a threat to himself or others.
The district court ordered Glem committed for an initial period not to exceed six months and issued a companion order authorizing intrusive treatment with neuroleptic medication. Both orders are stated on preprinted forms that provide blanks for information on dates and names, set forth findings in generic statutory language, and offer a selection of boxes to check to identify the statutory basis for commitment. The orders do not contain specific, individualized findings. Glem appeals, challenging (1) the propriety of the hearing procedures, (2) the foundation for the court-appointed examiner's testimony and report, (3) the adequacy of the findings, and (4) whether he was afforded due process.
DECISION I
The district court conducted Glem's hearing at the Cambridge Medical Center in a conference room that is approximately twelve feet by twelve feet, substantially smaller than a standard courtroom. Glem contends that the location and size of the courtroom violates the minimum requirements for general decorum in a court proceeding.
Statutory hearing procedures for judicial commitment require a hearing conducted "consistent with orderly procedure" in "a courtroom meeting standards prescribed by local court rule which may be at a treatment facility." Minn. Stat. § 253B.08, subd. 2a (2004); see also Minn. R. Civ. Commitment 14 (providing that presiding judge shall assure orderliness and decorum of proceeding and allow patient an adequate opportunity to speak privately with counsel).
The district court stated on the record at the hearing that the proceedings conformed to local court rule, which allows commitment hearings to take place in the Cambridge Medical Center's conference room. Glem has not provided contrary authority. The Cambridge psychiatric social worker further explained that the conference-room location was ordinarily used when patient safety was a consideration, and that the hearing was scheduled in the conference room because Glem had been angry and threatening to himself two days earlier. Both the county attorney and Glem's attorney agree that the district court recognized that the confined space required additional precautions to ensure that Glem could speak privately with his attorney. The court indicated it would suspend the proceedings at any time to allow Glem to speak privately to his attorney in an area outside the courtroom.
We discern no violation of court rules in the location and size of the hearing room. We also reject Glem's contention that reversal is necessary because the court failed to observe the "formalities in opening court." Although the judge did not announce the opening of court or require the participants to stand, this variance from Minn. R. Gen. Pract. 2.01(c) is at most a technical violation and did not prejudicially affect the proceedings.
II
Glem asserts that the district court improperly permitted the medical examiner to testify to hearsay evidence drawn from Glem's medical records without adequate foundation. The interpretation of procedural rules is a legal question, subject to de novo review. Kastner v. Star Trails Ass'n, 646 N.W.2d 235, 238 (Minn. 2002). A district court has broad discretion to determine the admissibility of evidence. State v. Boitnott, 443 N.W.2d 527, 534 (Minn. 1989).
The Commitment and Treatment Act Rules govern commitment proceedings and treatment hearings. Minn. R. Civ. Commitment 1(a); see also Minn. R. Civ. Commitment 1(b) (stating that commitment rules "shall supersede any other body of rules otherwise applicable . . . in conflict with these Special Rules."). Under Minn. R. Civ. Commitment 15, "[t]he Court may admit all relevant, reliable evidence, including but not limited to the respondent's medical records, without requiring foundation witnesses."
The district court properly received into evidence the medical report of the court-appointed examiner. The examiner's report was based on his personal interviews with Glem and relevant and reliable medical records. Glem fails to identify or demonstrate the unreliability or irrelevancy of any contents of the report.
III
A district court may order a person committed as mentally ill when the evidence clearly and convincingly establishes that the person has "an organic disorder of the brain or a substantial psychiatric disorder . . . which is manifested by instances of grossly disturbed behavior or faulty perceptions and poses a substantial likelihood of physical harm to self or others." Minn. Stat. §§ 253B.02, subd. 13(a), .09, subd. 1(a) (2004). "[T]he commitment must be justified by findings based upon evidence at the hearing." In re Knops, 536 N.W.2d 616, 620 (Minn. 1995). We will not reverse a district court's findings of fact unless the facts are clearly erroneous, but we independently review whether the findings are sufficient to support the statutory requirement. See In re McGaughey, 536 N.W.2d 621, 623 (Minn. 1995) (discussing required findings for commitment).
When ordering commitment, the district court must "find the facts specifically, and separately state its conclusions of law." Minn. Stat. § 253B.09, subd. 2 (2004). The statute requires that "the findings of fact and conclusions of law . . . specifically state the proposed patient's conduct which is a basis for determining that each of the requisites for commitment is met." Id. The findings also must identify less restrictive alternatives considered by the court and the reasons for rejecting them. Id.
Specific findings ensure that statutory requirements for commitment have been met and also facilitate effective appellate review. See In re Stewart, 352 N.W.2d 811, 813 (Minn.App. 1984) (observing legislative mandate for specific findings). For these reasons, we have held that legally insufficient findings require remand. See In re Danielson, 398 N.W.2d 32, 37 (Minn. App. 1986) (remanding for findings when district court failed to cite specific conduct that justified commitment); Stewart, 352 N.W.2d at 813 (remanding for findings in commitment proceeding).
Glem does not dispute that he suffers from mental illness, but he contends that he is not dangerous to himself or others. The preprinted form order for commitment neither includes specific, individualized findings on Glem's conduct nor identifies Glem's behavior that manifests a danger to himself or others. We conclude that this use of a form order, without more, fails to provide adequate findings to support commitment and that remand is necessary for more specific findings.
Similarly, Glem challenges the adequacy of the district court's order authorizing treatment with neuroleptic medication. Although the efficacy of the treatment order is contingent on the validity of the commitment order, we note that the same principles of particularity apply to both.
In evaluating a petition for involuntary treatment with neuroleptic medication, the court must determine whether the treatment is necessary and reasonable based on a number of factors, including the effect of the treatment, the risk of adverse side effects, and the extent of the intrusion. Jarvis v. Levine, 418 N.W.2d 139, 144 (Minn. 1988) (applying procedural protections delineated in Price v. Sheppard, 307 Minn. 250, 239 N.W.2d 905 (1976)); see also Minn. Stat. § 253B.092, subd. 7 (2004) (listing factors for consideration by court). Glem challenges the district court's order authorizing the administration of neuroleptics because it fails to specify the exact type of medication authorized, the duration of the treatment, and the strength of the dosage.
Each order authorizing the administration of neuroleptics must be tailored to individual circumstances. In re Steen, 437 N.W.2d 101, 104-05 (Minn.App. 1989) (disagreeing with state's argument that " Jarvis contemplated the use of open-ended orders on duration and levels of unspecified medications"). If the district court identifies specific behavior that manifests Glem's dangers to himself or others, the district court should also reevaluate the treatment order to ensure that the authorization for neuroleptic medication is sufficiently specific to meet the standards imposed by law.
IV
Finally, Glem asserts a general violation of his due-process rights. The Minnesota Supreme Court has recognized the preservation of a patient's procedural due-process rights during the commitment process. See In re Schmidt, 443 N.W.2d 824, 829-30 (Minn. 1989) (noting procedural protection of statutory scheme, which assures right to counsel under Minnesota Constitution during adversarial hearing for administration of neuroleptic medication). But Glem's due-process arguments only restate issues previously raised and individually addressed. These arguments afford him no further grounds for relief.