IN THE MATTER OF THE CIVIL COMMITMENT OF M.C. (ESCC-1134-2016, ESSEX COUNTY AND STATEWIDE)(RECORD IMPOUNDED)
A-0435-16T4
| N.J. Super. Ct. App. Div. | Dec 4, 2017Background
- M.C., diagnosed with chronic paranoid schizophrenia and alcohol abuse, was involuntarily hospitalized on June 17, 2016; initial commitment entered June 20, 2016.
- At an August 23, 2016 review hearing the treating psychiatrist testified M.C. had improved and was no longer dangerous, but sought a conditional extension pending placement (CEPP) to continue monitoring clozapine treatment and arrange weekly bloodwork.
- M.C.'s sister testified she was immediately willing to house him and provide transportation for weekly blood tests and outpatient follow-up.
- The psychiatrist acknowledged blood monitoring and medication administration could be performed in the community, but claimed it would take 1–6 weeks to locate an appropriate outpatient facility in the sister’s neighborhood and confirm M.C.’s "benefits."
- There was no evidence hospital staff had attempted to identify community treatment options before the hearing.
- Trial court placed M.C. on CEPP; on appeal the Appellate Division reversed and ordered that M.C. should have been released (subject to conditions), and that he not be held financially liable for hospitalization costs during the CEPP period.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether CEPP was permissible where M.C. was not presently dangerous and had an immediate family placement | M.C.: He was not dangerous; sister could immediately provide housing and supervise outpatient care, so he should be released | State: CEPP appropriate to allow hospital time to arrange outpatient monitoring and benefits verification | Reversed: CEPP improper where safe community placement was available; release (with conditions) required rather than continued involuntary confinement |
| Whether lack of immediate community arrangements justified continued involuntary confinement | M.C.: Hospital had not shown inability to provide community care; monitoring and bloodwork can be done in community | State: Needed time (1–6 weeks) to locate outpatient facility and verify benefits | Held for M.C.: Mere administrative delay or staff convenience does not justify CEPP; courts cannot extend commitment for hospital placement logistics |
| Mootness and financial liability for hospitalization costs during CEPP | M.C.: Appeal not moot because he may be liable for costs incurred during the improper CEPP period | State: Case moot because M.C. subsequently released | Held for M.C.: Not moot; ordered that M.C. is not financially responsible for costs between August 23, 2016 and date of release and that any lien be discharged |
| Standard of review/deference to trial court where record lacks expert evidence of present dangerousness | M.C.: Trial court’s order unsupported by clear and convincing evidence of current dangerousness | State: Trial court’s factual findings entitled to deference | Held: No deference where record lacks legal support; decision clearly erroneous and reversed |
Key Cases Cited
- In re S.L., 94 N.J. 128 (1983) (CEPP appropriate only when patient cannot safely survive in community and placement is unavailable)
- In re G.G., 272 N.J. Super. 597 (App. Div. 1994) (CEPP improper if patient can safely live in community with family or friends)
- In re T.J., 401 N.J. Super. 111 (App. Div. 2008) (CEPP cannot be used to extend commitment for hospital discharge planning delays)
- In re M.C., 385 N.J. Super. 151 (App. Div. 2006) (same principle: CEPP not a fallback for failed discharge planning)
- In re B.L., 346 N.J. Super. 285 (App. Div. 2002) (financial liability for hospitalization may survive release; appeals can be live when costs remain at issue)
- In re D.C., 146 N.J. 31 (1996) (appellate deference to trial court is warranted absent clear error)