J.R., Plaintiff-Appellant, v. Michael HANSEN, in his Official Capacity as Director of the Agency For Persons with Disabilities, Defendant-Appellee.
No. 12-14212.
United States Court of Appeals, Eleventh Circuit.
Aug. 20, 2013.
730 F.3d 959
Finally, we disagree with Mr. Jackson that
AFFIRMED IN PART and REMANDED. On remand, the district court should vacate the sentence and resentence Mr. Jackson consistent with our opinion.
Katherine Debriere, Kristen Cooley Lentz, Peter Prescott Sleasman, Florida Institutional Legal Services, Inc., Newberry, FL, for Plaintiff-Appellant.
Jonathan Daniel Grabb, Michael A. Paleeki, Agency for Persons with Disabilities, Tallahassee, FL, for Defendant-Appellee.
MARTIN, Circuit Judge:
J.R. is a man who was involuntarily admitted to “non-secure” residential services administered by the Florida Department of Children and Family Services in 2004. Under that same 2004 admission order, he continues to be committed in a non-secure residential facility. He filed suit against Michael Hansen, in his official capacity as the Director of the Agency for Persons with Disabilities (the successor to the Department of Children and Family Services), bringing a facial challenge to the constitutionality of Florida’s statutory scheme for involuntarily admitting intellectually disabled persons to residential services,
J.R. says that
The District Court, however, employed the doctrine of constitutional avoidance to find that the statutory scheme provided constitutionally sufficient process largely on the basis of its finding that
I. The Statute
Chapter 393 of the Florida Statutes provides for people with “Developmental Disabilities.” See
If a person has an intellectual disability and requires involuntary admission to
residential services provided by the agency, the circuit court of the county in which the person resides has jurisdiction to conduct a hearing and enter an order involuntarily admitting the person in order for the person to receive the care, treatment, habilitation, and rehabilitation that the person needs.
The circuit court may not involuntarily admit the person unless it finds that:
- The person is intellectually disabled or autistic;
- Placement in a residential setting is the least restrictive and most appropriate alternative to meet the person’s needs; and
- Because of the person’s degree of intellectual disability or autism, the person;
- Lacks sufficient capacity to give express and informed consent to a voluntary application for services pursuant to [§ ] 393.065 and lacks basic survival and self-care skills to such a degree that close supervision and habilitation in a residential setting is necessary and, if not provided, would result in a real and present threat of substantial harm to the person’s well-being; or
- Is likely to physically injure others if allowed to remain at liberty.
Within 45 days of receiving the order, the APD must provide the circuit court with a copy of a “support plan” for its client, outlining a treatment plan and showing “that the person has been placed in the most appropriate, least restrictive and cost-beneficial residential setting.”
“Support plans” are governed by
II. J.R.
J.R. is an intellectually disabled 48 year-old man with an IQ of 56 who functions at the level of a 7 year-old. It is not disputed that “although J.R.’s mental retardation will always exist, his potential for dangerousness ... can change” because “J.R. can develop skills that mitigate the effect of his disability and aid him in his ability to live independently.”
In 2000, J.R. was charged with sexual battery in Lee County, Florida. In 2001, the Lee County Circuit Court found J.R. incompetent to stand trial and involuntarily committed him to the Department of Children and Family Services (DCF), a precursor to the APD. In 2004, J.R. was involuntarily admitted to “nonsecure” residential services, pursuant to
J.R. has lived in several different group homes since the original involuntary admission order. Despite J.R.’s admission order specifying “non-secure” residential services, his movements and freedom are significantly limited. As the District Court explained, “[i]f he were to ‘elope,’ the police would probably be called to return him” to his group home. That being said, the scope of the limitations on J.R.’s movements has changed and will continue to change with periodic alterations to his support plan pursuant to
Since 2007, J.R. has been assigned a “support coordinator,” Jordan Goldstein, pursuant to
III. Standard of Review
“We review de novo the district court’s ruling on the parties’ cross-motions for summary judgment.” Owen v. I.C. Sys., Inc., 629 F.3d 1263, 1270 (11th Cir.2011).
In a facial challenge, “the challenger must establish that no set of circumstances exist under which the Act would be valid.” Horton v. City of St. Augustine, Fla., 272 F.3d 1318, 1329 (11th Cir.2001) (quotation marks omitted).
IV. Discussion
The Due Process Clause of the Fourteenth Amendment provides that a state shall not “deprive any person of life, liberty, or property, without due process of law.”
As the District Court explained, “[b]y its plain language, [
A. Overview
Constitutionally adequate process is a flexible concept that “cannot be divorced from the nature of the ultimate decision that is being made.” Parham v. J.R., 442 U.S. 584, 608, 99 S.Ct. 2493, 2507, 61 L.Ed.2d 101 (1979). It is well settled that people who are lawfully involuntarily committed must be released once the grounds for the initial commitment no longer exist. See O’Connor v. Donaldson, 422 U.S. 563, 575, 95 S.Ct. 2486, 2493, 45 L.Ed.2d 396 (1975) (where a plaintiff challenged his continued confinement in a mental institution and the Court explained that “even if his involuntary confinement was initially permissible, it could not constitutionally continue after that basis no longer existed”); Jackson v. Indiana, 406 U.S. 715, 738, 92 S.Ct. 1845, 1858, 32 L.Ed.2d 435 (1972) (where the Court held that “due process requires that the nature and duration of commitment bear some reasonable relation to the purpose for which the individual is committed”). Thus, when someone is civilly committed, there must be some form of periodic post-commitment review. See Parham, 442 U.S. at 607, 99 S.Ct. at 2506 (holding that continuing need for commitment must be reviewed periodically).7
First, the private interest that will be affected by the official action; second, the risk of an erroneous deprivation of such interest through the procedures used, and the probative value, if any, of additional or substitute procedural safeguards; and finally, the Government’s interest, including the function involved and the fiscal and administrative burdens that the additional or substitute procedural requirement would entail.
Id. at 335, 96 S.Ct. at 903. The Supreme Court in Mathews admonished courts employing this test to recognize that “procedural due process rules are shaped by the risk of error inherent in the truthfinding process as applied to the generality of cases, not the rare exceptions.” Id. at 344, 96 S.Ct. at 907.
In facial due process challenges, we have looked to the statute as written to determine whether the procedure provided comports with due process. We have declined to simply rely on the defendant’s description of how the statute operates in practice. See Catron v. City of St. Petersburg, 658 F.3d 1260, 1269 (11th Cir.2011) (holding a statute unconstitutional facially and as-applied because as written it failed to provide “constitutionally adequate procedural protections” despite the City’s arguments about how the statute operates in practice).
B. Relevant Precedents
We are cognizant—and thankful—that in our task of applying the flexible balancing test of Mathews to the case at hand we do not write on a blank slate. Two cases, one from the Supreme Court and one from a panel of this Circuit, are especially instructive in helping us consider what periodic review process is due in the civil commitment context: Parham v. J.R., 442 U.S. 584, 99 S.Ct. 2493, 61 L.Ed.2d 101 (1979) and Williams v. Wallis, 734 F.2d 1434 (11th Cir.1984).
1. Parham v. J.R.
In Parham, the Supreme Court examined the process due both before and after the voluntary commitment of children by their parents to state mental institutions. 442 U.S. at 587, 99 S.Ct. at 2496. In that case, Georgia state hospital superintendents were “given the power to admit temporarily any child for ‘observation and diagnosis’ and to, if ‘find[ing] ‘evidence of mental illness’ and that the child is ‘suitable for treatment,’ admit the child ‘for such period and under such conditions as may be authorized by law.’” Id. at 591, 99 S.Ct. at 2498. After that time, “the superintendent ... [had] an affirmative duty to release any child ‘who [had] recovered ... or who [had] sufficiently improved [such] that the superintendent determines that hospitalization ... is no longer desirable.’” Id.
A class action suit challenged the scheme arguing that the children had a right to notice and a hearing before commitment. Id. at 596-98, 99 S.Ct. at 2501-02. The Supreme Court ultimately disa-
But, importantly, Parham held that that procedure did not have to include adversarial judicial review. The Court explained that “[o]ne factor that must be considered is the utilization of the time of ... behavioral specialists in preparing for and participating in hearings rather than performing the task for which their special training has fitted them.” Id. at 605-06, 99 S.Ct. at 2506. Where, “the questions are essentially medical in character,” the Court rejected “the notion that the shortcomings of specialists can always be avoided by shifting the decision from a trained specialist ... to an untrained judge or administrative hearing officer after a judicial-type hearing.” Id. at 609, 99 S.Ct. at 2507-08. “Thus, [review by] a staff physician will suffice, so long as he or she is free to evaluate independently the child’s ... need for treatment.” Id. at 607, 99 S.Ct. at 2507.
Though the Court focused primarily on the admission procedures, the Court did note several times that “the superintendent of each hospital is charged with an affirmative statutory duty to discharge any child who is no longer ... in need of therapy.” Id. at 615, 99 S.Ct. at 2510 (emphasis added); see also id. at 591, 99 S.Ct. at 2498. The Court explained that “[w]e have held that the periodic reviews described in the record reduce the risk of error in the initial admission and thus they are necessary.” Id. at 617, 99 S.Ct. at 2511 (emphasis added). The Court remanded for determining exactly “what process is due to justify continuing a voluntary commitment,” but suggested the admission procedure principles should be considered. Id. at 619, 99 S.Ct. at 2512.
2. Williams v. Wallis
In Williams v. Wallis, this Court directly considered the process required in a periodic review. Williams involved a challenge to “Alabama’s procedures for the release of patients committed to the state’s mental health system after being found not guilty ... by reason of insanity.” 734 F.2d at 1436. Alabama’s scheme provided for “treatment team[s],” of medical professionals who would “devise[ ] an individualized treatment plan” with the “goal for acquittees [to] transfer to a less restrictive environment” and eventually be released. Id. The team would review the acquittee every 60 to 90 days. Id. The Court further described how
[t]he decision to release an acquittee is usually initiated by the treatment team.... After the team recommends release, an acquittee not classified as special, can be released with the approval of the forensic unit director of the hospital to which he is committed. The proposed release of special patients, [who are considered dangerous to themselves and others] must be reviewed by the hospital’s superintendent or his designee. The reviewing authority may communicate the proposed release to the committing court; the district attorney,
the acquittee’s family, and others, or may order further treatment for, or evaluation of, the acquittee. The hospital superintendent then makes the final decision whether to release the special patient.
The Court found that “[t/he[se] nonadversary proceedings do not create an undue risk of erroneous deprivation of liberty, and substituting an adversarial element would not provide significant increased protection against such risk.” Id. at 1439. The Court explained its reasoning as follows:
Hospitals and their medical professionals certainly have no bias against the patient or against release. Therefore, we can safely assume they are disinterested decision-makers. In fact, the mental health system’s institutional goal—i.e., transfer to a less restrictive environment and eventual release—favors release. Other factors also favor release, including a perennial lack of space and financial resources, which militates against any motivation to unnecessarily prolong hospitalization, and including the medical professional’s pride in his own treatment. The frequency of the evaluations also reduces the risk that the patient will be confined any longer than necessary.
Id. at 1438 (emphasis added). This Court also explained that “[t]o impose an adversarial atmosphere upon the medical decisionmaking process would have a natural tendency to undermine the beneficial institutional goal of finding the least restrictive environment including eventual release.” Id. at 1439 (emphasis added). Finally, the Court also reviewed Alabama’s habeas procedures and found this “secondary or backup procedure” sufficient given that “the release decision is first addressed in the nonadversary proceedings described above.” Id. at 1440 (emphasis added).
C. Guiding Principles
Parham and Williams—and persuasive precedents from other circuits—yield at least four guiding principles for our Court in analyzing Florida’s involuntary admission to residential services scheme which we consider here. First, with respect to deprivations of liberty in the form of civil commitments, some form of periodic review is required to protect against the erroneous deprivation of liberty. But adversarial review—arguably the gold standard of due process protections, see Goldberg v. Kelly, 397 U.S. 254, 266-69, 90 S.Ct. 1011, 1020-21, 25 L.Ed.2d 287 (1970) (requiring a hearing before ending welfare benefits)—is not necessarily required. See Parham, 442 U.S. at 607-08, 99 S.Ct. at 2506-07; Williams, 734 F.2d at 1439; see also Doe v. Austin, 848 F.2d 1386, 1396 (6th Cir. 1988) (holding that “due process requires that some periodic review take place” but that the Sixth Circuit “cannot say that due process requires a periodic judicial review”); Hickey v. Morris, 722 F.2d 543, 549 (9th Cir. 1983) (“Due process does not always require an adversarial hearing.”).
Second, adversarial judicial review is not necessary to protect against the erroneous deprivation of liberty where medical professionals are well positioned and mandated to consider the propriety of ongoing commitment. In other words, where medical professionals’ periodic reviews must consider release, courts are generally satisfied that the patient’s liberty rights are protected. See Parham, 442 U.S. at 615, 99 S.Ct. at 2510 (noting that the hospital superintendent “is charged with an affirmative statutory duty to discharge any child who is no longer mentally ill or in need of therapy”); Williams, 734 F.2d at 1439 (explaining that periodic reviews occur with “the beneficial institu-
Third, adversarial judicial review is not necessary to protect against the erroneous deprivation of liberty where medical professionals are well positioned and mandated to act when an ongoing commitment is no longer proper. See Parham, 442 U.S. at 607, 99 S.Ct. at 2506 (suggesting that reviewer of “the child’s continuing need for commitment” should have authority to release); Williams, 734 F.2d at 1436 (where the treatment team reports directly to the superintendent who has the power and duty to release). This principle present in Parham and Williams was captured well in Clark v. Cohen, where a plaintiff was given periodic medical and psychological reviews that “consistently recommended that [the plaintiff] be released ... but the reviewers lacked the authority to implement their recommendations.” 794 F.2d at 86. The Third Circuit found the scheme to violate due process because the review “required by the due process clause is not a moot court exercise. The [reviewers] must have the authority to afford relief.” Id.
Fourth, the availability of adversarial judicial review in the form of habeas proceedings serves as a backup plan to protect against erroneous deprivations of liberty. See Williams, 734 F.2d at 1440; see also Hickey, 722 F.2d at 549 (describing how the statute’s nonadversarial review is backstopped by the “court’s discretionary power” and the potential for “habeas relief’).
V. Application
Our task is to determine whether the Florida Statute really does provide procedures that protect J.R. from the risk of erroneous deprivations. Given the arguments made by the APD and the District Court’s finding of “implicit” obligations upon the APD in this case, we believe that the answer to that question would be aided by the statutory interpretation of the Supreme Court of Florida, the ultimate arbiter of Florida law. See Forgione v. Dennis Pirtle Agency, Inc., 93 F.3d 758, 761 (11th Cir. 1996).
A. Arguments
J.R. argues that
During oral argument before this Court, however, the APD insisted repeatedly that though there are no explicit procedures or requirements provided in the Florida statute for either examining the propriety of continued involuntary admission or seeking the release of a client from an improper involuntary admission order, that such considerations were “part of the analysis” involved in support plan review. The APD argued as well that the Medicaid Developmental Disabilities Waiver Services Coverage and Limitations Handbook, which was not in the record, specifies that such residential services are provided based on “medical necessity.” Also newly relying on this handbook, the APD says, “the intent of waiver services as noted in our brief is to help individuals live safely in the community as opposed to an institutional setting. That is the entire point of these services.” Thus the APD argued it was clear that the statute calls for periodic review of J.R.’s continued involuntary admission to residential services.9
B. Analysis
The problem for this Court is that it is not clear to us that the APD is “obligated to do” what the APD suggested at oral argument it is obligated to do: periodically review the involuntary admission orders of J.R. and people like him. The APD has pointed to nothing explicit in the statute indicating that an obligation exists and has offered no evidence of procedures in place to require periodic review of the involuntary commitment status of these people.
We cannot wholly disagree with J.R.’s argument that the face of the statute does not provide process that comports with the requirements of the relevant precedent. First, the APD admits that the statute does not explicitly require the APD to periodically review the propriety of J.R.’s continued involuntary admission order.10 The statute requires only that periodic support plan reviews ask whether the client has been placed in “the most appropriate, least restrictive, and most cost-beneficial environment for accomplishment of the objectives for client progress.”
As the APD pointed out in its brief, there are currently 20,000 people on the waiting list to voluntarily receive HCBS Medicaid services, including the residential services that J.R. receives. Thus the benefits provided to APD clients clearly continue beyond when one reaches the point of no longer being a danger to himself or others. As J.R.’s involuntary commitment order itself explains, in residential services he receives “vocational training and social skills training.” Conceivably, J.R. could continue to make progress with respect to his vocational and social skills by remaining in some form of residential services long after he is no longer a danger to himself or others.11 Thus the regime established in
Second, the statute does not provide procedures for the APD if it were to decide someone should be released from an involuntary admission order. Nothing on the face of
In contrast, there are a few specific instances in which the statute does call for an involuntary admission order to non-secure residential services to be reviewed by the court.
We are also aware that the Florida legislature has required periodic judicial review in other contexts. For example, the District Court recognized that an admitting court may choose to admit an intellectually disabled person into secure residential services under
In contrast, in Parham, the Court emphasized the statutory mandate to afford release to a child no longer needing commitment and that the decisionmaker in charge of a child’s periodic review should have the authority to afford release. See 442 U.S. at 607, 615, 99 S.Ct. at 2506, 2510. In Williams, a procedure existed by which a treatment team finding commitment no longer necessary was to report their recommendation to the hospital superintendent with the power and duty to afford release. See 734 F.2d at 1436.
Despite the distinguishing characteristics of the statutes reviewed in Parham and Williams, the District Court, employing the doctrine of constitutional avoidance, did find that the statute contained plausible implied obligations. The District Court explained, in pertinent part:
While section 393.11 contains no provision expressly describing APD‘s responsibilities should the time come when a developmentally disabled client no longer satisfies the involuntary admission requirements, the statute can and should be read to imply an obligation on the part of APD to petition the circuit court to end the “hold” on a[ ] client who is no longer deemed to be a danger to himself or others. The circuit court‘s order, after all, binds not only the client who is admitted to residential services but also the agency that is required to provide the ordered services. If APD were to determine that a client had reached the point of no longer meeting the involuntary admission requirements, the agency could not on its own authority cease to provide those services. Instead, acting in its own best interests as well as those of the individual the agency was ordered to serve, APD would have to petition the appropriate circuit court for an order releasing the agency from its responsibility to provide those services and, at the same time, releasing the client from the order of involuntary admission. If, for whatever reason, APD failed to seek a client‘s release from an involuntary admission no longer deemed necessary, or if the client were to disagree with an agency assessment that release would not be appropriate, then—as a safeguard—a petition for writ of habeas corpus may be filed “[a]t any time and without notice” by or on behalf of the client.
If the District Court is right about the APD’s obligations under the statute, it may be constitutional. We still have some concerns that the statute does not, even under this formulation, require that the APD consider the propriety of the continued involuntary admission order. However, we also recognize that if the APD were held to this implied obligation, it would also, arguably, be required to periodically consider whether the “hold” should be lifted.
Although we certainly share the District Court’s desire to avoid the constitutional question, we are not comfortable merely affirming its ruling based on implied obligations not explicit on the face of the statute. See Catron, 658 F.3d at 1269. Federal Courts are not the arbiters of Florida law; that responsibility rests squarely with the Supreme Court of Flori-
Questions Certified
- Does “support plan” review under
Fla. Stat. § 393.0651 require the Agency for Persons with Disabilities to consider the propriety of a continued involuntary admission to residential services order entered underFla. Stat. § 393.11 ? - Is the Agency for Persons with Disabilities required, pursuant to
Fla. Stat. § 393.0651 and/orFla. Stat. § 393.11 , to petition the circuit court for the release from an involuntary admission order in cases where the APD determines that the circumstances that led to the initial admission order have changed? - Does
Fla. Stat. § 393.062 et. seq. provide a statutory mandate to meaningfully periodically review involuntary admissions to non-secure residential services consistent with the commitment schemes discussed in Parham v. J.R., 442 U.S. 584, 99 S.Ct. 2493, 61 L.Ed.2d 101 (1979) and Williams v. Wallis, 734 F.2d 1434 (11th Cir.1984)?
QUESTIONS CERTIFIED.