The defendant, Priscilla J. Deters, was indicted on various counts of mail and wire fraud. Before trial, the defendant’s counsel requested that a psychiatric examination be performed on the defendant in order to determine her mental competency to stand trial and to evaluate her degree of sanity at the time of the alleged crimes, pursuant to 18 U.S.C. §§ 4241 and 4242. Although the statutory scheme allows courts to temporarily confine defendants during such psychiatric evaluations, see id. § 4247(b), the defendant asked to be examined on an outpatient basis. The court granted the defendant’s motion for the mental examinations but ordered that she be taken into custody and sent to Carswell, Texas, 1 for the purpose of those exams.
The defendant immediately appealed the commitment order on the basis that it violated the Constitution by depriving her of liberty without due process of law. 2 The *579 government urges us not to.reach the merits of this appeal. According to the government, the commitment order is not a final order, and therefore we have no jurisdiction to review it at this time. The government also argues, in the alternative, that the confinement order did not violate the defendant’s constitutional rights. We conclude that we do have jurisdiction over this appeal. Addressing the merits of the appeal, we conclude that there is no constitutional violation, and we affirm the order of the district court.
I. Jurisdiction
The threshold issue in this case is whether the commitment order is immediately appeal-able. Circuit courts, such as ours, have jurisdiction only over appeals from “final decisions” of the district courts. 28 U.S.C. § 1291. Generally, in criminal cases this rule requires that a defendant await conviction and sentencing before raising an appeal.
See Flanagan v. United States,
In
Cohen v. Beneficial Industrial Loan Corp.,
The district court in this case ordered commitment for two purposes: to evaluate the defendant’s competency to stand trial, and to determine her sanity at the time of the offense. We examine the appealability, of the order separately for each of these purposes.
A. Commitment For Purposes of Section 4241 (Evaluating Competency to Stand Trial)
The order that the court issued is often referred to as a “first Step” or “step-one” order in section 4241 cases, because it represents the first of a three-step system for determining the competency of a defendant to stand trial.
See United States v. Barth,
At the first step, the court must decide whether there is “reasonable cause to believe that the defendant may presently be suffering from a mental disease or defect rendering him mentally incompetent....”
Id.
Whenever a court, has reasonable cause to question the defendant’s competency, it may order a psychiatric or psychological examination of the defendant.
See id.
§ 4241(b);
Weissberger,
At step two, the court conducts a hearing and uses the psychological reports from the step-one examination to determine whether the defendant is able to understand the nature and consequences of the proceedings against her. If not, the defendant is incompetent to stand trial, and the court must order the defendant hospitalized for a reasonable period of time (up to four months) for the purpose of determining whether there is a “substantial probability” that the defendant will become competent in the foreseeable future. See id. § 4241(d). If the court finds that this substantial probability exists, the defendant’s “step-two” confinement may be extended for an “additional reasonable period of time” to allow him to gain the capacity for trial. See id. at § 4241(d)(2).
The third step occurs at the end of the second confinement period. At this stage, the court determines whether the defendant has become competent to stand trial or, alternatively, is a long-term incompetent requiring indefinite hospitalization.
See id.
§§ 4241(d), 4246;
United States v. Charters,
In
United States v. Cheama,
Other circuits that have addressed the ap-pealability of step-one orders have found those immediately reviewable also.
See United States v. Davis,
As noted above, the first prong of the
Cohen
test requires that the order being appealed “conclusively determine the disputed question.”
Coopers & Lybrand,
The defendant’s competency, however, is not the disputed question in this case. In order to determine what the disputed question is, “we must examine the grounds for [the] appeal.”
Ortiz v. Dodge,
There is no doubt that the district court’s order conclusively determined that the defendant would be confined during her initial examination. The court ordered that Deters be taken into custody and sent to Carswell, and there is no indication in either the record or the statutory scheme that the court had any plans to revisit that decision.
The order also “resolve[d] an important issue completely separate from the merits of the action,” as required by
Cohen. Coopers & Lybrand v. Livesay,
Finally, as the government apparently concedes, the order is “effectively unreviewable on appeal from a final judgment.”
Coopers & Lybrand,
[A]n appeal from a competency evaluation order is analogous to an appeal from a denial of bail. If appeal is not allowed from an order requiring pretrial detention, there can be no remedy for the resulting loss of liberty. - The issue becomes moot upon conviction and sentence. The same is true here____ [P]ost-confinement review will provide no relief for the loss of liberty associated with the competency evaluation.
Weissberger, 951 F.2d.at 396-97 (citations omitted). We adopted that reasoning in Boigegrain, see 122 F.3d at 1348-49 (quoting Weissberger), and we further stated-that “[a] defendant must not be left without recourse to áppellate review where there is an immediate and significant loss of personal liberty,” id. at 1349. Here, as in Boigegrain, the defendant faces “an immediate and significant loss of personal liberty” — a month and a half of involuntary confinement — -and should not be left without recourse.
Thus, a commitment order issued for the purpose of obtaining an evaluation of the defendant’s competency to stand trial as described in 18 U.S.C. § 4241(b) may be immediately appealed.
B. Commitment for Purposes of Section (Determining Defendant’s Degree of Sanity at the Time of the Offense)
Our Cohen analysis is much the same when we examine the appealability of the *582 order from the perspective of its other purpose, that is, obtaining an evaluation of the defendant’s sanity at the time of the offense.
The order satisfies the first of the
Cohen
criteria because it “conclusively determine[s] the disputed question.”
Coopers & Lybrand,
Moreover, the order “resolve[d] an important issue completely separate from the merits of the action,” as required by the second Cohen prong. Id. The confinement for evaluation regarding sanity at the time of the offense is both an important issue, because it involves Ms. Deters’ personal liberty interest, and is completely separate from the merits of the mail and wire fraud charges. Her liberty interest is even more significant when the order is based on section 4242 than it is from the perspective of section 4241. The statutory scheme allows confinement of up to seventy-five days for a section 4242 evaluation — forty-five days plus a possible thirty-day extension — as compared to a maximum confinement of forty-five days for a section 4241 evaluation. See 18 U.S.C. § 4247(b).
Finally, the order is “effectively unreviewable on appeal from a final judgment,” as required by the third part of the
Cohen
test.
Coopers & Lybrand,
Thus, a commitment order issued pursuant to section 4247(b) for the purpose of section 4242, that is, evaluation of a defendant’s sanity at the time of the offense, is immediately appealable; the defendant need not wait for a final judgment on the criminal charges.
In sum, we hold that a commitment order issued pursuant to 18 U.S.C. § 4247(b), whether it be for the purpose of ascertaining competency to stand trial under section 4241 or for the purpose of evaluating insanity at the time of the o'ffense under section 4242, is immediately appealable. We limit our holding to the circumstances presented here, where the defendant is contesting the district court’s decision to confine her during the evaluation period and is not basing her appeal on the underlying decision to conduct an evaluation. In a situation where a defendant is appealing a section 4247(b) order on the basis that the examination is unnecessary, the disputed question would be different and thus a different analysis would be required.
II. Due Process
Addressing the merits of Deters’s appeal, we conclude that the commitment order issued by the district court does not violate the Due Process Clause. The Due Process Clause has both a procedural and a substantive component. When government action deprives a person of life, liberty, or property without fair procedures, it violates procedural due process.
See United States v. Salerno,
Unlike procedural due process, substantive due process protects a small number of “fundamental rights” from government interference regardless of the procedures used.
See, e.g., Washington v. Glucksberg,
— U.S. -,-,
The Supreme Court has observed that an individual’s “strong interest in liberty” is of a “fundamental nature.”
Salerno,
*583
However, the Supreme Court has not articulated a clear test for determining when pretrial confinement of an accused is permissible under the Due Process Clause. In
Salerno,
the Court noted that the government’s interest in community safety was “legitimate and compelling,”
see id.
at 749,
In support of her position that psychological exams must be performed in the least restrictive manner — that is, on an outpatient basis — the defendant relies on
In re Newchurch,
The precise contours of the government’s burden here — whether it be demonstrating that Ms. Deters’s detention was a narrowly tailored means of achieving a compelling government interest, or a reasonably necessary means of achieving an important government interest, as Newchurch holds, or some other formulation of the Due Process standard — do not' alter the outcome of this case. Here, the district court identified at least two “sufficiently compelling” reasons to justify detaining the defendant during her examination.
First, the government “has a substantial interest in ensuring that persons accused of crimes are available for trials,” and confinement is “a legitimate means of furthering that interest.”
See Bell,
The district court seriously considered the defendant’s alternative request that she be examined on an outpatient basis in Kansas. The defendant, however, could not assure the district court that she could secure a place to stay in Kansas during the examination period. The district court then inquired into the availability of rooms at a local halfway house. Only when defense counsel informed the court that there was no room at the halfway house did the court make its final decision to commit the defendant to a federal medical facility for the duration of her exam.
Second, the government has a strong interest in providing the defendant with a speedy trial. Defendants, of course, have a fundamental right to a speedy trial.
See
U.S. Const. amend. VI;
Barker v. Wingo,
The district court noted at the hearing that almost 300 days had passed since the filing of the indictment in this case. Indeed, the defendant had raised the issue of psychiatric examinations late in the proceedings. Granting the defendant’s original request — which was for a continuance to obtain a psychological examination from a doctor in California— could have lead to further delay. For instance, the prosecution indicated that if the defendant were examined by the doctor in California on the defendant’s own initiative (i.e., rather than upon an order from the district court), the prosecution would have requested a re-examination with a doctor more familiar to the prosecution. The district court knew that it could avoid this potential delay by ordering the examinations itself and ordering that they be performed by doctors in the federal facilities, whose impartiality and qualifications were less likely to be questioned by either side.
The government interests at stake in this ease were “sufficiently weighty,”
Salerno,
Conclusion
In ordering commitment pursuant to 18 U.S.C. § 4241, a “district court should make findings of fact concerning the need for commitment,” and “[a]n appellate court should give appropriate deference not only to these findings but also to the conclusion reached by the district court” regarding the appropriateness of confinement.
In re Newchurch,
The order of the district court is AFFIRMED.
Notes
. Defendant has since been confined in several different facilities and, at the time the briefs in this case were filed, was detained at a'facility in Chicago.
. Although the defendant's initial commitment period has expired, this case is not moot. A commitment order issued under 18 U.S.C. § 4247(b) lasts a maximum of forty-five days,with a possible thirty-day extension upon a showing of good cause for the extension. Such an order will rarely if ever outlive the appellate process. This case, therefore, is "capable of repetition, yet evading review” and hence is justicia-ble.
United States v. Boigegrain,
.
United States v. Davis,
. The Supreme Court has recognized the need to identify the issue on appeal with particularity. For example, in two cases dealing with qualified immunity, the Court made it clear that the result of the
Cohen
test may turn on what issue the appellant raises. A public official asserting the defense of qualified immunity must prove that her actions were reasonable in light of clearly established law.
See Harlow
v.
Fitzgerald,
