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Mental Hygiene Legal Service ex rel. Aliza K. v. Ford, 1998 N.Y. Int. 0159 (Dec. 3, 1998).

DUE PROCESS - MENTAL HYGIENE LAW - MENTAL HEALTH LAW - TRANSFER OF PATIENTS

Judicial hearing prior to transfer to secure state mental health facility not required.

[SUMMARY] | [ISSUE & DISPOSITION] | [AUTHORITIES CITED] | [COMMENTARY]

SUMMARY

Plaintiff's cause of action arises from her involuntary commitment to the Manhattan Psychiatric Center ("MPC") and the Center's subsequent request to transfer Plaintiff to Kirby Forensic Psychiatric Center ("Kirby"). Kirby is a State Office of Mental Health ("OMH") secure facility. Plaintiff was originally admitted after being found unfit to withstand trial on charges of aggravated harassment. Plaintiff had served two prior sentences relating to such harassment after she "stalk[ed], threaten[ed], and harrass[ed] her former employer and the staff of his business." Diagnosed with erotomanic delusional disorder, Plaintiff was occasionally sent to a locked ward at MPC due to her physical acts against the staff. Upon the OMH Commisioner's authorization of Plaintiff's transfer, notification was provided to the Mental Hygiene Legal Service of the proposed transfer as was proper under title 14 of the Codes, Rules and Regulations of New York ("NYCRR") section 57.2. Because Plaintiff objected to the plan, an independent psychiatrist was appointed to further examine Plaintiff. This psychiatrist "confirmed that the determination to issue a transfer order was medically justified."

Plaintiff commenced this action, serving the MPC with a writ of habeus corpus. Plaintiff claimed that a judicial hearing must be conducted in order to transfer Plaintiff in non-emergency cases. This claim was based on due process and equal protection grounds.

The Supreme Court granted summary judgement on both stated grounds and determined that under 14 NYCRR 57.2 a hearing must be held. The Appellate Division affirmed on due process, but not on equal protection. Plaintiff sought leave to appeal to the Court of Appeals.

ISSUE & DISPOSITION

Issue

1. Whether the case should be dismissed because during the course of litigation the Supreme Court ordered Plaintiff's release from OMH, rendering the case moot.

2. Whether 14 NYCRR 57.2 gives involuntary mental health patients the right to a judicial hearing prior to a non-emergency transfer to a secure OMH facility where the primary motivation for transfer is security.

Disposition

1.  No. This case falls within the exception to the mootness doctrine because the issues involved are likely to recur.

2.  No. Denial of a judicial hearing does not violate the patient's due process or equal protection rights.

AUTHORITIES CITED

Cases Cited by the Court

Other Sources Cited by the Court

RELATED SOURCES

COMMENTARY

State of the Law Before Aliza K.

The procedure governing the transfer of involuntarily committed mental health patients in secure facilities is contained in 14 NYCRR 57. The procedure provides that a patient objecting to a transfer may appeal to the hospital or clinical director, who must review the patient's past history. Based on certain enumerated criteria, the director decides whether the transfer is in the best interests of the patient.

In Kesselbrenner v. Anonymous, 33 N.Y.2d 161 (N.Y. 1973), the court held unconstitutional a statute that mandated the transfer of dangerous mentally ill civil patients in State hospitals to a correctional facility primarily for mentally ill convicted criminals. The court held that the statute violated the patient's due process rights in so far as it infringed on his liberty by requiring his transfer to a correctional security oriented facility, rather than a facility operated by the Department of Mental Hygiene.

In Savastano v. Nurnberg, 77 N.Y.2d 300 (N.Y. 1990), the court held that even if a liberty interest was presented in the proposed transfers of three involuntarily committed mental health patients, the transfer decision reflects a medical decision on the therapy needs of the patients. In Mathews v. Eldridge, 424 U.S. 319 (1976), the United States Supreme Court set out three factors to balance in determining whether due process had been satisfied: the private interest that would be affected by the official action; the risk of erroneous deprivation of such interest with the current procedures; and the government's interest. After analyzing these factors, the court in Savastano found no denial of due process. The lack of a judicial hearing for involuntarily committed patients, who objected to transfers to other mental health facilities, did not violate due process.

Effect of Aliza K. on Current Law

This case defines the process required before the state may transfer an adult to a higher-security mental hospital, and upholds the constitutional validity of 14 NYCRR 57. The Kesselbrenner court emphasized the security measures and restrictions that differentiate a correctional hospital from a civil facility. The Court also stressed the fact that state concerns (security), not patient concerns (treatment), motivated the transfer. If Kesselbrenner were interpreted as a broad rule that restricted the transfers of committed individuals, Aliza K. makes clear that courts will apply the more flexible Mathews test to determine the rights of a transferee within the civil system.

This case involves Aliza K.'s transfer to a stricter facility without a judicial hearing. The move was arguably motivated by security concerns. Kesselbrenner is distinguishable from Aliza K. because in the instant case, the State was to transfer Aliza K. to another civil hospital, not a facility run by the Department of Correction. Also, in applying the Mathews test, the Court revealed the difficulty that future transferees will have in prevailing on a due process claim.

The conclusions the Court reached in applying the Mathews test favor the state's freedom to transfer patients without an oral judicial hearing. First, the Court adopts the noteworthy position that the more secure facility will permit more freedom for patients such as Aliza K. This minimizes the private interest element of the Mathews analysis. Second, the risk of error is minimal because physicians make the primary recommendation for transfer. A decision to increase supervision is a medical decision, and not one judges could better decide by adding formal procedure. see Savastano v. Nurnberg, 77 N.Y.2d 300 (N.Y. 1990). Third, the Court sees prior judicial hearings as unnecessarily burdensome for the state. If these approaches are maintained, the transfer of patients to even highly restrictive OMH facilities is unlikely to require a prior hearing.

Unanswered Questions

The opinion lacks a clear distinction between a correctional facility and an OMH facility. The Court indicates that a correctional facility is one which is run by the Department of Corrections, and the facility in question is different solely because it is an OMH facility. This distinction is essential in the determination of the liberty interest at stake, as the Court cited Kesselbrenner for holding that civilly committed patients are entitled to greater freedom than patients at a correctional facility. However, it is possible for a civil facility to have more stringent security measures than a correctional facility, thereby implicating a stronger liberty interest. In this regard, the Court fails to define how restrictive a non-correctional facility must be in order to succeed on a due process claim.

Survey of the Law in Other Jurisdictions

Courts have generally followed the approach enunciated by this case and Mathews v. Eldridge, 424 U.S. 319 (1976), holding that the fundamental requirement of due process is an opportunity to be heard at a meaningful time and in a meaningful manner. In that spirit, courts in many jurisdictions have applied the three-part test described above, distinguishing cases on a factual basis.

For example, in Grijalava v. Shalala, 152 F.3d 1115 (9th Cir. 1998) the court applied the three-part test to a case involving Medicare recipients. The court held that HMOs failed to provide adequate notice to Medicare recipients by refusing to provide a reason for denying their claim. Thus, the Mathews test was not satisfied and a pre-deprivation hearing was required.

In Roberts v. Maine, 48 F.3d 1287 (1st Cir. 1995), the court also applied the three-part due process test. Here the issue was examined in a criminal context. The court found that a misleading statement made by police, combined with the refusal to permit defendant to contact an attorney, deprived him of his due process rights as laid out under Mathews.

Video conferencing was the main concern in U.S. v. Baker, 45 F.3d 837 (4th Cir. 1995). Here the court found that the three-part test was satisfied by allowing a defendant in a civil commitment hearing to testify and participate via video conferencing. Further procedural safeguards were not necessary under the Mathews analysis.

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