Justia Health Law Opinion SummariesArticles Posted in Alaska Supreme Court
In the Matter of the Necessity for the Hospitalization of: Sarah D. & Mabel B.
Two women were hospitalized following psychiatric emergencies. In each instance hospital staff petitioned the superior court for an order authorizing hospitalization for evaluation, and the superior court granted the order. But the women were not immediately transported for evaluation because no beds were available at Alaska Psychiatric Institute (API). Each woman eventually moved for a review hearing to determine whether continued detention in a hospital was proper; in each case the superior court allowed continued detention. The women were finally transported to API more than 14 calendar days after their initial detentions. On appeal they argued their continued detention before being moved to API for evaluation violated their due process rights. The Alaska Supreme Court agreed, vacating the superior court order in each case: “We conclude there was no reasonable relation between the limited purpose of the evaluation orders and the extended duration of the respondents’ confinements. The State’s unreasonably lengthy detentions of Mabel and Sarah violated their substantive due process rights.” View "In the Matter of the Necessity for the Hospitalization of: Sarah D. & Mabel B." on Justia Law
Bohn v. Providence Health & Srvs – Washington
A patient sued a hospital, arguing the hospital violated the Alaska Health Care Decisions Act (HCDA) when it temporarily assumed decision-making authority over his medical care while he was incapacitated and treated him without his consent or that of his parents, whom he had previously authorized to make medical decisions on his behalf if he were rendered incompetent or incapacitated. The hospital argued it was entitled to immunity under the HCDA because it held a good faith belief that the patient’s parents lacked authority to make medical decisions for him, based on conduct that convinced health care providers at the hospital that the parents were not acting in the patient’s best interest. The superior court agreed with the hospital and granted its summary judgment motion, concluding that the immunity provisions applied. The superior court concluded the hospital was entitled to immunity because its doctors had acted in good faith and in accordance with generally accepted medical standards. In a matter of first impression for the Alaska Supreme Court, it determined the superior court overlooked the requirement for specific good faith as to the authority or lack thereof of the patient’s surrogate or agent. The grant of summary judgment was reversed and the matter remanded for further proceedings. View "Bohn v. Providence Health & Srvs - Washington" on Justia Law
In the Matter of the Necessity for the Hospitalization of Rabi R.
A man appealed superior court orders authorizing his hospitalization for evaluation, his 30-day commitment, and the involuntary administration of psychotropic medication. He argued the superior court’s failure to conduct a screening investigation was an error that required vacation of the evaluation order and the commitment and medication orders that followed it. He also specifically challenged the commitment order, claiming that the court erred by relying on facts not in evidence and by finding clear and convincing evidence that he was gravely disabled and that commitment was the least restrictive alternative. The Alaska Supreme Court concluded: (1) that failing to perform a screening investigation was error, but the error was harmless because the court made findings supported by clear and convincing evidence when ordering a 30-day commitment; (2) it was also harmless error to rely to any extent on facts not in evidence because there was sufficient evidence in the record to support a finding that the respondent was gravely disabled; (3) the superior court did not err when it found by clear and convincing evidence that the respondent was gravely disabled and that commitment was the least restrictive alternative, or when it granted the petition for involuntary hospitalization; and (4) the superior court did not err by finding that medication was in the respondent’s best interests and that there was no less intrusive alternative, or by granting the petition for its involuntary administration. View "In the Matter of the Necessity for the Hospitalization of Rabi R." on Justia Law
In the Matter of the Protective Proceedings of Tiffany O.
Tiffany O., a woman in her 60s, developed epilepsy early in childhood and suffered from regular seizures. She was also diagnosed with intellectual disability, and was described as "unable to engage in a meaningful conversation." In 2007, Tiffany's daughter Rachel petitioned for the appointment of a guardian for Tiffany. In March 2008, the superior court appointed the Office of Public Advocacy to serve as Tiffany’s public guardian. After a period of working well together, the relationship between Rachel and the public guardian soured. Rachel twice petitioned for review of the guardianship. In June 2011 Rachel was appointed as Tiffany’s guardian. The daughter relied on faith-based medicine to care for her mother, electing to, in one instance, pray over her mother after she became nonresponsive instead of calling emergency services. The superior court ultimately removed the daughter as guardian, finding that her behavior and “intractable belief system” caused her to deprive her mother of appropriate services and care. The Alaska Supreme Court found the superior court did not abuse its discretion when it removed the daughter as her mother’s guardian. The Court also concluded that removing the daughter as guardian did not violate the Alaska Constitution’s free exercise clause because the State possessed a compelling interest in preventing harm to the mother. View "In the Matter of the Protective Proceedings of Tiffany O." on Justia Law
In the Matter of the Necessity for the Hospitalization of M.B.
The respondent in an involuntary commitment proceeding, "Meredith B.," appealed the ex parte order authorizing her hospitalization for evaluation and the subsequent 30-day commitment order. Respondent argued that the screening investigation was inadequate because she was not interviewed. She asserted that, as a result, both the order hospitalizing her for evaluation and the 30-day commitment order should have been reversed and vacated. Further, she challenged the 30-day commitment order finding she was (1) "gravely disabled" and there (2) was a reasonable expectation she could improve with treatment. After review of the order at issue, the Alaska Supreme Court found the superior court's decision was supported by clear and convincing evidence. "If there was an error during the screening investigation, the error was harmless, because the respondent had the opportunity to testify at the 30-day commitment hearing." View "In the Matter of the Necessity for the Hospitalization of M.B." on Justia Law
D.B. v. Alaska
Danielle B., a 73-year-old woman who suffers from schizoaffective disorder, was involuntarily committed for 30 days. Her illness led to repeated hospitalizations and temporary improvements with the help of medication. But upon release she has deteriorated after stopping the medication. As a result she has had housing problems and incidents involving police due to her behavior, leading to more hospitalization. Since the 1980s she had been admitted to Alaska Psychiatric Institute (API) 30 times. The last such admission she appealed, arguing the State failed to prove that there were no less restrictive alternatives than commitment. Because the court did not err by finding clear and convincing evidence that there was no less restrictive alternative, the Alaska Supreme Court affirmed the court’s order committing her for involuntary treatment. View "D.B. v. Alaska" on Justia Law
In the Matter of the Necessity of the Hospitalization of Lucy G.
In a case of first impression for the Alaska Supreme Court, at issue was the use of electroconvulsive therapy (ECT) to a catatonic, non-consenting patient. In March 2017, police officers found Lucy G. in an Anchorage parking lot, wet and shivering. She was taken to a local hospital, where she initially exhibited “agitated, self-harming, and disoriented” behaviors requiring sedation for her and the staff’s safety. Lucy, who was calm but unresponsive by the end of the day, was diagnosed as catatonic. Hospital staff also noted her prior schizophrenia diagnosis and psychotropic medication prescriptions, as well as hospitalization the prior month. After a petition by hospital staff, the superior court authorized Lucy’s hospitalization for an involuntary commitment evaluation. She would ultimately be diagnosed with catatonia, involuntarily committed for 30 days, and given psychotropic medication and involuntary ECT. At the superior court hearing, the parties agreed that constitutional standards established in Myers v. Alaska Psychiatric Institute, 138 P.3d 238 (Alaska 2006) for ordering involuntary, non-emergency administration of psychotropic medication also applied to involuntary ECT. The patient argued there should have been heightened standards for ordering involuntary ECT and that, in any event, the superior court’s Myers analysis was legally deficient. The Alaska Supreme Court held that the superior court did not plainly err by applying the existing Myers constitutional standards to authorize involuntary ECT to the non-consenting patient. The Court also held the superior court made sufficient findings related to each relevant, contested mandatory Myers factor. Therefore, the Court surmised these findings supported the court’s involuntary ECT order. View "In the Matter of the Necessity of the Hospitalization of Lucy G." on Justia Law
Maxim Healthcare Services, Inc. v. Collens
In May 2009 Jesse Collens, then 21 years old, was permanently injured in a bicycle accident that left him a C-1 quadriplegic, paralyzed from the neck down, and dependent on a ventilator to breathe. In December 2009 he contracted with Maxim Healthcare Services, a national healthcare corporation with a home healthcare division, to provide his nursing care. In late 2011 issues arose between Collens and Maxim over the company’s management of his care. These issues escalated, and in early March 2012, Alaina Adkins, Maxim’s Alaska office manager, met with Collens to discuss his main concerns with Maxim’s services. The following business day, Adkins emailed various members of Maxim’s legal and administrative staff about one of the issues Collens had raised. Internal concerns surfaced about the legal compliance of the staff working with Collens. In an email responding to the report, Maxim’s area vice president wrote, “We are in dangerous territory right now with the liability of this case and we are going to have to seriously consider discharge.” Collens’s care plan was subject to routine recertification every 60 days; Maxim’s Alaska Director of Clinical Services visited Collens’s house to complete the review necessary for this recertification, noting “discharge is not warranted.” Concurrent to the recertification, Adkins requested Maxim’s legal department provide her a draft discharge letter for Collens. The draft letter stated the discharge had been discussed with Collens’s physician and care coordinator and that they agreed with the discharge decision. But in fact neither approved the discharge. The draft letter also included a space for names of other entities that could provide the care needed by the patient. Adkins noted in an email to the legal department, “We already know that there are no providers in our area that provide this type of service.” The discharge letter she eventually delivered to Collens filled in the blank with four agency names. Adkins delivered and read aloud the discharge letter at Collens’s home on March 30. Collens sued Maxim and Adkins for breach of contract, fraudulent misrepresentation, unfair and deceptive acts and practices under Alaska’s Unfair Trade Practices and Consumer Protection Act (UTPA), and intentional infliction of emotional distress (IIED). The superior court ruled for Collens on all his claims and entered a $20,379,727.96 judgment against Adkins and Maxim, which included attorney’s fees. Maxim and Adkins appealed, arguing that: (1) they were not liable under the UTPA; (2) the superior court erred in precluding their expert witnesses from testifying at trial; (3) the court’s damages award was excessive; and (4) the court’s attorney’s fee award was unreasonable. The Alaska Supreme Court agreed the superior court’s attorney’s fee award was unreasonable, but on all other issues it affirmed the superior court’s decision. View "Maxim Healthcare Services, Inc. v. Collens" on Justia Law
Alaska Spine Center, LLC v. Mat-Su Valley Medical Center, LLC
The Alaska Department of Health and Social Services required most healthcare facilities to document the need for proposed services before the state approves construction of a new facility. The agency determined that an ambulatory surgical facility seeking to relocate from Anchorage to Wasilla did not need to submit such documentation because it was moving within the same community as defined by the relevant statute. Competing medical facilities in the Matanuska-Susitna Borough objected to the determination, arguing that Anchorage and Wasilla were not the “same community” and that the proposed relocation required the usual certification of need. Because Anchorage and Wasilla were not the same community as contemplated by the statute, the Alaska Supreme Court reversed the determination that the facility was exempt from the required certification process. View "Alaska Spine Center, LLC v. Mat-Su Valley Medical Center, LLC" on Justia Law
In Re Hospitalization of Linda M.
The district court found that a woman, "Linda M.," charged with several misdemeanors was incompetent to stand trial and committed her to a state hospital. The hospital later brought petitions in the superior court for civil commitment and involuntary medication. Linda moved to dismiss or stay the proceedings, contending that the superior court was an improper forum because of the criminal case pending in the district court. The superior court denied the motion, asserted its jurisdiction to hear the case, and granted the hospital’s petition for authority to administer medication. Linda appealed. The Alaska Supreme Court held the superior court properly asserted its jurisdiction over the civil commitment and involuntary medication petitions and that the superior court did not err in finding that involuntary medication was in Linda's best interests. View "In Re Hospitalization of Linda M." on Justia Law