No. 1-13-2134

THIRD DIVISION February 18, 2015 ______________________________________________________________________________

IN THE APPELLATE COURT OF ILLINOIS FIRST JUDICIAL DISTRICT ______________________________________________________________________________

In re LINDA B., a Person Found Subject to ) Appeal from the Circuit Court Involuntary Admission ) of Cook County. ) (The People of the State of Illinois, ) ) No. 2013 COMH 1381 Petitioner-Appellee, ) v. ) ) The Honorable Linda B., ) David Skryd, ) Judge Presiding. Respondent-Appellant). )

______________________________________________________________________________

PRESIDING JUSTICE PUCINSKI delivered the judgment of the court, with opinion. Justices Lavin and Mason concurred in the judgment and opinion.

OPINION

¶1 Respondent Linda B. appeals from an order of the circuit court of Cook County finding

her to be a person subject to involuntary admission on an inpatient basis. Respondent contends

that the circuit court's order should be reversed because the petition to involuntarily admit her

was untimely filed in violation of section 3-611 of the Mental Health and Developmental

Disabilities Code (Mental Health Code) (405 ILCS 5/3-611 (West 2012)). Respondent

acknowledges that the issue is moot, but contends this appeal falls within the public-interest and

capable-of-repetition-yet-avoiding-review exceptions to the mootness doctrine. 1-13-2134

¶2 BACKGROUND

¶3 The undisputed facts in the record before us show that on May 9, 2013, Connie Shay-

Hadley, the mental health facility director at Mount Sinai Hospital, filed a petition alleging that

respondent was a person subject to involuntary admission to a treatment facility. The petition

sought emergency inpatient admission by certificate (405 ILCS 5/3-600 (West 2010)) and

indicated that respondent was admitted to the "Mental Health Facility/Psychiatric Unit" on April

22, 2013, at 1958 hours. The supporting certificates submitted by Dr. Medela Gartel, who

examined respondent on May 9, 2013, at 11 a.m., and Colleen Kurtz, the licensed clinical social

worker who examined respondent on May 9, 2013, at 12 p.m., opined that respondent was

mentally ill, unable to care for herself, and refusing both medical and psychiatric treatment.

¶4 Meanwhile, on May 14, 2013, the circuit court granted the petition of Dr. Gartel for the

involuntary administration of psychotropic medication to respondent for a period of 90 days.

¶5 Subsequently, at the June 11, 2013, hearing on the involuntary admission petition, Dr.

Elizabeth Mirkin, a board-certified psychiatrist, testified that respondent was admitted to the

"medical floor" of Mount Sinai Hospital on April 22, 2013, because she was experiencing

tachycardia, or a rapid heartbeat, and found to be severely anemic. Dr. Mirkin explained that

respondent was monitored by a psychiatrist and a sitter, who provided one-to-one supervision,

throughout her stay on the medical floor in light of her prior admission to the psychiatric unit of

Mount Sinai Hospital in January and her failure to take her medications. Dr. Mirkin stated that

respondent was much calmer on June 10, 2013, when she last saw her, than on May 25, 2013,

when she first saw respondent during her consultation rounds on the medical floor. Dr. Mirkin

added that respondent had been diagnosed with schizophrenia more than 10 years ago and that

she was admitted to the "psychiatric unit" of Mount Sinai Hospital earlier in January. Dr. Mirkin

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testified that she believed with a reasonable degree of psychiatric certainty that respondent, due

to her mental illness, was unable to provide for her physical needs so as to require treatment on

an inpatient basis. Dr. Mirkin explained that respondent was delusional, easily upset, and

aggressive, and she had a history of noncompliance in taking medications, particularly whenever

she was discharged from the hospital. Dr. Mirkin believed that respondent would benefit from

inpatient treatment at Park Shore Nursing Home because she must take medications on a regular

basis.

¶6 On cross-examination, Dr. Mirkin testified that respondent required constant supervision

by a sitter because she wandered the hall and went to the pediatric unit to see babies. On redirect

examination, Dr. Mirkin testified that respondent has been taking better care of herself because

of her hospitalization and recent compliance in taking her medications.

¶7 After the State rested, respondent's counsel moved to dismiss the petition for involuntary

admission "based upon the petition having been filed well beyond the 24 hours after

[respondent's] admission." Counsel argued that the petition was untimely filed where respondent

was admitted to the medical floor of Mount Sinai Hospital on April 22, 2013, but was being

treated psychiatrically. Over counsel's objection, the circuit court granted the State's request to

reopen its case to present the testimony of Dr. Mirkin, who responded that she and her medical

team do not submit petitions for patients admitted to the medical floor "unless we think the

patient needs to go to court because the patient is noncompliant with treatment." The circuit

court denied respondent's motion to dismiss the petition for involuntary admission, and following

a brief recess, respondent rested without testifying.

¶8 After closing arguments, the circuit court granted the petition for involuntary admission

of respondent and entered a written order, finding respondent subject to involuntary admission

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on an inpatient basis because she is a person with mental illness and who, because of that mental

illness, is unable to provide for her basic physical needs and refusing both medical and

psychiatric treatment. The written order also provided that respondent be treated at Park Shore

Nursing Home, based on Dr. Mirkin's recommendation, for a period of hospitalization not to

exceed 90 days.

¶9 ANALYSIS

¶ 10 In this court, respondent contends that the circuit court's involuntary admission order

should be reversed because the petition was untimely filed. Respondent further contends that

although the circuit court's involuntary admission order has expired and the matter is

undisputedly moot, this appeal falls within two recognized exceptions to the mootness doctrine.

¶ 11 Because the 90-day period of hospitalization that respondent appeals from has expired,

we must consider the threshold issue of whether the mootness doctrine precludes our review of

the merits of her appeal. In re Andrew B.,

(2008). "A case on appeal is

rendered moot where the issues that were presented in the trial court do not exist any longer

because intervening events have rendered it impossible for the reviewing court to grant the

complaining party effectual relief." In re India B.,

(2002). Because the

existence of an actual controversy is essential to the exercise of appellate jurisdiction, reviewing

courts will generally not decide questions that are abstract, hypothetical, or moot. In re James

W.,

. However, our supreme court has recognized the following exceptions

to the mootness doctrine: (1) the public interest exception; (2) the capable-of-repetition-yet-

avoiding-review exception; and (3) the collateral consequences exception. In re Laura H.,

(2010). Whether an appeal should be dismissed as moot presents a

question of law, which we review de novo. In re James W.,

.

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¶ 12 The public interest exception permits review of an otherwise moot appeal when: (1) the

issue is of a public nature; (2) an authoritative determination is required for the future guidance

of public officers; and (3) there is a likelihood of future recurrences. In re Andrew B.,

(2010). The exception must be construed narrowly and established by a clear showing

of each aforementioned criterion. In re Andrew B.,

.

¶ 13 Here, respondent challenges the validity of a petition seeking her involuntary admission

filed more than 24 hours after her admission to the medical floor of Mount Sinai Hospital on

April 22, 2013, based on her contention that she was being treated psychiatrically. This issue

presents a question of public nature and substantial public concern because it involves a dispute

over the procedural requirements for involuntary admission of individuals on an inpatient basis.

In re Lance H.,

, ¶ 14. Additionally, an authoritative determination of this issue

will contribute to the efficient operation of our judicial system. In re Robin C.,

(2009); see also In re Lance H.,

(a determination of the issue

"would aid the courts and future litigants in administering the Mental Health Code"). Moreover,

respondent's own history shows how this issue might recur as she has been found subject to

involuntary admission at least once before this adjudication. In re Lance H.,

. Under these circumstances, we conclude that the public interest exception to the mootness

doctrine applies to this case, and we thus need not address the capable-of-repetition exception.

In re Laura H.,

.

¶ 14 On the merits, respondent contends that we should reverse the involuntary admission

order because the petition was untimely filed in violation of section 3-611 of the Mental Health

Code (405 ILCS 5/3-611 (West 2012)).

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¶ 15 A brief outline of the applicable statutory framework is necessary for an understanding of

the procedural framework giving rise to this appeal. In re Andrew B.,

. Section

3-600 of the Mental Health Code authorizes involuntary admission of an individual 18 years of

age or more, in need of immediate hospitalization. 405 ILCS 5/3-600 (West 2006); see also In re

Andrew B.,

. Under such circumstances, "a petition may be filed with a mental

health facility." In re Andrew B.,

(citing 405 ILCS 5/3-601(a) (West 2006)).

¶ 16 Generally, the petition must include a detailed explanation of why the individual is

subject to involuntary admission and, specifically, signs and symptoms of a mental illness and

any other behavior supporting the allegation. In re Andrew B.,

-49 (citing 405

ILCS 5/3-601(b)(1) (West 2006)). The petition must also be supported by a certificate of a

physician or qualified examiner, stating that the individual is subject to involuntary admission

and requires immediate hospitalization. In re Andrew B.,

(citing 405 ILCS 5/3-

602 (West 2006)). Further, the certifying professional's statement must be based on a physical

examination of the individual within 72 hours of admission. In re Andrew B.,

(citing 405 ILCS 5/3-602 (West 2006)).

¶ 17 As relevant here, section 3-611 of the Mental Health Code requires that the mental health

facility director file in the trial court the petition and two supporting certificates within 24 hours

following the individual's admission to the facility. In re Andrew B.,

(citing

405 ILCS 5/3-611 (West 2006)). A final order for involuntary admission is limited to 90 days,

absent a determination by the trial court that the individual is subject to continued involuntary

admission. In re Andrew B.,

(citing 405 ILCS 5/3-813 (West 2006)).

¶ 18 Section 3-611 provides in pertinent part:

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"§ 3-611. Within 24 hours, excluding Saturdays, Sundays and holidays, after the

respondent's admission under this Article, the facility director of the facility shall file 2

copies of the petition, the first certificate, and proof of service of the petition and

statement of rights upon the respondent with the court in the county in which the facility

is located." (Emphases added.) 405 ILCS 5/3-611 (West 2012).

The 24-hour filing requirement of section 3-611 "is triggered by an individual's admission under

article VI, providing for emergency involuntary admission by certificate." (Emphasis in

original.) In re Andrew B.,

.

¶ 19 Respondent argues, for purposes of section 3-611, that the underlying admission petition

was late and, thus, defective because "the petition was not filed within 24 hours of [her]

admission on April 22." However, respondent's construction of the term "admission" as meaning

only physical entry into a facility is inconsistent with the use of the term in other provisions of

the Mental Health Code, which allow a patient physically inside a mental health facility to be

subjected to another "admission" when circumstances warrant further treatment or care. In re

Andrew B.,

(citing 405 ILCS 5/3-813, 3-801 (West 2006)). A reasonable

construction of these other provisions is that the Mental Health Code utilizes the term

"'admission' in a legal sense to describe the individual's legal status," and, accordingly, "section

3-611's reference to 'admission' is not always limited to the individual's original physical entry"

into a mental health facility. In re Andrew B.,

.

¶ 20 Respondent maintains that she was in a "mental health facility" as defined by the Mental

Health Code because she received mental health treatment "beginning April 22 and continuing

throughout her hospital stay," and in her reply brief, she submits that she was "treated as a

psychiatric patient, but on a medical floor."

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¶ 21 The Mental Health Code defines "mental health facility" as:

"any licensed private hospital, institution, or facility or section thereof, and any facility,

or section thereof, operated by the State or a political subdivision thereof for the

treatment of persons with mental illness and includes all hospitals, institutions, clinics,

evaluation facilities, and mental health centers which provide treatment for such

persons." 405 ILCS 5/1-114 (West 2012).

¶ 22 Correspondingly, the Mental Health Code defines "licensed private hospital" as "any

privately owned home, hospital, or institution, or any section thereof which is licensed by the

Department of Public Health and which provides treatment for persons with mental illness." 405

ILCS 5/1-113 (West 2012).

¶ 23 Assuming, arguendo, that respondent was in a mental health facility as defined by the

Mental Health Code, we nonetheless observe that "section 3-611's 24-hour filing requirement is

triggered by an individual's admission under article VI, providing for emergency involuntary

admission by certificate." (Emphasis in original.) In re Andrew B.,

.

Respondent here was not admitted in a legal sense pursuant to article VI when she first entered

the medical floor of Mount Sinai Hospital on April 22, 2013; Dr. Mirkin testified that respondent

was admitted to the medical floor because she was experiencing tachycardia and found to be

severely anemic. Furthermore, the plain language of the statutory definitions of "mental health

facility" and "licensed private hospital" recognizes that there may be sections within a licensed

private hospital dedicated to treatment of mentally ill patients. In re Moore,

(1998). "Those sections or units, and not the entire hospital, are mental health facilities

for purposes of the involuntary admission provisions of the [Mental Health] Code." In re Moore,

. This is consistent with Dr. Mirkin's explanation that respondent was

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monitored by a psychiatrist and a sitter throughout her stay on the medical floor, considering her

prior admission to the "psychiatric unit" of Mount Sinai Hospital in January of the same year and

her failure to take her medications. Because respondent was not admitted under article VI of the

Mental Health Code (405 ILCS 5/3-600 et seq. (West 2010)) on April 22, 2013, the 24-hour

filing requirement of section 3-611 is inapplicable. In re Andrew B.,

. We

thus conclude that the May 9, 2013, petition seeking respondent's emergency inpatient admission

by certificate was timely as it was filed within 24 hours after it was presented to Connie Shay-

Hadley, the mental health facility director at Mount Sinai Hospital. In re Andrew B.,

.

¶ 24 Accordingly, we affirm the order of the circuit court of Cook County finding respondent

to be a person subject to involuntary admission on an inpatient basis.

¶ 25 Affirmed.

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