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Wisconsin Supreme Court Affirms Helen E.F.

Posted on May 23, 2012 in Health Law News

Published by: Hall Render

On May 18, 2012, the Wisconsin Supreme Court affirmed  a decision by the Wisconsin Court of Appeals,  which held that individuals with disabilities that are likely to be permanent and not capable of rehabilitation should be treated under Wisconsin Statutes Chapter 55 rather than Chapter 51.

The case, In Re Helen E.F., reached the Wisconsin Supreme Court after the court of appeals reversed a decision by the circuit court and held that individuals with Alzheimer’s dementia were not appropriate subjects for involuntary commitment under Ch. 51.  Helen E. F. was an 85-year-old woman who had been living in a nursing home setting for six years.  After exhibiting aggressive behavior, she was taken to a hospital emergency room and placed in the hospital’s behavioral health unit under an emergency detention pursuant to Ch. 51.  At her probable cause hearing, her Ch. 51 petition was converted to a Ch. 55 protective placement.  Shortly thereafter, another Ch. 51 petition was filed, and the circuit court determined that Helen was a proper subject for a Ch. 51 involuntary commitment in a psychiatric unit.  The court of appeals reversed the decision based on the determination that Alzheimer’s disease could be managed but not treated and involuntary commitments under Ch. 51 would be inappropriate for individuals that could not be rehabilitated.

Although the Wisconsin Supreme Court noted the similarities between Chapters 51 and 55, the Court differentiated Ch. 55 as specifically tailored to provide for long-term care for individuals with incurable disorders, while Ch. 51 is designed to facilitate short-term commitment and treatment of mental illnesses for those capable of rehabilitation.  The Court noted that “if treatment will maximize the individual functioning and maintenance of the subject but not help in controlling or improving their disorder, then the individual is not capable of rehabilitation.”  Alternatively, “if treatment will go beyond controlling the activity and will go to controlling the disorder and its symptoms then the subject has rehabilitative potential” and the person is a proper subject for treatment under Ch. 51.

The Court recognized that Ch. 55 is better suited for individuals with long-term illnesses because it provides the opportunities for emergency protective placement and administration of psychotropic medications similar to Ch. 51, while also providing additional protections such as limiting the types of facilities an individual can be sent for protective placement and the mandatory appointment of a guardian ad litem.

The Court did not address whether an individual who has Alzheimer’s disease as well as a Ch. 51 qualifying mental illness may be involuntarily committed under Ch. 51, leaving this decision to the discretion of the circuit court.

As making these protective placement and involuntary commitment determinations is often complex and can implicate other legal standards, we would recommend contacting your Hall Render attorney to assist in developing policies and guidelines to address these situations.

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