People v. Craig H. (In re Craig H.)

2022 IL 126256

215 N.E.3d 143

465 Ill.Dec. 347

IN RE CRAIG H.

(The People of the State of Illinois, Appellee,

v.Craig H., Appellant).

Docket No. 126256

Supreme Court of Illinois.

Filed September 22, 2022

Rehearing denied November 28, 2022

Veronique Baker, Kelly Choate, Matthew Davison, Ann Krasuski, and Laurel Spahn, of Illinois Guardianship & Advocacy Commission, of Hines, for appellant.

Kwame Raoul, Attorney General, of Springfield (Jane Elinor Notz, Solicitor General, and Benjamin F. Jacobson, Assistant Attorney General, of Chicago, of counsel), for the People.

Rebecca J. O'Neill, of SIU Civil Practice Legal Clinic for Elderly at Southern Illinois University School of Law, of Carbondale, amicus curiae.

JUSTICE CARTER delivered the judgment of the court, with opinion.

¶ 1 In this appeal, we determine whether respondent, Craig H., was properly subjected to involuntary administration of psychotropic medication under section 2-107.1 of the Mental Health and Developmental Disabilities Code (Mental Health Code) ( 405 ILCS 5/2-107.1 (West 2018) ). Respondent argues that the Sangamon County circuit court's order permitting involuntary administration of medication violated his right to make health care decisions through the agent he appointed under the Powers of Attorney for Health Care Law (Powers of Attorney Law) ( 755 ILCS 45/4-1 et seq. (West 2018)). For the reasons that follow, we hold that the trial court's involuntary medication order was valid under the applicable statutory provisions. Accordingly, we affirm the appellate court's judgment that affirmed the trial court's order for involuntary treatment.

¶ 2 I. BACKGROUND

¶ 3 In 2013, respondent executed an Illinois statutory short form power of attorney for health care ( 755 ILCS 45/4-10 (West 2012) ), appointing his mother, Teresa H., as his agent. At that time, respondent was 49 years old, and he had been diagnosed with a mental illness for about 24 years. He had taken psychotropic medications over the years to treat his mental illness.

¶ 4 In November 2016, respondent was hospitalized at McFarland Mental Health Center (McFarland) after he was charged with burglary in La Salle County and found unfit to stand trial. In November 2018, Dr. Aura Eberhardt, a psychiatrist at McFarland, filed a petition seeking to involuntarily administer psychotropic medications to respondent under section 2-107.1 of the Mental Health Code ( 405 ILCS 5/2-107.1 (West 2018) ). A copy of respondent's power of attorney for health care was attached to the petition.

¶ 5 Respondent filed a section 2-619 motion under the Code of Civil Procedure to dismiss the petition for involuntary treatment ( 735 ILCS 5/2-619 (West 2018) ), asserting that he had executed a valid power of attorney for health care and that his agent disagreed with, and refused to consent to, administration of the proposed medications. Respondent alleged that the trial court lacked authority to order involuntary treatment under the Mental Health Code because the decision on medical treatment rested with his agent. Following a hearing, the trial court denied respondent's motion to dismiss and set the matter for a hearing on the petition for involuntary treatment.

¶ 6 At the hearing on the petition, Dr. Eberhardt testified that respondent was diagnosed with schizoaffective disorder, bipolar type, when he was 25 years old. Respondent was currently 54 years old, and he had been experiencing hallucinations with symptoms of paranoia, inability to sleep, poor impulse control, hypersexuality, physical aggression, and psychomotor agitation. Dr. Eberhardt stated that, "[a]s examples, he's pacing when—the entire time when he is awake. As far as hypersexuality, I have examples where [respondent] approached female peers and female staff, trying to kiss them, trying to sniff them, standing in their door while they were sleeping at night."

¶ 7 Dr. Eberhardt testified that respondent had no understanding or insight into his mental illness and that he lacked capacity to make rational decisions on his treatment. Respondent's mental illness had "an element of cycling," where "[t]here are times when symptoms get worse." Since late June 2018, respondent's ability to function had deteriorated. He would not sleep for days, followed by periods when he slept continuously and missed meals. She testified that respondent had begun collecting urine in cups in his room and he required prompts to shower and eat meals. Respondent also became aggressive with his roommate and hit another individual after he intervened. That individual had to be taken to a hospital emergency room for medical treatment.

¶ 8 In September 2018, respondent "shoved a peer to the ground" and made numerous threats to kill or harm people, including staff at McFarland. Respondent had also engaged in other aggressive and inappropriate behavior, including threatening a staff member with a coffee pitcher, digging through trash, urinating on floors, and writing on walls. Respondent had received emergency forced medications at least 10 times in the previous 5 months.

¶ 9 Dr. Eberhardt requested treatment with risperidone, lithium, lorazepam, and benztropine. She listed several alternatives to those medications and testified about the benefits and possible side effects of the medications. She testified that respondent had been treated with all of the medications in the past and that his symptoms had improved, allowing him to live in nursing homes for a couple years. She opined that the benefits of the medications outweighed any potential risk of adverse side effects. Without treatment, respondent was aggressive and hypersexual and would be unable to live anywhere other than a hospital. With the medications, Dr. Eberhardt expected respondent's symptoms to improve, and he could possibly regain capacity and eventually live in a nursing home. Dr. Eberhardt concluded that respondent's condition would not improve without medication.

¶ 10 Dr. Eberhardt further testified that respondent's 82-year-old mother, Teresa H., was his agent under his health care power of attorney. Dr. Eberhardt gave Teresa H. the written information on the risks, benefits, and potential side effects of the requested medications and on alternative medications. Teresa H. understood the proposed treatment plan, but she declined to consent to treatment with the medications. According to Dr. Eberhardt, Teresa H. "would not consent for any type of medications." Dr. Eberhardt testified that Teresa H. had repeatedly stopped respondent's medications in the past, believing that they caused brain damage, made respondent "like a zombie," and made him look "like a man without a head."

¶ 11 Dr. Eberhardt acknowledged that treatment alternatives may be used when a person refuses medication. Those alternatives include seclusion, restraints, one-on-one monitoring, and emergency forced medication, but Dr. Eberhardt testified that some of those treatment alternatives are a last resort. Based on the evidence, the trial court granted the petition for involuntary administration of psychotropic medication. The trial court's order was dated December 28, 2018, and it was effective for a period not to exceed 90 days.

¶ 12 On appeal, respondent again argued that the trial court's order violated his right to appoint an agent to make his health care decisions under the Powers of Attorney Law. The appellate court initially found that the appeal was moot because the involuntary administration order expired 90 days after it was entered, but the appellate court determined that this case was subject to review under both the public interest exception to mootness and the exception for issues capable of repetition yet evading review. 2020 IL App (4th) 190061, ¶¶ 24-30, 439 Ill.Dec. 926, 149 N.E.3d 268.

¶ 13 On the merits, the appellate court observed that section 2-102(a-5) of the Mental Health Code provides, in pertinent part, that

" ‘[i]f the recipient lacks the capacity to make a reasoned decision about the treatment, the treatment may be administered only (i) pursuant to the provisions of Section 2-107 or 2-107.1 or (ii) pursuant to a power of attorney for health care under the Powers of Attorney for Health Care Law or a declaration for mental health treatment under the Mental Health Treatment Preference Declaration Act.’ " Id. ¶ 37 (quoting 405 ILCS 5/2-102(a-5) (West 2018)).

Section 2-107.1(a-5)(1) provides that, if a power of attorney for health care exists and is available to the petitioner, "the instrument or a copy of the instrument shall be attached to the petition [for involuntary treatment] as an exhibit." 405 ILCS 5/2-107.1(a-5)(1) (West 2018). The statute also requires providing a copy of the petition to " ‘any known agent or attorney-in-fact.’ " 2020 IL App (4th) 190061, ¶ 37, 439 Ill.Dec. 926, 149 N.E.3d 268 (quoting 405 ILCS 5/2-107.1(a-5)(1) (West 2018)).

¶ 14 Based on those statutory provisions, the appellate court held that the existence of a power of attorney does not preclude the State from filing a petition for involuntary administration of psychotropic medication, reasoning that "[t]he use of the disjunctive ‘or’ [in section 2-102(a-5) ] indicates involuntary medication can be administered either under a section 2-107.1 petition or when authorized by a power of attorney." (Emphasis in original.) Id. ¶ 38. The appellate court concluded that "[n]othing in the plain language indicates the decision by a power of attorney precludes the filing of a section 2-107.1 petition." Id.

¶ 15 While the Powers of Attorney Law allows appointment of an agent with broad authority to make health care decisions for another person, the appellate court determined that the Mental Health Code applies more specifically to this case. Id. ¶¶ 44-46. The State has both a parens patriae interest in providing for people suffering from mental illness and a penological interest in restoring respondent to fitness to stand trial. Id. ¶ 45. Accordingly, the appellate court affirmed the...