[212 NJSuper Page 146] B.H. is a patient who was conditionally discharged from Camden County Health Services Center, Psychiatric Division, (Lakeland Hospital). In the proceedings before the court, the Public Advocate for Mental Health who represents B.H. contends that her due process rights were violated when she was summarily returned to Lakeland Hospital on March 11, 1986 by
her case manager. She decompensated after failing to take her medications, a condition of her discharge. B.H. was conditionally released again at a hearing held approximately two weeks after her return to Lakeland Hospital. The Public Advocate moves to set aside this conditional discharge contending it is void due to her status in the hospital as an improper committee. Although there are informal policies regarding the monitoring of conditionally discharged patients, neither the civil commitment rule, R. 4:74-7(g), nor any court decision, provides procedural guidelines for the review of conditional discharges. The purpose of this opinion is to resolve the motion in the matter of B.H. and to provide guidelines of patients' conditional status which protect their due process rights.
B.H. was admitted to Lakeland on November 4, 1985 on a class B civil commitment. She was conditionally discharged at a hearing held on November 15, 1985, effective November 18, 1985. The conditions of discharge were attendance at Jefferson House, an outpatient clinic, and the taking of prescribed medication. A 60-day discharge review was ordered to be scheduled by January 18, 1986, but, due to an oversight in the county adjuster's office, it was not scheduled until March 14, 1986. Her case worker's written report of March 10, 1986 recommended a continuation of the conditional release since B.H. was non-compliant with scheduled clinic appointments and obtaining medication.
However, before the scheduled hearing, B.H. was returned to Lakeland under emergent conditions. No notice was given to the court or to B.H.'s counsel and no written report of the circumstances of her return was filed.
Laura Abrams, Director of the Crisis Center at Our Lady of Lourdes, later reported to the court that B.H. was brought there by an ambulance called by her case manager and by an outpatient counselor at Camcare. The case manager believed that when conditionally discharged patients are decompensating
and/or non-compliant, they should be brought to a crisis center for recommitment.
B.H. stayed at the crisis center for approximately one hour. She was not seen by a doctor, but only by a crisis worker. Abrams stated that she heard B.H. tell the crisis worker that she was hearing voices and wanted to kill herself. Abrams also stated that B.H. voluntarily agreed to return to Lakeland Hospital because she was not "feeling well." The hospital chart indicates that the case manager attempted to contact the court during the lunch hour, but was unsuccessful.
When B.H.'s case worker was told by the crisis center personnel that recommitment or Class B commitment papers were not necessary for a conditional discharge violation, she drove B.H. to Lakeland Hospital in her car. The case worker and the crisis center personnel were unaware that B.H.'s conditional discharge period was beyond the 60 days set by the court.
Due to B.H.'s summary return to Lakeland Hospital on March 11, 1986, the March 14, 1986 hearing was rescheduled for March 27. On that date, B.H.'s doctor at Lakeland submitted a written report recommending that the commitment be continued, but updated the report with testimony recommending a six-month conditional release. The Public Advocate moved to have B.H. discharged unconditionally on the grounds that the State's application for a further conditional release was not properly before the court because B.H.'s previous commitment had expired. Counsel's motion was denied, and B.H. was conditionally released, with a review scheduled in six months.
On April 7, the Public Advocate filed this motion for an order vacating the conditional release order dated March 27, and discharging B.H. from commitment, or, alternatively, for an order reopening the record and entering a modified conditional release order.
Movant's position is that the court lacks jurisdiction to conditionally release B.H. because the November 15, 1985 order had expired before her return ...