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In re Commitment of P.D.

November 30, 2005


On appeal from the Superior Court of New Jersey, Law Division, Camden County, Docket Nos. CASC-1038-04 and 1126-04.

The opinion of the court was delivered by: Stern, P.J.A.D.




Argued October 19, 2005 and telephonically on October 31, 2005

Before Judges Stern, Grall and Sapp-Peterson.

In separate appeals, consolidated for purposes of this opinion, P.D. and J.M. appeal from a "civil commitment order" involuntarily committing each to the Camden County Health Services Center (Lakeland Hospital) for thirty days. In both cases the appellant argues that the State failed to prove and/or the judge improperly found that he "suffered from a mental illness" and was "dangerous to others," warranting an involuntary civil commitment, and that the appeal is not moot by virtue of the appellant's discharge or non-extension of the commitment. In their briefs appellants argue that the appeals are not moot because of the hospital lien imposed as a result of the commitment and because the appeals involve issues "which are capable of repetition yet evading review" and involve "important issues of public policy and constitutional dimension."

Because the appellants were both discharged at or before the thirty-day period, and no subsequent review proceedings had to be conducted, we conclude that the appeals, principally dealing with issues of sufficiency of evidence and the committing judge's findings, should be dismissed as moot. See In re Geraghty, 68 N.J. 209, 212-13 (1975) (dismissing appeal as moot because the "broad issues concerning the procedural aspects of involuntary civil commitment which justified" consideration of moot cases were resolved by amendment of R. 4:74-7).

We recognize that we have frequently declined to dismiss challenges to involuntary civil commitments as moot despite the discharge. In In re B.L., 346 N.J. Super. 285, 292 (App. Div. 2002), we declined to dismiss a challenge to an involuntary hospitalization notwithstanding that the appellants were "no longer involuntarily committed." We so held because of the liberty interests involved, because the appellants remained "liable for the cost of their confinement" and because "a finding in the patient's favor will entitle the patient to a credit for any period of illegal confinement." Ibid. See also In re N.N., 146 N.J. 112, 124 (1996) (case challenging the construction of the statute and dealing with the standard governing involuntary commitments of minors not dismissed because of the significant issue of public policy which might likely recur without opportunity for adjudication); In re D.M., 285 N.J. Super. 481, 486 n.1 (App. Div. 1995), certif. denied, 144 N.J. 377 (1996) (noting the need to review the allegedly wrongful confinement because of its impact under N.J.S.A. 30:4-27.5(b) with respect to a future commitment, as well as the financial liability which attached to the bills); In re G.G., 272 N.J. Super. 597, 600 (App. Div. 1994) (court considered whether hospital treatment team's failure to arrange follow-up care could be basis for continued commitment under R. 4:74-7(h)(2)); In re Robert S., 263 N.J. Super. 307, 309 (App. Div. 1992) (declining to dismiss in light of N.J.S.A. 30:4-27.5 with respect to impact of three commitments to a short-term care facility).

The parties agree that, following the commitments and discharges involved in this case (and after the briefs were filed), the statute which imposes the lien for the commitment, N.J.S.A. 30:4-80.1, was repealed as applied to liens filed against persons treated at a psychiatric facility. See N.J.S.A. 30:4-80.6a.*fn1 The County Adjuster, in response to our questions at oral argument, has advised us that independent of the lien, the County will not seek to collect the cost of hospitalization, irrespective of any changes to the committees' financial condition, and to that extent we incorporate herein the representations made by counsel which we accept and rely upon in dismissing the case as moot. According to counsel:

For each former patient, the Camden County Adjuster's office performed its required financial investigation and prepared an Order of Settlement that stated the patient was responsible for $0.00 for his or her care and maintenance and a Judge of the Superior Court signed each Order.

I spoke with Ms. Elaine Villanova, Chief Financial Officer of the Camden County Health Services Center immediately after oral argument concluded. Ms. Villanova told me that when she receives the signed Order of Settlement, if the patient does not have a financial obligation a bill for services is not generated. Prior to the change in the psychiatric lien law, a bill was generated and sent to each patient, even if the patient was indigent. This billing procedure is no longer done and bills are sent only to patients with a financial responsibility as determined by the Camden County Adjuster's investigation.

Ms. Villanova told me the Camden County Health Services Center does not have open receivables accounts. She stated that for indigent patients, the charges are written-off upon receipt of the Order of Settlement. If an indigent patient remains in the hospital for a lengthy period of time, additional charges that are incurred are written-off at the end of each month until discharge. Ms. Villanova said that once charges are written-off the County of Camden and State of New Jersey reimburse the hospital for the cost of care for the patients that cannot pay. The County's portion is 10% and the State's portion is the remaining 90%.

I asked Ms. Villanova what the hospital would do if a former patient who had been determined indigent received some type of financial windfall such as a legal settlement or inheritance. Her first question was, "How would we know if a former patient came into money?" She told me that the hospital does not do any follow-up on a former patient's financial status. Ms. Villanova then said if for some reason the hospital found out about this ...

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