FOR PUBLICATION
ATTORNEYS FOR APPELLANTS: ATTORNEYS FOR APPELLEES:
AREND J. ABEL DAVID F. McNAMAR
SANDRA L. BLEVINS Indianapolis, Indiana
Indianapolis, Indiana
DONALD B. KITE
Carmel, Indiana
IN THE
COURT OF APPEALS OF INDIANA
FRANK OBANNON, Governor of the State )
Of Indiana, JOHN HAMILTON, Secretary, )
Indiana Family and Social Services )
Administration, MELANIE BELLA, )
Assistant Secretary, Office of Medicaid Policy )
And Planning, JANET CORSON, Director, )
Division of Mental Health, STEVE COOK, )
Director, Division of Disability, Aging, and )
Rehabilitative Services, )
)
Appellants-Defendants, )
)
vs. ) No. 40A01-0206-CV-200
RICHARD SCHINDLER, by his Sister )
and Guardian, CAROLYN ERNSTBERGER, )
NANCY EGNER, by her Mother and Guardian )
FRANCES EGNER, FRANK MIGLIANO, by )
his Parents and Health Care Representatives )
FRANK AND JOYCE MIGLIANO, )
GARY TUTTLE, by his Parent and Guardian )
RUTH TUTTLE, AMANDA BREWER, by )
Her Guardian MIRIAM OGAN, PHILIP PRATT )
by his Parents and Guardians JAMES and )
BARBARA PRATT, and MUSCATATUCK )
ASSOCIATION FOR RETARDED CITIZENS, )
)
Appellees-Plaintiffs. )
APPEAL FROM THE JENNINGS CIRCUIT COURT
The Honorable William E. Vance, Special Judge
Cause No. 40C01-0203-PL-0055
SEPTEMBER 26, 2003
OPINION - FOR PUBLICATION
HOFFMAN, Senior Judge
Defendants-Appellants, various officials of the executive branch of the State of Indiana (collectively,
the State), appeal the trial courts grant of the preliminary injunction requested by
a class consisting of current and former patients of Muscatatuck State Development Center.
We affirm in part and reverse in part.
The State raises five issues for our review, which we consolidate and restate
as:
I. Whether the trial courts grant of an injunction is supported by its findings
of fact and conclusions of law.
II. Whether the portion of the injunction relating to staffing Muscatatuck State Development Center
violates the Indiana Constitutions separation of powers clause.
III. Whether the portion of the injunction requiring Muscatatuck State Development Center to allow
transferred or discharged residents to return to the Center is appropriate.
IV. Whether the portion of the injunction purporting to prevent pressuring of parents and
guardians is appropriate.
On or about July 27, 1998, the Attorney General of the United States,
by and through the Acting Assistant Attorney General, Civil Rights Division, notified the
Governor of Indiana of her intention to investigate allegations of unconstitutional and unlawful
conditions at Muscatatuck State Development Center (MSDC) and Fort Wayne Development Center (FWDC).
Appellants App. at 36. Following an investigation, the Attorney General informed
Indiana officials of her belief that persons residing in or confined in the
two state institutions were being subjected to conditions that deprived them of rights,
privileges and immunities secured by the Constitution of the United States and federal
statute. Id.
On January 18, 2001, the State entered into a Stipulation of Amended
Settlement Agreement with the United States that declared Indianas willingness to continue to
improve conditions implicating the constitutional and federal statutory rights of SDC residents.
Appellants App. at 38. As part of the settlement, the State provided
a plan that detailed methods by which it would improve conditions affecting the
constitutional and federal statutory rights of the clients at the SDCs and that
expressed the goal of providing for improvements that go beyond the constitutional minimum.
Appellants App. at 39.
In its plan arising from the federal governments investigation, the State acknowledged that
it has an obligation under federal law to provide treatment to the SDCs
residents in the most integrated setting appropriate to the residents needs. Appellants
App. at 68. Accordingly, the plan provides that each SDC will be
individually, professionally evaluated to determine the residents appropriateness for community-based placement. . .
. Id. at 69. The plan stated that such community placements
shall be designed to provide safe and humane environments and shall be adequate
to meet individualized needs. Id.
In April or May of 2001, officials of the State of Indiana announced
their intention to close MSDC in 2003. The officials stated that all
current MSDC patients would be transferred to other types of facilities.
Several parents and guardians of MSDC patients examined the alternative facilities and determined
that the facilities did not provide services comparable to those provided by MSDC.
Accordingly, the group of parents and guardians filed suit in the name
of MSDC patients (the Class). The suit was certified as a class
action in 2002, with the Class consisting of those patients living at MSDC
and those former MSDC patients who had been discharged and desired to return.
In the amended complaint, the Class members are characterized as medically frail and
at risk individuals. App. at 18. The amended complaint alleged that
large institutions such as MSDC are currently the only appropriate residences for the
Class members. Id. The complaint also alleged that the State has
failed to develop or identify any community-based facilities that provide suitable care for
the Class members. The complaint further alleged that members of the Class
who had moved from MSDC were residing in inadequate facilities as a result
of [the States] rush to closure. Id. at 21 (emphasis in original).
The amended complaint stated that the Class sought redress for the deprivation of
civil rights secured by the provisions of I.C. 12-11-1.1-1, I.C. 12-24-13-6, and I.C.
12-11-2.1-1(c). Id. at 18. The complaint emphasized that the Class was
seeking redress only under State law, and not under Federal law. Id.
The Class asked the trial court to grant an injunction prohibiting the
State from closing MSDC until the State provides adequate and appropriate facilities.
Id. at 22.
After a hearing, the trial court granted preliminary injunctive relief. In so
doing, the trial court entered findings of fact and conclusions of law.
Among other things, the trial court found that there was no evidence to
show that any existing alternative facilities provide the same level of care and
staffing as MSDC. (Finding of Fact #12; App. at 10). The
trial court also found that it was unable to conclude that these alternative
facilities can, at present, provide the care needed by [the Class]. (Finding
of Fact #16; App. at 11). The trial court further found that
the injunction was necessary to maintain the status quo until such time as
appropriate facilities are in existence. (Finding of Fact # 19; App. at
11). Accordingly, the trial court enjoined the State from removing, transferring or
discharging any [Class member] from MSDC absent written consent of the guardian of
record of the patient, which written consent explicitly states that the guardian has
received notice of this Preliminary Injunction, and after such advise [sic], decides that
the best interests of their [sic] ward is to transfer to another facility.
App. at 13. The trial court also enjoined the State from
(1) restricting in any manner the return to MSDC of any former patient
that was transferred or discharged and now wants to return to MSDC, (2)
pressuring in any way any parent or guardian to transfer their son, daughter
or ward into transferring from MSDC to another facility, and (3) reducing or
removing existing staffing at MSDC, unless the conduct of the employee violates applicable
statutes, regulations, or rules of the facility. App. at 13-14.
The State now appeals.
I.
In determining whether a trial court abused its discretion in granting a preliminary
injunction, we will review the findings of fact to ascertain whether they are
supported by the evidence and whether they are sufficient to support the judgment.
Goebel v. Blocks and Marbles Brand Toys, Inc., 568 N.E.2d 552, 553
(Ind. Ct. App. 1991). We will not set aside the findings unless
they are clearly erroneous. Id. We may not affirm the trial
courts judgment on any ground which the evidence supports. Id. Instead,
we must determine whether the special findings are adequate to support the trial
courts decision. Id. Whether special findings are adequate depends upon whether
they are sufficient to disclose a valid basis under the issues for the
legal result reached in the judgment. Willett v. Clark, 542 N.E.2d 1354,
1357 (Ind. Ct. App. 1989).
The State contends that the trial courts grant of a preliminary injunction is
not supported by adequate findings. Specifically, the State contends that the trial
court failed to identify which of the Class members statutory rights were violated
by the States current practices.
A review of the trial courts findings discloses that the trial court referred
to Ind. Code § 12-24-5-3, Article 9, § 1 of the Indiana Constitution,
and Ind. Code § 12-27-1 et seq. The first statutory reference sets
forth the rights of current patients admitted to MSDC, as it provides that
an Indiana resident admitted to a state institution is entitled to appropriate care
in the institution. The constitutional reference refers to the Legislatures duty to
provide support for institutions that care for those who are mentally and physically
challenged. The aforementioned references provide the milieu in which the particular rights
set forth in Ind. Code § 12-27-1 et seq. are found. Title
12 pertains to Human Services, and Article 27, denominated as Rights of Individuals
Being Treated for Mental Illness or Developmental Disabilities, sets forth the statutory rights
of the Class members. Specifically, Chapter 2 of the Article states that
a patient is entitled to mental health services or developmental training that is
in accord with standards of professional practice, appropriate to the patients needs, and
designed to afford a reasonable opportunity to improve the patients condition. Ind.
Code § 12-27-2-1(1). Chapter 2 further specifies that a patient is entitled
to humane care and protection from harm. Ind. Code § 12-27-2-1(2).
The trial court found that the Class members are classified as profoundly retarded
as evidenced by the data in their medical charts. (Finding of Fact
#8; Appellants App. at 10). The trial court also found that individual
Class members have severe medical conditions that place them medically at risk requiring
substantial medical care and medications. (Finding of Fact #7; Appellants App. at
10). Some of the Class members have severe behavioral problems that can
cause substantial injury to themselves, other persons or property. Some are blind
and/or deaf, and many cannot ambulate or communicate. Id. The trial
court further found that certain individual Class members needed the care and professional
staffing levels provided at MSDC or a similarly staffed facility. (Finding of
Fact #9; Appellants App. at 10). In addition, the trial court found
that the Class members would suffer extensive harm if they do not receive
the level and quality of care currently provided at MSDC. (Finding of
Fact #11; Appellants App. at 10). Significantly, the court found that although
a new type of alternative facility is being developed, the alternative facilities now
available are incapable of providing the care needed by the Class members.
(Findings of Fact #16-#19; Appellants App. at 11). In short, the evidence
is sufficient to show that the States transfer of a number of the
Class members to alternative facilities that are currently available deprives those particular Class
members of their Chapter 2 rights of treatment appropriate to the Class members
needs, humane care, and protection from harm.
Furthermore, the trial courts findings are sufficient to support its conclusion (1) that
irreparable harm to the Class members would occur if the injunction did not
prohibit the State from transferring the Class members to the alternative facilities presently
available; (2) that the harm suffered by the Class members is outweighed by
any possible injury to the State; (3) that the Class members will most
likely succeed on the merits; and (4) that public policy is best served
by the grant of the injunction. Although the trial court could have
been more explicit, we cannot conclude that the trial court failed to identify
the rights violated as those arising under Chapter 2 of Title 27.
Furthermore, we cannot conclude that the trial court failed to make findings that
support its conclusion that the State has generally failed to protect those rights.
The State cites K.W. v. Logansport State Hospital, 660 N.E.2d 609, 612 (Ind.
Ct. App. 1996) as support for its contention that the trial court erroneously
placed the burden upon the State to show that the alternative facilities are
presently capable of providing appropriate treatment to the Class members. K.W., however,
addresses the question of appropriate or effective treatment in a recommitment hearing under
the specific provisions of Ind. Code § 12-26-15. The case has no
application here.
II.
The State contends that the trial court erred in including a
provision in the injunction that prohibits the State from [r]educing or removing existing
staffing levels at [MSDC], unless the conduct of the employee violates applicable statutes,
regulations, or rules of the facility. Appellants App. at 14. Specifically,
the State contends that this provision violates the separation of powers clause in
the Indiana Constitution and is in direct conflict with this courts holding in
Logansport State Hospital v. W.S., 655 N.E.2d 588 (Ind. Ct. App. 1995).
Article III, § 1 of the Indiana Constitution provides that the powers of
Indiana government are divided into the legislative, executive, and judicial departments and that
no person charged with official duties under one of these departments shall exercise
any of the functions of another, except as in this Constitution expressly provided.
In Logansport, we recognized that the non-delegable duty to provide for individuals
who have a mental illness is given to the legislative department. Logansport,
655 N.E.2d at 589 (citing Article IX, § 1 of the Indiana Constitution).
We stated that the trial courts attempt to order increased staffing at
an institution was essentially appropriating state funds and deciding how they should be
spent. Id. We further stated that this appropriation of funds is
the right and responsibility . . . for the General Assembly alone.
Id. at 590. We noted that [t]he people have imposed the duty
upon the legislative department, and to the people it must give account, and
not to the courts. Id. (quoting Hovey v. State, 119 Ind. 95,
21 N.E. 21 (1889)). We held that the trial court overstepped its
authority in ordering an institution to hire more medical staff because it is
the express duty of the Indiana General Assembly and not of the courts
to provide for the staffing and maintenance of facilities such as [F.W.D.C., an
institution similar to MSDC]. Id.
In the present case, the Class contends that the difference between the trial
courts order and the order in Logansport is significant. Thus, the Class
concludes that Logansport and Article III, § 1 of the Indiana Constitution do
not apply in this case. The Class fails, however, to show that
forcing appropriation of funds to maintain staffing levels is constitutionally distinguishable from forcing
appropriation of funds to increase staffing levels. As we held in Logansport,
staffing decisions are the responsibility of the legislative department and that department answers
to the citizens of this state, not to Indiana courts. We conclude
that the trial courts provision regarding the maintenance of staffing levels at MSDC
violates the separation of powers clause of our Constitution.
III.
The State contends that the trial court erred in including a provision in
the injunction prohibiting the State from [r]estricting in any manner the return to
[MSDC] of any former patient that was transferred or discharged and now wants
to return to [MSDC]. Appellants App. at 13. The State premises
its contention on its belief that the Class did not request this relief,
that the return of former patients is an individualized determination, and that the
challenged provision exceeds the trial courts expressed intention to maintain the status quo.
Appellants Reply Brief at 14.
With regard to the States belief that the Class did not request relief
for those former patients who had already been transferred or released from MSDC,
we note that these patients were included as members of the class.
Furthermore, although the Class did not specifically ask that the former patients be
allowed to return to MSDC, it did ask for all other relief that
was just and proper. Appellants App. at 22. Given the inadequacy
of the alternative facilities available at the time the injunction was issued, the
only just and proper relief is to allow former patients to return to
the facility which will provide them with the level of care mandated by
Indiana statute.
With regard to the States belief that the return of former patients is
an individualized determination, we note that under the evidence presented at the injunction
hearing the trial court concluded that there are no alternative facilities that can
provide appropriate care to Class members. There is no individualized determination that
needs to be made under the evidence that was before the trial court.
Additionally, with regard to the States concerns about maintenance of the status quo,
we conclude that the State is defining the term status quo much too
narrowly. In this case, the status quo is the appropriate treatment that
all of the Class members were given before the State began transfers to
inadequate alternative facilities. In order to maintain this status, transferred or discharged
Class members must have the right to return to the only facility that
provides them with appropriate treatment under Indiana statutes.
IV.
The State contends that the trial court erred in including a provision in
the injunction that prohibits the State from [p]ressuring in any way any parent
or guardian to transfer their son, daughter or ward into transferring from [MSDC]
to another facility. Appellants App. at 14. Specifically, the State contends
that the provision is too vague because it could be interpreted to preclude
activities that are legal. In support of this contention, the State cites
Crawley v. Oak Bend Estates Homeowners Association, 753 N.E.2d 740 (Ind. Ct. App.
2001) and Blair v. Anderson, 570 N.E.2d 1337 (Ind. Ct. App. 1991).
The Class counters that the term pressuring or pressure is defined as to
force, as by overpowering influence or persuasion. Appellees App. at 35.
The Class argues that the provision simply prohibits the State from using scare
tactics or threats of sudden closure in communicating with parents or guardians about
transfers to alternative facilities.
In the present case, it is clear that the State is in the
process of closing MSDC and that it will be necessary at some point
to transfer Class members to appropriate alternative facilities. Thus, the State will
have to communicate with the parents and guardians of the Class members in
an effort to facilitate appropriate transfers. It doesnt take an active imagination
to determine that these necessary communications may be considered as pressuring by parents
or guardians who are upset about the closing of MSDC. The injunction,
which does not prohibit only scare tactics or threats of sudden closure, but
instead prohibits [p]ressuring in any way, is vague because it may be construed
to prohibit necessary communications that will be perceived by the hearer hostile to
the closing of MSDC as pressuring. Accordingly, the trial court erred in
including this provision in its injunction.
Given the evidence that the alternative treatment facilities were incapable of giving appropriate
treatment at the time of the injunction hearing, the trial court did not
abuse its discretion in enjoining the State from removing, transferring, or discharging any
Class member from their current residence at MSDC. Furthermore, the trial court
did not abuse its discretion in enjoining the State from restricting the return
of former patients to MSDC. However, the trial courts provisions regarding staffing
and pressuring of parents or guardians are clearly erroneous. On remand, they
shall be stricken.
See footnote
Affirmed in part. Reversed and remanded in part.
KIRSCH, J., and NAJAM, J., concur.
Footnote: We note that subsequent to the issuance of the trial courts injunction,
the legislature has passed two versions of statutes addressing the closure of MSDC.
In both versions, the legislature prohibited the closure of MSDC until the
residents of MSDC are placed in adequate placements that: (A) fully meet the
capabilities and needs of the residents; and (B) are located sufficiently close to
the families of residents so that the families may maintain the same level
of contact with the residents that the families had before the residents were
transferred from [MSDC]. Ind. Code § 12-24-1-10(g)(2). The statute also requires
development of a plan for moving residents to alternative placements that protects the
physical health, mental health, and safety of the residents. Ind. Code §
12-24-1-10(e)(2).
We further note that the State has argued that a portion of the
injunction providing that the State obtain written permission of a guardian before the
transfer of a Class member is mooted by the subsequent passage of Ind.
Code § 12-24-1-10(g). In making its argument, the State points to a
subsection of the statute which provided that residents may not be transferred until
the residents are placed in transfers that are acceptable to the individual or
the individuals representative. This subsection has been deleted from the current version
of the passage. Thus, the States argument is moot.