Appeal from the Order of the Superior Court entered January 23, 2009 at No. 1302 WDA 2007, affirming the Order of the Court of Common Pleas of Allegheny County entered June 12, 2007 at No. 1081-07. 966 A.2d 1131 (Pa. Super. 2009).
The opinion of the court was delivered by: Madame Justice Todd
CASTILLE, C.J., SAYLOR, EAKIN, BAER, TODD, McCAFFERY, GREENSPAN, JJ.
ARGUED: September 15, 2009
We granted allowance of appeal in order to consider whether 71 P.S. § 1690.112a ("Act 53")*fn1 of the Pennsylvania Drug and Alcohol Abuse Control Act,*fn2 which permits a parent or guardian to petition for civil involuntary commitment of their drug dependent child to a drug and alcohol treatment program, violates the due process protections provided by the Fourteenth Amendment to the United States Constitution.*fn3 For the reasons set forth below, we reject this constitutional challenge and hold that Act 53 does not violate our federal charter. Thus, we affirm the order of the Superior Court.
By way of background, C.K., Appellant F.C.'s grandmother, has had custody of Appellant since he was 4-years-old. In 2007, when Appellant was 14-years-old, Appellant's grandmother was attempting to deal with the challenges of Appellant's regular drug use, stealing, truancy from school, and his running away from home. Unable to maintain control of her grandson, and in an attempt to address this situation, on May 30, 2007, C.K. filed a petition pursuant to Act 53 to compel Appellant to receive drug and alcohol abuse treatment on an involuntary basis. That same day, the Honorable Guido A. DeAngelis of the Court of Common Pleas of Allegheny County, Juvenile Court, entered a preliminary order appointing counsel for Appellant and ordered him to undergo a drug and alcohol assessment by a licensed drug addiction counselor. The juvenile court also directed Appellant to appear for a hearing scheduled for June 12, 2007, and required C.K. to provide Appellant with a copy of the petition and the order of the court.
Although it is not clear from the record, evidently, due to her inability to maintain control of Appellant, C.K. requested assistance in securing Appellant's attendance at the hearing on her petition. On June 12, 2007, Allegheny County Sheriff's deputies took custody of Appellant at his home and transported him to juvenile court for attendance at the hearing. The sheriff's deputies delivered Appellant to a secured area within the juvenile court facility, where he was held in an area which was not occupied by adults or other juveniles who were charged with delinquent activities. Appellant was interviewed by Josie Morgano, a certified addiction counselor, and was then taken to the courtroom.
At the hearing before Judge DeAngelis, Appellant's counsel raised the constitutionality of Act 53 with regard to the petition and assessment process as well as Appellant being shackled. After discussion of these preliminary matters, Morgano testified, inter alia, that Appellant told her that he smoked marijuana every day and sometimes used alcohol, and had been doing so for one year. Furthermore, Morgano offered that the 14-year-old had a history of outpatient mental health treatment, had been truant at school, had run away from home, had stolen money from his grandmother, and had been very difficult to contain in the home environment. This testimony was based upon Morgano's interview with Appellant as well as information provided by Appellant's grandmother. According to Morgano, Appellant's diagnosis was cannabis dependence, and she did not believe it was possible to contain Appellant in the home environment and have outpatient assistance. She therefore recommended inpatient therapy for Appellant's drug dependence. Appellant's counsel cross-examined Morgano during the hearing.
Based upon this testimony, the juvenile court granted C.K.'s petition and ordered Appellant to receive inpatient treatment for marijuana dependency with a review scheduled within 45 days. Thereafter, Appellant was taken to an inpatient drug treatment facility. On July 10, 2007, Appellant filed a notice of appeal challenging the constitutionality of Act 53 and a motion for an evidentiary hearing, which was denied. Two weeks later, on July 24, 2007, the court conducted a hearing to review Appellant's commitment. After receiving evidence regarding the positive progress of Appellant's inpatient treatment, the juvenile court determined that it was in Appellant's best interest to remain committed to the same inpatient program for an additional two to three weeks.
On December 21, 2007, the juvenile court rendered an opinion supporting its prior decision to require Appellant to receive inpatient drug treatment and upholding the constitutionality of Act 53. Specifically, after recognizing the strong presumption that legislative actions do not offend the Constitution, the court noted that, while children share many constitutional protections afforded adults, it is the court's mandate to act in the best interest of the child. The court also noted that there is a difference between civil and criminal proceedings. In light of the dearth of caselaw analyzing Act 53, the juvenile court looked to the Mental Health Procedures Act ("MHPA"), 50 P.S. §§ 7101-7503. The court explained that, consistent with the purposes behind both statutes to immediately treat those suffering from medical maladies, both statutes provided sufficient due process protections. Based upon this reasoning, the court rejected Appellant's challenges to Act 53 and his treatment.
On appeal, a unanimous panel of the Superior Court, in an opinion authored by the Honorable Robert Colville, upheld the constitutionality of Act 53. In the Interest of: F.C., 966 A.2d 1131, 1137-38 (Pa. Super. 2009). The court addressed Appellant's contentions that he was denied due process and his right to counsel when, based solely on the Act 53 petition, he was detained, subjected to an assessment in which, in order to test the allegations in the petition, he was compelled to divulge private information without being given notice and an opportunity to be heard; he was assessed without counsel present; he was denied due process by virtue of his restraint in shackles; and his right to counsel was infringed because, held in restraints, he could not communicate with counsel. Id. at 1133.
In resolving these challenges, the Superior Court, inter alia, turned to the involuntary commitment provisions of the MHPA for guidance. The court first examined Section 7302 of the MHPA, which allows a county administrator to issue a warrant requiring a person to undergo an involuntary emergency examination at a treatment facility and directing a peace officer to take such person to the facility specified in the warrant. The court observed the warrant may issue under Section 7302 upon reasonable grounds that the person is severely mentally disabled*fn4 and in need of immediate treatment. The court further referenced that, after he is transported to the specified facility, the person is subject to an examination by a physician. Depending on the results of the examination, the person is either discharged or treated. If treated, the person may not be held involuntarily for more than 120 hours unless, upon application, the trial court orders extended involuntary treatment. The Superior Court further detailed that, if an application for extended involuntary treatment is filed, the trial court then appoints counsel for the person, and, within 24 hours of the filing of the application, an informal hearing is held. The informal hearing may result in extended treatment which, at that point, may not exceed 20 days.
The Superior Court noted that the initial infringement of liberty, when the person is transported to a treatment facility, subjected to an involuntary assessment, and, then, a possible informal hearing for a 20-day period, takes place with minimal due process protections. Nevertheless, the Superior Court recognized that the process has been found to be constitutionally sound pursuant to our decision in In Re: J.M., 556 Pa. 63, 726 A.2d 1041 (Pa. 1999), in light of the therapeutic/non-punitive intent and short duration of the Section 7302 procedures.
The court next compared the procedures of Sections 7302 and 7303 of the MHPA with those of Act 53 and highlighted their similarities. Among other things, the court referred to the likeness between the provision in Section 7302, calling for a warrant to be issued after reasonable grounds are presented to a court, and Act 53's provision calling for an order to be issued after "sufficient facts and good reason" are presented by petition to the court. 71 P.S. § 1690.112a(a). Additionally, the court explained, just as the MHPA provides increasing constitutional protections as the person is subjected to continuing and increased periods of commitment, Act 53 provides for ongoing hearings if the court wishes to recommit the minor to treatment.
In light of the foregoing, the Superior Court was persuaded that the MHPA and Act 53 "serve similar purposes through similar steps with similar constitutional protections." In the Interest of: F.C., 966 A.2d at 1137. The court reasoned that, just as the MHPA survived constitutional scrutiny, so did Act 53. While recognizing that the legislative enactments were not mirror images, the Superior Court nevertheless found them to be sufficiently analogous to conclude that Act 53 was constitutional. Id. at 1137-38. The court explained that the procedures under Act 53 were fundamentally fair and provided constitutionally adequate protections for minors subject thereto, particularly given Act 53's important goal of facilitating treatment for drug-dependent minors, and given the dangers posed to minors and those around them when those minors abuse drugs. The prerequisite of a court-ordered assessment conducted by a psychiatrist, licensed psychologist, or certified addiction counselor; the appointment of counsel; an in-court hearing requiring clear and convincing evidence prior to involuntary commitment; and the provision of ongoing review prior to recommitment all underscored the protections afforded to minors under Act 53. Thus, the Superior Court rejected Appellant's claim that he was denied due process or his right to counsel.
The Superior Court also denied Appellant's contention that he was denied due process by virtue of his restraint prior to and during his hearing, specifically, claiming that the visible restraints rendered his hearing unfair and that the restraints were improper as the proceedings are civil in nature. The court offered that, while, generally, due process guarantees defendants the right to appear in court free of restraints, defendants may be restrained to prevent escape and to protect others and maintain order in the courtroom. Here, the Superior Court reasoned, the proceedings did not involve a jury, but a judge. Furthermore, the court believed that the hearing would only last five to ten minutes, and it was in fact relatively brief. Therefore, the Superior Court concluded that Appellant did not establish that his constitutional rights were violated by his wearing restraints before the judge. Moreover, the court expressed its concern that Appellant was a flight risk, and Appellant was known to run away from home. In light of these circumstances, the Superior Court found that keeping Appellant restrained did not infringe his due process rights. Related thereto, the Superior Court rejected Appellant's assertion that his restraints impeded his ability to communicate with counsel, as the record disclosed that Appellant and counsel were able to freely communicate. Based upon the foregoing, the Superior Court affirmed the juvenile court's order and denied Appellant's challenges thereto. Appellant appealed to our Court.
On July 13, 2009, we granted allocatur on the issue of whether Act 53 violates due process protections provided by the 14th Amendment to the United States Constitution or Article I, Section 1 of the Pennsylvania Constitution.*fn5
In resolving this issue, we first consider the contentions of the parties. Appellant raises facial challenges to Act 53, asserting that the statute is void on due process grounds. Specifically, Appellant initially argues that the lower tribunals' reliance on an analysis of the involuntary commitment provisions under the MHPA is misplaced and cannot serve as a substitute for a due process analysis of the specific statute challenged. Moreover, Appellant maintains that, while the MHPA and Act 53 share a purpose of providing treatment to individuals in need, the MHPA permits forced confinement and treatment not of mentally ill persons, but of mentally ill persons that pose a clear danger to themselves or others. He claims that, at its core, it is the threat of harm that justifies the involuntary confinement, not simply the mental illness. Act 53 does not require the threat of harm to others or self as a core prerequisite for involuntary treatment. Appellant asserts that less evidence of necessity is required to justify involuntary treatment under Act 53 than the MHPA, yet fewer procedural protections are provided to children subject to Act 53 than to individuals subjected to involuntary treatment under the MHPA.
According to Appellant, the MHPA provides checks at each stage of the examination and commitment process that make it constitutionally sound, but which are absent from Act 53. Specifically, while an emergency examination may be made under the MHPA only upon a showing of immediate need for treatment, under Act 53, initiation of proceedings requires only "sufficient facts and good reason for the commitment." 71 P.S. § 1690.112a(a). Likewise, Appellant advances the position that, under Act 53, minors may be involuntarily committed without any evidence of specific conduct within the preceding 30 days indicating the need for involuntary treatment; minors may be involuntarily committed for up to 45 days even though not all of the criteria for commitment have been established by clear and convincing evidence; and, while the court is required to find that the minor will benefit from involuntary treatment services, there is no standard of proof by which the court is to make this finding. Moreover, Appellant maintains that minors may be committed for unlimited successive 45-day periods with few procedural safeguards; minors have no right to be released by the facility or treatment program as soon as the director determines that treatment is no longer necessary; minors have no right to the assistance of an independent medical expert; and minors have no right to be committed only on the basis of a medical determination regarding the need for involuntary treatment. Related thereto, Appellant avers Act 53 is unconstitutional insofar as it fails to require that minors be committed to the least restrictive placement setting that also meets their treatment needs. At a minimum, he claims that, where, in the view of qualified professionals, the best means of meeting an individual's need for treatment dictates community placement, institutionalization contrary to that professional judgment violates that individual's due process rights.
Next, Appellant contends that Act 53 fails to provide the process which is due under the Constitution. Specifically, Appellant stresses the individual's interests and casts the assessment as extremely intrusive. As, under Act 53, the assessment is ordered upon the filing of a petition by the minor's parent or guardian alleging drug dependence, Appellant asserts that the statute on its face deprives the child of fundamental rights and that, at a minimum, the minor is entitled to notice and an initial hearing to test the sufficiency of the petition prior to the initial assessment. Additionally, Appellant maintains that the United States Supreme Court's decision in Parham v. J.R., 442 U.S. 584 (1979), requires the commitment decision to involve a careful analysis of the youth's background and treatment history, as well as an examination, in order to comport with due process. Appellant argues the full and comprehensive inquiry required in Parham is not provided by Act 53, which allows the commitment decision to rest on an assessment triggered by a petition of untested allegations. Moreover, Appellant contends that Act 53 fails to require notice when the petition is filed, when the court orders an assessment, and when the court schedules a hearing. Related thereto, while Appellant acknowledges that Act 53 requires the appointment of counsel at the same time an assessment is ordered, it does not specifically provide for counsel to be present at the assessment or the ability to challenge the administration of the assessment. Thus, Appellant focuses upon the need for full due process protection before the assessment of the minor is ordered.
Additionally, Appellant asserts that Act 53 infringes upon an individual's right to privacy. Appellant details that the right to privacy is a fundamental right protected under both constitutions, and that the assessment constitutes a substantial invasion of privacy. Moreover, Appellant also submits, inter alia, that Act 53's definition of "drug dependent" is unconstitutionally vague. According to Appellant, Act 53's definition of "drug dependent person" does not correspond to the definition of substance dependence set forth in the Diagnostic and Statistical Manual of Mental Disorders ("DSM-IV"), which is a classification of mental disorders developed and published under the auspices of the American Psychiatric Association. Appellant argues that, by failing to track the DSM-IV, Act 53 allows a minor to be involuntarily committed without an appropriate medical diagnosis. Furthermore, Appellant offers that the procedures adopted by Allegheny County highlight the facial deficiencies of Act 53. Specifically, Appellant points to procedures requiring questioning of the petitioner at the time the petition is filed, the requirement that a parent or guardian serve a copy of the order upon the minor, and the prohibition against attachments being issued prior to the hearing. Appellant also contends that the judge's role as a neutral arbitrator during the hearing on the petition is compromised by Act 53's statutory scheme because the presiding judge performs both prosecutorial and adjudicatory functions at the hearing on the petition.
Finally, Appellant alleges that Act 53 was unconstitutionally applied to him with respect to the manner in which he was taken into custody, his detention in a holding cell and, subsequently, at a facility for delinquent minors, and by how he was kept in leg irons and shackles throughout the proceedings. Appellant maintains the record does not reflect that a warrant or any other such document was issued justifying his custody.*fn6 Appellant stresses his detention was therefore illegal, and any statements he made during that detention should have been suppressed. With respect to having been shackled during the proceedings, Appellant avers the trial court should have made an independent determination as to whether the restraints were necessary instead of blindly deferring to the sheriff's office, which indicated unrestrained subjects were contrary to its policy.
In response, the Commonwealth emphasizes the complexity of the constitutional dimension of this appeal by offering that the constitutional rights of the parents are at issue as well as those of the child. As noted by the Commonwealth, both the United States Supreme Court and our Court have recognized that a parent has a fundamental right to make decisions concerning the care, custody, and control of his or her children. Troxel v. Granville, 530 U.S. 57, 65 (2000); Schmel v. Wegelin, 592 Pa. 581, 588, 927 A.2d 183, 186 (2007). Moreover, a parent has a duty to provide needed medical care for the child, especially in light of exigent or potentially life-endangering circumstances. Prince v. Massachusetts, 321 U.S. 158, 166-67 (1944); Commonwealth v. Nixon, 563 Pa. 425, 428-29, 761 A.2d 1151, 1153 (2000). According to the Commonwealth, Act 53 represents an effort to ensure parents' ability to act in their child's best interests when confronted with a situation in which they require the assistance of the state. Thus, the constitutional rights of the parent and the child are in tension.
The Commonwealth advocates that Act 53 properly balances the constitutional rights of the parents and the child. It argues that Act 53 is explicitly civil in nature with a focus on treatment and recovery. Thus, in the situation where evading treatment may be harmful, therapeutic concerns are ill-served by a process that is animated by the restrictive approach to due process that is characterized by criminal procedure. The Commonwealth, in asserting the constitutionality of Act 53, points to the procedure for providing involuntary mental health treatment of a minor under the MHPA and urges our adoption of the approach taken by the Superior Court.
Moreover, with respect to the specific assertion that Appellant's grandmother's Act 53 petition was insufficient, the Commonwealth points out that the petition was made under penalty of unsworn falsification to authorities, 18 Pa.C.S.A. § 4904, and that it set forth sufficient grounds to require an assessment. Concerning the argument that Appellant did not have the benefit of counsel during the pre-hearing assessment, the Commonwealth highlights that a medical assessment is not a police interrogation as in a criminal case. In essence, the Commonwealth submits that Appellant's grandmother enabled Appellant, her grandchild, "to 'see someone,' so to speak, who was a qualified professional, about his drug problem, in order to see if he indeed had a serious problem, needed treatment for it and needed to go to [a] facility to get it." Commonwealth's Brief at 24. As an assessment is essentially a medical proceeding, the Commonwealth maintains that counsel had no role to play at that preliminary stage.
Finally, the Commonwealth asserts the Superior Court properly determined Appellant was not deprived of substantive due process rights by virtue of having been handcuffed and shackled during the Act 53 hearing. This treatment, in and of itself, did not violate the Constitution, nor did it interfere with Appellant's right to counsel, according to the Commonwealth. As the Superior Court explained, Appellant was not before a jury and there is no reason to presume that a seasoned and well-regarded juvenile court trial judge was prejudiced by seeing Appellant in restraints. Moreover, Appellant was confined by these restraints for a relatively brief period of time and the trial judge specifically considered whether the restraints prevented Appellant from communicating with counsel, and concluded they did not interfere with that relationship. Thus, the Commonwealth asks that we affirm the unanimous decision of the Superior Court.
Before addressing the merits of the issues raised by Appellant, we first must determine which issues were preserved, and, thus, are properly before us. The Commonwealth argues that Appellant has waived certain challenges to Act 53. Moreover, according to the Commonwealth, Appellant has also failed to present claims regarding relief under the Pennsylvania Constitution as he has not engaged in an Edmunds analysis. Commonwealth v. Edmunds, 526 Pa. 374, 390, 586 A.2d 887, 895 (1991) (setting forth the suggested four-factor analysis to be used when dealing with issues implicating our Commonwealth's Constitution). Therefore, according to the Commonwealth, only two issues are properly before our Court: (1) whether Act 53 is unconstitutional under the federal Constitution on its face; and (2) whether Appellant's constitutional right to due process was violated because he was handcuffed and shackled during the hearing and because his right to counsel was violated by the possibility posed by these restraints to impair his ability to communicate with counsel.
The Superior Court concluded certain issues were not raised during or before the Act 53 hearing, and, thus, were waived. In the Interest of: F.C., 966 A.2d at 1131 n.1 (Pa. Super. 2009). Specifically, the Superior Court found to be waived legal theories regarding whether Act 53 is unconstitutionally vague; whether it compromises the neutrality of the court; whether it impermissibly denies a minor the opportunity to offer evidence or adequately challenge evidence at a hearing; whether it is narrowly tailored to withstand ...