Geen v. Mo. Dep't of Mental Health

• Court: Missouri Court of Appeals
• Writing for the Court: Lisa P. Page, Presiding Judge
• Docket Number: ED112026
• Decision Date: 23 July 2024
• Citation: Geen v. Mo. Dep't of Mental Health, ED112026 (Mo. App. Jul 23, 2024)
• Parties: DAWNETTE GEEN, Appellant, v. MISSOURI DEPARTMENT OF MENTAL HEALTH, Respondent.

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DAWNETTE GEEN, Appellant, v. MISSOURI DEPARTMENT OF MENTAL HEALTH, Respondent.

No. ED112026

Court of Appeals of Missouri, Eastern District, Third Division

July 23, 2024

Appeal from the Circuit Court of Madison County 22MD-CC00216 Honorable Daniel P. Fall

Before Lisa P. Page, P.J., Gary M. Gaertner, Jr., J., and Angela T Quigless, J.

OPINION

Lisa P. Page, Presiding Judge

Dawnette Geen (Plaintiff) appeals from the trial court's judgment affirming the decision of the Missouri Department of Mental Health (DMH) to place her on a disqualification registry for two years based on DMH's administrative finding that she committed two acts of physical abuse. We reverse.

BACKGROUND

Plaintiff was an in-home caregiver with Covenant Care Services, which contracts with DMH to provide services to individuals with developmental disabilities. Covenant Care provides assistance to residents in individualized support living (ISL) facilities. Plaintiff was the caregiver for an adult male (Consumer^[1]) in an ISL facility for four years. Consumer's physical and mental disabilities limit his mobility, fine motor skills, and verbal communication, requiring significant hands-on assistance for all of his daily activities, to include physical restraint when his behavior becomes aggressive and unpredictable.

Plaintiff was accused of committing three separate acts of physical abuse involving Consumer in February 2022. The first incident on February 4, 2022, was ultimately unsubstantiated. The same day, Plaintiff's co-worker (Co-Worker 1) reported a second instance of alleged abuse, claiming she observed Consumer on the floor with the bottom half of his body under his wheelchair as Plaintiff held the wheelchair in place over his legs. Co-Worker 1 took a video of the incident, which was admitted into evidence at the hearing. A third incident in mid-February 2022 was also reported by another co-worker (Co-Worker 2) who claimed that while Consumer was sitting in his recliner she observed Plaintiff grab his wrists, hold them to his chest, and put her left knee on his abdomen. Co-Worker 2 took a photograph during the incident; however it only showed Plaintiff from the back and Consumer sitting in the recliner with her leaning over him. Neither her left knee nor her hands are visible in the photo.

The Director of the Sikeston Regional Office for DMH (Director) investigated the allegations and made a preliminary determination that Plaintiff had physically abused Consumer. After Plaintiff pursued her right to a hearing, DMH issued its final decision affirming Director. DMH found there was sufficient credible evidence to establish Plaintiff used more force than was reasonable for Consumer's control and treatment in both the wheelchair and recliner incidents. Plaintiff was placed on the disqualification registry for two years. This appeal follows.

DISCUSSION

Plaintiff raises three points on appeal. In her first point she claims the judgment affirming DMH's decision was arbitrary capricious, and unreasonable because the evidence did not establish an objective standard of care.^[2] We find point one dispositive and decline to review points two and three.

Standard of Review

We review the decision of DMH rather than the trial court. Baker v. Dept. of Mental Health for State of Missouri, 344 S.W.3d 751, 753 (Mo. App. W.D. 2011) (internal citations omitted). Appellate review of an administrative agency decision is, as relevant to this appeal, whether the decision was supported by competent and substantial evidence upon the record as a whole, was authorized by law, and whether it was arbitrary, capricious or unreasonable. Section 536.140.2 RSMo (2016).^[3] We do not view the evidence in the light most favorable to the agency's decision. Stone v. Missouri Dep't of Health & Senior Servs., 350 S.W.3d 14, 20 (Mo. banc 2011). Nevertheless, we defer to the factual findings and credibility determinations of the administrative agency. Baker, 344 S.W.3d at 754. If the evidence supports either of two opposing findings, we are bound by the factual determinations of the agency. Peruque, LLC v. Shipman, 352 S.W.3d 370, 374 (Mo. App. E.D. 2011). However, if the administrative decision is based on its interpretation and application of law, we review the agency's decision and the conclusions of law de novo. Id.

Accordingly, although we defer to the factual findings of the agency decision regarding the facts of the alleged incidents, we review de novo its conclusions that these facts constituted physical abuse. See Oakes v. Mo. Dept. of Mental Health, 245 S.W.3d 153, 157 (Mo. App. E.D. 2008) (reviewing de novo agency's decision that facts constituted physical abuse).

Analysis

In point one, Plaintiff claims DMH's decision she committed physical abuse by handling Consumer with more force than was reasonable for his proper control, treatment, or management was arbitrary, capricious, and unreasonable because the evidence in the record did not establish an objective standard of care to measure what force would be reasonable in this case.

Plaintiff's testimony, as well as the testimony of others and the documentary evidence, including Consumer's individualized service plan (ISP), established that he suffered from significant physical limitations and was limited in his ability to communicate verbally. Consumer's behavior was erratic, unpredictable, aggressive, and physical with his caregivers and his mother (Mother). Mother testified Consumer had injured himself and previous caregivers had quit because of this behavior. Consumer's ISP detailed his need for "total hands-on assistance" with daily living, as well as to address his aggressive conduct to prevent him from harming himself and others, to include physical restraint.

Plaintiff testified she had established a good rapport with Consumer as his caregiver. She testified that during the wheelchair incident Consumer had scooted himself under the chair and she was only holding the wheelchair to keep him from pulling it onto himself and because his leg was in the cross-bar of the chair at the time from his kicking. With respect to the alleged incident occurring in the recliner, Plaintiff testified she was resting her knee on the armrest of the chair to keep Consumer from flipping the chair over, which he had a habit of doing.

Mother also testified on behalf of Plaintiff. She believed her son had a good relationship with Plaintiff, and she "never" had any concern about the care Plaintiff provided. She acknowledged he was challenging to care for when he was aggressive. Mother claimed Consumer would scoot under his wheelchair and broke his foot during one episode. She also agreed Consumer had flipped himself out of his recliner. Mother did not believe Plaintiff had ever abused her son.

Two of Plaintiff's co-workers reported the incidents of alleged abuse. Each of them participated in the investigation and testified at the DMH hearing. They stated Plaintiff restrained Consumer during the alleged incidents. Co-Worker 1 testified that in February 2022, she heard Consumer "hollering" from the living room. When she entered the room she saw Plaintiff standing with the wheelchair over his legs. She believed Consumer was trying to get away and Plaintiff was pushing on the wheelchair to pin him down.

Co-Worker 2 testified Plaintiff held Consumer down with her knee on his chest when he was sitting in his recliner. She did not believe it was necessary to restrain him at the time because he was not trying to get out of the chair or doing anything to merit such restraint. She took a photo of Plaintiff at the time, which DMH found was inconclusive.

Based upon the testimony from Plaintiff's co-workers, the video, photo, and the investigative report, DMH found that Plaintiff's actions in the wheelchair incident and in the recliner incident constituted physical abuse. DMH concluded in both instances Plaintiff handled the Consumer with more force than was reasonable for the Consumer's proper control, treatment, or management.

An agency must have a rational, predictable basis for its decision, based on objective guidelines and data rather than "mere surmise, guesswork, or 'gut feeling.'" Missouri Nat'l Ass'n v. Missouri State Bd. of Educ., 34 S.W.3d 266, 281 (Mo. App. W.D. 2000) (citing Barry Serv. Agency Co. v. Manning, 891 S.W.2d 882 893 (Mo. App. W.D. 1995)). Without such a rational, objective basis, the agency decision is arbitrary, capricious, and unreasonable. Compare Oakes, 245 S.W.3d at 157-58 (reversing as arbitrary, capricious, and unreasonable agency decision that was not based on existing legal standards and definitions but on "personal whim" of fact finder), with Missouri Nat'l Ass'n, 34 S.W.3d at 281 (agency decision that followed specific procedures was not...