Waukesha County v. J. A. K.

COURT OF APPEALS
DECISION NOTICE
DATED AND FILED This opinion is subject to further editing. If
published, the official version will appear in
the bound volume of the Official Reports.
June 25, 2025
A party may file with the Supreme Court a
Samuel A. Christensen petition to review an adverse decision by the
Clerk of Court of Appeals Court of Appeals. See WIS. STAT. § 808.10
and RULE 809.62.

Appeal No. 2024AP2535 Cir. Ct. No. 2022ME18

STATE OF WISCONSIN IN COURT OF APPEALS
DISTRICT II

IN THE MATTER OF THE MENTAL COMMITMENT OF J.A.K.:

WAUKESHA COUNTY,

PETITIONER-RESPONDENT,

V.

J.A.K.,

RESPONDENT-APPELLANT.

APPEAL from orders of the circuit court for Waukesha County:
CODY J. HORLACHER, Judge. Affirmed.
No. 2024AP2535

¶1 GUNDRUM, P.J.1 J.A.K., referred to herein with the pseudonym
Janice, appeals from circuit court orders extending her involuntary commitment,
pursuant to WIS. STAT. § 51.20, for twelve months and allowing for the
involuntary administration of medication and treatment during that time. She
asserts Waukesha County failed to present sufficient evidence to prove she is
currently dangerous under § 51.20(1)(a)2. and the circuit court failed to make
specific factual findings on dangerousness with reference to a subdivision
paragraph of § 51.20(1)(a)2. as required by Langlade County v. D.J.W., 2020 WI
41, ¶40, 391 Wis. 2d 231, 942 N.W.2d 277. She also asserts the County failed to
present sufficient evidence to establish she is incompetent to refuse medication.
We disagree on all points and affirm.

BACKGROUND

¶2 On May 24, 2024, the County filed a petition for Janice’s
recommitment pursuant to WIS. STAT. ch. 51. The circuit court held a hearing on
the petition, and the following relevant evidence was presented.

¶3 Waukesha County Health and Human Services clinical therapist
Danielle Weber, a licensed clinical social worker whose licensing permits her to
diagnose and treat mental illness, testified that Janice has a treatment team that
includes psychiatrist Dr. Rada Malinovic, as well as the nursing staff who
administer Janice’s psychiatric medication injections. In conjunction with her
testimony, Weber’s “Evaluation and Recommendation for Recommitment” of

1
This appeal is decided by one judge pursuant to WIS. STAT. § 752.31(2)(d) (2023-24).
All references to the Wisconsin Statutes are to the 2023-24 version.

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Janice was admitted into evidence without objection at the final hearing on the
recommitment petition. The report summarizes Janice’s treatment records.

¶4 Between her report and testimony, Weber presented evidence that
Janice is diagnosed with schizophrenia and is prescribed Abilify, which she
receives by injection approximately every eight weeks. Janice’s initial
commitment stemmed from a January 2022 petition for examination filed by the
County and supported by petitioner questionnaires of Janice’s three adult
daughters as well as three of Janice’s neighbors at her senior living apartment
complex. The questionnaires were completed following concerning behavior by
Janice, beginning with an incident in November 2021.

¶5 According to Weber’s report, in November 2021, Janice was at a
hotel waterpark and “was lifting the shirts of random adults and children to expose
their backs, as she was checking for curves in their spines based on her paranoid
and delusional beliefs.” She was kicked out of the waterpark and later “became
aggressive in the hotel room,” pushing and shoving her daughter and son-in-law.

¶6 On December 30, 2021, Janice grabbed a female neighbor’s arm and
screamed at her, stating the neighbor knew where Janice’s husband was “and that
she needed to give him back,” even though Janice’s husband was deceased. Janice
then went through the apartment complex “slamming doors and screaming that she
was from another universe and that the residents must worship her or they would
need to die.” Later that day, Janice “charg[ed] towards her neighbor” while
screaming that the neighbor took Janice’s “boogers” and needed to give them
back. The neighbor retreated to her apartment for safety, and Janet screamed
outside the neighbor’s apartment door for 10 to 15 minutes. Janice then went

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down the hallway, slamming doors and “screaming that everyone must worship
her.”

¶7 A few hours later, Janice flipped over furniture in the lobby and
threw cushions and Christmas decorations “while screaming that she needed to
find her boogers.” Janice followed a neighbor “outside the apartment complex
and came right up to her screaming that she would cut off [the neighbor’s] limbs
and stating that [the neighbor] must die.” The neighbor called the police due to
fear of Janice. A male neighbor intervened, and Janice also threatened him,
stating she “would remove his limbs.” A few hours later, Janice pounded on the
female neighbor’s door and yelled at the neighbor. Janice was later screaming in
the parking lot and out her apartment window. Her screaming included stating, “I
have got my gun loaded,” which neighbors interpreted as a threat “that she was
going to start shooting.” “The apartment manager indicated that the neighbors
were very scared ….”

¶8 Weber’s report details other erratic and concerning conduct and
verbalizations by Janice. One of Janice’s adult daughters “expressed fear that her
mother would potentially set fire to [the daughter’s] home in her current
psychiatric state, as [Janice had] ask[ed the daughter] if she had home owner’s
insurance because [Janice] wished [her] house would burn down.”

¶9 According to the report, Janice insists she does not have a mental
illness and repeatedly states she does not want to receive medication and will not
take such if not ordered by the court. Janice has failed to report for medication
management several times, only to report later, accompanied by an adult daughter.
An adult daughter reported that Janice was stable, “doing well,” had improved,
and was “functioning better on medications than she did when off of medications.”

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The report indicates Malinovic “regularly engages [Janice] in conversation
regarding the advantages, disadvantages, benefits, and risks of her medications, as
well as alternative[s] to her medications,” with the last discussion as to advantages
and disadvantages occurring on April 12, 2024, less than two months before the
final hearing on this petition. The report notes Malinovic’s opinion that Janice has
demonstrated poor insight into her illness and need for medication.

¶10 Weber testified Janice had not engaged in any new dangerous
conduct since being on the injectable medication, adding, “The medication is
holding her symptoms and allowing her to remain independent in the community.”
Since being on medication, Weber further explained, Janice has not had contact
with the police or faced eviction from her apartment and her daughters report
Janice “is doing well; that she is engaging in family outings and engaging and
acting appropriately with family and members of the community.”

¶11 Weber testified that during Janice’s meetings with outpatient
providers in the two years since her initial commitment, Janice has never
expressed insight as to her need for medication to treat her mental illness. Weber
added that Janice

regularly presents at the appointments stating that she
wants off of the medication because she’s not mentally ill
and does not need it. She’s often reporting somatic
complaints[2] or side effects from medications that are not
visible. Most recently over the past few appointments she’s
had with Dr. Malinovic, she’s come reporting rashes on her
face that are not visible to either her adult daughter or
Dr. Malinovic.

2
Weber explained that “somatic complaints” “are anxieties that we believe that we are
having a reaction to something that isn’t actually there, and it causes individuals to focus on
those.”

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Weber confirmed that Malinovic “routinely discuss[es] the advantages,
disadvantages, and alternatives of Abilify” with Janice.

¶12 On cross-examination, Weber stated she had personally met with
Janice once or twice in the two years she had been overseeing Janice’s
commitment. She acknowledged that Janice’s dosage of Abilify was at some
point decreased because of adverse side effects. She stated that she knows
Malinovic regularly has conversations with Janice about the advantages,
disadvantages, and alternatives to medication because of her review of the records
as well as her direct conversations with Malinovic, but she did not recall if she had
ever been present during such conversations “or when it would’ve taken place.”
Weber agreed Janice has been compliant with attending appointments and
receiving her injections but added, “[w]ith the assistance and support of her adult
daughters.”

¶13 Upon questioning from the circuit court about only having met with
Janice twice in two years, Weber explained that her role is essentially one of
oversight to ensure Janice “is being compliant with receiving her injection.”

¶14 Psychiatrist Dr. Michele Andrade testified that she was appointed by
the circuit court to conduct an examination of Janice, which she did on May 31,
2024, less than a week before the final hearing. She conducted the one-hour
examination by phone, because Janice would not agree to a meeting by Zoom.
Prior to testifying, Andrade had also reviewed the petition for recommitment and
“an in-depth and lengthy history … of [Janice’s] symptoms and behaviors and
hospitalizations since her initial commitment.”

¶15 According to Andrade, Janice suffers from “[s]chizophrenia, chronic
paranoid, type severe,” which is a substantial disorder of thought, mood, and

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perception. Andrade agreed Janice’s illness grossly impairs her judgment and
behavior and “ha[s] an impact on her reality.” Janice

consistently and even presently, when I had spoken with
her, denied any sort of mental illness or any symptoms….

She believed that her medication was poisoning her.
She … had a lot of somatic delusions. That she believed
the medicine that she was taking was causing her[:] the
inability to read and write, the inability to open her eyes,
the inability to walk … [and] psoriasis on her face.

…[T]here were quite a few other somatic complaints
that she had, and she related those to her medication.

Andrade added that “[t]he delusions about her somatic complaint are actually
symptoms—real symptoms of schizophrenia. She has presented over the phone as
unable to distinguish the reality between those somatic complaints [and] … the
benefits of her taking medication.”

¶16 Andrade stated that Janice “ha[d] been aggressive when
decompensated[] and that has improved with medications. She ha[d] threatened to
… cut the limbs off of her neighbor.” “[S]he had asked the police to kill her….
She asked the nurses, while she was in the hospital, if they would care if she died.
She asked her daughter if her daughter had insurance on her house because she
wanted to burn it down.” Andrade expressed concern about Janice “going to
strangers and lifting their clothing up, to check to see if they had a curvature in
their spine” because it is not only “[j]ust very odd and bizarre kind of behavior”
but also makes Janice vulnerable “because you don’t know what a stranger is
going to do when you’re essentially assaulting them by lifting their clothing up …
unwanted and unannounced.”

¶17 Andrade confirmed that medication is necessary to improve Janice’s
thought, mood, and perception, it is in fact having therapeutic value for Janice, and

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due to her schizophrenia, Janice is incapable “of applying her condition to whether
she should take Abilify.” She also confirmed that she explained to Janice the
advantages and disadvantages of the medication but stated she did not explain any
alternatives. She stated that Janice told her “she was intending to stop any
medication if she was not on court order because she didn’t believe she had a
mental illness or a need, and that the medications were poisoning her.” Andrade
explained that Janice’s “medication is benefiting not only her but [also] the
community, by reducing the incidences of either dangerousness or potential
dangerousness.” Andrade indicated that if the commitment is not extended, and
thus treatment is withdrawn, it is much more likely than not that Janice “would
become significantly symptomatic.” Andrade explained that “[o]ften times …
with repeated episodes of ceasing medication and resulting decompensation, it
becomes harder and harder … on the next trial of treatment and medication, to get
back to a level of health and well-being that was previously seen.”

¶18 On cross-examination, Andrade agreed that her testimony as to
Janice asking her daughter about the house insurance, her daughter’s related fear
of Janice burning down her house, and Janice asking to be killed were based on
Weber’s report and not statements Janice made to Andrade directly. Andrade
explained that her record review of Janice’s history was based on Weber’s report
and the petition. She explained she did not discuss “the alternatives to
medications” with Janice “[b]ecause I don’t believe there are any alternatives to
treatment for schizophrenia. There [is] complementary help often given but
medications are the treatment for schizophrenia.” Andrade acknowledged that
Janice had been medication compliant but added that she has been compliant “as
long as she has been on court order.” Andrade agreed that Janice’s medication
dosage had been decreased at some point.

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No. 2024AP2535

¶19 Andrade’s report, which was admitted into evidence without
objection, references the concerning conduct and statements by Janice noted in
Weber’s report. Andrade’s report notes Andrade’s concern that Janice’s “history
of inappropriate behavior to strangers leav[es] herself vulnerable to potential
defensive actions by strangers.” It states that Janice is a proper subject for
treatment and “is dangerous” under the second and third dangerousness standards,
based on the recommitment alternative of WIS. STAT. § 51.20(1)(am), and it
details all of the standards. Andrade’s report indicates that “medication or
treatment [will] have therapeutic value” for Janice and details that Andrade
explained to Janice the advantages of the recommended medication, those being
“[l]essen[ing] hallucinations/delusions/aggression,” and the disadvantages, those
being “w[eigh]t gain, sedation, movement abnormalities, NMS.” The report
further indicates that due to her mental illness, Janice is “incapable of expressing
an understanding of the advantages, disadvantages and alternatives to accepting
the recommended medication or treatment,” explaining that “among other somatic
complaints, [Janice] feels medication prevents her from opening her eyes. Per
records, she has never had an issue with opening her eyes.” The report provides
that due to her mental illness, Janice is “substantially incapable of applying an
understanding of the advantages, disadvantages and alternatives to … her
condition in order to make an informed choice as to whether to accept or refuse
the recommended medication or treatment,” further explaining that Janice
“[d]oesn’t feel she has a mental illness so [she has] no need for medications which
she feels are poisoning and killing her.” The report explains that

if treatment were to be withdrawn, [Janice] would quickly
become again a proper subject for treatment due to
decompensation of her chronic and persistent mental
illness. She lacks insight into need for treatment due to
mental illness and has expressed to [Andrade] and others,
her intent to stop medications if not on court ordered

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No. 2024AP2535

treatment/medication. [Janice] has shown her inability to
take medications voluntarily and has become aggressive in
a delusional state when not taking medication which then
leads to decompensations. [Andrade] opines that it is
essential to continue court ordered treatment and
medication for safety of community, family and herself.

¶20 Following the close of evidence, Janice made an unsworn statement
that “[m]ost of … what they said were lies about what I had said,” and “I’m under
this medication for no reason at all, and I’m suffering and being tortured every
single day. I don’t even know if I’m going to wake up tomorrow. That’s how
serious this medication is.”

¶21 The circuit court stated that “it’s unrefuted that [Janice] suffers from
schizophrenia.”3 The court noted there was

no testimony really refuting what the … two witnesses
have testified [to] today … and the history of what brings
us here today: from the underlying reports of the incident at
the waterpark, the history of delusions and hallucinations.
We have from [Janice] herself that she doesn’t think that
she’s got schizophrenia, that she doesn’t [need] medication.

The court stated:

I do find, taking on its face value, what has been
testified to by the two witnesses today, even with the

3
The circuit court made some preliminary comments indicating this was

kind of a weird [case] because quite frankly having the testimony
of the social worker … who only met with [Janice] for twice
now, out of two years, and yet speaking to the dangerousness is
heavily scrutinized by this [c]ourt as it should be. And the fact
that the attending physician that was testifying today had a
one-hour long phone conversation. And quite frankly the rest of
her testimony also, not stellar.

The court also expressed that “[i]t is odd” and “positioned differently than anything else I’ve
seen” with the County “lessening the medications over time, in consultation with the family and
yet continuing on with the [medication] order.”

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No. 2024AP2535

minimal actual face-to-face contact, which this [c]ourt is
concerned of, but, again, is [un]refuted[.] I do find that the
grounds for the extension of commitment have been
established. I do find, based on the statements of [Janice]
today that she doesn’t want to take the medications. She
does not believe she has a mental illness, based off of the
collateral source review that the other witnesses have
testified to today and her behavior if she goes noncompliant
with those medications, this [c]ourt does make the finding
that [Janice] is mentally ill and dangerous because she
evidences … [a] substantial probability of physical harm to
others and a substantial probability of impairment or injury
to herself or others due to impaired judgment.

¶22 The circuit court further found that Janice is a proper subject for
treatment and added that: “The dangerousness has manifested or shown by a
substantial likelihood, based on the subject’s individual treatment, that the
individual would be [a] proper subject for commitment if treatment [were]
withdrawn.” The court found that her dangerousness “is likely to be controlled
with appropriate medication administered on an outpatient basis,” and it ordered
her commitment extended on an outpatient basis for another twelve months.

¶23 The circuit court further determined that Janice “is in need of
medication or treatment” and such “will have a therapeutic value.” It found that
“[t]he advantages, disadvantages, and alternatives to this medication have been
explained,” but “[d]ue to mental illness, [Janice] is not competent to refuse
psychotropic medication because [she] is substantially incapable of applying an
understanding of the advantages, disadvantages, and alternatives to her condition
or to make an informed choice whether to accept or refuse psychotropic
medications.” The court ordered Janice “to take all psychotropic medications as
prescribed by your treatment provider” and “[s]chedule, keep, and attend all
appointments recommended by the [WIS. STAT. §] 51.42 Board and your treatment
provider.”

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No. 2024AP2535

¶24 Janice appeals.

DISCUSSION

¶25 An individual is a proper subject for recommitment under WIS.
STAT. § 51.20(1) if the County proves by clear and convincing evidence that the
individual is mentally ill, a proper subject for treatment, and dangerous to herself
or others. See D.J.W., 391 Wis. 2d 231, ¶32; § 51.20(1)(a), (13)(e). Of these
three, Janice only challenges the circuit court’s determination that she is
dangerous.

¶26 Whether the County met its burden of proof to support Janice’s
recommitment presents a mixed question of law and fact. See Waukesha County
v. J.W.J., 2017 WI 57, ¶15, 375 Wis. 2d 542, 895 N.W.2d 783. “[W]e will uphold
a circuit court’s findings of fact unless they are clearly erroneous,” D.J.W., 391
Wis. 2d 231, ¶24, and “we accept reasonable inferences from the facts,”
Winnebago County v. Christopher S., 2016 WI 1, ¶50, 366 Wis. 2d 1, 878
N.W.2d 109 (citation omitted). Whether the facts satisfy the statutory standard,
however, is a question of law we review independently. D.J.W., 391 Wis. 2d 231,
¶25; Outagamie County v. Melanie L., 2013 WI 67, ¶39, 349 Wis. 2d 148, 833
N.W.2d 607. On appeal, Janice has the burden to show that the circuit court erred.
See Gaethke v. Pozder, 2017 WI App 38, ¶36, 376 Wis. 2d 448, 899 N.W.2d 381.

Sufficiency of Evidence for Commitment Order

¶27 Janice first contends “[t]he County failed to present sufficient
evidence of [her] current dangerousness”; ultimately, that it “failed to present
sufficient evidence to prove Janice would be a proper subject for commitment if
treatment were withdrawn.” We disagree.

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No. 2024AP2535

¶28 To support a commitment order, a circuit court need only conclude
that the person is dangerous under one of the five dangerousness standards of WIS.
STAT. § 51.20(1)(a)2. See Sauk County v. S.A.M., 2022 WI 46, ¶5, 402 Wis. 2d
379, 975 N.W.2d 162 (“If the government presents clear and convincing evidence
that the committed person remains mentally ill, treatable, and dangerous under one
of the five standards ... then the court must order that person recommitted ....”).
Janice recognizes that the court “concluded that [she] [i]s dangerous under
… §§ 51.20(1)(a)2.b. and c.” “by way of the recommitment alternative
… § 51.20(1)(am).” See S.A.M., 402 Wis. 2d 379, ¶32. Under these provisions, a
person is dangerous if, based on her treatment history, she would again evidence
“a substantial probability of physical harm to other individuals” or “physical
impairment or injury to … herself or other individuals” if treatment were
withdrawn. Secs. 51.20(1)(a)2.b.-c., 51.20(1)(am).

¶29 Janice contends Andrade

did not provide any information that would suggest that
[Janice] continues to hold those unusual beliefs regarding
curved spines or that others should worship her. The fact
that [Janice] once engaged in those beliefs or behaviors is
not sufficient to prove that she is currently dangerous. To
prove current dangerousness, the County needed to show
how those behaviors—occurring over two years ago—
make her dangerous to herself or others today.

But, as WIS. STAT. § 51.20(1)(am) makes clear, the County does not need to show
that Janice currently holds those same unusual beliefs, as she has been on
medication to control such peculiarities since her initial commitment. This is why
para. (am) exists. See Portage County v. J.W.K., 2019 WI 54, ¶19, 386 Wis. 2d
672, 927 N.W.2d 509 (pointing out that § 51.20(1)(am) “recognizes that an
individual receiving treatment may not have exhibited any recent overt acts or
omissions demonstrating dangerousness because the treatment ameliorated such

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No. 2024AP2535

behavior, but if treatment were withdrawn, there may be a substantial likelihood
such behavior would recur”). As long as the County shows, as it has here, that
there is a substantial likelihood that the individual would be a proper subject for
commitment if treatment were withdrawn, the dangerousness requirements of “a
recent overt act, attempt or threat” (§ 51.20(1)(a)2.b.) and “pattern of recent acts
or omissions” (§ 51.20(1)(a)2.c.) are satisfied. To this point, Andrade clearly
opined in her testimony and admitted report that if treatment were withdrawn,
Janice would “quickly” decompensate and again be a danger to the “community,
[her] family, and herself.”4 See J.W.K., 386 Wis. 2d 672, ¶19 (“[P]aragraph (am)
functions as an alternative evidentiary path, reflecting a change in circumstances
occasioned by an individual’s commitment and treatment.”). Further, as we have
recognized,

neither … an expert [n]or circuit court [is required] to
speculate on the precise course of an individual’s
impending decompensation by identifying specific future
dangerous acts or omissions the individual might
theoretically undertake without treatment.…
Dangerousness in an extension proceeding can and often
must be based on the individual’s precommitment behavior,
coupled with an expert’s informed opinions and predictions
….

Winnebago County v. S.H., 2020 WI App 46, ¶13, 393 Wis. 2d 511, 947 N.W.2d
761.

4
Janice writes: (1) while Weber and Andrade testified Janice desired to stop receiving
the prescribed medication, Weber also testified that Janice had been medication compliant; (2) the
circuit court disapprovingly noted Weber had only met with Janice twice in two years and found
it “odd” the County had reduced the frequency and dosage of medication yet sought
recommitment; (3) the court criticized portions of testimony as “not stellar”; and (4) the court
relied on another doctor’s report that “was never introduced into the record.” Because Janice fails
to develop an argument with regard to any of these points, we do not address them. See ABKA
Ltd. P’ship v. Board of Rev., 231 Wis. 2d 328, 349 n.9, 603 N.W.2d 217 (1999) (“[We] will not
address undeveloped arguments.”).

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No. 2024AP2535

¶30 Janice’s behavior in late 2021 and early 2022 supported her initial
commitment, and she does not argue to the contrary. Since receiving medication,
she has not engaged in additional concerning behavior because, as Andrade
testified, the Abilify injections make it possible for her to successfully remain in
the community. The circuit court’s finding in this regard is sufficiently supported.

¶31 Relying on our supreme court’s decision in D.J.W., 391 Wis. 2d
231, Janice also complains her right to due process was short-changed because
“[t]he circuit court failed to make specific factual findings on dangerousness with
reference to a subdivision paragraph of [WIS. STAT.] § 51.20(1)(a)2.” The D.J.W.
decision, however, was driven by the fact that “[i]t was not clear at either the
initial commitment hearing or the extension hearing on which subdivision
paragraph of … § 51.20(1)(a)2. the commitment was based.” D.J.W., 391 Wis. 2d
231, ¶36. In this case, however, the court’s extension order was based
unambiguously on § 51.20(1)(a)2.b. and c. by way of the recommitment
alternative § 51.20(1)(am).5

¶32 Following the hearing, the circuit court entered a written order
extending Janice’s commitment in which the court made it clear it determined

5
Indeed, in her brief-in-chief, Janice begins the “ARGUMENT” section with “[i]n this
case, the court concluded that [Janice] was dangerous under [WIS. STAT] §§ 51.20(1)(a)2.b. and
c. The court indicated that this dangerousness was manifested by a substantial likelihood, based
on [Janice’s] treatment history, that [she] would be a proper subject for commitment if treatment
were withdrawn,” tracking the language of § 51.20(1)(am). (Emphasis added.) Janice later
modifies her certainty some, stating “the circuit court appeared to find dangerousness based on
… §§ 51.20(1)(a)2.b. and c.” (Emphasis added.) In her reply brief, Janice further states that she
“acknowledges that the circuit court did find that [she] evidenced ‘[a] substantial probability of
physical harm to others and a substantial probability of impairment or injury to herself or others
due to impaired judgment,’ with language that appears to largely track that of …
§ 51.20(1)(a)2.b.-c.” She also modestly appears to admit that the court “may have accurately
noted the [subdiv. paras.] under which it found [her] dangerous.” Here, there was no uncertainty
under which subdivision paragraphs of § 51.20(1)(a)2 the court determined Janice was dangerous.

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No. 2024AP2535

Janice dangerous “because [she] evidences one or more of the standards … under
[WIS. STAT.] § 51.20(1)(a)2. in combination with § 51.20(1)(am).” It checked
boxes indicating she evidences “a substantial probability of physical harm to other
individuals” and “a substantial probability of physical impairment or injury to …
herself or other individuals due to impaired judgment,” respectively corresponding
to § 51.20(1)(a)2.b. and c., “[a]s manifested or shown by … a substantial
likelihood, based on the subject individual’s treatment record, that the individual
would be a proper subject for commitment if treatment were withdrawn,”
corresponding to § 51.20(1)(am). This order tracked comments made by the court
during the hearing.

¶33 The circuit court made clear that there was “no testimony really
refuting what [Weber and Andrade] have testified [to] today, with what has been
said, and the history of what brings us here today: from the underlying reports of
the incident at the waterpark, the history of delusions and hallucinations.” The
court found that the unrefuted testimony of Weber and Andrade established “the
grounds for the extension of commitment.” The testimony and evidence presented
to the court provided ample support for its conclusion that Janice is currently
dangerous, i.e., that if treatment were withdrawn, she would satisfy WIS. STAT.
§ 51.20(1)(a)2.b. or c.

¶34 Janice further states that “the court made no factual findings
regarding how [the standard of a substantial probability that Janice would become
a proper subject for commitment if treatment were withdrawn] was evidenced.”
But, the circuit court ultimately and obviously did credit Andrade’s testimony to
this effect, and she had unambiguously opined that Janice would “quickly”
decompensate if her medication were withdrawn and become a danger again to the
community, her family and herself. Furthermore, it is well established that we

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No. 2024AP2535

may affirm the court’s decision if the record evidence clearly supports it, see
Kraemer v. Kraemer, 67 Wis. 2d 319, 320, 227 N.W.2d 61 (1975); see also State
v. Margaret H., 2000 WI 42, ¶37, 234 Wis. 2d 606, 610 N.W.2d 475, which is the
case here. The County presented ample evidence, both in testimony and admitted
reports, showing Janice’s concerning threats to harm certain persons in specific
ways and her direct engagement in aggressive and/or uninvited physical contact—
physically fighting with her daughter and son-in-law at a hotel; lifting up
strangers’ shirts “unwanted and unannounced,” which could easily lead to
aggressive physical retaliation against her, as Andrade noted; grabbing a female
neighbor’s arm and making aggressive physical comments and threats toward her,
including threatening to “cut off [her] limbs and stating that [the neighbor] must
die”; and screaming “I have got my gun loaded,” which neighbors interpreted “as
a threat that she was going to start shooting,” to name a few.

Sufficient evidence for medication order

¶35 “[U]nder WIS. STAT. § 51.61, a person has the right to refuse
medication unless a [circuit] court determines that the person is incompetent to
make such a decision.” Melanie L., 349 Wis. 2d 148, ¶53. “[T]he County bears
the burden of proof on the issue of competency in a hearing on an involuntary
medication order.” Id., ¶94.

¶36 As relevant here, the County establishes a person’s incompetency to
refuse medication by proving by clear and convincing evidence that due to mental
illness

and after the advantages and disadvantages of and
alternatives to accepting the particular medication ... have
been explained to the individual, one of the following is
true:

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No. 2024AP2535

a. The individual is incapable of expressing an
understanding of the advantages and disadvantages of
accepting medication or treatment and the alternatives.

b. The individual is substantially incapable of applying an
understanding of the advantages, disadvantages and
alternatives to … her mental illness ... in order to make an
informed choice as to whether to accept or refuse
medication or treatment.

See WIS. STAT. § 51.61(1)(g)4. (emphasis added); WIS. STAT. § 51.20(13)(e).
Janice argues we must vacate the involuntary medication order because “the
County failed to present sufficient evidence that anyone adequately explained the
advantages, disadvantages, and alternatives to medications” to her. We disagree.

¶37 In her testimony, Weber agreed that the psychiatrist on Janice’s
treatment team, Malinovic, “routinely discuss[es] the advantages, disadvantages,
and alternatives of Abilify” with Janice. This is also supported by Weber’s
admitted report, which further indicates Malinovic last discussed the advantages
and disadvantages with Janice less than two months before the final hearing.
Andrade testified that she, too, explained the advantages and disadvantages of
Abilify to Janice, detailing in her report the specific advantages and disadvantages
she explained to her. Andrade testified that she did not discuss alternatives with
Janice “[b]ecause I don’t believe there are any alternatives to treatment for
schizophrenia. There [is] complementary help often given but medications are the
treatment for schizophrenia.”

¶38 While Janice would like us to invalidate the medication order
because Andrade did not discuss alternatives with Janice, Andrade clearly testified
that no sufficient alternatives to medication exist for schizophrenia and that is why
she did not explain any to Janice. Understandably, Andrade could not discuss

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No. 2024AP2535

with Janice alternatives that do not exist. Moreover, the evidence indicated that
Malinovic did “routinely discuss … alternatives of Abilify” with Janice.

¶39 Janice made it abundantly clear, repeatedly and consistently, that
despite the obvious and extensive evidence to the contrary, she did not believe she
had a mental illness and did not believe she needed medication. Even though the
record clearly shows she was benefitting from and able to stay in the community
safely because of the Abilify, she opposed the medicine at every opportunity, even
making preposterous claims that it prevented her from seeing, despite the fact she
had no problem seeing.

¶40 In Melanie L., our supreme court stated that it is “logical[]” that “if a
person cannot recognize that he or she has a mental illness, ... the person cannot
establish a connection between his or her expressed understanding of the benefits
and risks of medication and the person’s own illness.” 349 Wis. 2d 148, ¶72. As
the evidence showed, that is the case here.

By the Court.—Orders affirmed.

This opinion will not be published. See WIS. STAT.
RULE 809.23(1)(b)4.

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