Peo in Interest of Leensvaart

24CA1387 Peo in Interest of Leensvaart 10-17-2024

COLORADO COURT OF APPEALS

Court of Appeals No. 24CA1387
Pueblo County District Court No. 24MH30052
Honorable Timothy O’Shea, Judge

The People of the State of Colorado,

Petitioner-Appellee,

In the Interest of Edward S. Leensvaart,

Respondent-Appellant.

ORDER AFFIRMED

Division VII
Opinion by JUDGE PAWAR
Tow and Schutz, JJ., concur

NOT PUBLISHED PURSUANT TO C.A.R. 35(e)
Announced October 17, 2024

Cynthia Mitchell, County Attorney, Kate H. Shafer, Special Assistant County
Attorney, Pueblo, Colorado, for Petitioner-Appellee

Tezak Law, P.C., Mary Tezak, Florence, Colorado, for Respondent-Appellant
¶1 Edward S. Leensvaart appeals the district court’s order

authorizing staff at the Colorado Mental Health Hospital in Pueblo

(CMHHIP) to involuntarily medicate him. We affirm the order.

I. Background

¶2 Leensvaart was committed to CMHHIP upon a finding that he

was incompetent to proceed in a legal matter. He was diagnosed

with an unspecified personality disorder and presented with “a

chronic history of difficulties controlling his behaviors, agitated

behaviors, aggressiveness, difficulties with impulse control, and

threats of suicidal ideation.”

¶3 In July 2024, Leensvaart refused to take medications

prescribed by his treating psychiatrist, Dr. Hareesh Pillai, M.D. The

Pueblo County Attorney’s Office petitioned the court for an order

authorizing involuntary administration of the medications —

namely, valproic acid (Depakote) and olanzapine (Zyprexa). The

request was amended to add chlorpromazine (Thorazine).

¶4 The district court held an evidentiary hearing on the petition.

Dr. Pillai testified for the petitioner, and Leensvaart testified on his

own behalf. At the end of the hearing, the court found that the

petitioner had proved all four elements set forth in People v. Medina,

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705 P.2d 961 (Colo. 1985), and issued an order allowing CMHHIP

staff to administer the requested medications to Leensvaart against

his will.

II. Legal Principles and Standard of Review

¶5 A court may authorize the involuntary administration of

medication when clear and convincing evidence demonstrates that

(1) the person is incompetent to effectively participate in the

treatment decision; (2) the treatment is necessary to prevent a

significant and likely long-term deterioration in the person’s mental

health condition or to prevent the likelihood of the patient causing

serious harm to himself or others in the institution; (3) a less

intrusive treatment alternative is not available; and (4) the person’s

need for treatment is sufficiently compelling to override any bona

fide and legitimate interest of the person in refusing treatment. Id.

at 973.

¶6 We determine whether the evidence, viewed as a whole and in

the light most favorable to the prevailing party, is sufficient to

support the court’s order. People in Interest of R.K.L., 2016 COA 84,

¶ 13. Application of the Medina test is a mixed question of fact and

law. People v. Marquardt, 2016 CO 4, ¶ 8. We defer to the district

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court’s factual findings if they are supported by the record but

review the court’s legal conclusions de novo. Id. Both the

resolution of testimonial conflicts and the determination of witness

credibility are solely within the province of the fact finder. People in

Interest of Ramsey, 2023 COA 95, ¶ 23. The testimony of the

physician seeking to administer treatment may be sufficient,

without more, to satisfy the Medina test. R.K.L., ¶ 30.

III. Discussion

¶7 Leensvaart does not contest the district court’s determination

of the second, third, and fourth elements of the Medina test. He

contends only that the evidence presented at the hearing was

insufficient to prove the first Medina element: that he is

incompetent to effectively participate in the treatment decision. We

are not persuaded.

¶8 At the hearing, Dr. Pillai testified that Leensvaart is

incompetent to effectively participate in decisions affecting his

health, including the decision on whether and what psychiatric

medications are needed for his treatment. Dr. Pillai based this

opinion on Leensvaart’s “long history of impulsive behaviors and

inability to control his behaviors when he becomes frustrated or

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emotional.” This was reflected, Dr. Pillai said, through “behaviors

like throwing feces, banging his head on the wall, and flooding his

cell” while he was in jail, and a continuing pattern of aggressive

behaviors at CMHHIP, “including charging at security, spitting at

staff, and, more specifically, spitting blood.” Dr. Pillai also

recognized that Leensvaart requested different medications than

those prescribed and testified that Leensvaart’s preferred

medications were not effective and one was contraindicated for

effectively treating his condition.

¶9 For his part, Leensvaart testified that he had a mental illness

and identified the medications he preferred to take.

¶ 10 The district court credited Dr. Pillai’s testimony, finding it

credible and persuasive. Based on the opinions expressed by Dr.

Pillai, the court found that Leensvaart had limited insight into his

mental illness, was incapable of making informed treatment

decisions, and was incompetent to effectively participate in

treatment decisions.

¶ 11 On appeal, Leensvaart asserts that he “demonstrated a clear

understanding and insight into his mental illness.” And he

contends that any discrepancy between his and Dr. Pillai’s

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assessments of his condition and appropriate treatment were mere

differences of opinion that do not render him incompetent to

effectively participate in treatment decisions under Medina’s first

factor. But the district court credited Dr. Pillai’s testimony that

Leensvaart’s preferred medications were ineffective and

contraindicated and that Leensvaart refused to voluntarily take

medications that were effective. We are not free to disturb this

credibility-based determination and indeed, must defer to it.

Ramsey, ¶¶ 23, 30. As a result, we conclude that sufficient

evidence supports the court’s determination that Leensvaart is

incompetent to effectively participate in the relevant treatment

decision to administer the prescribed medications.

IV. Disposition

¶ 12 The order is affirmed.

JUDGE TOW and JUDGE SCHUTZ concur.

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