In Re Bishop

COLINS, President Judge.

The Pennsylvania Department of Public Welfare (DPW) and Mayview State Hospital (Mayview) appeal from the orders of the Court of Common Pleas of Allegheny County joining them as indispensable parties in the commitment of Bobbie Jean Bishop, directing Mayview to admit Bishop or face contempt proceedings, and directing that Bishop be transported to Mayview.

On August 21, 1997 the court of common pleas ordered that Bishop be committed involuntarily to Mayview for a period of 180 days pursuant to Section 305 of the Mental Health Procedures Act (MHPA).1 As of that date, Bishop was just a few months short of her 18 th birthday. In attendance at the commitment hearing were Bishop and her counsel, Allegheny County mental health authorities, and Dr. Burton Singer,2 Bishop’s treating psychiatrist at St. Francis Medical Center. The court ordered Bishop’s commitment to Mayview based on the recommendation of her treating psychiatrist and based on Bishop’s willingness to be committed at May-view. Although the court was aware of, and considered, DPW and Mayview’s policy against admitting patients under the age of 18, the judge ordered commitment to Mayview for adult treatment in view of Bishop’s history of treatment at that hospital and her approaching 18th birthday.

In violation of the court’s commitment order, Mayview refused to admit Bishop for treatment and arranged for her transportation to Southwood Psychiatric Hospital. Mayview’s violation of the commitment order prompted a series of hearings in connection with Bishop’s involuntary commitment at which Mayview and DPW asserted that they were not parties to the proceeding, were not subject to the court’s jurisdiction, and could not be compelled to admit a patient for court-ordered involuntary treatment. On September 17, 1997, the trial court joined DPW and Mayview as indispensable party defendants and ordered Bishop transferred to Mayview. DPW and Mayview immediately filed their notice of appeal.

On appeal, DPW and Mayview raise the following issues: 1) whether the MHPA gives a court of common pleas jurisdiction to compel a state mental hospital to admit a patient when the hospital has determined that the patient is “inappropriate for treatment”; and 2) - whether the MHPA gives a court of common pleas jurisdiction to join DPW, a Commonwealth agency, and May-view, a state mental hospital, as indispensable parties in a commitment proceeding. The parties concede that these questions, as they relate to Bishop, are moot; however, the Court has discretion to decide substantial questions, otherwise moot, that are capable of repetition unless settled. Colonial Gardens Nursing Home, Inc. v. Bachman, 473 Pa. 56, 373 A.2d 748 (1977).

The Mental Health and Mental Retardation Act of 1966 (MH/MR Act)3 and the MHPA govern county mental health programs and procedures for commitment of mentally ill persons. The MH/MR Act confers upon DPW the power and duty to assure the availability of mental health services; to make and enforce regulations; to assist coun*1117ties in carrying out their mental health programs; to operate state mental health facilities; to supervise mental health facilities, services, and programs; in addition to some other administrative and financial functions. Section 201, 50 P.S. § 4201. DPW operates all state facilities and assigns their functions. Section 202 of the MH/MR Act, 50 P.S. § 4202.

Local authorities4 establish county mental health programs under the MH/MR Act and appoint county administrators. Sections 202 and 304, 50 P.S. § 4202 and § 4304. Among the duties of the county administrator is to designate facilities to provide mental health services within catchment areas5 under his or her jurisdiction and to designate which facilities are available for involuntary treatment. 55 Pa.Code §§ 4200.32(12), 5100.12(f). The administrator designates appropriate facilities to which a court may commit patients either by way of a blanket notification or on an ad hoc basis. 55 Pa.Code § 4210.12. The administrator arranges for all professional and nonprofessional staff necessary to providing all mental health services, 55 Pa.Code § 4210.21, and that staff is responsible for developing and carrying out a comprehensive treatment program, coordinating patient services, and maintaining continuous liaison with state facilities. 55 Pa.Code § 4210.22.

Articles II and III of the MHPA confer jurisdiction on the courts of common pleas over voluntary and involuntary commitments. Sections 201 to 306, 50 P.S. §§ 7201-7306. Court-ordered involuntary commitment is made to the facility designated by the county administrator, with input from the patient’s treating physicians and other members of the treatment team. 55 Pa.Code §§ 5100.86(h), 5100.87-.89. By virtue of this statutory jurisdiction over court-ordered commitments, the courts of common pleas also have jurisdiction to order commitment to any approved facility designated within a given service area; by its participation in the county mental health program, a mental health facility is subject to the terms of the MH/MR Act and MHPA for the purposes of receiving and treating court-committed patients. Under the terms of these statutes, when a court orders treatment at a designated state mental hospital, the designated facility must admit the patient for treatment; at that time, the facility is without recourse to deny admission.

The MH/MR Act and the MHPA contain ample provisions for coordination of services between DPW and the county administrator as to the approval of facilities and their functions, and for coordination among the county administrator, county mental health authorities, and the approved facilities designated to provide treatment within a service area as to admissions policies and patient-appropriate treatment. Although DPW may designate a state mental hospital’s functions — and in the case of Mayview, terminate its adolescent treatment program — it has no authority under either statute to designate the facility for a court-ordered commitment or to override, case by case, a designation of treating facility made by the county authorities and the patient’s treating psychiatrist. When the director of a facility or a member of its professional staff determines for clinical reasons that admission, or continued treatment, of a patient is not appropriate, the patient may be transferred according to the strict procedures set forth in the MHPA and the regulations.6 Disputes between the county administrator and DPW or a hospital director as to facility designations should be resolved among those parties; a facility cannot simply refuse to admit a court-committed patient.

*1118In this case, common pleas was within its jurisdiction to order that Bishop be committed to Mayview based on the recommendations of county authorities and Bishop’s treating psychiatrist. The court and the mental health professionals in attendance at the proceeding acknowledged Mayview’s lack of a treatment program for adolescents, but the court agreed to order commitment to Mayview based on their professional recommendation, and given Bishop’s state of mind, her treatment history at Mayview, and the fact that she did not need an adolescent program. Accordingly, Mayview had no recourse but admit Bishop for treatment, and it acted in contempt of the commitment order by arranging for Bishop’s transfer to another facility without following the procedures set forth in the MHPA.

Within the scope of its subject matter jurisdiction, a court of common pleas has inherent power to enforce its own orders and judgments. When Mayview failed to admit Bishop in accordance with the commitment order, the court had the inherent power to cite Mayview for contempt. The court need not have joined DPW and Mayview as indispensable parties in order to enforce its orders.7

In Commonwealth v. Alessi, 119 Pa.Cmwlth. 160, 546 A.2d 157 (Pa.Cmwlth.1988), petition for allowance of appeal denied, 524 Pa. 623, 571 A.2d 385 (1989), we addressed the issue of whether a court of common pleas, in the context of a commitment proceeding, had personal jurisdiction over DPW and its Secretary when it ordered DPW to fund the care of a patient committed involuntarily. We held that the court did not have personal jurisdiction to order DPW and its Secretary to do anything and therefore could not hold them in contempt for failure to obey.

This case is distinguishable both on its facts and in its resolution. In this case, the court ordered commitment to a designated state mental hospital on the recommendation of the county administrator and the patient’s treating physician as provided in the MHPA. The court therefore had the power to enforce its order by holding the hospital in contempt. In Alessi, we held that the common pleas court had no authority under the MH/MR Act to order that DPW fund the ordered commitment care and consequently no authority to enforce that order. In this case, we hold only that Mayview had no choice but to obey the commitment order and that the court of common pleas had the authority to enforce its order; we do not address the court’s jurisdiction over DPW or its authority to cite DPW for contempt.

ORDER

AND NOW, this 17 th day of September, 1998, the order of the Court of Common Pleas of Allegheny County joining DPW and Mayview as indispensable parties is reversed. The order directing Mayview to admit Bishop or face contempt charges and the transportation order are affirmed.

.Act of July 9, 1976, P.L. 817, as amended, 50 P.S. § 7305. This section of the Act provides for extended periods of court-ordered involuntary treatment based on the patient’s conduct during his or her most recent period of court-ordered treatment. The record reveals that Bishop’s most recent court-ordered treatment consisted of a 90-day period of treatment at St. Francis Medical Center beginning on June 5, 1997. The record shows that Bishop has been admitted to either voluntary or involuntary in-patient treatment almost continuously at least since early 1994.

. The hearing transcript designates Bishop's treating psychiatrist as Dr. Singer and also as Dr. Singerman.

. Act of October 20, 1966, Special Sess. No. 3, P.L. 96, as amended, 50 P.S. §§ 4101-4704.

. County commissioners, city councils, mayors of first class cities, or two or more of these acting in concert. Section 102 of the MH/MR Act, 50 P.S. § 4102.

. Catchment area refers to the geographical territory of a city, county, or combination of counties with population of 75,000 to 200,000 in which a full range of mental health services is available. 55 Pa.Code § 4210.1.

. Section 306 of the MHPA, 50 P.S. § 7306, and 55 Pa.Code § 5100.90 provide for transfer of court-committed patients in coordination with the county administrator and mental health authorities responsible for ensuring continuity of care and availability of services.

. Because the court of common pleas need not have joined Mayview and DPW as indispensable parties in order to enforce its commitment order, we do not address their claim that naming them as indispensable party defendants brought this matter within the exclusive jurisdiction of Commonwealth Court.