Winnebago County v. A.A.L.

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.
March 24, 2021
A party may file with the Supreme Court a
Sheila T. Reiff 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. 2020AP1511 Cir. Ct. No. 2020ME135

STATE OF WISCONSIN IN COURT OF APPEALS
DISTRICT II

IN THE MATTER OF THE MENTAL COMMITMENT OF A.A.L.:

WINNEBAGO COUNTY,

PETITIONER-RESPONDENT,

V.

A.A.L.,

RESPONDENT-APPELLANT.

APPEAL from an order of the circuit court for Winnebago County:
TERESA S. BASILIERE, Judge. Affirmed.
No. 2020AP1511

¶1 REILLY, P.J.1 A.A.L. appeals from an order of the circuit court
involuntarily committing her under WIS. STAT. ch. 51.2 A.A.L. argues that
Winnebago County (the County) failed to establish that she is dangerous pursuant
to WIS. STAT. § 51.20(1)(a)2. We conclude that the evidence supports the circuit
court’s conclusion that A.A.L. is mentally ill, is a proper subject for treatment, and
is dangerous. Accordingly, we affirm.

Background

¶2 On March 19, 2020, A.A.L. was taken into custody on an emergency
detention under WIS. STAT. ch. 51. See WIS. STAT. § 51.15(5) (“The filing of the
statement [of emergency detention] has the same effect as a petition for
commitment under [WIS. STAT. §] 51.20.”). A circuit court commissioner held a
probable cause hearing on March 24, 2020, finding probable cause to support
A.A.L.’s continued detention and the administration of medication and treatment
subject to a final hearing.

1
This appeal is decided by one judge pursuant to WIS. STAT. § 752.31(2)(d) (2017-18).
All references to the Wisconsin Statutes are to the 2017-18 version unless otherwise noted.
2
The circuit court also entered an order for involuntary medication and treatment, which
may be entered following a finding by the circuit court that the subject is not competent to refuse
medication or treatment. See WIS. STAT. § 51.61(1)(g)3. While A.A.L.’s notice of appeal
indicates she is appealing from both orders, the medication and treatment order is not a final order
for the purposes of appeal. Moreover, A.A.L. challenges only the commitment order, and she
makes no argument that the circuit court erred in concluding that she is not competent to refuse
medication. Accordingly, we will address the order for involuntary medication and treatment no
further.

2
No. 2020AP1511

¶3 The following facts are taken from testimony presented at the
probable cause hearing.3 A.A.L.’s emergency detention resulted from an incident
on Oneida Street in downtown Appleton, Wisconsin. On that day, A.A.L. ran out
of gas and was stalled in traffic. As there was no shoulder to pull over onto, she
remained in the right lane of the four-lane street. The conditions on that day were
unfavorable: it was raining; it was dusk and growing dark; and there was “heavy
traffic flow.” A.A.L. did not have her lights or hazard lights on.

¶4 When a community service officer (CSO) arrived to assist her,
A.A.L. refused. Instead, she “attempted to flag down traffic in order to get
someone else’s attention” by “roll[ing] down her window and … waiving her
hands at traffic as it was passing.” The CSO sought to assist A.A.L. for about an
hour; each time A.A.L. would “roll up the window when the CSO would talk to
her.” A police officer eventually arrived on scene; she testified that A.A.L.’s
“demeanor was non-cooperative and relatively aggressive.”4 A.A.L. declined to
identify herself, but she suggested that her refusal to speak to the CSO was a result
of her belief that the officers “had deactivated her vehicle with their cell phones
and [she] blamed officers for her being stalled in traffic.”

¶5 Eventually, A.A.L.’s brother and mother arrived on the scene, and
after “lengthy negotiations,” were able to convince A.A.L. to exit her vehicle. Her

3
A.A.L. cited the testimony at her probable cause hearing in her briefs. While the
County observed that “this is an unusual occurrence,” it agreed that “providing some details about
[A.A.L.’s] detention and history of dangerousness found in the probable cause transcript” is
helpful. We agree and will do so as well.
4
The officer testified that A.A.L. “exhibited body language, behaviors of someone that
would have posed an imminent threat to officers,” including “the thousand-yard stare, staring off
in the distance, not appearing to look at anything, avoiding eye contact, body shifting movements,
[and] reaching around for things inside of the vehicle.”

3
No. 2020AP1511

brother testified that when A.A.L. did finally leave her vehicle, she “hit [the door]
forcefully” by “kick[ing] it open,” and her brother explained that “[i]f [he] would
have lost [his] footing, [A.A.L.] would have thrown [him] into traffic.” At that
point he reported being “afraid for myself, for my mom, and for my sister”; he did
not know “what her reaction would be,” as A.A.L. had previously “threatened
[their] mom.” A.A.L.’s brother also testified that there had been “multiple
occasions” in the preceding sixty to ninety days in which A.A.L. reported being
lost or stranded and in need of assistance. A.A.L. was eventually taken to the
hospital.

¶6 At the final commitment hearing, on April 2, 2020,
Dr. Marshall Bales, M.D., and Dr. Kevin W. Miller, Ph.D., testified. Each
opined that A.A.L. was mentally ill, a proper subject for treatment, and
dangerous.5 The circuit court concluded that the County had satisfied the
requirements under WIS. STAT. § 51.20(1)(a)1.-2., and it entered a six-month
commitment order, including a firearm ban, and an order for involuntary
medication and treatment. A.A.L. appeals.

Involuntary Commitment and Standard of Review

¶7 Pursuant to WIS. STAT. § 51.20(1)(a), to involuntarily commit an
individual, the county must establish by clear and convincing evidence that the
person is (1) mentally ill, (2) a proper subject for treatment, and (3) dangerous.
See § 51.20(1)(a)1.-2., (13)(e); Langlade County v. D.J.W., 2020 WI 41, ¶29, 391
Wis. 2d 231, 942 N.W.2d 277. Where the challenged order is an initial

5
The testimony of the examiners will be discussed in more detail later in the decision.

4
No. 2020AP1511

commitment, § 51.20(1)(a)2.a.-e. outlines “five different means of demonstrating
that a person is ‘dangerous.’” D.J.W., 391 Wis. 2d 231, ¶30. If any of those
subparagraphs are demonstrated, an individual is “dangerous.” Id. Whether the
county has met its burden under the statute is a mixed question of fact and law.
Id., ¶24. “[W]e will uphold a circuit court’s findings of fact unless they are clearly
erroneous,” meaning that they are “against the great weight and clear
preponderance of the evidence.” Id. “Whether the facts satisfy the statutory
standard is a question of law that we review de novo.” Waukesha County v.
J.W.J., 2017 WI 57, ¶15, 375 Wis. 2d 542, 895 N.W.2d 783. We now address the
issues raised by A.A.L. on appeal.

Mootness

¶8 As an initial matter, A.A.L. concedes that the initial commitment
order in this case has expired. A.A.L. argues, however, that her appeal is not moot
as her commitment carries collateral consequences for her, including the firearms
ban, “the stigma associated with an involuntary commitment,” and possible travel
restrictions.

¶9 We agree that the issue is not moot. Whether an issue is moot is a
question of law that we review de novo. Marathon County v. D.K., 2020 WI 8,
¶16, 390 Wis. 2d 50, 937 N.W.2d 901. “An issue is moot when its resolution will
have no practical effect on the underlying controversy.” Id., ¶19 (citation
omitted). Our supreme court has “previously concluded that an expired initial
commitment order is moot,” but where an individual remains “subject to the
lasting collateral consequence of a firearms ban” after the order has expired, the
expired commitment order is “not moot.” Id., ¶¶22, 25. Here, A.A.L.’s
commitment order expired on October 2, 2020. The involuntary commitment

5
No. 2020AP1511

order also contained a firearms restriction, which did not terminate with the
expiration of the order. See WIS. STAT. § 51.20(13)(cv)1m. Therefore, as the
County concedes, A.A.L.’s appeal is not moot.

Procedural Due Process

¶10 A.A.L. next argues, for the first time on appeal, that she was denied
procedural due process, as she “did not receive particularized notice of which
standard of dangerousness was alleged.” A.A.L. concedes, however, that she did
not object to notice in the circuit court, nor did she request clarification or an
adjournment of the hearing to properly prepare. She argues that we should still
reach this issue on the merits “because the facts with respect to this issue are
undisputed and the case presents an issue of law.”

¶11 A.A.L. cites to Lessard v. Schmidt, 349 F. Supp. 1078 (E.D. Wis.
1972), vacated and remanded, 414 U.S. 473 (1974), reinstated, 413 F. Supp. 1318
(E.D. Wis. 1976). There, the court explained that an individual subject to an
involuntary commitment must receive notice “‘sufficiently in advance of
scheduled court proceedings so that reasonable opportunity to prepare will be
afforded,’ and it must set forth the basis for detention with particularity.” Id. at
1092 (citation omitted). The County argues that A.A.L. was not denied procedural
due process, as the dangerousness standards that applied at her final hearing “were
clearly stated in the supporting court documents and explained with expert
testimony.” A.A.L. admits in her brief that the reports from the examiners
identified the dangerousness standards that the examiners felt were applicable:
Bales’ report checked the boxes of the third and fourth standard and Miller
checked the box for the fifth standard.

6
No. 2020AP1511

¶12 We decline to reach the merits of this argument, as A.A.L. has
forfeited this argument. “Arguments raised for the first time on appeal are
generally deemed forfeited.” State Farm Mut. Auto. Ins. Co. v. Hunt, 2014 WI
App 115, ¶32, 358 Wis. 2d 379, 856 N.W.2d 633 (citation omitted). “The
[forfeiture] rule is not merely a technicality or a rule of convenience; it is an
essential principle of the orderly administration of justice.” State v. Huebner,
2000 WI 59, ¶11, 235 Wis. 2d 486, 611 N.W.2d 727. “The purpose of the
‘forfeiture’ rule is to enable the circuit court to avoid or correct any error with
minimal disruption of the judicial process, eliminating the need for appeal.” State
v. Ndina, 2009 WI 21, ¶30, 315 Wis. 2d 653, 761 N.W.2d 612. A.A.L. has
provided no persuasive reason for us to discount the importance of the forfeiture
rule and reach the merits on this issue, and we decline to do so.

¶13 Even if we were to set aside the forfeiture issue, A.A.L.’s arguments
fail to persuade us that reversal is necessary under any theory. While A.A.L.
argues that her hearing “strategy” would have differed depending on the
dangerousness standard the County was proceeding under, she does not argue or
provide any evidence that defense counsel was ill-prepared or needed more time.
See WIS. STAT. § 51.20(10)(c) (“The court shall, in every stage of an action,
disregard any error or defect in the pleadings or proceedings that does not affect
the substantial rights of either party.”). She does make suggestions as to how
defense counsel might have prepared differently based on the different standards;
yet, she concedes that defense counsel addressed many of those issues during
cross-examination at the probable cause and final hearings. A.A.L. does note that
if the County were proceeding under the third, fourth, or fifth standard, counsel
may have “attempted to locate witnesses to support a claim that A.A.L. had
adequate support in the community to assist her with meeting her basic needs.”

7
No. 2020AP1511

As A.A.L. admits, however, the examiners’ reports indicated the standards the
examiners believed were applicable to A.A.L., which included the third, fourth,
and fifth standard. Thus, defense counsel was well aware that those standards
were at issue. Further, those examiners’ reports, the Statement of Emergency
Detention by Law Enforcement Officer, and the testimony at the probable cause
hearing provided sufficient notice of the basis for her involuntary commitment and
all the facts upon which the County planned to proceed at the final hearing. See
Adams County v. D.R.D., No. 2020AP1426, unpublished slip op. ¶¶21-22 (WI
App Jan. 28, 2021); Winnebago County v. D.D.A., No. 2020AP1351, unpublished
slip op. ¶¶9-14 (WI App Dec. 23, 2020).6

¶14 A.A.L. also argues that this case presents the same issue our
supreme court noted with concern in D.J.W., that where it is unclear which
subdivision paragraph of WIS. STAT. § 51.20(1)(a)2. the commitment is based, it
creates a “moving target.” D.J.W., 391 Wis. 2d 231, ¶36. D.J.W. was released
after the final hearing in this case. While acknowledging that our supreme court’s
decision in D.J.W., requiring courts to reference the specific subdivision
paragraph of § 51.20(1)(a)2., was prospective, id., ¶59 (“going forward”), she
“contends … that due process requires that the D.J.W. requirement apply to her
case as well.” A.A.L. does not support her conclusory assertion with any
argument or legal authority. See State v. Pettit, 171 Wis. 2d 627, 646-47, 492
N.W.2d 633 (Ct. App. 1992) (noting we can “decline to review issues
inadequately briefed”); see also Associates Fin. Servs. Co. of Wis. v. Brown, 2002
WI App 300, ¶4 n.3, 258 Wis. 2d 915, 656 N.W.2d 56 (stating we do not consider

6
We cite to these unpublished cases for persuasive authority. See WIS. STAT.
RULE 809.23(3)(b).

8
No. 2020AP1511

conclusory assertions and undeveloped arguments). Further, we have previously
determined that D.J.W.’s directive “is inapplicable” where the commitment order
predates D.J.W., and, under those circumstances, failure to make the required
findings with reference to § 51.20(1)(a)2. “cannot compel reversal.” Winnebago
County v. S.H., 2020 WI App 46, ¶14, 393 Wis. 2d 511, 947 N.W.2d 761.

Sufficiency of the Evidence: Dangerousness

¶15 Finally, A.A.L. argues that the testimony presented was insufficient
to establish that she is dangerous, pursuant to WIS. STAT. § 51.20(1)(a)2.7 She
claims that she was “left to guess which standard of dangerousness the evidence is
to be applied to.” The circuit court also did not specify under which subparagraph
of § 51.20(1)(a)2.a.-e. it was basing its conclusion that the County had satisfied
the statute. The County argues that “[t]he third of the five standards of
dangerousness applies most directly to A.A.L.”

¶16 Consistent with the County’s argument, we will address the
sufficiency of the evidence as it relates to WIS. STAT. § 51.20(1)(a)2.c. This
subparagraph provides that an individual is dangerous when he or she

[e]vidences such impaired judgment, manifested by
evidence of a pattern of recent acts or omissions, that there
is a substantial probability of physical impairment or injury
to himself or herself or other individuals. The probability
of physical impairment or injury is not substantial under
this subd. 2.c. if reasonable provision for the subject
individual’s protection is available in the community and
there is a reasonable probability that the individual will
avail himself or herself of these services, if the individual
may be provided protective placement or protective
services under [WIS. STAT.] ch. 55, or, in the case of a

7
A.A.L. does not challenge the finding that she is mentally ill and a proper subject for
treatment under WIS. STAT. § 51.20(1)(a)1.

9
No. 2020AP1511

minor, if the individual is appropriate for services or
placement under [WIS. STAT. §] 48.13(4) or (11) or [WIS.
STAT. §] 938.13(4). The subject individual’s status as a
minor does not automatically establish a substantial
probability of physical impairment or injury under this
subd. 2.c. Food, shelter or other care provided to an
individual who is substantially incapable of obtaining the
care for himself or herself, by a person other than a
treatment facility, does not constitute reasonable provision
for the subject individual’s protection available in the
community under this subd. 2.c.

Sec. 51.20(1)(a)2.c. A.A.L. argues that the testimony presented by Dr. Bales and
Dr. Miller at the final hearing was insufficient to establish that there is a
“substantial probability of physical impairment or injury.” We disagree.
Although a close case, we conclude that the evidence presented at the hearing was
legally sufficient to meet the third statutory standard for dangerousness.

¶17 On appeal, the County conceded that “the [C]ounty and the trial
court could have done more to create a better record in this case. More facts could
have been developed through testimony and the court could have supported its
findings with more facts.” We agree with the County’s assessment. Given our
supreme court’s decision in D.J.W.—released after the final hearing in this case—
our expectation is that this will be the last year a petitioner in a mental
commitment case will need to make such a concession. See D.J.W., 391 Wis. 2d
231, ¶59.8 These cases should be held to the highest legal standards. As our
supreme court explained in D.J.W.,

the purpose of making specific factual findings with
reference to a subdivision paragraph of WIS. STAT.
§ 51.20(1)(a)2. is twofold. First, it provides clarity and

8
We recognize that Langlade County v. D.J.W., 2020 WI 41, ¶59, 391 Wis. 2d 231, 942
N.W.2d 277, specifically dealt with recommitment proceedings, but we see no reason why the
court’s mandate would not apply for initial commitments as well. The “purpose of making
specific factual findings” is equally applicable to initial commitments. See id., ¶¶42-44.

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No. 2020AP1511

extra protection to patients regarding the underlying basis
for a recommitment. The United States Supreme Court
“repeatedly has recognized that civil commitment for any
purpose constitutes a significant deprivation of liberty that
requires due process protection.” Addington v. Texas, 441
U.S. 418, 425 (1979). “Freedom from physical restraint is
a fundamental right that ‘has always been at the core of the
liberty protected by the Due Process Clause from arbitrary
governmental action.’” State v. Post, 197 Wis. 2d 279,
302, 541 N.W.2d 115 (1995) (quoting Foucha v.
Louisiana, 504 U.S. 71, 80 (1992)).

With such an important liberty interest at stake, the
accompanying protections should mirror the serious nature
of the proceeding. Requiring circuit courts to provide
specific factual findings with reference to the subdivision
paragraph of WIS. STAT. § 51.20(1)(a)2. on which the
recommitment is based provides increased protection to
patients to ensure that recommitments are based on
sufficient evidence.

Id., ¶¶42-43 (footnote omitted).

¶18 At the final hearing, both Bales and Miller testified.9 Bales testified
that he met with A.A.L. in person for about thirty or forty minutes and also
reviewed all of A.A.L.’s treatment records.10 He opined, based on this review and
his examination of A.A.L., that she has a mental illness: bipolar disorder with
psychotic features. When asked for his opinion on whether A.A.L. “is either a
danger to herself or others,” Bales responded,

The main dangerousness is that she is so psychotic and
catatonic that she is unable to care for her basic needs, but

9
We note that although the County requested that the examiners’ reports be entered into
evidence, the court never ruled on that request. Since Bales’ and Miller’s reports were not
entered into evidence, we review only their testimony at the hearing. See D.J.W., 391
Wis. 2d 231, ¶7 n.4; Winnebago County v. S.H., 2020 WI App 46, ¶2 n.3, 393 Wis. 2d 511, 947
N.W.2d 761.
10
Bales reported that A.A.L. recognized him during the examination, and when she
mentioned this, Bales remembered he “was her psychiatrist years ago.” He noted on cross-
examination that he “did treat her many years ago which does not impede [his] ability to be
independent.”

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No. 2020AP1511

also she was at such grossly impaired judgment that she
was wandering around when her car stalled or something or
ran out of gas on Oneida Street and I think that was also
dangerous.[11]

Bales testified that he “directly observed her to be in a very disorganized mental
state, catatonic, unable to have a detailed coherent conversation, and it was very
clear to me that just from that observation that she was in a very psychotic state
and would be unable to care for her basic needs. That was a direct observation.”
He reported that, based on A.A.L.’s treatment records, her “apartment was in
shambles” with “[r]otten food around.”12 “The refrigerator was unplugged with
rotting food; had not paid her rent; and was quote, an absolute mess, end quote.”

¶19 Miller also testified to his opinions regarding A.A.L. Miller was not
able to examine A.A.L., as on the day he called, the nurse explained that A.A.L.
“was not able to respond intelligently to her request to come to speak with [Miller]
on the phone.” Miller, like Bales, also testified that A.A.L. has bipolar disorder,
type one, with psychosis. He explained that A.A.L. is a proper subject for
treatment as her bipolar disorder is “highly treatable,” and “when she has been
compliant in the past she has responded well.” Based solely on a record review,

11
On cross-examination, defense counsel challenged Bales’ suggestion that “she was
running around on the road,” asking him to identify where in the petition it indicated that A.A.L.
was doing so and stating that there was no testimony on this at the probable cause hearing. Bales
responded, “She was not running but she told me that she got out of her car and was in the rain.
She was not running…. [S]he said that she was wandering around and she admitted she was
confused and getting rained on.” Bales explained that A.A.L. told him this when he “reviewed”
the “detention document” with her during the examination. We note that the statement of
emergency detention does state that “[o]nce [A.A.L.] exited her vehicle she stood in the rain in
the lane of traffic.”
12
During the hearing, defense counsel objected to much of Bales’ testimony based on
hearsay. At several points, the court required the County to establish a better foundation, but
after recognizing that Bales’ opinions were based on information he obtained from A.A.L.’s
treatment records, the court allowed the testimony. See WIS. STAT. § 907.03. A.A.L. does not
raise her hearsay objection to Bales’ testimony again on appeal.

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No. 2020AP1511

Miller also opined that A.A.L. had met the standard for dangerousness,
specifically as can be inferred from his testimony, the fifth standard. According to
Miller,

One of the issues was her being on Oneida Street in
Appleton, and I took a look at the descriptions so there is a
possibility of harm to her in the future. As, again, required,
we have to look is it a substantial probability in the future,
and I felt that her behavior when officers detained her was
certainly a risk of harm but not a substantial risk of harm in
the future based upon her mental illness.

So for me what I placed weight on was very clear
documentation that she has received mental health
treatment beginning in or about 2011 for bipolar disorder;
that she stopped treatment regularly at various times; and
when she did, she developed paranoia and manic stage;
thus, that she was not able to, in this case, navigate a
vehicle and then get assistance properly when she ran out
of gas.

She had not been able to pay her rent. She had lost her
job. She had rotten food, per collateral records, in her
apartment, and family had reported that she had periods of
violence over the past year so all of that collectively
suggested she had lost volitional control over her thoughts,
moods, and behaviors. She had the risk of benefits and
alternatives of medication explained to her but she refused;
and, therefore, to prevent further deterioration of her
condition and get her back to a baseline mental state, she
met the standard for dangerousness.

¶20 Based upon the above evidence, the circuit court found that the
County had established the dangerousness element by clear, satisfactory, and
convincing evidence. The court observed that the finding of a mental illness had
essentially been “stipulated to.” As to dangerousness, the court found that “the
standard of dangerousness is met”:

[T]he impairment here is one in which she constitutes a
substantial risk of harm to herself; specifically, the Court
took into consideration the apartment being in shambles,
there being rotted food, wandering after running out of gas,
and her being catatonic and unable to articulate her needs.

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No. 2020AP1511

¶21 We see no error. The fact that A.A.L.’s car ran out of gas or stalled
on the side of a busy street in downtown Appleton is not in dispute. The circuit
court concluded that A.A.L. was then “wandering” around in the rain because she
was “catatonic” and “unable to articulate her needs.” These findings by the court
are supported by the evidence and a weighing of the credibility of the witnesses.
This is also not the first time in the preceding months that A.A.L. needed
assistance while driving in her vehicle. As the examiners put it, A.A.L.’s
judgment was “grossly impaired.” She “developed paranoia and manic stage” as a
result of stopping treatment, and “she was not able to, in this case, navigate a
vehicle and then get assistance properly when she ran out of gas.” There is no
question this was a dangerous situation. There is also no question that A.A.L.’s
behavior on that day, as a result of her mental illness, could have easily resulted in
injury to A.A.L., those who were attempting to assist her, or other motorists on the
road.

¶22 Additionally, when Bales met with A.A.L. she was “in a very
disorganized mental state, catatonic, unable to have a detailed coherent
conversation,” and in a “very psychotic state,” which he opined meant that she
“would be unable to care for her basic needs.” As the court noted, her apartment
was in “shambles” and there was “rotting food” as a result of her refrigerator being
unplugged. She had lost her job and was unable the pay her rent. This pattern of
behavior—or acts or omissions—all indicate an inability to “care for her basic
needs,” which under certain innumerable circumstances, as demonstrated by the
Oneida Street incident, would create “a substantial probability of physical
impairment or injury” to herself or others.

¶23 While, as stated previously, we agree that the County and the court
could and should have done more to develop a record in this case—at a minimum

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No. 2020AP1511

by entering the examination reports into evidence absent an objection from
A.A.L.—we conclude that the evidence presented at the final hearing was
sufficient to establish “impaired judgment” such “that there is a substantial
probably of physical impairment or injury” to A.A.L. or others.13 See WIS. STAT.
§ 51.20(1)(a)2.c. Accordingly, A.A.L. is mentally ill, a proper subject for
treatment, and dangerous as defined under § 51.20(1)(a)2.c. We affirm the circuit
court’s commitment order.

By the Court.—Order affirmed.

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

13
We note that A.A.L. does not make an argument about the second part of WIS. STAT.
§ 51.20(1)(a)2.c., which notes that the probability of physical impairment or injury under that
statute is not substantial “if reasonable provision for the subject individual’s protection is
available in the community and there is a reasonable probability that the individual will avail
himself or herself of these services.” We acknowledge that the County must prove all the
required facts by clear and convincing evidence, and we note that the circuit court did not make
any findings on this issue. Regardless, whether the facts satisfy the statutory standard for
dangerousness is a question of law that we review independently.

In this case, we conclude the County presented sufficient facts to establish that it was not
reasonably probable that A.A.L. would avail herself of services in the community. For example,
at the final hearing, Bales testified that A.A.L. had “been off of her medication for a year” and
was not able to “reasonably or rationally discuss [the medication] at all.” Miller testified that
A.A.L. “had the risk [and] benefits and alternatives of medication explained to her but she
refused,” and was “refusing treatment after the staff did speak with her about treatment options.”
Therefore, on this record, the County met its burden to prove that it was not reasonably probable
that A.A.L. would avail herself of services in the community because she went off her
medication, and even after the benefits were explained to her, she refused treatment.

15