Asylums

An asylum founded and supported by the state has the status of a public institution. The state has the true ownership of the property that a state asylum occupies, and the character of the state's interest in such property is dependent upon the terms of the deed or contract under which it is held for the institution.

When a county conveys property to a board of directors of an insane asylum acting as trustees, title is not vested in the state to the extent that the power to reconvey the land to the county is restricted. In a situation in which property has been conveyed for a particular purpose connected to the operation of the asylum, it has been held that the trustees are permitted to reconvey the property to the county for the establishment of a general hospital.

Location and Support When no constitutional provision prescribing the location of public institutions exists, the state may designate a location or arrange for a place to be found by a specially appointed committee or commission.

A state asylum may be funded either by general state taxation or through an allocation of a portion or all of the costs among political subdivisions or to the inmates of the asylum.

Regulation Under the POLICE POWER of the state, the establishment and regulation of private asylums are subject to the state legislative authority. Such powers may be delegated to political subdivisions and administrative agencies. If legislative authority is delegated in such situations, guidelines and standards for regulatory enforcement must be present.

In order for a regulation to be valid, it must be reasonable, applied uniformly, and it must not infringe upon constitutional rights. A state or political subdivision cannot proscribe the lawful operation of an asylum or care facility or create or enforce unreasonable or ARBITRARY requirements regarding its construction or physical location. Similarly, it cannot make capricious requirements relating to the classification and nature of individuals to be admitted. Regulations and practices must comply with constitutional and statutory provisions.

The governing board of an asylum or institutional care facility is empowered to create all necessary rules and bylaws and is responsible for its policies and general administration. The courts will neither prescribe rules nor alter those created by the authorities, unless they are unreasonable or inappropriate.

Investigation and Inspection The legislature has the exclusive power to order an investigation of the management of an asylum or care facility. Private individuals may not conduct an investigation. When an investigation is initiated, the institution's governing board has the power to set forth regulations regarding relations with employees and patients and access to the

records. A nursing home operator must make records kept pursuant to a public health statute available for inspection by authorized public officials. In addition, a private facility can be required to turn over annual fiscal reports to a regulatory agency.

Statutory requirements for the safety of individuals in institutions are imposed and must be observed. Similarly, standards concerning the type of personnel needed to care for the patients are usually set forth, but they must not be unreasonable.

Licenses Ordinarily, a license is required to operate an asylum or institutional care facility in order to ensure that minimal health and safety requirements imposed by law are observed. When a license is necessary, operation of a facility without one may be enjoined and, under certain statutes, a contract made by an unlicensed person is void, which would bar recovery for necessaries provided for individuals. The procedure for procuring a license is governed by statute, and the state licensing authorities have the discretion concerning whether it should be granted. When there is a final decision, determinations in licensing proceedings may be subject to JUDICIAL REVIEW. The proceedings on judicial review are generally regulated by statutory provisions that limit the proceedings to those initiated by aggrieved individuals.

Under some statutes, before an institutional care facility can be built, a certificate of need, which establishes approval of its construction by a public agency, is required.