ASYLUMS
Establishments that exist for the aid and protec-
tion of individuals in need of assistance due to dis-
ability, such as insane persons, those who are
physically handicapped, or persons who are
unable to properly care for themselves, such as
orphans.
The term asylum has been used, in constitu-
tional and legislative provisions, to encompass
all institutions that are established and sup-
ported by the general public.
Asylums
An insane asylum is one in which custody
and care is provided for people with mental
problems. An orphanage is an asylum set up as a
shelter or refuge for INFANTS and children who
do not have parents or guardians.
Establishment and Maintenance
In the absence of constitutional restrictions,
the state is permitted to fulfill its obligation to
aid or support individuals in need of care by
contributions to care facilities established or
maintained by political subdivisions and private
charity. In addition, the state may inaugurate a
state asylum, delegating the management
responsibility thereof to a private corporation.
Some authorities view contributions to asylums
of religious organizations or private enterprises
as violative of constitutional prohibitions of
government aid to parochial institutions or
individuals. Express exceptions can be made by
state statute or constitution for the payment of
funds for designated purposes to specific types
of asylums. In situations that are embraced by
such exceptions, the contribution that the state
makes to the maintenance of the asylum is not
regarded as a charity but as part of the state’s
duty to aid its citizens who cannot do so them-
selves.
Public Asylums Ownership and Status
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 pur-
pose 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 constitu-
tional provision prescribing the location of pub-
lic 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 gen-
eral state taxation or through an allocation of a
portion or all of the costs among political subdi-
visions or to the inmates of the asylum.
Regulation Under the POLICE POWER of the
state, the establishment and regulation of pri-
vate asylums are subject to the state legislative
authority. Such powers may be delegated to
political subdivisions and administrative agen-
cies. If legislative authority is delegated in such
situations, guidelines and standards for regula-
tory 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 classifi-
cation and nature of individuals to be admitted.
Regulations and practices must comply with
constitutional and statutory provisions.
The governing board of an asylum or insti-
tutional 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 unrea-
sonable or inappropriate.
Investigation and Inspection The legisla-
ture has the exclusive power to order an investi-
gation 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 unrea-
sonable.
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 facil-
ity without one may be enjoined and, under cer-
tain statutes, a contract made by an unlicensed
person is void, which would bar recovery for
necessaries provided for individuals. The proce-
dure 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, determi-
nations in licensing proceedings may be subject
to JUDICIAL REVIEW. The proceedings on judi-
