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You can search the entire site. or go to the recent opinions, or the chronological or subject indices. In the Matter of the Protective Proceedings of Tiffany O. (7/24/2020) sp-7471

In the Matter of the Protective Proceedings of Tiffany O. (7/24/2020) sp-7471

           Notice:   This opinion is subject to correction before publication in the P                      ACIFIC  REPORTER.  

           Readers are requested to bring errors to the attention of the Clerk of the Appellate Courts,  

                                                                                                                           

           303 K Street, Anchorage, Alaska 99501, phone (907) 264-0608, fax (907) 264-0878, email  

                                                                                                                              

           corrections@akcourts.us.  



                       THE SUPREME COURT OF THE STATE OF ALASKA                                         



In  the  Matter  of  the  Protective                               )  

Proceedings  of                                                    )    Supreme  Court  No.  S-17192  

                                                                   )  

                    

TIFFANY O.                                                                                                                          

                                                                   )    Superior Court No. 3AN-07-01380 PR  

                                                                   )  

                                                                                             

                                                                   )    O P I N I O N  

                                                                   )  

                                                                                                           

                                                                   )    No. 7471 - July 24, 2020  



                                                                                                                 

                                             

                      Appeal from the Superior Court of the State of Alaska, Third  

                                                                                              

                      Judicial District, Anchorage, Eric Aarseth, Judge.  



                                                                                                                   

                      Appearances: Rachel O., pro se, Anchorage, Appellant. Erik  

                                                                                                                   

                      A.  Fossum,  Assistant  Attorney  General,  Anchorage,  and  

                                                                                                                      

                      Kevin G. Clarkson, Attorney General, Juneau, for State of  

                                                                                                            

                      Alaska, Department of Health and Social Services, Division  

                                                                                                        

                      of  Senior  and  Disabilities  Services,  and  Adult  Protective  

                                                                                                                  

                      Services, Appellees. Notice ofnonparticipation filed by Julie  

                                                                                                            

                      L.  Webb, Office of Public Advocacy, Adult and Juvenile  

                                                                                                                           

                      Representation Section, Anchorage, for Appellee Tiffany O.  

                                                                                       

                      No appearance by Appellee Martha S.  



                                                                                                          

                      Before:  Bolger, Chief Justice, Winfree, Stowers, Maassen,  

                                            

                      and Carney, Justices.  



                                                    

                      BOLGER, Chief Justice.  



I.         INTRODUCTION  



                                                                                                                                          

                      A daughter was appointed as guardian for her mother, a woman in her 60s  



                                                                                                                                           

who suffers from epilepsy.  The daughter relied on faith-based medicine to care for her  


----------------------- Page 2-----------------------

mother,   electing   to,   in   one   instance,  pray   over   her   mother   after   she   became  



nonresponsive instead of calling emergency services.                                                                                            The superior court ultimately                       



removed the daughter as guardian, finding that her behavior and "intractable belief                                                                                                                            



system" caused her to deprive her mother of appropriate services and care.                                                                                                                        



                                  We conclude that the superior court did not abuse its discretion when it                                                                                                                 



removed the daughter as her mother's guardian.                                                                                 We also conclude that removing the                                                     



daughter   as guardian did                                           not violate the Alaska Constitution's free exercise clause                                                                              



because the State possessed a compelling interest in preventing harm to the mother.                                                                                                                



II.              FACTS AND PROCEEDINGS                  



                 A.               Facts  

                                                              1  developed epilepsy early in childhood and suffers regularly  

                                  Tiffany O.                                                                                                                                                           



from seizures. She was also diagnosed with intellectual disability and was described by  

                                                                                                                                                                                                                        



the court visitor as "unable to engage in a meaningful conversation."  In 2007 Tiffany's  

                                                                                                                                                                                                       



daughter Rachel petitioned for the appointment of a guardian for Tiffany.  She noted  

                                                                                                                                                                                                                



Tiffany's long-standing diagnosis of epilepsy, inability to secure long-termhousing, and  

                                                                                                                                                                                                                      



intellectual disability.  Rachel did not want to be Tiffany's guardian at the time due to  

                                                                                                                                                         



ongoing family conflict and her own caretaking duties for her two children.  In March  

                       



2008 the superior court appointed the Office of Public Advocacy to serve as Tiffany's  

                                                                                                                                                                                                      

public guardian.2  

                                              



                                  After a period of working well together, the relationship between Rachel  

                                                                                                                                                                                      



and  the  public  guardian  soured.                                                         In  September  2010,  after  becoming  increasingly  

                                                                                                                                                                                              



                 1                We use pseudonyms to protect the parties' privacy.                                                              



                 2                The  guardianship  appointment  also  included  conservator  power.                                                                                                                See  

                                                                                                                                                                                                                   

AS  13.26.316  (addressing  general  powers  and  duties  of  guardians);  AS  13.26.520  

                                                                                                                                                                                                   

(addressing appointment and general duties of conservators).  

                                                                                                                         



                                                                                                            -2-                                                                                                   7471
  


----------------------- Page 3-----------------------

                                                                                                                               

frustrated  with  the  public  guardian,  Rachel  twice  petitioned  for  review  of  the  



                                                                                                  

guardianship.  In June 2011 Rachel was appointed as Tiffany's guardian.  



                                                                                                                                  

                    Rachel saw herself as Tiffany's "spiritual authority" due to her training in  



                                                                                                                          

ministry. Furthermore, she believed that, because she graduated from a ministry school,  



                                                                                                                                      

she was justified in "rely[ing] entirely on prayer in lieu of hospital care" for her mother.  



                                                                                                                                  

Rachel, in a July 2018 motion for reconsideration, provided the court with an excerpt of  



                                                                                                                          

the "About Us" section of her school of ministry's website which states, "As people  



                                                                                                                                    

come before the Lord in repentance [and] forgiveness, destroying the lies of Satan, . . .  



                                                                                                                            

most emotional [and] physical diseases are healed [and] bodies return to peace [and]  



                            

proper function."  



                                                                                                                      

                    By 2016 Rachel was concerned about whether her mother was receiving  



                                                                                                                         

the right medication.  In an email to the court visitor, Rachel reported that when Tiffany  



                                                                                                           

had  seizures,  Rachel  prayed  for  her.                    She  stated  that  it  was  up  to  Tiffany  to  self- 



                                                                                                                                

administer her own medications.  She also wrote that "psych meds aren't God!; nor are  



                                                    

they life preserving, nor are they healing!"  



                                                                                                                        

                    Rachel's behaviors and beliefs prevented Tiffany from receiving valuable  



                                                                                                                               

medical services.  In 2016 Rachel fired Tiffany's personal care assistant.  Tiffany's care  



                                                                                                                              

was "consumer directed," meaning Tiffany's guardian could select an approved care  



                                                                                                                                

provider for Tiffany, and the contract company, Easter Seals in this case, would pay for  



                                                                                                                              

the personal care assistant services. After the firing, Easter Seals ended its contract with  



                                                                                                                        

Tiffany,  citing  concerns  that  "the  home  environment  is  much  too  volatile,  appears  



                                                                                                                       

unsafe[,] and is not an appropriate situation for [Easter Seals] staff" due to Rachel's  



                                                            

hostile behavior and communications.  



                                                                                                                       

                    Thecourtvisitor'sreport containedlettersfromtwo personal careproviders  



                                                                                                                              

and the State's Division of Senior and Disability Services.   The two personal care  



                                                                -3-                                                         7471
  


----------------------- Page 4-----------------------

                                                                                                                               

providers explained they were ending services for Tiffany because of Rachel, and the  



                                                                                                                          

Division of Senior and Disability Services stated that Tiffany was in danger of losing  



                                                                                                                                     

state funding for personal care services if Rachel did not provide proper documentation.  



          B.        Proceedings  



                                                                                                                                 

                    In June 2017 the Office of Public Advocacy filed a petition for review of  



                                                                                                                                     

guardianship after receiving a report that Rachel was financially exploiting Tiffany.  



                                                                                                                              

Tiffany's daughter Martha also filed a petition for review of guardianship in June.  She  



                                                                                                                                     

alleged that Rachel was either physically abusing their mother or failing to keep her safe.  



                                                                                                                           

An attorney was appointed to represent Tiffany in early July.   In September Adult  



                                                                                                                          

Protective Services filed a motion to intervene due to additional reports accusing Rachel  



                                                                                                                    

of financial exploitation and physical abuse.   Proceedings began before a magistrate  



                                                                                               

judge on September 12, 2017, and ended on January 2, 2018.  



                                                                                                                        

                    During  the  proceedings,  witnesses  described  two  instances  of  Tiffany  



                                                                                                                            

enduring physical harm.  Rachel also described these instances in emails to the court  



                                                                                                                               

visitor. The first occurred over Memorial Day weekend in 2017, when Tiffany fell in the  



                                                                                                                                

garage while Rachel was sleeping.   Rachel decided to spray hydrogen peroxide on  



                                                                                                                               

Tiffany's face to treat the injury.  Rachel testified before the superior court that she did  



                                                                                                              

not seek immediate medical care for Tiffany because she believed that doctors would  



                                                                                                                              

have just told her that Tiffany had a concussion and to watch Tiffany while she was  



                                                                                                                                 

sleeping.  Rachel stated in an email to the court visitor that she refrained from going to  



                                                                                                  

the doctor because "all they would've done is document it all."  



                                                                                                                           

                    During the second incident, in October or November 2017, Rachel asked  



                                                                                                                              

a family friend to come over and pray over her mother.  The family friend testified that  



                                                                                                                             

when he arrived he found Tiffany lying on the floor.  He described her as "not very  



                                                                                                    

responsive."  Together, they moved her to the couch and prayed.  



                                                                -4-                                                        7471
  


----------------------- Page 5-----------------------

                                                    In                August                                2018                         the                  superior                                 court                         adopted                                 the                   magistrate's  



recommendation to remove Rachel as guardian.                                                                                                                                                     The superior court remarked that a                                                                                                         



"conventional approach" to decision-making for a ward and "a faith-based, holistic                                                                                                                                                                                                                                  



view" are "not necessarily in opposition."                                                                                                                              However, in this case, "the situation [had]                                                                                                          



come to a head."                                                   The superior court was primarily concerned with Rachel's "hostility,                                                                                                                                                                    



bordering on paranoia, toward outside entities" that ensure that Tiffany gets the care she                                                                                                                                                                                                                                           



needs.   The superior court found that Rachel's "deeply held convictions about medical                                                                                                                                                                                                                             



care and state agencies" and her "intractable belief system" prevented her from pursuing                                                                                                                                                                                                                        



reasonable care options for her mother.                                                                                                                   The superior court was particularly alarmed by                                                                                                                                



the incident described by Rachel's witness when Rachel and family friends elected to                                                                                                                                                                                                                       



pray over Tiffany rather than call an ambulance.                                                                                                                                                        The superior court found that the                                                                                            



"Office of Public Advocacy should be substituted as guardian                                                                                                                                                                                                    and  conservator   for  



 [Tiffany]."   Rachel appeals the superior court's order.                                                                                                                                  



III.                       STANDARD OF REVIEW                                                      



                                                    We review an order granting a request to remove a guardian under an abuse                                                                                                                                                                                               

                                                                                      3  "The superior court abuses its discretion if it considers improper  

of discretion standard.                                                                                                                                                                                                                                                                                       



factors, fails to consider statutorily mandated factors, orassigns too much weight to some  

                                                                                                                                                                                                                                                                                                                              

factors."4   "Questions of statutory interpretation and constitutional law are . . . reviewed  

                                                                                                                                                                                                                                                                                                       

de novo."5  

                                           



                          3                         H.C.S.  v. Cmty. Advocacy Project of Alaska, Inc. ex rel. H.L.S.                                                                                                                                                                                           , 42 P.3d        



 1093, 1096 (Alaska 2002) (citing 39 A                                                                                                                   M. J   UR. 2                       D  Guardian and Ward                                                                     § 40 (1999)).                                          



                          4                         Id .
  



                          5
  

                                                                                                                                                                                                                                     

                                                    Huffman v. State, 204 P.3d 339, 343 (Alaska 2009).  



                                                                                                                                                                    -5-                                                                                                                                                        7471
  


----------------------- Page 6-----------------------

IV.	      DISCUSSION  



                                                                                                                     

          A.	       The Superior Court Did Not Abuse Its Discretion When It Removed  

                                                       

                    Rachel As Tiffany's Guardian.  



                                                                                                                               

                    Under Alaska Statute 13.26.286, the court may remove a guardian and  



                              6  

                                                                                                                               

appoint a successor.             The process for removing a guardian requires that a petitioner first  



                                                                                                               

demonstrate that there has  been  a change in circumstances since the guardian  was  



                7  

                                                                                                                                

appointed.          Then "the court must decide whether the existing appointment is in the  



                                  8  

                    

ward's best interests." 



                                                                                                                                   

                    The record supports the superior court's determination that there was a  



                                                                                                                      

change  in  circumstances.                  Rachel  became  Tiffany's  guardian  in  2011.                            By  2016  



                                                                                                                             

allegations arose concerning Rachel neglecting Tiffany's needs.  These concerns were  



                                                                                                                              

about Tiffany being physically abused and financially exploited. Rachel disagreed with  



                                                                                                                               

the opinions of medical doctors regarding her mother's medication.   In at least one  



                                                                                                                                 

instance, Rachel did not seek medical attention when her mother was nonresponsive. As  



                                                                                                                         

thesuperior courtstated, "Given [Rachel]'s strong beliefs and resistanceto other options,  



                                                        

the situation [had] come to a head."  



                                                                                                                       

                    Alaska Statute 13.26.311(d) dictates who has priority to serve as a guardian  



                                                                                                                               

of an incapacitated person.   The adult child of an incapacitated person typically has  

                                                  9   However, AS 13.26.311(f) provides that "in the best  

                                                                                                                               

priority over the public guardian. 



interest of the incapacitated person" the court may decline to appoint the person who has  

                                                                                                                                



          6         AS   13.26.286(a)(2)(B)   ("On   petition   of   the   ward,   the   guardian,   or   any  



person  interested  in  the  ward's  welfare, or on  the  court's  own  motion,  the  court  may  

.  .  .  remove  a  guardian  and  appoint  a  successor").  



          7         H.C.S., 42 P.3d at 1099.  

                                                  



          8         Id.  



          9         AS  13.26.311(d).  

                           



                                                                -6-	                                                        7471
  


----------------------- Page 7-----------------------

priority under section (d).                   "If the court appoints a person with a lower priority" then it                                      



"shall   make   appropriate   written   findings   related   to   why   the   best   interests   of   the"  

incapacitated person necessitate the appointment of the lower priority individual.                                                        10  



                                                                                                                                        

                       In H.C.S. v. Community Advocacy Project of Alaska, we discussed several  



                                                                                                                                       

important  factors  for  a  court  to  consider  when  determining  whether  a  current  

                                                                    11   The court should first "take into account the  

                                                                                                                                               

appointment is in a ward's best interest. 

closeness of the ward's relationships to the existing and prospective guardians."12  Next,  

                                                                                                                                           

the court can examine "[t]he length and quality of the existing appointments."13                                                             The  

                                                                                                                                             



court can also consider "[o]ther circumstances [that] may . . . be relevant in particular  

                                                                                                                                    

cases."14  



                       In this case, while Rachel is Tiffany's daughter and cared for Tiffany as her  

                                                                                                                                               



guardian for several years, the superior court correctly noted that Rachel's beliefs and  

                                                



behavior constituted a barrier to Tiffany getting her needs met.  The court pointed out  

                                                                                                                                               



that, due to her condition, Tiffany needs a guardian to make "objective decisions" for  

                                                                                                                                               



her.  The superior court noted that a history of family tension and Rachel's "hostility,  

                                                                                                                                   



bordering on paranoia, toward outside entities" resulted in Tiffany "losing valuable  

                                                                                                                                     



services and resources to which she is entitled."  

                                                                                    



                       The superior court also noted that Rachel's belief system "foreclose[d] her  

                                                                                                                                               



willingness to consider other options" when it comes to obtaining medical care for her  

                                                                                                                                               



            10         AS   13.26.311(f).  



            11         42  P.3d  at   1099-1100.  



            12         Id.   at   1099   ("This   inquiry   gives   weight   to   the   substantive   values   that  



apparently  underlie  the  statutory  priorities  for  appointing  guardians  and  conservators.").  



            13         Id.  at   1100.  



            14         Id.  



                                                                       -7-                                                                 7471
  


----------------------- Page 8-----------------------

mother.   The superior court was primarily concerned with the suggestion that Rachel                                                                                                                                                                                                      



may "rely entirely on prayer in lieu of hospital care."                                                                                                                 



                                                The record supports the superior court's determination that there was a                                                                                                                                                                                        



 change in circumstances and that Rachel's appointment was no longer in Tiffany's best                                                                                                                                                                                                               



 interest.   The superior court did not abuse its discretion.                                                                                                    



                        B.	                     TheSuperiorCourt's                                                               RelianceOnTheGuardianshipStatutes                                                                                                                     DidNot   

                                                Violate Alaska's Free Exercise Clause                                                                                                           .  



                                                Rachel   argues   that   it   is   "religious   discrimination   to   replace   [her]   as  



 guardian, because [she] care[s] for [her] mother based on the tenets of religion instead   



                                                                                                                                                                           15  

 of how the State wants her [mother] cared for."                                                                                                                                                                                                                                  

                                                                                                                                                                                     We interpret this to be an argument  



                                                                                                                                                                                                                                                                                      

that Rachel's removal under the guardianship statute violated her rights to free exercise  



                                                       

 of her religion.  



                                                                                                                                                                                                                    16  

                                                                                                                                                                                                                                                                                                   

                                                The Alaska Constitution's free exercise clause                                                                                                                             states that "[n]o law shall  



                                                                                                                                                                                                                                                                                    

be  made  respecting  an  establishment  of  religion,  or  prohibiting  the  free  exercise  



                        15                      Rachel also argues that "[t]he guardianship statutes cannot be used in any                                                                                                                                                                            



matter to violate [her] mother's [First] Amendment rights."                                                                                                                                                         In the context of this case,                                                  

 it appears that Rachel argues that replacing her as Tiffany's guardian violated Tiffany's                                                                                                                                                                                         

 free exercise of religion.                                                              Generally, litigants lack "standing to assert the constitutional                                                                                                          

rights of another."   Keller v. French, 205 P.3d 299, 304 (Alaska 2009) (quoting                                                                                                                                                                                                              State,  

Dep'ts of Transp. & Labor v. Enserch Alaska Constr., Inc.                                                                                                                                                                  , 787 P.2d 624, 630 n.9                                                     

 (Alaska 1989)).                                           Tiffany had appointed counsel in this case provided by the Office of                                                                                                                                                                            

Public   Advocacy.     Through   this   representation,   Tiffany   has   the   ability   to   assert  

 constitutional   claims    on    her    own    behalf.      Tiffany's    counsel    filed    a    notice   of  

non-participation in response to this appeal.                                                                                                                 



                        16                      While the texts of the free exercise clause of the U.S. Constitution and the  

                                                                                                                                                                                                                                                                                                         

Alaska Constitution are nearly identical, we interpret the Alaska Constitution's free  

                                                                                                                                                                                                                                                                                                     

                                                                                                                                                                                                    OLE  DURHAM  &R                                               OBERT  SMITH,  

 exercise clause to require a strict scrutiny analysis. W.C 

                                                                                                                                                                                  

            ELIGIOUS ORGS. AND THE LAW  § 3:26 (2017). Therefore, this analysis focuses on the                                                                                                                                                                                                           

                                                                                                      

 1 R 

Alaska Constitution rather than the U.S. Constitution because the Alaska Constitution                                                                                                                                                                                  

provides a more protective standard.                                                                                                Id.  



                                                                                                                                                     -8-	                                                                                                                                         7471
  


----------------------- Page 9-----------------------

                17  

thereof."            As we have reiterated on numerous occasions, "[n]o value has a higher place                                                    



                                                                                                                                    18  

in our constitutional system of government than that of religious freedom."                                                                            

                                                                                                                                        We use our  



                                                                                                                                                       

independent judgment to review constitutional questions, "adopting the rule of law that  



                                                                                                            19  

                                                                                                                  

                                                                                               

is most persuasive in light of precedent, reason and policy." 



                                                                                                                                                   20  

                        Alaska's free exercise clause was first interpreted in Frank v. State.                                                           In  

                                                                                                                                                         



Frank we determined that, to invoke a religious exemption from a facially neutral state  

                                                                                                                                                     



law, three requirements must be met:  (1) a religion must be involved, (2) the conduct in  

                                                                                                                                                          



question must be religiously based, and (3) the claimant must be sincere in his or her  

                                                                                                                                                       

religious belief.21  "Oncethesethreerequirementsaremet,'[r]eligiously impelled actions  

                                                                                                                                                 



can be forbidden only "where they pose some substantial threat to public safety, peace  

                                                                                                                                                   



or order," or where there are competing governmental interests "of the highest order . . .  

                                                                                                                                                               



                                                                   22  

[that] [are] not otherwise served." ' "    

                                                                 



                        Rachel meets the first Frank  requirement because her beliefs regarding  

                                                                                                                                           



medical care are strongly informed by her religion.  She meets the second requirement  

                                                                                                                                       



because her treatment decisions are based on her religious training and beliefs.  And in  

                                                                                                                                                          



            17          Alaska  Const.  art  I,  §  4.  



            18          Sands  v.  Living   Word  Fellowship,   34  P.3d  955,  958  n.11  (Alaska  2001)  



(alteration  in  original)  (quoting  Frank  v.  State,  604  P.2d   1068,   1070  (Alaska   1979)).  



            19          Treacy  v.  Municipality  of  Anchorage ,  91  P.3d  252,  260  (Alaska  2004).  



            20          604 P.2d 1068, 1070-71 (Alaska 1979).  

                                                                                     



            21          Swanner  v.  Anchorage  Equal  Rights  Comm'n,  874  P.2d  274,  281  (Alaska  



 1994)  (citing  Frank,  604  P.2d  at   1071).  



            22          Id. (first and fourth alterations in original) (quoting Seward Chapel, Inc. v.  

                                                                                                                                                          

City of Seward, 655 P.2d 1293, 1302 n.33 (Alaska 1982)).  

                                                                                             



                                                                            -9-                                                                    7471
  


----------------------- Page 10-----------------------

the absence of any evidence to the contrary, we assume that Rachel's religious beliefs         



 are sincere.           



                          With these three requirements met, the second part of the test under                                                             Frank  



requires that a facially neutral statute that interferes with religious-based conduct be                                                                           

                                                                          23   In other words, the question becomes whether  

justified by a compelling state interest.                                                                                                                



the government's interest in protecting Tiffany outweighs Rachel's interest in following  

                                                                                                                                                     

her religious beliefs.24  

                           



                          The  guardianship  statutes  reflect  the  government's  strong  interest  in  

                                                                                                                                                                   



protecting the health and safety of a vulnerable ward. A guardian has the duty to "assure  

                                                                                                                                                          



the care, comfort, and maintenance of the ward" and to "assure that the ward receives the  

                                                                                                                                                                  



 services necessary to meet the essential requirements for the ward's physical health and  

                                                                                                                                                                 

               25   A guardian may be dismissed if "there is an imminent danger that the physical  

 safety."                                                                                                                                               

health or safety of the ward will be seriously impaired."26                                                      These statutory interests are  

                                                                                                                                                                  



 similar to the government's interests in protecting the life, health, and safety of other  

                                                                                                                                                              



                                                                                                                                                    27  

vulnerable groups, interests that we have previously found to be compelling.                                                                             

                                                                                                                              



             23           Frank, 604 P.2d at 1074 (citing                                  Sherbert v. Verner                   , 374 U.S. 398, 407             



 (1963)).  



             24           Swanner, 874 P.2d at 282.  

                                                                     



             25           AS 13.26.316(c)(2)-(3).  

                                                                          



             26           AS 13.26.286(e).  

                                  



             27           Myers v. Alaska Psychiatric Inst ., 138 P.3d 238, 249 (Alaska 2006) (noting  

                                                                                                                                                          

that the State has a compelling interest, under its parens patriae obligation, to protect the  

                                                                                                                                                                  

health of civilly committed individuals in certain situations); Planned Parenthood of The  

                                                                                                                                                                 

 Great Northwest v. State, 375 P.3d 1122, 1139 (Alaska 2016) (noting that the State has  

                                                                                                                                                                 

 a compelling interest in protecting the health of minors who seek abortions); see also  

                                                                                                                                                                

                                                                                                                                              (continued...)  



                                                                                -10-                                                                          7471
  


----------------------- Page 11-----------------------

                         "[A]fter   a   court   determines   that   the   claimed   exemption   implicates   a  



compelling government interest," the appropriate question "is 'whether that interest                                                               



                                                                                                                                                              28  

. . . will suffer if an exemption is granted to accommodate the religious practice.' "                                                                             



                                                                                                                                                      

Here there is evidence that, should this exemption be granted, Tiffany's health and safety  



                                                                                                                                                 

would be at risk.  If Rachel cares for her mother following the tenets of her religious  



                                                                                                                                                

beliefs, then shewill abandon theduties described by theguardianship statutes,including  



                                                                                                                                                      

the  duty  "to  meet  the  essential  requirements  for  [Tiffany's]  physical  health  [and]  

              29   By depriving her mother of personal care services and emergency services in  

safety."                                                                                                                                                      



favor of prayer, Rachel not only fails to satisfy the essential requirements under the  

                                                                                                                                                           



statute, but also puts Tiffany's health and safety at risk.  

                                                                                               



                         Granting this exemption would be directly counter to the State's interest in  

                                                                                                                                                              



protecting its most vulnerable citizens from harm.  Rachel stated that if her mother were  

                                                                                                                                                        



to have a heart attack or stroke, she would first pray for her rather than call emergency  

                                                                                                                                             



services.  The threat to Tiffany's health, should she be returned to Rachel's care, is not  

                                                                                                                                                           



speculative.  While serving as guardian, Rachel did not ensure that Tiffany received her  

                                                                                                                                                           



epilepsy medication as prescribed, putting Tiffany at significant risk.  

                                                                                                                                  



                         Should Rachel be reinstated as guardian, Tiffany's health and safety will  

                                                      



be seriously compromised.  If Tiffany required immediate medical attention, the results  

                                                                                                                                                     



            27           (...continued)  



                                                                                                                                             

Sampson v. State, 31 P.3d 88, 96 (Alaska 2001) (noting that other courts have recognized  

                                                                                                                                  

substantial state interests in preserving life and protecting vulnerable persons).  



            28           Larson v. Cooper, 90 P.3d 125, 132 (Alaska 2004) (quoting Frank, 604  

                                                                                                                                                          

P.2d at 1073).  

               



            29           AS 13.26.316(a).  

                                 



                                                                            -11-                                                                       7471
  


----------------------- Page 12-----------------------

could be fatal.  For this reason, while religious liberty is a fundamental right under the                                                                                                                                                                                                                                                                                                                                                                                         



Alaska Constitution, the State's actions in this case are justified by a compelling interest.                                                                                                                                                                                                                                                                                                                                                            



V.                                    CONCLUSION  



                                                                           The superior court's judgment is AFFIRMED.                                                                                                                                                 



                                                                                                                                                                                                                                                           -12-                                                                                                                                                                                                         7471
  

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