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In 1996, John Markwart (defendant) was found not guilty by reason of insanity ofaggravated arson in a bench trial before the circuit court of Cook County. He was thencommitted to the custody of the Illinois Department of Human Services pursuant to section 5-2-4of the Unified Code of Corrections. 730 ILCS 5/5-2-4 (West 2000). In April 2000, defendantsought review of the treatment plan report filed by the mental health facility housing him,alleging that the plan did not comply with governing statutes. Defendant also sought review ofhis treatment at that facility, alleging that it was not adequate. The circuit court held that theexisting plan complied with the statute and denied defendant's request for a hearing to review hisactual treatment. Defendant appeals the circuit court's rulings, claiming that the finding that theplan was adequate is against the manifest weight of the evidence and that the hearing requested ismandatory and not within the discretion of the circuit court to deny. For the reasons discussedbelow, we affirm.

BACKGROUND

In August 1995, defendant was charged with aggravated arson for setting on fire a desk atCook County Hospital. According to testimony given during defendant's bench trial, defendantapproached the desk of a hospital employee, poured liquid on it from a jar and then lit the deskon fire. At trial, the parties stipulated that if a detective from the Chicago Police DepartmentBomb and Arson Unit were to have testified, he would have stated that the fire in questioncaused structural damage and was intentionally set. The detective would also have testified thatdefendant told him that he set the fire because he was dissatisfied with the psychiatric treatmenthe was receiving at Cook County Hospital. The defense presented the testimony of Dr. StaffordHenry, a forensic psychologist, who performed a psychiatric evaluation of defendant andconcluded that defendant was suffering from schizophrenia and was legally insane at the time thefire was set. The trial court found that the State proved all the elements of the crime beyond areasonable doubt but further found that the defense proved, by clear and convincing evidence,that defendant was legally insane at the time of the crime. The court then found defendant notguilty by reason of insanity.

From his acquittal in December 1996, until the present, defendant has been in the custodyof the Department of Human Services at the Elgin Mental Health Center. During this period,Cora Markwart was appointed legal guardian of her son, defendant, pursuant to section 11a-1 etseq. of the Probate Act and pursued these proceedings on his behalf. 755 ILCS 5/11a-1 (West2000).

Under section 5-2-4 of the Unified Code of Corrections, the facility housing a defendantacquitted by reason of insanity must file a treatment plan report with the court every 60 daysduring the defendant's confinement. 730 ILCS 5/5-2-4(b) (West 2000). The report Elgin filed inFebruary 2000, is at issue in this case. According to the contents of this report, defendant suffersfrom delusions, including the notion that he has an increased sensitivity to pain. These delusionsled defendant to demand that Cook County Hospital perform "$3,000" worth of tests on him andtheir refusal to accede to this apparently psychotic demand led defendant to set the fire at thatlocation. According to the treatment plan report, in February 2000, defendant was still activelydelusional. In 1999, the report states that defendant experienced a period of anorexia, his weighdropping to 127 pounds, during which he claimed that starving himself would get him out ofElgin "sooner than later." Through the administration of medication and court approvedelectroconvulsive therapy (ECT), defendant's weight was raised to 179 pounds, but Elgin staffapparently still strictly monitored defendant's eating and his efforts to sell his food. The reportalso indicates that defendant manifested significant problems with social skills and personalhygiene. The report reveals that defendant's primary form of treatment is anti-psychoticmedications. Apparently, the treating psychiatrist has tried a number of different medications,the one in use in February 2000, offering only moderate success in limiting defendant's delusion.

In addition, the June 2000, treatment plan report, submitted during the course of thislitigation, indicates that defendant followed a nurse into a restricted area, would not leave, andwhen set on by another patient coming to the nurse's aid, bit the other patient, drawing blood. Defendant then went on a medications strike which was eventually resolved.

In April 2000, defendant filed a petition for review of treatment alleging that his February2000, treatment plan did not conform to the statutory requirements set out in sections 3-209 and3-814 of the Mental Health and Developmental Disabilities Code (Mental Health Code). 405ILCS 5/3-209 and 5/3-814 (West 2000). Defendant asked that the court enter an order requiringElgin to submit a revised treatment plan. Defendant also requested a hearing to determinewhether he was receiving adequate and humane care and services under his treatment plan asdefined in section 1-101.2 of the Mental Health Code. 405 ILCS 5/1-101.2 (West 2000). Ondefendant's first request, the trial court reviewed the treatment plan and concluded that it wasadequate and necessary for defendant's condition. Upon the trial judge's ruling, defendantreiterated his request for a hearing on the adequacy of his treatment and requested that anindependent psychiatric exam be performed as part of that review. The trial court denieddefendant's petition, stating "[a]t its discretion the Court denies that request." This appealfollowed.

ANALYSIS

By his first issue, defendant argues that the trial court erred in finding that the treatmentplan submitted by the Elgin Mental Health Center was adequate. Defendant contends that theplan failed to articulate several of the statutorily mandated elements and those it did include werefacially inadequate. Although no case directly addresses the standard of review of a trial court'sholdings on a treatment plan, defendant and the State agree that the applicable standard of reviewis whether the finding was against the manifest weight of the evidence. See, e.g., Whyte v.Estate of Whyte, 244 Ill. App. 3d 746, 748, 614 N.E.2d 372, 373 (1993) (trial court's ruling thatpreviously void marriage became lawful would only be disturbed if it were against the manifestweight of the evidence).

Defendant's right to challenge the facial adequacy of his treatment plan is outlined in theinter-referential subsections of the two statutes governing his confinement: section 5-2-4 of theUnified Code of Corrections and section 3-814 of the Mental Health Code. 730 ILCS 5/5-2-4(West 2000); 405 ILCS 5/3-814 (West 2000). Defendant was committed to Elgin, after beingfound not guilty by reason of insanity (NGRI), under section 5-2-4 of the Unified Code ofCorrections. 730 ILCS 5/5-2-4(a) (West 1996). This section provides detailed directions aboutthe process of commitment in such cases, the reporting requirements of the treatment facility, andthe rights to and procedures for review of certain aspects of a defendant's confinement. Part (b)of this section also provides that

"[i]f the Court finds the defendant subject to involuntary admission or in need ofmental health services on an inpatient basis, the admission, detention, care,treatment or review of treatment and treatment plans, and discharge of thedefendant after such order shall be under the Mental Health and DevelopmentalDisabilities Code." 730 ILCS 5/5-2-4(b) (West 2000).

Under that code, section 3-814(c) states that "[o]n request of the recipient or an interested personon his behalf, or on the court's own discretion, the court shall review the current treatment plan todetermine whether its contents comply with the requirements * * *. If the court determines thatany of the information required by this Section * * * to be included in the treatment plan is not inthe treatment plan * * * the court shall indicate what is lacking and order the facility director torevise the current treatment plan to comply with this Section." 405 ILCS 5/3-814(c) (West2000). Thus section 5-2-4(b), by incorporating section 3-814, allows a defendant to make afacial challenge to his treatment plan and request that a complying plan be submitted by thetreating facility.

Section 5-2-4(b) of the Unified Code of Corrections dictates that such a treatment planreport must be submitted by the treating mental health facility every sixty days during theduration of the defendant's involuntary confinement. 730 ILCS 5/5-2-4(b) (West 2000). Thissection also states the required contents of the treatment plan report. The treatment plan reportshall include:

"an opinion as to whether the defendant is currently subject to involuntaryadmission, in need of mental health services on an inpatient basis, or in need ofmental health services on an outpatient basis. The report shall also summarize thebasis for those findings and provide a current summary of the following itemsfrom the treatment plan: (1) an assessment of the defendant's treatment needs, (2)a description of the services recommended for treatment, (3) the goals of eachtype of element of service, (4) an anticipated timetable for the accomplishment ofgoals, and (5) a designation of the qualified professional responsible for theimplementation of the plan." 730 ILCS 5/5-2-4 (West 2000).

Defendant argues that on its face the February 2000, plan fails to adequately outline theserequirements and that based upon these obvious defects the trial judge should have ordered Elginto submit a revised plan.

Defendant's underlying concern in forwarding these arguments centers on the fact thatthese reports are used by non mental-health professionals--the defendant, his attorney, the State'sattorney, and the trial judge--to evaluate the adequacy, humaneness, and duration of hisconfinement. If these reports contain nothing but vague and overbroad generalizations aboutdefendant's care, then defendant and the courts have no way to assess the care given by Elgin, norany way to assess whether defendant's continued involuntary commitment is appropriate. Whilewe recognize the cogency of defendant's concerns, and in small part share his apprehensionsabout the level of specificity provided in the treatment plan at issue, we find that the trial court'sassessment that the report was adequate under the statute was not against the manifest weight ofthe evidence.

Going through defendant's contentions point by point, he first asserts that the treatmentplan does not set forth information from which the basis for his confinement can be determined. Defendant argues that the plan assumes that he is in need of mental health services on aninpatient basis, but fails to articulate whether he is a current danger to himself or others. Defendant goes on to note that many individuals diagnosed with schizophrenia are treated in thecommunity, not in a mental hospital, and that Elgin's report provides no reason why suchtreatment cannot be pursued in his case.

The State counters that the report states that defendant is actively psychotic and continuesto suffer from the same delusions that led him to commit the crime which provided the basis forhis initial confinement. In addition, the report indicates that defendant is still working through asevere eating disorder, which initially caused him to drop to a dangerously low weight. Thereport states that defendant continues to sell his food and to make statements such as "I hate foodand shouldn't have to eat any of it." Although not articulated in the exact language of the statutedefining qualifications for commitment, we find that the trial court's reliance on theseassessments of defendant's condition as the basis for his continued confinement is not against themanifest weight of the evidence.

Defendant next argues that the treatment plan does not contain an assessment of histreatment needs. The plan does, however, list five problems experienced by defendant and anindication of how Elgin is responding to each of them. The plan indicates that defendant is stillactively psychotic and is in the process of being treated with medication in an attempt to controlhis delusions. Defendant is not complying with unit rules and staff are actively working toencourage greater compliance. Defendant is not taking care of personal hygiene or his livingquarters and again staff is working regularly with him on improvement in these areas. Defendantis withdrawn and thus has been enrolled in a social skills program, which staff are encouraginghim to regularly attend. Finally, defendant continues to manifest problems with food and theseare being addressed with medication and staff intervention. These details provide sufficientinformation about defendant's treatment needs to support the trial court's finding that the plan isadequate in this area.

Likewise, defendant contends that the plan does not contain a description of the servicesrecommended for treatment. The plan does, however, indicate that defendant is being treatedwith anti-psychotic medication and an antidepressant. Although the anti-psychotic drug isproviding only minimal to moderate relief, the plan reveals that the facility is in midst of the notuncommon process of serially administering different medications in search of one that willalleviate defendant's delusions. While medication appears to be the primary focus of treatment,the plan also indicates, as discussed above, that defendant's anorexia is being monitored andaddressed by unit staff, that defendant is participating in a social skills program, and the he isbeing guided towards better personal hygiene. While more detail about the specific plan Elginhas for treating defendant's several mental health issues might indeed have been edifying, we findthat the trial court did not err in considering this portion of the plan to be adequate.

Finally, defendant contends that the report does not contain the goals of each type ofelement of service, the timetable for the accomplishment of the goals, nor the designation of thequalified professional responsible for the plan's implementation. As to the last two, the plan doesindeed provide a timetable for the achievement of the five objectives it outlines, and does list thestaff member responsible for overseeing each of these objectives. Under each objective is listedthe "Staff Responsible" and the "Expected Achievement Date." While defendant argues that thetimetable does not correspond to the overall discharge date listed in the plan, we find that such areading puts a greater exactitude on the report than it can reasonably be expected to bear. Theplan estimates the time that it will take for defendant to reach specific objectives and a later datefor his ultimate discharge. The discharge date may well be calculated to allow for defendant'sfailure to meet an objective by the deadline (for any variety of reasons) or to allow for a period ofstability within the facility before defendant is discharged.

On the question of the existence of goals themselves, the report provides an overlappinglist of goals and objectives in two sections which focus on the control of delusions, compliancewith routine expectations and rules of the unit, accomplishment of daily living and social skills,maintenance of weight, and development of a relapse prevention program and realistic aftercareprogram. The latter two are listed as deferred goals, presumably because they depend on theprimary goal of controlling defendant's delusions. Again, although the report itself might providea clearer single list of goals, Elgin's plan for defendant's rehabilitation is sufficiently clear thatboth his progress and Elgin's specific treatment efforts can be determined by those to whom thereport is aimed, namely, defendant, his attorney, the State and the reviewing court. Thus we findthat the trial court's finding that the treatment plan as a whole is adequate is not against themanifest weight of the evidence.

Defendant next argues that the court erred in refusing to grant him a hearing to review theadequacy of his treatment and in refusing to order an independent psychiatric examination as apart of that hearing. We disagree.

The issue presented here is whether defendant had a right to a hearing as a matter of lawunder the two governing statutes. We will therefore review the trial court's holding de novo. People v. O'Brien, 197 Ill. 2d 88, 91, 754 N.E.2d 327, 329 (2001). Because analysis of this issuedepends upon the construction of recently amended statutes, we must also be cognizant of basicrules of statutory interpretation. We begin our analysis with the language of the statute, giving itits plain and ordinary meaning. Davis v. Toshiba Machine Co., America, 186 Ill. 2d 181, 184,710 N.E.2d 399, 401 (1999). Where the language is unambiguous, we will "apply the statutewithout resort to further aids of statutory construction." O'Brien, 197 Ill. 2d at 90, 754 N.E.2d at329. Nor will we read into it "exceptions, limitations, or conditions that the legislature did notexpress." Solich v. George & Anna Portes Cancer Prevention Center of Chicago, Inc., 158 Ill. 2d76, 83, 630 N.E.2d 820, 823 (1994).

As an initial matter, we note that this issue differs from defendant's first issue in thesubstance of the request. As section 3-814 indicates, involuntarily committed patients maychallenge both their treatment plan and their actual treatment. 405 ILCS 5/3-814(c) & (d) (West2000). At issue in defendant's appeal, are both these challenges. The first, as discussed above, isa facial challenge to the plan based on allegations that it does not conform to the statutoryrequirements. 405 ILCS 5/3-814(c), 730 ILCS 5/5-2-4(b) (West 2000). Specifically, section814(c) states: "On request of the recipient * * * the court shall review the current treatment planto determine whether its contents comply with the requirements of this Section * * * ." 405 ILCS5/3-814(c) (West 2000). Through the incorporation by reference of section 3-814(c) in section 5-2-4(b) of the Unified Code of Corrections, such a challenge is also available to NGRI acquittees. 730 ILCS 5/5-2-4(b) (West 2000).⁽¹⁾

In addition to section 814(c), section 814(d) contemplates a review of an inpatient's actualtreatment. Section (d) states that: "The recipient or an interested person on his or her behalf mayrequest a hearing or the court on its own motion may order a hearing to review the treatmentbeing received by the recipient." (Emphasis added.) 405 ILCS 5/3-814(d) (West 2000). Thissubsection contemplates a review not of the plan on its face, but of the actual treatment adefendant is receiving under the plan. Section 3-814(d) is also applicable to NGRI acquitteesunder the incorporation language of section 5-2-4(b). 730 ILCS 5/5-2-4(b) (West 2000).

Defendant argues that even if the trial court is correct in its ruling that the plan itself isfacially adequate under the statute, the treatment he is receiving under the plan must be reviewedto determine if it is adequate and humane. Defendant contends that under section 5-2-4(e) andsection 3-814(d), both applicable to NGRI acquittees, a hearing on this question is mandatory andthus that the trial court erred in declining to allow defendant a hearing to review his treatment. 730 ILCS 5/5-2-4(e) (West 2000). The State counters that review of actual treatment is governedexclusively by section 3-814(d) of the Mental Health Code and that, by the plain language of thestatute, such hearings are discretionary. A reading of the plain and unambiguous language ofboth section 3-814 and section 5-2-4 convinces us that defendant is incorrect in contending thatthe statutes mandate a hearing to review actual treatment.

Defendant argues that the newly revised language of section 5-2-4(e) dictates that arequest to review the adequacy of treatment under the treatment plan must be the subject of ahearing. This section now reads:

"A defendant admitted pursuant to this Section, or any person on his behalf, mayfile a petition for treatment plan review, transfer to a nonsecure setting within theDepartment of Human Services or discharge or conditional release under thestandards of this Section in the Court which rendered the verdict. Upon receipt ofa petition for treatment plan review, transfer to a nonsecure setting or discharge orconditional release, the Court shall set a hearing to be held within 120 days." [Emphasis added.] 730 ILCS 5/5-2-4(e) (West 2000).

Defendant interprets this section as stating that a hearing to review treatment plans is mandatoryand that the phrase "treatment plan review" encompasses both section 3-814(c) challenges (facialreview of the plan for statutory compliance) and section 3-814(d) challenges (review ofdefendant's treatment under the plan). That both types of review are contemplated by section 5-2-4(e), according to defendant, is clear when section 3-814, entitled generically "TreatmentPlan," is read as a whole. This section contains the procedures for both challenges and statesthat"the purpose of the filing, forwarding, and review of treatment plans and treatment is toensure that the recipient is receiving adequate and humane care and services." 405 ILCS 5/3-814(b) (West 2000). The Code defines adequate and humane care and services as "servicesreasonably calculated to result in a significant improvement of the condition of a recipient ofservices confined in an inpatient mental health facility * * * or services reasonably calculated toprevent further decline in the clinical condition of the recipient." 405 ILCS 5/1-101.2 (West2000). Defendant contends that both types of challenges serve a similar purpose and that bothare encompassed by the umbrella phrase "treatment plan review." Defendant further contendsthat the legislature also intended section 3-814(d) to require mandatory hearings for treatmentreview.

We agree with defendant that under the rules of statutory construction, the word "shall,"as used in section 5-2-4(e), is generally indicative of mandatory intent. People v. Singleton, 103Ill. 2d 339, 341, 469 N.E.2d 200 (1984). However, we are not persuaded by defendant'sinterpretation of the phrase treatment plan. We read the unambiguous language of the section tocover only procedures for review of treatment plans and not actual treatment. Section 5-2-4(e) by its plain language makes no mention of review of actual "treatment." Section 5-2-4(b)recognizes a distinction between the two concepts, stating, "the admission, detention, care,treatment or habitation, treatment plans, review proceedings, including review of treatment andtreatment plans, * * * shall be under the Mental Health and Developmental Disabilities Code." 730 ILCS 5/5-2-4(b) (West 2000). This section demonstrates that within this Act, the legislatureconsidered the concepts of treatment and treatment plan as distinct. We therefore conclude thatprocedures for review of actual treatment of NGRI acquittees are unaffected by section 5-2-4(e)and are instead governed by section 3-814(d) of the Mental Health Code. Under section 3-814(d), an inpatient's right to a hearing to review actual treatment is provided for by repeated useof the word "may," indicating that holding such a hearing is within the discretion of the court. 405 ILCS 3-814(d) (West 2000).

As the court in People v. Chiakulas 288 Ill. App. 3d 248, 252, 681 N.E.2d 35, 37 (1997)noted, the two statutes at issue are designed to complement each other and can be read togetherand harmonized. Section 5-2-4(b) indicates that most aspects of a patient's involuntaryadmission and confinement are governed by the Mental Health Code but also provides specificprovisions applicable only to NGRI acquittees. The Mental Health Code offers comprehensivedefinitions, requirements, and procedures for involuntary confinement and review of thatconfinement but indicates that when the patient is an NGRI acquittee, specific provisions insection 5-2-4 governing review of treatment plans should dictate the proper procedures. 405ILCS 5/3-814(c) (West 2000). In essence, both statutes incorporate each other by reference andsend the reader back and forth between them depending upon which section applies.

Sections 5-2-4(e)-(g) unequivocally outline an NGRI defendant's right to a hearing onreview of treatment plan but are silent on the issue of review of actual treatment. Section 5-2-4(b) indicates that where the Code of Corrections is silent, the Mental Health Code governs. 730ILCS 5/5-2-4(b) (West 2000). The Mental Health Code unequivocally states that when a patientseeks review of his or her actual treatment, whether to hold a hearing is within the discretion ofthe court. The section reads: "[t]he recipient or an interested person on his or her behalf mayrequest a hearing or the court on its own motion may order a hearing to review the treatmentbeing received by the recipient." (Emphasis added.) 405 ILCS 5/3-814(d) (West 2000). Wethus find that defendant is not correct that the court erred simply by exercising its discretion notto hold a hearing. Defendant forwards no argument that, in substance, this decision was an abuseof discretion.

Finally, we acknowledge that an anomaly lingers in this analysis. Section 5-2-4(e)-(g)provide a mandatory, fully adversarial hearing with mandatory review by an independentpsychiatrist for the complex and involved questions of transfer to a nonsecure facility anddischarge. Under our reading, these sections also provide such protections for the much lesscomplex analysis of whether an NGRI acquittee's treatment plan is facially adequate, whilewithholding the protections for the obviously complex question of review of defendant's actual treatment.

We note that the Mental Health Code, recognizing that treatment plan review is a moreministerial process, does not even provide for a discretionary hearing of such a challenge,offering merely "court review." 405 ILCS 5/3-814(c) (West 2000). On the other hand, the Codedoes provide a discretionary hearing and independent psychiatric review of the more involvedquestion of review of actual treatment. 405 ILCS 5/3-814(d). That section 5-2-4 of the Code ofCorrections should do the opposite is indeed anomalous. Be that as it may, however, the plainand unambiguous language of section 5-2-4(e) provides only for treatment plan review andleaves this court no room to expand its coverage to review of actual treatment.

Defendant next appeals the trial court's decision to deny him the right to review of histreatment by an independent psychiatrist under section 5-2-4(f). 730 ILCS 5/5-2-4(f). In his oralrequest at the conclusion of the court's consideration of the treatment plan, defendant reiteratedhis desire for a hearing to review his actual treatment and made his first request for anindependent psychiatric evaluation as part of that proceeding. The trial court denied the requestfor a hearing and a psychiatric evaluation.

Defendant is correct that under section 5-2-4(f), "[i]f requested by either the State or thedefense or if the court feels it is appropriate, an impartial examination of the defendant by apsychiatrist or clinical psychologist * * * who is not in the employ of the Department of HumanServices shall be ordered, and the report considered at the time of the hearing." [Emphasisadded]. 730 ILCS 5/5-2-4 (f) (West 2000). However, the "hearing" referred to in this subsectionis the hearing mandated by section 5-2-4(e), which, as just discussed, covers only treatment planreview, transfer to a nonsecure setting, or discharge. Independent psychiatric examination forreview of actual treatment is governed by section 3-814(d). Under that section, "[t]he court mayorder an independent examination on its own initiative and shall order such an evaluation ifeither the recipient or the State's Attorney so requests and has demonstrated to the court that theplan cannot be effectively reviewed by the court without such an examination." 405 ILCS 3-814(d) (West 2000). Defendant contends that the trial court erred in failing to give him anopportunity to demonstrate the need for an independent examination. Under our reading of thesection, however, defendant has put the cart before the horse. The issue of whether to grant anindependent examination is not raised until the court, in its discretion, decides to hold a hearing. In this case, the court declined to hold a hearing to review defendant's treatment and thus thequestion of an independent examination never became an issue. We therefore conclude that itwas not error for the trial court to exercise its discretion in declining to address the issue of anindependent psychiatric review when declining to grant defendant a hearing to review his actualtreatment.

CONCLUSION

In conclusion, we affirm the trial court's finding that defendant's treatment plan wasadequate. We also find that the trial court did not err in denying defendant's request for a hearingand an independent psychiatric evaluation to determine whether he is receiving adequatetreatment.

Affirmed.

CAHILL and McBRIDE, JJ., concur.

1. Although our disposition obviates the need to rule on this issue, we note thatdefendant's initial challenge to his treatment plan is subject to the procedural provisions ofsection 5-2-4(e)-(g), including a mandatory, adversarial hearing, and review by an independentpsychiatrist. 730 ILCS 5/5-2-4(e)-(g) (West 2000). However, by pursuing his relief in two tiers,defendant specifically declined a formal hearing on his facial challenge to the treatment plan andcan not now contest the court's failure to hold a full hearing on the issue.