RLB AND PMB
[2015] WASAT 64
•10 JUNE 2015
RLB AND PMB [2015] WASAT 64
| STATE ADMINISTRATIVE TRIBUNAL | Citation No: | [2015] WASAT 64 | |
| 10/06/2015 | |||
| GUARDIANSHIP AND ADMINISTRATION ACT 1990 (WA) | |||
| Case No: | GAA:4182/2014 | 9 FEBRUARY 2015 | |
| Coram: | MS H LESLIE (MEMBER) | 4/05/15 | |
| 15 | Judgment Part: | 1 of 1 | |
| Result: | The Tribunal refused the applicant's request that the independent guardian be replaced, declining to find that the independent guardian was not acting in the best interests of the represented persons and declining to find that it was in the represented persons' best interests that the applicant be appointed as guardian | ||
| B | |||
| PDF Version |
| Parties: | RLB PMB |
Catchwords: | Guardianship Suitability Guardian acting in best interests Weighing of risk against wishes and views Need for independence |
Legislation: | Guardianship and Administration Act 1990 (WA), s 4(2), s 4(7), s 43(1), s 44, s 44(5) State Administrative Tribunal Act 2004 (WA), s 77 |
Case References: | Nil |
Summary | The applicant sought the replacement of the independent guardian of his parents, RLB and PMB. The same guardian is guardian for both parents. The applicant claimed that, in declining to place his parents in residential care and allowing them to remain residing at home as was claimed to be their wish, the guardian was failing in her duty to act in his parents' best interests. The applicant relied on the opinion of a geriatrician that his parents were deteriorating and now required residential care. The opinion, whilst in line with what the applicant had always claimed in the proceedings, was new evidence. The position of the parents had deteriorated somewhat over time. It did, however, appear that the geriatrician had only heard the applicant's version of the factual circumstances of the parents and the level of support that they were actually getting (which was in dispute). The independent guardian sought to justify the decision made to maintain the parents in their home up until the time of the hearing, on the basis that it was in line with their very strongly held desire to stay at home and, given the support that she believed was in place for the parents, represented a reasonable decision when weighing actual risk against the wishes of the parents. The guardian acknowledged that the new specialist opinion evidence warranted consideration and might affect the guardian's view as to the future situation. The guardian took the view that, given the conflict and disagreement within the family, it was not in the parents' best interests that one family member, with a very definite view as to outcome, be the decisionmaker, and that an independent guardian was still required.,The Tribunal accepted the guardian's submissions and found that the rationale of the decisions made to that point by the guardian was reasonable on the facts available to her and did not constitute a failure to act in the best interests of the parents; the guardian was open to a change in view and was acting appropriately in following up on the new evidence; in the circumstances of conflict in the family, an independent guardian was required going forward; and that the Public Advocate should be reappointed to make decisions as previously and on the same basis. |
JURISDICTION : STATE ADMINISTRATIVE TRIBUNAL ACT : GUARDIANSHIP AND ADMINISTRATION ACT 1990 (WA) CITATION : RLB AND PMB [2015] WASAT 64 MEMBER : MS H LESLIE (MEMBER) HEARD : 9 FEBRUARY 2015 DELIVERED : 4 MAY 2015 PUBLISHED : 10 JUNE 2015 FILE NO/S : GAA 4182 of 2014
- GAA 4782 of 2014
- PMB
Represented Persons
Catchwords:
Guardianship Suitability Guardian acting in best interests Weighing of risk against wishes and views Need for independence
Legislation:
Guardianship and Administration Act 1990 (WA), s 4(2), s 4(7), s 43(1), s 44, s 44(5)
State Administrative Tribunal Act 2004 (WA), s 77
Result:
The Tribunal refused the applicant's request that the independent guardian be replaced, declining to find that the independent guardian was not acting in the best interests of the represented persons and declining to find that it was in the represented persons' best interests that the applicant be appointed as guardian
Summary of Tribunal's decision:
The applicant sought the replacement of the independent guardian of his parents, RLB and PMB. The same guardian is guardian for both parents. The applicant claimed that, in declining to place his parents in residential care and allowing them to remain residing at home as was claimed to be their wish, the guardian was failing in her duty to act in his parents' best interests. The applicant relied on the opinion of a geriatrician that his parents were deteriorating and now required residential care. The opinion, whilst in line with what the applicant had always claimed in the proceedings, was new evidence. The position of the parents had deteriorated somewhat over time. It did, however, appear that the geriatrician had only heard the applicant's version of the factual circumstances of the parents and the level of support that they were actually getting (which was in dispute). The independent guardian sought to justify the decision made to maintain the parents in their home up until the time of the hearing, on the basis that it was in line with their very strongly held desire to stay at home and, given the support that she believed was in place for the parents, represented a reasonable decision when weighing actual risk against the wishes of the parents. The guardian acknowledged that the new specialist opinion evidence warranted consideration and might affect the guardian's view as to the future situation. The guardian took the view that, given the conflict and disagreement within the family, it was not in the parents' best interests that one family member, with a very definite view as to outcome, be the decisionmaker, and that an independent guardian was still required.
The Tribunal accepted the guardian's submissions and found that the rationale of the decisions made to that point by the guardian was reasonable on the facts available to her and did not constitute a failure to act in the best interests of the parents; the guardian was open to a change in view and was acting appropriately in following up on the new evidence; in the circumstances of conflict in the family, an independent guardian was required going forward; and that the Public Advocate should be reappointed to make decisions as previously and on the same basis.
Category: B
Representation:
Counsel:
Represented Persons : N/A
Solicitors:
Represented Persons : N/A
Case(s) referred to in decision(s):
Nil
Introduction
1 By orders made on 13 October 2014, the Public Advocate (guardian) was appointed limited guardian of both RLB and PMB, with authority to make decisions about accommodation, treatment decisions, and services and supports (order). Certain directions were given, the content of which does not, for these purposes, require detailing. The order was to be reviewed after three months. Pursuant to the granting of the order, the guardian made the decision that RLB and PMB should remain living at home with a designated regime of supports - some formal, some informal.
Background
2 On 6 October 2014, CB, one of the sons of RLB and PMB, made applications with respect to both of his parents for the review of the order. The matters were relisted in January 2015 but were deferred due to the unavailability of some parties to attend a hearing.
3 The matters were ultimately heard on 9 February 2015. Given the common threads in both applications, the two matters, that of RLB and that of PMB, were heard together. The hearing was attended in person by:
• TD, the delegated guardian from the Office of the Public Advocate (OPA);
• CB and his wife LB;
• the other two sons of RLB and PMB, namely, PB (and his partner) and TB (and his wife);
• PMB's sister, MB; and
• a niece, SLB.
- RLB and PMB's daughter, DH, attended by telephone. Dr RC gave evidence by telephone.
4 Having reserved its decision at the conclusion of the hearing, on 4 May 2015, the Tribunal made an order reappointing the Public Advocate as limited guardian for each of RLB and PMB, with the same authorities as previously, namely, accommodation, treatment decisions, and services and supports.
5 The following are the reasons for that decision pursuant to s 77 of the State Administrative Tribunal Act 2004 (WA).
The relevant legislation
6 The relevant legislation is the Guardianship and Administration Act 1990 (WA) (GA Act).
7 The GA Act requires the Tribunal to proceed through a number of steps in order to arrive at a decision about the appointment or reappointment of a guardian, and to make findings about various matters along the way. A number of those steps attracted little controversy in this matter.
8 The sole contested issue for determination in this matter is who should act as guardian. There was no live issue at the hearing in relation to the question of the incapacity of either RLB or PMB, and there was clear, recent, unchallenged expert evidence confirming the same. Nor was there any live issue as to the need for someone to hold the role of appointed guardian to make decisions in view of the differences of opinion within the family as to the type of care required for both RLB and PMB. Nor was there any live issue as to the scope of the order; that is, the need for authority to make decisions regarding accommodation, care and treatment arrangements.
9 As to who should be named as guardian, s 44 of the GA Act provides guidance to the Tribunal in the answer to that question. The Tribunal must be satisfied that the proposed guardian:
• will act in the represented person's best interests;
• will not be in a position where the proposed guardian's interests conflict, or may conflict, with the represented person's interests; and
• that the person otherwise be suitable to act as guardian.
- Suitability takes into account the desirability of preserving existing family relationships; the compatibility of the proposed guardian with the represented person; the represented person's wishes; and whether the proposed guardian will be able to perform the role that he or she is given.
10 The Public Advocate is able to be appointed as guardian only if it is determined by the Tribunal that there is no one else suitable or willing to undertake that role: s 44(5) of the GA Act.
11 The Tribunal must as far as possible seek to ascertain the represented person's views and wishes, but ultimately must make a decision in what the Tribunal determines to be in his or her best interests: s 4(2) and s 4(7) of the GA Act.
Relevant history
12 In addition to the oral evidence of the parties at the hearing and the submissions of the Public Advocate, the Tribunal had the benefit of certain reports containing pertinent information to which reference will be made.
13 The background to the matter is as follows. In October 2014, the Public Advocate was appointed as limited guardian because of the level of conflict and disagreement between the siblings as to what should be done regarding their parents' care. The issue at that time was whether RLB and PMB should remain living at home with support services, both formal and informal, or whether they should be moved into residential care. CB was the original applicant in the proceedings and sought to be appointed as guardian to make the decision to place both of his parents in residential care, it being his belief that that was in their best interests. His position was opposed by his siblings who advocated care at home with supports. The latter position represented the course followed by the limited guardian upon appointment.
The applicant's position
14 CB claims that things have now reached a point where, such is his concern about his parent's situation, that he seeks to have the independent guardian replaced and to have himself appointed. He claims that the independent guardian is failing to act upon the current medical advice, which is that his parents require residential care. Whilst it is acknowledged that there is room for different views as to what is in someone's best interests, implicit in what CB is saying in seeking the replacement of the independent guardian is the suggestion that the guardian is, in fact, not acting in his parents' best interests. CB agreed with this proposition when it was put to him at the hearing.
15 In support of his argument, the applicant relied on the evidence of Dr RC. It is to be noted that, despite the guardian holding sole authority in relation to medical treatment matters, CB arranged for Dr RC to review both RLB and PMB without reference to the guardian and without the guardian's consent. CB and his wife, LB, attended the review appointment with his parents.
16 In his report to the general practitioner following his review of the parents, Dr RC set out his clinical observations and his recommendations. In relation to RLB, he expressed the view that RLB is 'totally dependent [upon] others for most activities of daily living'. He comments that PML 'is demented and cannot fulfil a caregiving role'. He went on to set out the supports he understood to be in place medication prompts from Silver Chain for PMB five days a week and cleaning services once a fortnight. He expressed his concerns about nutrition and hydration issues and went on to opine:
Both [the ACAT nurse]and I feel that the best decision … is that the Public Advocate decides to relocate both [RLB and PMB] into residential care[.]
- He went on to say that:
The overarching concern is that [RLB] be adequately nourished and hydrated and that [the] risk of falls and infection be reduced as much as possible[.]
... if [PMB] wants to stay at home, then she would need services twicedaily to ensure adequate nutrition and hydration, medication compliance and assistance with personal hygiene[.]
18 He referred to his understanding that, other than medication prompts from Silver Chain five days a week and cleaning services once a fortnight, PMB would not allow carers into the house for any other tasks. He referred to her as having little insight and as 'remain[ing] at risk continuing to live at home'. He stated that 'our recommendation again [is] that permanent residential accommodation be provided to [PMB]'.
19 In his evidence to the Tribunal, Dr RC commented that:
… in terms of risk … because of their advanced age, frailty and dementia, the risk of a bad outcome is high. We know that as a broad fact, people who need ACAT assessments have a high risk of ending up in hospital. And that's usually as a result of an infection or a fall and a broken bone … hospital admission for an older person doesn't do much for their quality of life … So [my assessment] is really just based on broad principles and years of experience dealing with these cases[.]
20 He expressed the view that RLB and PMB did not need 24/7 care but did need more frequent attention to nutrition and hydration. He expressed concern about the long periods each day where 'they're not visited'and went on to say:
… in an ideal world, they would both have a high a homecare package level 4 which would facilitate two or three visits a day and of much greater duration than is currently being received, so that meals can be prepared and personal hygiene can be monitored, [and] fluid intake can be monitored. And just much more adequate surveillance of their safety[.]
21 It is to be inferred that the factual information about supports received at home by RLB and PMB upon which Dr RC based his conclusions came from CB and his wife, LB, at the time of the home visit in January 2015. It appears that he had no input from any other party, including OPA.
22 Notwithstanding this, Dr RC's opinion evidence was largely unchallenged, and was to the effect that his assessment and that of the ACAT nurse in his team on the information that was available to them (my emphasis) was that RLB and PMB required to be cared for in a residential facility. The issue that emerged seemed rather to be the accuracy of the information which Dr RC had been given and upon which his opinion had been based.
23 The combined evidence of PB and TB was that there was a deal more informal support going into the house than had been revealed by CB to Dr RC. Their evidence as summarised by the Tribunal was that, on an average day, RLB and PMB would get themselves up in the morning; that they would largely have the morning on their own; that at lunchtime or a little after, the Silver Chain carer would attend at the house for medication administration; and then that at some point later in the afternoon or early evening, either PB or TB would drop in to visit and to ensure that some sort of evening meal was available for RLB and PMB. PB, who is a school teacher, insisted that he was there late afternoon most days barring some sort of emergency. He also stated that Silver Chain have been asked as part of their early afternoon visit to check that something is available for the evening meal just in case he was caught up and unable to visit in the evening. TB stated that he visits usually once on the weekend and often one evening during the week after work. Both PB and TBassist on the weekend with various things, including taking the parents shopping. They both agreed that after the evening meal, RLB and PMB usually sit and watch television for an hour or so and then, by which time any visitors have left, they would get themselves organised for bed and so the day ends. DH confirmed in her evidence that she had spent many days with her parents recently when staying in Perth. She was confident that they manage getting their own breakfast and lunch and that they are able to shower. She expressed the view that there is just as much risk in nursing care but less quality of life.
24 CB gave evidence that his parents needed to be 'cared for more thoroughly' and that there were many 'aspects of their daytoday life that [need] to be properly monitored'. CB questioned the amount of time actually spent by his two brothers with RLB and PMB. MB expressed concern about PMB's weight loss and about her (PMB's) struggles in managing the care of RLB.
25 Dr RC stated that the picture painted by the evidence of PB and TB (which he listened to by telephone link into the hearing) described more family support than he and the ACAT team were aware of. He agreed that such a scheme of support 'certainly does reduce the risk of bad outcomes somewhat'. He acknowledged that the central issue is about the assessment of risk and 'how much risk the people who are providing care and who are making the decisions for [RLB and PMB] want to take'. His observation as to what additional support was required was:
… [greater] surveillance of safety, provision of adequate nutrition and fluid intake … surveillance which can really only be provided in a [nursing home].
26 He acknowledged that a homecare package would enhance what was described as being provided by family, but would only work if RLB but more particularly PMB was accepting of the package and allowed the carers to help, something all agreed she had not been prepared to do in the past.
The Public Advocate's position
27 TD's report to the Tribunal and his statements in the hearing confirmed his view that the evidence of Dr RC pointed to there perhaps being a need to reconsider the current situation.
28 He summarised his approach to the decisions made over time for RLB and PMB. His assessment had been that they were able to manage at home with assistance in place; their home was always very clean and tidy; and they were always neat and well dressed. He confirmed that he had had consistent reports from Silver Chain to the same effect and that it was the view of that agency that RLB and PMB could be maintained at home with support.
29 TD stated that his assessment had been that, despite all of the potential risks, they were able to cope at home and were, in fact, coping and that 'they are in a very routine situation [that is a routine they have had for years]'. He acknowledged the issue of weight loss and that the actual consumption of food was not monitored. However, he stated that it appeared that the shopping was being done, food was being prepared, and that there was nothing upon which to base a conclusion that food was not being eaten and was simply being thrown out. He acknowledged that no other medical explanation for PMB's weight loss had been raised with him. DH raised the question of medication possibly supressing appetite. TD conceded that PMB might not be eating enough. He went on to state that the house is well set up for RLB and PMB and is relatively hazard free. He fully accepted that there are risks such as falls and their consequences, and that something could go wrong, but he stressed that there was a quality of life issue that was just as important to consider, particularly given the very strongly expressed wish of PMB, upon whom RLB is dependent, to remain at home. The guardian acknowledged that it was 'a very difficult balance at the moment'. He stated that he had, to that point, made the judgment to support care at home, notwithstanding some risk, but that the matter warranted reconsideration in light of the opinion of Dr RC, which was information that was new to him since he had not been involved in the medical review.
The proposed represented persons' position
30 Neither RLB nor PMB attended the hearing. Both, to a greater or lesser extent, have been clear in their wish, at least as expressed to the Public Advocate, to remain living at home. There is dispute about this within the family however. It is to be noted that CB challenges the strength of the wish and continues to insist that both RLB and PMB were settling into care when they were taken home, a view supported by MB and LB but opposed by PB. In relation to questions about emotional happiness, LB and MB maintained that PMB was tired of cooking and managing the care of RLB. It appears that PMB had expressed a degree of ambivalence when asked about being in care and her levels of happiness by CB. CB did acknowledge when it was put to him, that it is the wish of his parents to live at home but he maintained that neither parent was 'capable of making a decision like that' and that any wish expressed by PMB is not a rationally expressed wish that 'if my mother was capable of making … rational judgment as to her condition and my father's condition she would rather be in care and looked after properly' - which rather begs the question as to what the Tribunal might do with the articulated wishes of a person found to be incompetent, and yet the Tribunal is required to have regard to any wish expressed.
Findings
31 There is no argument, and the Tribunal finds, that RLB and PMB are persons for whom guardianship orders can be made. The criteria set out in s 43(1) of the GA Act have been made out on the largely unchallenged clinical opinion evidence of Dr RC as to the incapacity of both RLB and PMB. That evidence is consistent with the earlier medical evidence which supported the making of the original orders in these matters.
32 Nor is there any evidence that there is a need for a guardian. There is clearly significant disagreement between the family members about what care arrangements are required for RLB and PMB and what will best meet their respective needs, both physical and emotional. That disagreement has not been capable of resolution, as was the case when the original order was made. If anything, positions are now even more entrenched.
33 The question for the Tribunal is not whether or not RLB and PMB should be placed into residential care, but rather, what mechanism should be employed to enable a decision to be made on that, and other questions.
34 CB believed, genuinely the Tribunal finds, that it is in the best interests of both his parents that they go into care. He has sought to be appointed as guardian in order to be able to give effect to his view of what should happen. He was quite candid about the fact that if made guardian, that is the course he would adopt, regardless of the strongly held views of his siblings and regardless of the wishes and views that have been expressed by his parents, particularly his mother. It has been his view from the beginning that this course should be adopted and, given that the guardian has not agreed with him on this subject, he now accuses the guardian of failing to act in the interests of his parents. He does so in the context of medical evidence obtained by him inappropriately.
35 Firstly, he arranged for the review of his parents by a specialist geriatrician without the consent of the duly appointed guardian (holding authority inter alia for all treatment and healthcare decisions), indeed, without even informing the guardian of his actions in arranging and then participating in the review.
36 Secondly, in the course of the review appointment which he arranged without invitation to or notification to other family members, the facts provided by him to the reviewing specialist appear to have been limited to facts that might be seen as supporting his claim that his parents were inadequately supported at home and were at risk. It is a moot point whether, had Dr RC been given access to input from other family members or from the guardian, his opinion on the question of the need for residential care as articulated in his written report would have been the same. Clearly in his evidence, when the evidence of other family members as to the support they say exists was put to him, Dr RC stated that 'that's more family support than we were aware of' and conceded that such a scheme of support 'certainly does reduce the risk of bad outcomes somewhat'. The Tribunal is concerned about the extent to which the provision of selective information to Dr RC by CB may have been an attempt to 'skew' the medical evidence to his advantage.
37 The matters set out above lead the Tribunal to the view that CB ought not be appointed as guardian. His conduct in ignoring the authority of the appointed guardian and in acting as he has done with respect to the medical evidence from Dr RC raises the question of his suitability to hold the role, as does his clearly stated intention to ignore all views but his own as to the future care of his parents. A guardian is required to at least attempt to act in a consultative and collaborative way in the interests of the represented person. The Tribunal is not satisfied that this will occur if CB is appointed as guardian. In view of the conflict within the family as to the issue of the care arrangements, the view of the Tribunal is that the best interests of both RLB and PMB will be much better served by the continuance of an independent guardian. That guardian can continue to talk independently to the doctors and care agencies, and can consult with all family members and with RLB and PMB in determining whether the current arrangements should stand, can or should be augmented, or whether a different plan needs to be considered. It is noted that most other family members support an ongoing independent appointment.
38 The Tribunal is not satisfied that the independent guardian has at any time failed to act in the interests of RLB and PMB. In particular, the suggestion that the guardian failed to act on current medical advice is not supported on the evidence. The application by CB for a change in the order was made on 6 October 2014. It was initially listed on 13 January 2015 but was deferred in early December 2014 at the request of the guardian, TD, as he was to be on leave in midJanuary 2015. The hearing was deferred to 9 February 2015 to accommodate TD's leave. In Dr RC's report to the general practitioner, he states that CB asked him to review RLB and PMB (although the date of the request is not stated) and that the review appointment occurred on 21 January 2015. The report letter is dated 28 January 2015. It is clear from the dates that the advice of Dr RC was likely available to the general practitioner from a date late in January or early February 2015. The rehearing of the matter occurred on 9 February 2015, a bit over one working week from the date of the report, for some of which the delegated guardian may still have been on leave. Even assuming that the delegated guardian had not been on leave and OPA had been provided with the report immediately when it was available (which the Tribunal understands it was not), it simply cannot be accepted that the guardian has failed to move swiftly enough and so failed in her duty to RLB and PMB or that, in failing to act immediately upon Dr RC's recommendations for residential care without further enquiry of others, the guardian failed in her duty to RLB and PMB.
39 The guardian sought to justify the initial decision made to maintain the parents in their home and the ongoing implementation of this decision until the time of the hearing on the basis that it was in line with their very strongly held desire to stay at home and, given the support that TD believed was in place for the parents and the information from and views of most of the children of RLB and PMB, that it represented a reasonable decision when weighing actual risk against those other matters. The Tribunal agrees. The guardian acknowledged at the February 2015 hearing that the new specialist opinion evidence warranted consideration and might affect the guardian's view as to the future situation. The Tribunal accepts that this is a measured and appropriate approach to take and that it was done in a timely manner.
40 There is always scope for different views about what is in a person's best interests. Best interests can be a very elastic concept and variable from one set of circumstances to another. Difference does not necessarily make one of the views wrong; it just makes it a different view. The Tribunal does not doubt that CB cares very much about his parents and wants what is best for them. The difficulty is that his assessment of what is in their best interests is different from the views of others, and in particular, different from the assessment, to this point, of the legitimately appointed guardian. It cannot be said that just because the guardian takes a view that is different to CB's view, that, of itself, means that the guardian is failing to act in the best interests of RLB and PMB. This is the trap into which the applicant falls in making his argument.
41 The OPA recommendation to the Tribunal is that, given the conflict and disagreement within the family, it was not in the parents' best interests that one family member with a very definite view as to outcome be the decisionmaker and that an independent guardian is still required. The Tribunal agrees.
The decision of the Tribunal
42 The Tribunal accepts the guardian's submissions and finds that the rationale of the decisions made to that point by the guardian was reasonable on the facts available to her and did not constitute a failure to act in the best interests of the parents as alleged by CB; the Tribunal accepts that the guardian is appropriately open to a change in view and is acting appropriately in following up on the new evidence; and further, the Tribunal finds CB should not be appointed as guardian and that, in the circumstances of conflict in the family, an independent guardian is required going forward and that the Public Advocate should be reappointed to make decisions as previously and on the same basis.
Orders
The Tribunal declares that the represented persons:
(a) are incapable of looking after their own health and safety;
(b) are unable to make reasonable judgments in respect of matters relating to their person;
(c) are in need of oversight, care or control in the interests of their own health and safety or for the protection of others; and
(d) are in need of a guardian,
and the Tribunal orders that:
1. The Public Advocate of Level 2, International House, 26 St Georges Terrace, Perth, Western Australia be appointed limited guardian of the represented persons with the following functions:
(a) to decide where the represented persons are to live, whether permanently or temporarily;
(b) to decide with whom the represented persons are to live;
(c) subject to Division 3 of Part 5 of the Guardianship and Administration Act 1990 (WA), to make treatment decisions for the represented persons; and
(d) to determine the services to which the represented persons should have access.
2. The Tribunal approves delegation by the Public Advocate of her functions as guardian of the represented persons to an officer or employee employed in the Office of the Public Advocate.
3. Reasons for decision will be published.
4. This order is to be reviewed by 4 May 2020.
I certify that this and the preceding [42] paragraphs comprise the reasons for decision of the State Administrative Tribunal.
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MS H LESLIE, MEMBER
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