California Assn. of Psychology Providers v. Rank

• Decision Date: 25 June 1990
• Docket Number: No. S002524,S002524
• Citation: 793 P.2d 2,270 Cal.Rptr. 796,51 Cal.3d 1
• Court: California Supreme Court
• Parties: , 793 P.2d 2 CALIFORNIA ASSOCIATION OF PSYCHOLOGYPROVIDERS et al., Plaintiffs and Respondents, v. Peter RANK, as Director, etc., et al., Defendants and Respondents; California Hospital Association et al., Movants and Appellants.

Page 796

270 Cal.Rptr. 796

51 Cal.3d 1, 793 P.2d 2

CALIFORNIA ASSOCIATION OF PSYCHOLOGYPROVIDERS et al., Plaintiffs and Respondents, v. Peter RANK, as Director, etc., et al., Defendants and Respondents California Hospital Association et al., Movants and Appellants.

No. S002524.

Supreme Court of California In Bank.

June 25, 1990.

As Modified on Denial of Rehearing

Sept. 20, 1990.

Horvitz, Levy & Amerian, Horvitz & Levy, Ellis J. Horvitz, Grant Marylander and David S. Ettinger, Encino, for movants and appellants.

Kirk B. Johnson, Chicago, Ill., Sidley & Austin, Los Angeles, Carter G. Phillips, Onek, Klein & Farr, Joel I. Klein, Washington, D.C., Munger, Tolles & Olson, Allen M. Katz, Los Angeles, Davis, Cowell & Bowe and Richard G. McCracken, San Francisco, as amici curiae, on behalf of movants and appellants.

Licht & Bloom, Michele H. Licht, Richard H. Bloom, Sherman Oaks, Hogan & Harsten, Clifford D. Stromberg and Barbara F. Mishkin, Washington, D.C., for plaintiffs and respondents.

Jenner & Block, Donald N. Bersoff, Washington, D.C., and John Keiser, Los Angeles, as amici curiae, on behalf of plaintiffs and respondents.

No appearance for defendants and respondents.

BROUSSARD, Justice.

The issue before us is whether a hospital may permit clinical psychologists to take primary responsibility for the diagnosis and treatment of their hospitalized patients. Prior to 1978, regulations of the Department of Health Services (hereafter Department) declared that a psychiatrist must take charge of the diagnosis and treatment of all patients admitted to psychiatric wards or hospitals. ¹ In 1978, however, the Legislature enacted Health and Safety Code section 1316.5, ² which after confirming that hospitals could admit psychologists to their staffs, provided that such psychologists may, subject to the rules of the hospital, "carry professional responsibilities consistent with the scope of their licensure and competence." In 1980 the Legislature added language declaring that if such a hospital offered services that both physicians and psychologists could perform, "such service may be performed by either, without discrimination."

When the Department in 1983 reissued its 1975 regulations prohibiting hospitals from permitting a psychologist to carry primary responsibility for the diagnosis and treatment of patients, plaintiffs sued for

[793 P.2d 4] declaratory relief. The trial court granted their motion for summary judgment, declared the regulations invalid, and directed the Department to issue new regulations permitting psychologists to take primary responsibility for the diagnosis and treatment of hospitalized patients. After a complex procedural history, recounted later in this opinion, the Court of Appeal reversed the trial court. [51 Cal.3d 7] We granted review, and now uphold the ruling of the trial court, which we believe conforms to the language and carries out the purpose of the 1978 and 1980 legislation.

I. BACKGROUND AND HISTORY OF THIS LITIGATION

Following the enactment of section 1316.5 in 1978, and its amendment in 1980, the Department considered amending its regulations to permit clinical psychologists to be responsible for the diagnosis and treatment of their patients. After public hearings, however, the Department on January 6, 1983, adopted regulations which provided that for patients admitted to psychiatric wards or hospitals, "[a] psychiatrist shall be responsible for the diagnostic formulation for each patient and the development and implementation of the individual patient's treatment plan." (Cal.Code Regs., tit. 22, §§ 70577, subd. (d)(1) and 71203, subd. (a)(1)(A), italics added.) These regulations are essentially the same as those in effect before the enactment and amendment of section 1316.5.

Plaintiffs, the California Association of Psychology Providers (CAPP) and several individual clinical psychologists, brought suit against the Department, the Department of Finance, and their directors. The complaint asserted seven causes of action. The first simply set out the facts recited previously in this opinion. The second cause of action sought mandamus on the theory that the regulations conflict with the statute. The third sought mandamus on the theory that the regulations were adopted in violation of the public hearing requirements of Government Code section 11346.8. The fourth, fifth and sixth causes of action sought injunctive relief. The seventh cause of action requested a declaration of plaintiffs' rights with respect to the challenged regulations. ³

Plaintiffs moved for summary judgment on the seventh cause of action. The trial court granted the motion, and entered a judgment declaring that under section 1316.5, "clinical psychologists on the medical staff of a health facility are authorized to independently provide psychological services within the legal scope of their licensure, without physician supervision and without discriminatory restrictions. The provision of psychological services includes ultimate responsibility for the psychological care of hospitalized patients and authority to admit and discharge patients provided that a physician shall be responsible for the necessary medical care of patients including completion of a physical examination upon admission of each patient." The court held regulations 70577, subdivision (d)(1) and 71203, subdivision (a)(1)(A) invalid, and ordered the Department to adopt the regulations originally proposed in 1982. ⁴ The Department announced that it would not appeal the trial court order and, about a month after the oral statement of decision (and before the filing of the written judgment), adopted the regulations as directed by the court. The California Hospital Association, the California Medical Association, and the California Psychiatric Association, joined by individual doctors, moved to vacate the judgment. The trial court denied the motion for want of standing, and the moving parties appealed.

Plaintiffs moved to dismiss the appeal, contending that appellants were not properly parties to the action and that the Department's adoption of new regulations rendered the matter moot. The Court of Appeal granted the motion. In an order dated October 16, 1986, we granted appellants' petition for review and retransferred the case to the Court of Appeal with directions to vacate the order of dismissal.

Upon retransfer, the Court of Appeal ruled sua sponte that the trial court judgment was not appealable. On November 25, 1987, we again granted review and retransferred, directing the Court of Appeal to vacate its dismissal and to hear the appeal on its merits.

Pursuant to our order, the Court of Appeal addressed the merits of the appeal and reversed the judgment below. It held that the Legislature intended clinical psychologists to have the right to diagnose and treat their hospitalized patients without supervision from a physician "only in those instances where a physician has initially ruled out a medical basis for the patient's mental disorder and determined that it is not subject to medical treatment, and where the patient's mental disorder does not subsequently become susceptible to medical treatment after admission to the health facilitysS The statutory prohibition against discrimination, it said, prohibits requiring supervision by a psychiatrist, but only "after a medical diagnosis and medical treatment have been ruled out...." We granted review and retained the case for decision.

II. PRELIMINARY PROCEDURAL ISSUES

Our prior orders necessarily determined that the trial court ruling was appealable, that appellants have standing to appeal, and that the matter has not become moot. Those rulings are controlling under the doctrine of law of the case. (See Pigeon Point Ranch, Inc. v. Perot (1963) 59 Cal.2d 227, 230-232, 28 Cal.Rptr. 865, 379 P.2d 321.) Nevertheless, because our minute orders did not set out the reasoning of the court, and cannot serve as precedent to guide future decisions, we believe it appropriate to explain the basis for our decisions.

(a) Appealability.

The trial court entered summary judgment only as to plaintiffs' seventh cause of action. The Court of Appeal originally concluded that because the judgment did not address plaintiffs' other six asserted causes of action, appeal was barred by the one final judgment rule. (Code Civ.Proc., § 904.1.) Plaintiffs' seventh cause of action, however, sought a declaration of plaintiffs' rights with respect to the facts alleged in all other causes of action. The resulting judgment effectively disposed of the case. Once the trial court had determined that the existing regulations were invalid, and directed the Department to adopt new regulations, there would be no purpose in conducting further proceedings to decide whether to compel the same result by writs of injunction or mandamus. A judgment that leaves no issue to be determined except the fact of compliance with its terms is appealable. (Agricultural Labor Relations Bd. v. Tex-Cal Land Management, Inc. (1987) 43 Cal.3d 696, 702, 238 Cal.Rptr. 780, 739 P.2d 140; Lyon v. Goss (1942) 19 Cal.2d 659, 669-670, 123 P.2d 11; see Etienne v. DKM Enterprises (1982) 136 Cal.App.3d 487, 489, 186 Cal.Rptr. 321.)

(b) Standing to Appeal.

" 'Any aggrieved party' may appeal from an adverse judgment.... [O]ne who is legally 'aggrieved' by a judgment may become a party of record and obtain a right to appeal by moving to vacate the judgment pursuant to Code of Civil Procedure section 663." (County of Alameda v. Carleson (1971) 5 Cal.3d 730, 736, 97 Cal.Rptr. 385, 488 P.2d 953.) Appellants having filed such a motion, the only question is whether they qualify as persons aggrieved by the judgment.

The issue is clear as to appellant California Hospital Association since the trial court directed the Department to issue regulations binding its member hospitals. The matter is less clear as to appellants California Medical Association, ...