In re L.S.

• Decision Date: 20 September 2022
• Docket Number: 55559-0-II
• Citation: 517 P.3d 490
• Parties: In the MATTER OF the Detention of: L.S., Petitioner.
• Court: Washington Court of Appeals

517 P.3d 490

In the MATTER OF the Detention of: L.S., Petitioner.

No. 55559-0-II

Court of Appeals of Washington, Division 2.

Filed September 20, 2022

Marie Jean Trombley, Attorney at Law, P.O. Box 829, Graham, WA, 98338-0829, for Appellant.

Soc. & Hlth. Svc. A.G. Office, Amanda Kaye Smitley, Attorney at Law, 7141 Cleanwater Lane Sw., P.O. Box 40124, Olympia, WA, 98504-0124, for Respondent.

PUBLISHED OPINION

Lee, J.

¶1 L.S. appeals the superior court's 90-day commitment order for involuntary treatment under the "Involuntary Treatment Act" (ITA), ch. 71.05 RCW. L.S. argues that the superior court abused its discretion and violated L.S.’s procedural due process rights by admitting hearsay evidence as substantive evidence. L.S. also claims that the evidence was insufficient to support the superior court's findings of fact and conclusions of law.

¶2 We hold that the superior court did not admit hearsay as substantive evidence nor did the court violate L.S.’s procedural due process rights. We do not address L.S.’s insufficiency of the evidence claim because she fails to provide any argument on that claim. Accordingly, we affirm L.S.’s 90-day commitment order for involuntary treatment.

FACTS

¶3 The superior court commissioner held a hearing on a petition¹ to commit L.S. for involuntary treatment for 90 days.² At the hearing, the State argued that L.S. was gravely disabled. At the time of the hearing, L.S. was detained at Western State Hospital (WSH).

¶4 Dr. Christine Collins, a forensic evaluator, was the sole witness at the hearing on the petition to commit. Dr. Collins had attempted to conduct an interview with L.S. for evaluation, but L.S. declined to participate. Instead, Dr. Collins conducted her evaluation by reviewing L.S.’s records and consulting with members of L.S.’s treatment team.

¶5 Dr. Collins testified that, in her opinion, L.S. met criteria for unspecified schizophrenia

spectrum and other psychotic disorder and had a history of substance use disorder. Dr. Collins began describing the symptoms that L.S. was currently exhibiting that supported her diagnoses, stating that L.S. "has been observed, according to (inaudible)." 2 Verbatim Report of Proceedings (VRP) (Feb. 22, 2021) at 15. L.S.’s counsel objected based on hearsay. The court commissioner overruled the objection, stating it was premature.

¶6 Dr. Collins started to again describe the symptoms L.S. was exhibiting that supported her diagnoses of unspecified schizophrenia

spectrum and other psychotic disorder, stating, "According to the records, [L.S.] has been—." 2 VRP (Feb. 22, 2021) at 18. L.S.’s counsel again objected based on hearsay, and the State responded that it was offering the evidence under ER 703.³ The court commissioner allowed the testimony, ruling that "[w]ith the ER 703 limitation, Dr. Collins is an expert, can rely on hearsay in formulating her own personal, professional opinion." 2 VRP (Feb. 22, 2021) at 18.

¶7 Dr. Collins then testified that, according to L.S.’s records, L.S. had been observed yelling at internal stimuli and displayed disorganized thought processes, rapid and pressured speech, anxiousness, and guardedness. Dr. Collins also testified that, earlier in her admission at WSH, L.S. displayed paranoia and some delusional beliefs and had difficulty completing her activities of daily living, including hygiene and grooming, though these symptoms had recently improved.

¶8 The State asked Dr. Collins what symptoms L.S. was currently exhibiting that support Dr. Collins’ diagnosis of a history with stimulant use disorder. Dr. Collins answered, "That is purely from the records." 2 VRP (Feb. 22, 2021) at 19. L.S.’s counsel made another hearsay objection, and the State again stated it was offering the testimony under ER 703. The court commissioner accepted Dr. Collins’ testimony with an ER 703 limitation, acknowledging the testimony as hearsay but allowing Dr. Collins to rely on it in formulating her professional opinion.

¶9 Dr. Collins testified that, according to the records, L.S. "displayed impaired insight into her condition as well as her legal situation." 2 VRP (Feb. 22, 2021) at 19. Dr. Collins stated that L.S.’s chart notes said she displayed confusion regarding her diagnosis, symptoms, and medication. Dr. Collins also stated that, when staff asked L.S. to talk about her medications, L.S. described the experience of hypersalivation

. Additionally, Dr. Collins stated that L.S. said she would take half of her medication if she left WSH. L.S.’s counsel again objected to Dr. Collins’ references to L.S.’s chart notes as hearsay, and the court commissioner again accepted the testimony with an ER 703 limitation.

¶10 Dr. Collins also testified that it was difficult to assess how reality-based L.S.’s thoughts were because L.S. displayed disorganized speech with staff and had delusional beliefs about her mother-in-law. Also, L.S. displayed impaired judgment because she expressed confusion and frustration about using a previous attorney for her civil commitment; was unable to identify her medications or how to obtain them in the community; and stated that she did not know if she would talk to a doctor about any negative side effects, but she would instead talk to God about it.

¶11 Dr. Collins further testified that, in her opinion, L.S. would not consistently be able to ensure that her basic health and safety needs were met if she was released on the day of the hearing. Dr. Collins explained that L.S. would find it difficult to find places to get medications and to be able to access food and services, and that L.S. might not know how to obtain health insurance. Dr. Collins also testified that, in her opinion, L.S. would be at serious risk of physical harm if she was released on the day of the hearing.

¶12 Dr. Collins testified that, based on L.S.’s records, L.S. did not recognize the need for medication but did participate in some aspects of treatment, like nursing groups and social activities. In Dr. Collins’ opinion, L.S. was not capable of making rational decisions regarding her treatment. Dr. Collins stated that this opinion was based on L.S.’s records showing that L.S. was confused and frustrated whenever she was trying to make her needs known or attempting to understand her current legal matter. Dr. Collins’ opinion was also based on the chart notes that showed L.S. would only take half of her medication and was unaware of how to obtain her medication.

¶13 Dr. Collins stated that, in her professional opinion, L.S. was gravely disabled as a result of her behavioral health disorder. Dr. Collins testified that L.S. needed to live in a supervised living facility that could offer medications as well as treatment options, and that L.S.’s discharge plan was to have L.S. live with her daughter or in a hotel. Additionally, Dr. Collins testified that, while a less restrictive alternative placement could be beneficial if they found one with supervision, medications, and treatment, L.S. had not recently expressed any desire to go to a less restrictive alternative.

¶14 During cross-examination, Dr. Collins testified that her opinion at the hearing was based largely on a review of L.S.’s chart notes and discussions with L.S.’s treatment team. Dr. Collins stated that her interactions with L.S. were limited to casual observation and one attempt to meet with her, when L.S. seemed confused and did not want to talk to Dr. Collins.

¶15 In its oral ruling, the court commissioner concluded that L.S. was gravely disabled. The commissioner based this conclusion on Dr. Collins’ diagnoses and professional opinion and acknowledged that Dr. Collins relied on chart notes, medical records, and her own brief observation of L.S.

¶16 The court commissioner made written findings and conclusions in its order committing L.S. for involuntary treatment. The order incorporated by reference the commissioner's oral findings of fact and conclusions of law. The order also included the following findings:

Respondent suffers from a behavioral health disorder. The diagnosis is: Unspecified Schizophrenia

Spectrum and Other Psychotic Disorder ; and History of Substance Use Disorder (Stimulant).

....

??Is/Continues To Be Gravely Disabled and Respondent:

? as a result of a behavioral health disorder is in danger of serious physical harm resulting from the failure to provide for his/her essential needs of health or safety.

Clerk's Papers (CP) at 21-22.

¶17 The order listed "Facts in Support" underneath this finding. CP at 22 (boldface omitted). In this section, the order provided a summary of the hearing and testimony at the hearing. This summary included Dr. Collins’ testimony based on her review of L.S.’s records and consultation with members of L.S.’s treatment team. The summary also included the fact that Dr. Collins was unable to interview L.S. and that Dr. Collins’ opinions were based on medical records.

¶18 The order included the following conclusions of law:

1. Jurisdiction. The court has jurisdiction over the parties and subject matter of this behavioral health proceeding.

2. Detention Criteria. The Respondent as a result of a behavioral health disorder:

....

? is/continues to be gravely disabled.

CP at 23.

¶19 L.S.’s counsel moved to revise the order and argued that the State had not presented sufficient evidence to support the finding of grave disability without the use of hearsay. During the hearing on the motion to revise, the superior court noted that Dr. Collins based her opinion on L.S.’s

ongoing signs of what appears to be hallucinations and responding to internal stimuli, her failure to engage in any discussion regarding planning for discharge, her rather delusional statements as to how she would survive if she were to be released, [and] her statement that she would only take half of her medication if released.

VRP (Mar. 19, 2021) at 13. The superior court also stated that L.S.’s statements could be considered as statements of a party opponent. The superior court denied L.S.’s motion to...