Oregon Advocacy Center v. Mink

• Decision Date: 06 March 2003
• Docket Number: No. 02-35530.,02-35530.
• Citation: 322 F.3d 1101
• Parties: OREGON ADVOCACY CENTER; Metropolitan Public Defender Services, Inc.; and A.J. Madison, Plaintiffs-Appellees, v. Bobby MINK, Director of the Department of Human Services, in his official capacity; and Stanley Mazur-Hart, Superintendent of Oregon State Hospital, in his official capacity, Defendants-Appellants.
• Court: U.S. Court of Appeals — Ninth Circuit

322 F.3d 1101

OREGON ADVOCACY CENTER; Metropolitan Public Defender Services, Inc.; and A.J. Madison, Plaintiffs-Appellees, v.Bobby MINK, Director of the Department of Human Services, in his official capacity; and Stanley Mazur-Hart, Superintendent of Oregon State Hospital, in his official capacity, Defendants-Appellants.

No. 02-35530.

United States Court of Appeals, Ninth Circuit.

Argued and Submitted September 11, 2002.

Filed March 6, 2003.

COPYRIGHT MATERIAL OMITTED

COPYRIGHT MATERIAL OMITTED

COPYRIGHT MATERIAL OMITTED

Richard D. Wasserman, Assistant Attorney General, Salem, OR, for the defendants-appellants.

Kathleen L. Wilde, Oregon Advocacy Center, and Spencer M. Neal, Oregon Law Center, Portland, OR, for the plaintiffs-appellees.

Appeal from the United States District Court for the District of Oregon; Owen M. Panner, Senior District Judge, Presiding.D.C. No. CV-02-00339-PA.

Before: T.G. NELSON, GRABER and FISHER, Circuit Judges.

FISHER, Circuit Judge.

Oregon, in recognition of the constitutional rights of mentally incapacitated persons charged with a crime, commendably has enacted statutory procedures for the identification and restorative treatment of such persons so that their guilt or innocence can be determined in a trial.This case presents the question of what happens when the state mental hospital (Oregon State Hospital or "OSH"), which is charged with evaluating and treating mentally incapacitated defendants, refuses to accept such defendants on a timely basis.Plaintiffs contend that OSH's delays in accepting mentally incapacitated defendants violate those defendants' substantive and procedural due process rights.OSH argues that it is the county jails' responsibility to maintain and treat incapacitated defendants until OSH has an open bed.After a bench trial, the district court agreed with the plaintiffs and entered an injunction requiring OSH to admit defendants within seven days of a trial court's finding of their incapacity to proceed to trial.We have jurisdiction under 28 U.S.C. § 1291, and we affirm.

BACKGROUND

I.Parties

Plaintiffs(appellees here) include A.J. Madison, a mentally incapacitated criminal defendant who was detained in a county jail while awaiting transfer to OSH, and two nonprofit organizations that represent such defendants.Plaintiff Oregon Advocacy Center ("OAC") is a federally authorized and funded law office established under the Protection and Advocacy for Mentally Ill Individuals Act of 1986 ("PAMII"), 42 U.S.C. §§ 10801-10851.OAC represents the rights of people with disabilities, including mentally ill individuals.Plaintiff Madison is one of OAC's constituents and requested that OAC bring this suit on his behalf.PlaintiffMetropolitan Public Defender Services, Inc.("MPD") represents indigent criminal defendants in two Oregon counties.

These plaintiffs sued Stanley Mazur-Hart, the Superintendent of the Oregon State Hospital, and Bobby Mink, the Director of Oregon's Department of Human Services, in their official capacities (collectively referred to as "OSH" in this opinion).The plaintiffs alleged that OSH was violating mentally incapacitated defendants' due process rights by unreasonably delaying such defendants' transfer from county jails to OSH for treatment.

II.The Problem

Under Oregon law, state circuit (trial) courts may, before or during trial, find a criminal defendant to be incapacitated as a result of a mental disease or defect such that the defendant is unable to assist and cooperate with defense counsel or participate in the defense.¹Such a finding triggers a process designed to evaluate, treat and restore the defendant's mental health so that judicial proceedings may resume."If [a]court determines that [a criminal]defendant lacks fitness to proceed [to trial], the proceeding against the defendant shall be suspended ... and the court shall commit the defendant to the custody of the superintendent of a state mental hospital designated by the Department of Human Services...."Oregon Revised Statute("ORS")§ 161.370(2).The Oregon State Hospital is the only "state mental hospital" that has been designated under this statute.

OSH is required to evaluate a defendant committed to its custody within 60 days of the defendant's arrival to determine "whether there is a substantial probability that, in the foreseeable future, the defendant will have the capacity to stand trial."ORS § 161.370(3)(emphasis added).²If, at any time, the defendant becomes capable of standing trial or will never have that capacity, OSH must immediately so notify the court.ORS § 161.370(4).Within 90 days of the defendant's arrival, OSH must notify the court whether the defendant has the capacity to stand trial and, if not, whether there is a substantial probability that the defendant will gain or regain that capacity in the foreseeable future.Id.If OSH determines that such a probability exists, "the defendant shall remain in [OSH's] custody where the defendant shall receive treatment designed for the purpose of enabling the defendant to gain or regain capacity."ORS § 161.370(5).

After a bench trial, the district court found that, during 2001 and early 2002, incapacitated criminal defendants spent on average about one month in county jails before OSH accepted them for the requisite evaluation and treatment.In many cases, defendants had to wait two, three or even five months.The court also spelled out in a series of factual findings — for the most part undisputed by OSH — the harms suffered by defendants who are relegated to a wait-list status and remain in jail until OSH has room for them.We set out the most relevant undisputed findings here:

9.Jails can provide medication management for people who are willing to take medications, but cannot administer medication involuntarily, except in a life-threatening emergency.When resources permit, treatment for "unfit to proceed"defendants may possibly include basic clinical psychiatry and intervention.Such treatment is designed to stabilize the inmate.However, some inmates, particularly those with personality disorders, refuse or do not respond to medication, and do not otherwise respond to the treatment the jails can provide.

10.None of the jails in which these persons are held is able to provide treatment designed to restore a person found unfit to proceed to competency.People found unfit to proceed are often overtly psychotic and require special housing or segregation.They are unpredictable and disruptive, taking up valuable resources needed for the care of other inmates.If they refuse to take medications, they often decompensate rapidly.They often are confined in their cells for 22 to 23 hours a day because of their behavior.This exacerbates their mental illness.

11.Necessarily, the jails' only system for controlling inmates is disciplinary, which is behavior-driven.Such a system is ineffective for mentally ill persons, and possibly harmful.

12.Unlike the county jails, OSH has the capacity to treat a person's mental illness.Each of the units housing persons found unfit to proceed is staffed by a full-time psychiatrist, a psychologist, a mental health specialist, a recreation counselor, a social worker, a mental health technician and nurses.

13.In addition to assessment, medication evaluation and management, and individual and group psychotherapy, OSH provides legal skills training three times a week to assist patients in learning about the law, pleas, and returning to court.This treatment is designed to enable a person to regain fitness to proceed to trial.

17. .... This population has a high suicide risk, and psychosis can be an emergency requiring immediate treatment.

18. .... Depriving [persons deemed unfit to proceed] of necessary medical treatment increases the likelihood that they may decompensate and suffer unduly.The delays also hamper efforts to provide effective representation regarding their criminal prosecution.

19. ....[A]s the client spends weeks and months in jail awaiting hospitalization, th[e] evaluation [required by state law] is delayed....[F]or people declared to be unable to aid and assist, delays in the subsequent evaluative process can postpone the opportunity for a trial for much longer than 60 days.

20.The jails have the capacity to transport inmates to a treatment facility within 24 hours.The reason they do not transport the inmates is because defendants refuse to accept them.

III.The Suit

Plaintiffs sued OSH on March 19, 2002, seeking injunctive and declaratory relief.OAC and MPD both brought suit on behalf of constituents who suffer injury as a result of OSH's failure to provide them timely treatment.MPD also sued in its own right.As of the date of filing, there were seven persons, including Madison, who had been declared unfit and who were being held in county jails awaiting transfer to OSH.As of March 25, 2002, there were 11 such persons including Madison.Madison was held in jail for a total of 23 days before being admitted to OSH on March 28, 2002.

The district court held a bench trial on April 8, 2002, and issued its findings of fact and conclusions of law on May 9.It held that (1) OAC had standing to sue on behalf of its constituents, mentally incapacitated criminal defendants, and MPD had standing to sue in its own right; and (2) OSH was violating the incapacitated defendants' Fourteenth Amendment due process rights by unreasonably detaining them in county jails that lack the facilities to treat and restore the defendants' mental health.The district court entered an injunction requiring OSH to admit mentally incapacitated defendants within seven days of the judicial finding of their incapacity to proceed to trial.

Thereafter, OSH moved to stay the injunction pending appeal and to clarify and modify the injunction so that the seven-day period would begin to run upon OSH's receipt of notice of a finding of unfitness.On May...