Pierce County Office of Involuntary Commitment v. Western State Hospital

• Decision Date: 29 April 1982
• Docket Number: 48421-1,Nos. 18-50-60 and 18-50-60,R,Nos. 48069-9,s. 18-50-60 and 18-50-60,s. 48069-9
• Citation: 97 Wn.2d 264,644 P.2d 131
• Parties: PIERCE COUNTY OFFICE OF INVOLUNTARY COMMITMENT, by and through Norman Fournier, Pierce County Mental Health Professional, and on behalf of persons named in Pierce County Involuntary Commitment Caseespondent, v. WESTERN STATE HOSPITAL, an institution of the Department of Social and Health Services, an agency of the State of Washington, Appellant. KING COUNTY, Respondent, v. WASHINGTON STATE DEPARTMENT OF SOCIAL AND HEALTH SERVICES; Alan J. Gibbs, in his official capacity as Secretary of the Washington State Department of of Social and Health Services; Delbert Kole, M.D., in his official capacity as Director of the Division of Mental Health, a division of the Department of Social and Health Services; Western State Hospital; and Morgan Martin, M.D., in his capacity as Superintendent of Western State Hospital, Appellants.
• Court: Washington Supreme Court

Page 264

97 Wn.2d 264

644 P.2d 131

PIERCE COUNTY OFFICE OF INVOLUNTARY COMMITMENT, by and

through Norman Fournier, Pierce County Mental Health

Professional, and on behalf of persons named in Pierce

County Involuntary Commitment Case Nos. 18-50-60 and 18-50-60A, Respondent, v. WESTERN STATE HOSPITAL, an institution of the Department of

Social and Health Services, an agency of the State

of Washington, Appellant.

KING COUNTY, Respondent, v. WASHINGTON STATE DEPARTMENT OF SOCIAL AND HEALTH SERVICES;

Alan J. Gibbs, in his official capacity as Secretary of the

Washington State Department of of Social and Health

Services; Delbert Kole, M.D., in his official capacity as

Director of the Division of Mental Health, a division of the

Department of Social and Health Services; Western State

Hospital; and Morgan Martin, M.D., in his capacity as

Superintendent of Western State Hospital, Appellants.

Nos. 48069-9, 48421-1.

Supreme Court of Washington, En Banc.

April 29, 1982.

Kenneth Eikenberry, Atty. Gen., Karen M. Lundahl, David R. Minikel, Asst. Attys. Gen., Olympia, for appellant.

Don Herron, Pierce County Prosecutor, Jill G. Walter, Deputy Pros. Atty., Tacoma, Norman K. Maleng, King County Prosecutor, Richard W. Elliott, Sr. Deputy Pros. Atty., Seattle, for respondent.

ROSELLINI, Justice.

These cases are before the court for direct review of writs of mandamus issued to Western State Hospital and the Department of Social and Health Services, requiring them to accept for evaluation persons presented to Western State Hospital by mental health professionals, pursuant to RCW 71.05.150(2). It is the position of the appellants that the hospital is not obliged to accept patients if all of the beds in the evaluation and treatment facility are occupied. The question is governed by statute.

Under RCW 71.05.020(16),

"(e)valuation and treatment facility" means any facility which can provide directly, or by direct arrangement with other public or private agencies, emergency evaluation and treatment, outpatient care, and short term inpatient care to persons suffering from a mental disorder, and which is certified as such by the department of social and health services: Provided, That a physically separate and separately operated portion of a state hospital may be designated as an evaluation and treatment facility: Provided further, That a facility which is part of, or operated by, the department of social and health services or any federal agency will not require certification: And provided further, That no correctional institution or facility, or jail, shall be an evaluation and treatment facility within the meaning of this chapter.

RCW 71.05.150(2) provides:

(2) When a mental health professional designated by the county receives information alleging that a person, as the result of a mental disorder, presents an imminent likelihood of serious harm to himself or others, or is in imminent danger because of being gravely disabled, after investigation and evaluation of the specific facts alleged and of the reliability and credibility of the person or persons providing the information if any, the mental health professional may take such person, or cause by oral or written order such person to be taken into emergency custody in an evaluation and treatment facility for not more than seventy-two hours as described in RCW 71.05.180.

A third provision governing this controversy is RCW 71.05.170. In pertinent part, it reads:

Whenever the designated county mental health professional petitions for detention of a person whose actions constitute a likelihood of serious harm to himself or others, or who is gravely disabled, the facility providing seventy-two hour evaluation and treatment must immediately accept on a provisional basis the petition and the person. The facility shall then evaluate the person's condition and admit or release such person in accordance with RCW 71.05.210.

As a facility operated by the Department of Social and Health Services, Western State Hospital is exempt from the requirement of certification. It has designated a unit containing 52 beds as an evaluation and treatment facility. The staff which it provides in that unit can properly serve only that number of patients at any one time. There are seven additional wards in the adult psychiatric unit, with a 217-bed capacity, for the treatment of persons involuntarily committed under RCW chapter 71.05 for 90- or 180-day treatment of mental illness. Admission of persons beyond the stated capacity of any of the wards jeopardizes the physical safety of patients and staff and adversely affects the hospital's ability to adequately treat its patients.

Western State Hospital is an accredited hospital and is in danger of losing both its accreditation and Medicare certification because of loss of adequate staff-patient ratios. Pursuant to an admissions control policy which was established in 1981, the evaluation and treatment center would not admit patients beyond its 52-bed capacity in the absence of a court order. These mandamus actions were brought to obtain comprehensive orders that would eliminate the necessity of applying to the court each time a patient is rejected.

Western State Hospital serves patients from 22 counties. There are 21 certified facilities in the area, in addition to the one at Western State Hospital. Both Pierce and King counties have pursued a policy of applying to Western State Hospital only if all of the beds in local facilities are filled. In neither county have mental health professionals sought court orders to compel local facilities to accept patients beyond their capacity. It is not disputed that such overcrowding would create the same kind of problems which confront Western State Hospital when it must accept patients for whom it has neither adequate staff nor beds.

The statutes we have quoted plainly mandate that Western State Hospital, as a "facility providing seventy-two hour evaluation and treatment" accept all petitions for detention, as well as the persons on whose behalf the petitions are submitted.

RCW 71.05.150 gives the mental health professional discretion in deciding (1) whether to detain a person who qualifies for detention under that section and (2) which evaluation and treatment facility he will petition for detention of the person. Since his "jurisdiction" is confined to the county employing him, we can perceive in the statute an implied requirement that he petition only facilities which are within the county or which are provided by the State to serve the county. There is nothing in the statute which requires him to utilize one of these rather than another. No distinction is made between state and local, public or private facilities. For aught that is revealed in the statute, no thought was taken by its drafter (or the drafters of the regulations passed pursuant to RCW 71.05.540 requiring the department to establish standards to be met by a public or private facility certified as an evaluation and treatment center) of the possibility that a particular facility might be called upon to exceed its capacity; and so there are no directions as to the proper procedure to follow in that event.

At the same time, such a facility is defined in RCW 71.05.020(16) as one which "can provide ... emergency evaluation and treatment, outpatient care, and short term inpatient care to persons suffering from a mental disorder" and which is certified. WAC 275-55-280(3)(b) defines "(e)mergency service for involuntary clients" as "the provision of immediate therapeutic intervention in cases involving involuntary clients." It provides that such service shall have the ability to respond immediately to clients and to admit clients on a 24-hour per day, 7-day per week basis, and provides in some detail the kind of services that must be immediately available. It provides that the facility must have the ability to detain dangerous individuals. Presumably the State's own institutions are expected to meet these standards, even though certification is not required.

Also, RCW 71.05.360(2) gives all persons detained or committed pursuant to the involuntary treatment act the right to adequate care and individualized treatment.

It should be obvious that every such facility has a capacity beyond which it cannot perform these functions-at least not "immediately". Yet nothing is said in the statute or regulations about capacity.

It is suggested that in spite of the clear language of RCW 71.05.170, the court should find in these provisions an implied condition that the facility where admission is sought must be able to give the patient the care required by the statute and regulations.

However, to alleviate the problem for the state hospital in this way only creates a further dilemma. If a...