Pierce County v. State

• Decision Date: 28 May 2008
• Docket Number: No. 34423-8-II.,34423-8-II.
• Citation: 185 P.3d 594,144 Wn. App. 783
• Parties: PIERCE COUNTY, a political subdivision of the State of Washington; Pierce County Regional Support Network, a division of Pierce County Department of Human Services; and Puget Sound Behavioral Health, a psychiatric facility owned by Pierce County Regional Support Network; Washington Protection and Advocacy System, Inc., Respondents/Cross-Appellants, v. STATE of Washington; and State of Washington, Department of Social and Health Services; Maryanne Lindeblad, in her official acting capacity as Director of Mental Health Division; and Andrew Phillips, in his official capacity as Chief Executive Officer of Western State Hospital, Appellants/Cross Respondents.
• Court: Washington Court of Appeals

185 P.3d 594

144 Wn. App. 783

PIERCE COUNTY, a political subdivision of the State of Washington; Pierce County Regional Support Network, a division of Pierce County Department of Human Services; and Puget Sound Behavioral Health, a psychiatric facility owned by Pierce County Regional Support Network; Washington Protection and Advocacy System, Inc., Respondents/Cross-Appellants, v. STATE of Washington; and State of Washington, Department of Social and Health Services; Maryanne Lindeblad, in her official acting capacity as Director of Mental Health Division; and Andrew Phillips, in his official capacity as Chief Executive Officer of Western State Hospital, Appellants/Cross Respondents.

No. 34423-8-II.

Court of Appeals of Washington, Division 2.

May 28, 2008.

Deborah A. Dorfman, New York City Law Department, New York, NY, David B. Girard, Attorney at Law, Stacie Berger Siebrecht, Disability Rights Washington, Seattle, WA, for Defendant.

Carrie L. Bashaw, Attorney General's Office, William Lee Williams, Attorney at Law, Eric Nelson, Attorney General of Washington, Olympia, WA, for Appellant/Cross-Respondent.

Sanford E. Pitler, Michael F. Madden, Marie Renee Westermeier, Bennett Bigelow & Leedom PS, Linda O'neil Coleman, Quorum Review, Inc., Seattle, WA, for Respondent/Cross-Appellant.

ARMSTRONG, J.

¶ 1 Pierce County contracted with the State to provide short-term mental health care services to county residents. The contracts required the County not to exceed the number of hospital beds at Western State Hospital allocated to it under former WAC 388-865-0203 (2005), and to pay liquidated damages if it exceeded its allocation at a time when the number of patients at the hospital exceeded its overall funded capacity. When the County exceeded its bed allocation, the State began "wait-listing" long-term patients for admission to the hospital and assessing liquidated damages against the County. The State also refused to continue providing short-term evaluation and treatment services to county residents at the hospital. The County initiated this lawsuit, and the State filed counterclaims.

¶ 2 The trial court concluded that the State is solely responsible for the care and treatment of long-term public mental health patients under the Involuntary Treatment Act, chapter 71.05 RCW, and it granted the County monetary and injunctive relief. It invalidated former WAC 388-865-0203 and the contract provisions incorporating it. And it refused to retroactively apply the legislature's 2006 amendments to the Involuntary Treatment Act and the Community Mental Health Services Act, chapter 71.24 RCW. The trial court further concluded that the contracts did not require the County to use Medicaid funds to pay for non-Medicaid services and that the short-term mental health care provided at Western State Hospital did not count toward the County's obligation to provide 85 percent of short-term care within its boundaries.

¶ 3 The State appeals the trial court's orders granting the County monetary and injunctive relief. The County cross-appeals the trial court's orders denying the County's Medicare funding and short-term care claims, as well as its refusal to award prejudgment interest.

¶ 4 We affirm the trial court's judgment and order awarding monetary damages as well as its dismissal of the Medicaid funding and 85 percent short-term care requirement claims. We reverse the trial court's denial of the motion to vacate the injunction and the denial of prejudgment interest on the liquidated damages claim, but we affirm the denial of prejudgment interest on the long-term care claim. Finally, we grant the State's motion to strike in part and deny sanctions against the County.

FACTS

¶ 5 The plaintiffs in this case are Pierce County, Pierce County Regional Support Network, Puget Sound Behavioral Health, and Washington Protection and Advocacy System. Unless otherwise noted, we refer to these groups as the County. The defendants include the State of Washington, Department of Social and Health Services, Mary Anne Lindeblad (as director of the mental health division of the Department of Social and Health Services), and Andrew Phillips (as chief executive officer of Western State Hospital). Unless otherwise noted, we refer to the defendants as the State or the Department.

I. THE PUBLIC MENTAL HEALTH SYSTEM

¶ 6 In Washington, the State supports the adult public mental health system in two ways. The Department is designated as the state mental health authority and operates Western State Hospital and Eastern State Hospital. RCW 71.24.035(1); RCW 72.23.020.¹ These inpatient psychiatric facilities are statutorily mandated to handle "the most complicated long-term care needs of patients with a primary diagnosis of mental disorder." RCW 72.23.025(1). The State also provides mental health services through contracts between the Department and county regional support networks. See RCW 71.24.035(5)(e), (15)(b). Entered into under the Community Mental Health Services Act, these contracts transfer funding and responsibility for the mentally ill from the State to the regional support networks to maintain the mentally ill in their communities where possible through the provision of short-term, acute care, and less complicated long-term care. See RCW 71.24.035(15); Former RCW 72.23.025(1) (2004).

¶ 7 Washington's 39 counties are divided into 14 regional support networks, which are responsible for crisis response services, hospital admissions, discharge coordination, and follow-up care. The decision to create a regional support network or join with other counties in creating a multi-county network is optional. A county may choose not to contract at all, in which case the Department assumes direct responsibility for all aspects of that county's mental health system. RCW 71.24.035(4), (14). At the time of trial, Western State Hospital was the intensive inpatient state psychiatric facility for 9 regional support networks, including Pierce County Regional Support Network.

¶ 8 The regional support networks administer the involuntary commitment process, which begins when someone alleges that a person either poses a risk of serious harm or is gravely disabled as a result of a mental disorder. RCW 71.05.025, .150(1)(a). If a county designated mental health professional² employed by the regional support network concludes that the allegations are true and the person will not voluntarily seek treatment, the mental health professional seeks an order from the superior court detaining the person for up to 72 hours of treatment at an evaluation and treatment facility. RCW 71.05.150(1)(a)-(b). Following the 72-hour detention, the superior court can order a person detained for up to 14 additional days of involuntary treatment. RCW 71.05.230, .240. The 72-hour and 14-day timeframes are referred to as short-term care. Evaluation and treatment facilities take only patients who are detained for 72 hours or committed for up to 14 days. RCW 71.05.150(1)(b), .240.

¶ 9 At the time of trial, Puget Sound Behavioral Health was the County's evaluation and treatment facility, although Western State Hospital also provided some short-term care.³ The regional support networks then were responsible for providing at least 85 percent of short-term care needs within their community; they must now provide 90 percent. RCW 71.24.300(6)(c); former RCW 71.24.300(1)(d) (2004).

¶ 10 If involuntary care beyond 17 days is required, the professional in charge may petition the superior court for up to 90 days of involuntary treatment. RCW 71.05.290. If the court or a jury determines that the patient meets the criteria for 90 days of involuntary treatment, the court "shall remand him or her to the custody of the department or to a facility certified for ninety day treatment by the department for a further period of intensive treatment." RCW 71.05.320(1). In certain cases, the initial long-term commitment may be 180 days, in which case the commitment must be in a "facility certified for one hundred eighty day treatment by the department." RCW 71.05.320(1)(a)-(b).

¶ 11 If further treatment is required, the professional in charge may file a new petition and the court may order the patient to return to the facility for 180 days. RCW 71.05.320(3). The court may order successive 180-day commitments as necessary. RCW 71.05.320(3). The 90-day and 180-day timeframes and subsequent extensions are referred to as long-term care. Western State Hospital is the only facility in western Washington that is legally authorized to accept and treat persons who have been involuntarily committed on a long-term basis, i.e., 90 days or longer. RCW 72.23.020, .025.

¶ 12 The Department provides much of the regional support networks' funding through biennial contracts authorized by the Community Mental Health Services Act. RCW 71.24.035(15)(b). Of relevance here are the two contracts that the County entered into between 2001 and 2005.⁴ Under these contracts, the State distributed Medicaid funds so that the County could provide services to Medicaid-eligible persons; it also distributed "state-only" funds so that the County could serve non-Medicaid patients as well. These contracts required that the County not exceed the number of hospital beds at Western State Hospital allocated to it under former WAC 388-865-0203. If the County did exceed its allocated beds at a time when the number of patients at the hospital exceeded its overall funded capacity, the State deducted liquidated damages from its payments to the County.⁵

¶ 13 The Center for Medicare and Medicaid Services is the federal agency that administers the Medicaid program. Under section 1915(b) of the Social Security Act (codified at 42 U.S.C. § 1396n(b)), a state may apply for a waiver of certain Medicaid requirements in order to implement a managed-care delivery system. The contracts at issue here implement the State's section 1915(b) mental health waiver and...