Powell v. Md. Dep't of Health
| Citation | 455 Md. 520,168 A.3d 857 |
| Decision Date | 28 August 2017 |
| Docket Number | No. 77, Sept. Term, 2016.,77, Sept. Term, 2016. |
| Parties | Fredia POWELL, et al. v. MARYLAND DEPARTMENT OF HEALTH, et al. |
| Court | Court of Special Appeals of Maryland |
Argued by Ralph S. Tyler (Maggie T. Grace, Susan R. Schipper, Kelly E. Johnson, Venable LLP, Baltimore, MD), on brief, for Appellants.
Argued by Matthew J. Fader, Assistant Attorney General (Julia Doyle Bernhardt, Kathleen A. Ellis, Assistant Attorneys General, Brian E. Frosh, Attorney General of Maryland, Baltimore, MD), on brief, for Appellee.
Argued before Barbera, C.J., Greene, Adkins, McDonald, Hotten, Getty, Irma S. Raker (Senior Judge, Specially Assigned), JJ.
A criminal prosecution may not proceed against a defendant who is not competent to stand trial. For that reason, a defendant may not be continued in pretrial detention unless the government is taking steps to provide treatment to restore the defendant to competence or to have the defendant civilly committed. Maryland law provides for a trial court to determine whether a defendant is competent, is dangerous to self or others, and, if incompetent, has the potential to be restored to competence. If these criteria are met, the trial court may commit the defendant to a mental health facility designated by Appellee Maryland Department of Health1 ("MDH") for appropriate treatment to restore the defendant to competence. Maryland Code, Criminal Procedure Article ("CP"), § 3–104 et seq. This case concerns implementation of that law within constitutional parameters.
MDH and its head, Appellee Secretary of Health,2 have adopted a policy on admission to State psychiatric hospitals to manage the demand for the limited beds available at those facilities. That policy has resulted in the creation of a waiting list for admission to State psychiatric hospitals—a list that has included criminal defendants who have been found incompetent to stand trial and committed for treatment, including the four Appellants in this case. The Circuit Court for Baltimore City—at least in the four instances spotlighted in this case—has adopted a practice of requiring admission of a defendant to a hospital within one day of the issuance of the commitment order.
In this case, the Circuit Court found each of the Appellants—defendants in separate criminal cases—to be incompetent to stand trial and dangerous. The court committed each of them to a State psychiatric facility pursuant to the statute and ordered their admission within one day of the commitment order. When MDH failed to admit them by that deadline, they collectively brought this action challenging the MDH policy on statutory and constitutional grounds.
We hold that the statute itself does not set a deadline for admission to a psychiatric hospital. Nor does it authorize a circuit court to do so. Accordingly, a delay in admitting a criminal defendant by a deadline set forth in a commitment order does not violate the statute, although it may violate the commitment order. Nevertheless, depending on the circumstances of the particular case, such delay may violate the due process guarantee of the Maryland Declaration of Rights unless the delay is reasonable under the circumstances of the particular case.
Under the common law, a criminal prosecution could not proceed if the defendant was unable, as a result of a mental or physical disability, to understand the proceedings or to assist in the defense. A criminal defendant in that condition is said to be incompetent to stand trial.3 See Note, Incompetency to Stand Trial , 81 Harv. L. Rev. 454 (1967). That standard has prevailed in Maryland since 1967. Raithel v. State , 280 Md. 291, 297–98, 372 A.2d 1069 (1977) ; see also CP § 3–101(f) (). Because the prohibition against trying or convicting an incompetent defendant is considered "fundamental to the adversary system of justice," it is also an element of the due process right to a fair trial under the United States Constitution. Drope v. Missouri , 420 U.S. 162, 172, 95 S.Ct. 896, 43 L.Ed.2d 103 (1975). While the State thus has no legitimate interest in criminally prosecuting a defendant who is incompetent to stand trial, it does have an interest in restoring a defendant to competency for the purpose of resolving the criminal charges. See Allmond v. Dept. of Health & Mental Hygiene , 448 Md. 592, 608–13, 141 A.3d 57 (2016).
Under Maryland law, trial courts are charged with determining whether a defendant is in fact incompetent to stand trial and, if so, what to do about it. CP §§ 3–104 through 3–108. If it appears that a defendant may be incompetent to stand trial (or the defense alleges incompetence), the trial court must determine, from "evidence presented on the record," whether the defendant is in fact competent to stand trial. CP § 3–104. Part of the evidence considered by the court may be a report from MDH following its examination of the defendant.
To obtain an assessment by MDH, the court may order MDH to examine the defendant and submit a report to the court, the prosecutor, and defense counsel concerning whether the defendant is competent to stand trial. CP § 3–105(d)(1). If, upon examination, MDH determines that the defendant is incompetent to stand trial, the report must include a supplementary opinion concerning "whether, because of mental retardation or mental disorder, the defendant would be a danger to self or the person or property of another, if released." CP § 3–105(d)(3).
If the court finds that the defendant is incompetent to stand trial, but is not dangerous to self or the person or property of others, the court is to set bail or release the defendant on personal recognizance. CP § 3–106(a). The court is then required to hold a hearing at least annually to reconsider the issues of competence and dangerousness. CP § 3–106(f).
If, however, the court finds that the defendant is dangerous as well as incompetent, "the court may order the defendant committed to the facility that [MDH] designates until the court finds that: (i) the defendant no longer is incompetent to stand trial; (ii) the defendant no longer is, because of mental retardation or a mental disorder, a danger to self or the person or property of others; or (iii) there is not a substantial likelihood that the defendant will become competent to stand trial in the foreseeable future." CP § 3–106(b)(1).4 In other words, the three criteria for commitment and retention of a criminal defendant in a psychiatric hospital under this provision can be understood as incompetence, dangerousness, and restorability. See State v. Ray , 429 Md. 566, 578–79, 57 A.3d 444 (2012).
If the court finds that a defendant meets these criteria5 and commits the defendant, the court is to conduct a hearing at least once a year from the commitment date to determine whether the defendant continues to meet the criteria for commitment. CP § 3–106(c)(1)(i). The court may hold earlier or additional hearings on its own initiative, upon receipt of a report from MDH containing new information, or upon motion of a party setting forth new facts or circumstances. CP § 3–106(c)(1)(ii)–(iii), (2).
If a defendant remains incompetent to stand trial, the court must eventually decide whether to take other action. If it appears that the defendant remains incompetent and is not restorable—i.e. , "not likely to become competent in the foreseeable future"—the court may civilly commit the defendant if certain criteria are met. CP § 3–106(d).6 If the defendant has not been restored to competence and the criminal charges have not been resolved, the statute also requires the court to dismiss the criminal charges after specified periods of time (based on the nature of the charges and the potential penalty) have elapsed, unless the State petitions the court "for extraordinary cause" to extend the statutory deadline. CP § 3–107.
Under the statute, MDH thus functions as a legislatively-designated expert that may assist the court in making the necessary findings and as the provider of treatment that may restore the defendant to competence. The statute contemplates a cooperative process in which MDH evaluates the defendant initially and periodically, provides reports and opinions to the court, and designates facilities at which evaluation and treatment take place. The court is charged with determining whether the criteria of incompetence, dangerousness, and restorability are met, revisiting those determinations periodically, and taking appropriate action based on its findings.
MDH's Behavioral Health Administration operates five psychiatric hospitals in Maryland. Maryland Code, Health–General Article ("HG"), § 10–406. The Director of the Behavioral Health Administration is charged by State law with setting standards for admission to those facilities. HG § 10–407.
There are four regional hospitals to which individuals are committed by courts in the region served by the particular hospital.7 However, individuals charged with serious crimes are generally committed to the Clifton T. Perkins Hospital Center ("Perkins"), regardless of the location of the court that ordered the commitment.
The basic facts of this case are set forth in the complaint and accompanying affidavit of Appellants' counsel, and in an affidavit supporting the motion to dismiss subsequently filed by MDH and the Secretary. These facts are largely undisputed, although the parties differ on the characterization of those facts, the inferences to be drawn from them, and their legal significance.
The complaint was filed on behalf of Fredia Powell, James Powell, Shane...
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