Washington State's Legislative Building, on the Capitol Campus
The Legislative Building, seen here from above the Temple of Justice, is the heart of Washington State's Capitol Campus in Olympia (Photo: Andrew Villeneuve/NPI)

A major­i­ty of Wash­ing­ton’s thir­ty-nine coun­ties, along with the Wash­ing­ton Asso­ci­a­tion of Coun­ties, announced today they are suing the Wash­ing­ton Depart­ment of Social and Health Ser­vices, alleg­ing that the state has failed to ful­fill its oblig­a­tion to eval­u­ate and treat patients with behav­ioral health conditions.

The patients the dis­pute revolves around are crim­i­nal defen­dants whose men­tal com­pe­ten­cy can­not be restored. In such cas­es, tri­al courts — mean­ing, coun­ty supe­ri­or courts — dis­miss the charges against the defen­dants and they are com­mit­ted to the cus­tody of the Depart­ment of Social and Health Services.

DSHS is then sup­posed to eval­u­ate them for poten­tial civ­il com­mit­ment, and it has an oblig­a­tion to do so after the Supe­ri­or Court orders an evaluation.

“Nonethe­less, DSHS has selec­tive­ly refused admis­sion to civ­il con­ver­sion patients since at least Decem­ber 2022 and, on infor­ma­tion and belief, has refused to admit any civ­il con­ver­sion patients for statu­to­ri­ly required civ­il com­mit­ment eval­u­a­tions since July 13, 2023,” says the com­plaint, pre­pared by Lynn Allen Award Hon­oree Paul Lawrence of Paci­fi­ca Law Group and a long list of local chief civ­il deputy pros­e­cut­ing attor­neys from dozens of the state’s counties.

“By ignor­ing the dic­tates of the leg­isla­tive and judi­cial branch­es, DSHS is depriv­ing a par­tic­u­lar­ly at-risk pop­u­la­tion of the oppor­tu­ni­ty for nec­es­sary men­tal health treat­ment to the detri­ment of both patient well-being and com­mu­ni­ty safe­ty,” the intro­duc­tion states in one of its open­ing pas­sages. “In the face of DSH­S’s con­tin­u­ing con­tempt for both leg­isla­tive and judi­cial author­i­ty, Wash­ing­ton’s coun­ties have joined in an unprece­dent­ed coali­tion to enforce DSH­S’s legal obligations.”

The coun­ties par­tic­i­pat­ing direct­ly in the law­suit are:

  • Pierce
  • Asotin
  • Clal­lam
  • Cowlitz
  • Dou­glas
  • Grant
  • Grays Har­bor
  • Island
  • Jef­fer­son
  • King
  • Kit­sap
  • Klick­i­tat
  • Lewis
  • Lin­coln
  • Pacif­ic
  • Skag­it
  • Ska­ma­nia
  • Sno­homish
  • Spokane
  • Thurston
  • What­com
  • Yaki­ma

All four of the state’s largest coun­ties — King, Pierce, Sno­homish, and Spokane — are plain­tiffs, along with pret­ty much every oth­er pop­u­lous coun­ty in the state except for Clark. Addi­tion­al­ly, the Wash­ing­ton Asso­ci­a­tion of Coun­ties is a plain­tiff. Gov­er­nor Jay Inslee is not named as a defen­dant, but Jil­ma Mene­ses, his DSHS Sec­re­tary, is, along with the Depart­ment of Social and Health Ser­vices itself.

“For the ben­e­fit of the patient and the pub­lic, DSHS has a basic legal oblig­a­tion to pro­vide behav­ioral health treat­ment to those involved in the legal sys­tem,” said King Coun­ty Exec­u­tive Dow Con­stan­tine in a press release.

“The real­i­ty is that peo­ple in these cir­cum­stances are often failed by mul­ti­ple sys­tems that, rather than offer­ing hope and restora­tion, leave them untreat­ed and at risk of reof­fend­ing. It is the state’s respon­si­bil­i­ty in these cir­cum­stances to pro­vide peo­ple treat­ment and a chance to recov­er. Our behav­ioral health vision at King Coun­ty is for every­one to access care, any­where, at any time, even in a moment of cri­sis. That’s why we are active­ly work­ing to increase access to treat­ment through invest­ments in behav­ioral health facil­i­ties, mobile cri­sis treat­ment, and the vot­er-approved Cri­sis Care Cen­ters initiative.”

“Every gov­ern­ment faces lim­it­ed finances and work­force short­ages. Coun­ties can­not now be asked to also shoul­der the state’s long-time responsibility.”

The full com­plaint is avail­able below.

Com­plaint against DSHS by Wash­ing­ton counties

The coun­ties say their motion for a pre­lim­i­nary injunc­tion could be heard as ear­ly as Sep­tem­ber 8th. The venue for their action is Pierce Coun­ty Supe­ri­or Court.

After receiv­ing the coun­ties’ release, NPI reached out to Gov­er­nor Jay Inslee’s com­mu­ni­ca­tions team to ask if they or DSHS have any com­ment on the lawsuit.

“Our legal coun­sel are still review­ing this fil­ing,” Inslee spokesman Mike Faulk told us in reply. “These are chal­leng­ing issues, but we reject any notion that the state is not com­mit­ted to meet­ing its oblig­a­tions under the True­blood order.”

“While we respect all judi­cial deci­sions, by order­ing DSHS not to admit these patients into state hos­pi­tals a fed­er­al court has sub­stan­tial­ly impaired our abil­i­ty to treat and care for patients such as these. (See para­graph 33a of the order.) The coun­ties bring this action as if no such court order exists.”

“We have tak­en actions nec­es­sary to com­ply with the court’s orders and those mul­ti-pronged efforts con­tin­ue in the face of sig­nif­i­cant challenges.”

“The state has invest­ed more than $2 bil­lion into expand­ing capac­i­ty for com­pe­ten­cy ser­vices since 2015. The state has recent­ly added 278 beds with at least anoth­er 680 in the works. But local gov­ern­ments and courts are refer­ring sig­nif­i­cant­ly more peo­ple for com­pe­ten­cy ser­vices – for exam­ple, refer­rals increased 40% from 2021 to 2022 for a total of 8,596 indi­vid­u­als, rough­ly triple the num­ber being referred a decade ago.”

“To cre­ate and staff the num­ber of facil­i­ties required to meet such a rapid increase in patients will take time, and also requires reforms to the over­all sys­tem. This year, the gov­er­nor called on leg­is­la­tors to pass reforms and in May signed SB [Sen­ate Bill] 5440 to reduce refer­rals by pro­vid­ing more options for ser­vices out­side the courts, as well as improv­ing access to care while peo­ple wait.”

“This month, the Depart­ment of Social and Health Ser­vices final­ized the pur­chase of the for­mer Cas­cade Behav­ioral Health facil­i­ty in Tuk­wila, and is work­ing as quick­ly as pos­si­ble to add about 100 beds for indi­vid­u­als in need of behav­ioral health ser­vices, includ­ing those in need of ser­vices through the civ­il con­ver­sion process. Mul­ti­ple new facil­i­ties are cur­rent­ly in the process of being devel­oped and opened to serve thou­sands of addi­tion­al patients every year.”

“Much work remains ahead for us in part­ner­ship with the Leg­is­la­ture, state agen­cies, local gov­ern­ments and the many stake­hold­ers involved to meet the state’s over­whelm­ing demand for com­pe­ten­cy services.”

Note that the links in the quot­ed text above were pro­vid­ed by Gov­er­nor Inslee’s office; we’ve left them in place because they pro­vide con­text to Faulk’s comments.

About the author

Andrew Villeneuve is the founder and executive director of the Northwest Progressive Institute, as well as the founder of NPI's sibling, the Northwest Progressive Foundation. He has worked to advance progressive causes for over two decades as a strategist, speaker, author, and organizer. Andrew is also a cybersecurity expert, a veteran facilitator, a delegate to the Washington State Democratic Central Committee, and a member of the Climate Reality Leadership Corps.

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