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:
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.
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