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SUMMARY
A new lawsuit against the Washington Department of Social and Health Services, filed by a coalition of 22 counties, holds the state accountable to fulfill its obligation to evaluate and treat patients with behavioral health conditions and would reduce further strain on a crumbling behavioral health system that the state legislature and local governments are actively working to restore.
STORY
Following repeated violations of court orders by the state, a coalition of 22 counties including King County, and the Washington State Association of Counties (WSAC) filed a lawsuit in Pierce County Superior Court against the Washington Department of Social and Health Services today over the department’s decision to stop providing initial evaluation and subsequent treatment for a rising number of patients in need of behavioral health support when exiting the criminal legal system.
The counties have also filed a motion for preliminary injunction to compel DSHS’s immediate compliance with state law and court orders. The coalition includes Asotin, Clallam, Cowlitz, Douglas, Grant, Grays Harbor, Island, Jefferson, King, Kitsap, Klickitat, Lewis, Lincoln, Pacific, Pierce, Skagit, Skamania, Snohomish, Spokane, Thurston, Whatcom, and Yakima Counties.
"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. 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," said Executive Constantine. "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."
When a person with a serious mental health condition or cognitive disability has their charges dismissed because they are unable to understand the charges, DSHS is ordered by the court to evaluate that individual and if necessary, provide effective behavioral health treatment. This system, called a civil conversion commitment, focuses on people with severe behavioral health conditions who have not been adequately served by the crisis and outpatient behavioral health system.
Despite court orders and state laws requiring them to do so, DSHS has asserted that it is no longer obligated to either evaluate or treat patients whose criminal charges are dismissed, citing a federal judge’s orders in a separate case. To date, the agency has repeatedly argued that it will not follow what appear to be clear statutory and court ordered legal requirements, leaving hundreds of individuals across the state to lose their chance for mental health treatment that might break the cycle of re-offense.
Charges are dropped against individuals when they are determined to be not competent to stand trial and the state fails to provide restoration services or is unable to restore their competency. The individuals are then released back into the community without facing justice, nor receiving the treatment courts have ordered. When DSHS fails to provide restoration services, individuals are referred back to their home counties to designated crisis responders, placing the burden of care on counties despite state law requiring the state to do so. These releases further a harmful cycle where the state does not meet its responsibility of care and leaves individuals are left at risk to re-offend, repeating the legal process without any interruption for care and treatment.
In the Trueblood case, after failing to follow its legal obligations, DSHS was held in contempt and the federal court imposed a $100 million fine. DSHS now claims that its refusal to follow state law with conversion patients is the fault of the federal court. However there is nothing in the court’s orders that interferes with DSHS’s obligation or ability to provide evaluations and restorative services.
While the state has made recent investments in this past legislative session, and recently purchased a former behavioral health hospital in Tukwila to address a shortage of capacity, the department has refused to provide the care ordered by courts and required by state law.
The request for preliminary injunction filed Wednesday asks the court to immediately order DSHS to comply with its obligations under state law. It creates a pathway for the court to make an immediate determination of the underlying legal issue, and to restore the civil conversion commitment process.
The Counties’ motion for preliminary injunction may be heard as early as September 8 in Pierce County Superior Court. The case is known as Pierce County vs. Washington State Department of Social and Health Services, and more information on the case is available here.
RELEVANT LINKS
QUOTES
"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. 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." -- King County Executive Dow Constantine
“Refusing to admit and indiscriminately releasing those with serious behavioral health issues – who were previously charged with felony crimes – without providing necessary treatment or proper notice to local authorities and crime victims is a clear dereliction of duty by DSHS. There is no doubt that the agency’s failure to act will impact public safety and further strain local police agencies and courts. The current failures in our state systems must be addressed; otherwise, more people may be harmed and many vulnerable defendants will be denied the mental health services they so critically need.” -- King County Prosecutor Leesa Manion
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