In Re The Detention Of K.c. ( 2021 )

Filed
Washington State
Court of Appeals
Division Two
May 11, 2021
IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON
DIVISION II
No. 54600-1-II
In the Matter of the
Detention of
K.C.,
Appellant. UNPUBLISHED OPINION
CRUSER, J. — KC appeals a superior court order denying his motion to revise the
commissioner’s ruling imposing 90 days of involuntary treatment for his mental health condition
following dismissal of his nonviolent felony charges. KC argues that the trial court’s factual
findings were not supported by substantial evidence and that therefore, its conclusion that he was
gravely disabled was not supported by the findings.
We hold that although the State did not provide clear, cogent, and convincing evidence that
that KC was gravely disabled under subsection (a) of former RCW 71.05.020(22) (2019), it did
set forth substantial evidence sufficient to support the trial court’s finding that KC was gravely
disabled as defined in subsection (b) in former RCW 71.05.020(22). Therefore, we hold that the
trial court’s conclusion that KC was gravely disabled was supported by its findings, and the 90-
day involuntary commitment order was properly entered.
Accordingly, we affirm in part and reverse in part and remand for the superior court to
strike the gravely disabled finding under former RCW 71.05.020(22)(a).
No. 54600-1-II
FACTS
KC is an individual who has had an extensive history of severe mental health issues that
resulted in several admissions to Western State Hospital and multiple contacts with other mental
health services. In October 2019, KC was arrested and charged with a second degree burglary and
unlawful use of drug paraphernalia following an incident at a pharmacy. During the incident, KC
exhibited behaviors that employees of the pharmacy described as erratic and that made them afraid
to approach him. A trial court found that KC was not competent to stand trial and dismissed the
charges. The trial court ordered KC to undergo evaluation for civil commitment.
During the intake process, when KC was admitted to Western State Hospital following
dismissal of the felony charges, KC initially denied that he had a history of issues with mental
health. He also denied that he had a present mental health condition. Eventually, however, KC
stated that he had been admitted for treatment on one prior occasion. A physician on KC’s
treatment team noted that KC’s disposition on intake indicated mood lability, rigid and tangential
thinking, with some delusional ideations.
KC stated that he lived in Spanaway before his arrest, but he did not provide any additional
details regarding his prior living circumstances. In response to questions regarding his plans on
discharge, KC claimed that he owned multiple homes in Spanaway, but he could not provide any
addresses for these residences.
When asked about his financial circumstances, KC told the psychiatric social worker who
conducted his intake that he was a part owner of a popular fast food chain. He also explained that
he received disability income through social security, but when he was asked what disability the
benefits were based on, KC responded that he did not have a disability. KC also explained that he
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had a payee who managed his disability benefits, but he provided two alternate names and could
not or would not provide contact information for either individual.
Petitioners Benjamin LaLiberte, Ph.D., and Daniel Ruiz-Paredes, M.D., filed a petition for
involuntary treatment. The petitioners initially recommended that KC should be involuntarily
committed to 180 days of treatment because he presented a substantial likelihood of repeating
similar acts to the charged felony offense and because he was gravely disabled. At the hearing on
the petition, however, the petitioners recommended 90 days of involuntary treatment based on
grave disability alone.
The petition detailed KC’s prior competency evaluations dating back to 2007 and outlined
other significant events in KC’s mental health history. The petition also described the incident that
led to KC’s felony charge as well as KC’s interactions with members of his treatment team since
admission. The information contained in the petition is consistent with the facts stated above.
Dr. LaLiberte testified on behalf of the petitioners at KC’s commitment hearing. He
described the sole interview he had with KC prior to the filing the petition and noted that the
interview was brief because KC exercised his right to terminate the conversation. In addition to
his brief interaction with KC, Dr. LaLiberte explained that his opinions were also based on Western
State Hospital records from KC’s prior admissions, prior competency evaluations, the police report
from the index felony, treatments notes, and conversations with members of KC’s treatment team.
Following his review of KC’s records and other information, Dr. LaLiberte diagnosed KC with
“schizophrenia by history; a history of alcohol, marijuana, and methamphetamine use; as well as
a provisional diagnosis of intellectual disability.” Sealed Verbatim Report of Proceedings (VRP)
(Nov. 15, 2019) at 6-7.
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No. 54600-1-II
During Dr. LaLiberte’s brief interaction with KC, he observed that KC’s speech was
difficult to understand and indicated some cognitive dysfunction. Dr. LaLiberte asked KC about
KC’s discharge plans and KC responded by saying only that he would return to Spanaway and
concluded the interview at that point. During the interview, KC appeared to have adequate
grooming and hygiene. KC was also alert and polite throughout his contact with Dr. LaLiberte.
Dr. LaLiberte believed that while some of KC’s symptoms, such as KC’s delusional
statements, lessened since KC’s admission, other symptoms remained. Dr. LaLiberte noted further
that KC lacked insight into his mental condition. Based on the foregoing, Dr. LaLiberte opined
that KC was gravely disabled and that KC’s continued symptoms and lack of insight into his
condition would prevent KC from meeting his essential health and safety needs. Without the highly
structured setting of a treatment facility like Western State Hospital, Dr. LaLiberte testified that
KC’s mental health condition would deteriorate.
The commissioner found that KC was gravely disabled under both alternative definitions
of gravely disabled in former RCW 71.05.020(22) and ordered 90 days of involuntary treatment.
KC moved for revision before the superior court, arguing that the State did not satisfy its burden
of showing that he was gravely disabled. KC also argued that the commissioner erred in admitting
Dr. LaLiberte’s testimony under ER 703 because the testimony improperly interposed
inadmissible hearsay into the record. The superior court denied KC’s motion to revise the
commissioner’s ruling. KC appeals the order denying his motion to revise the commissioner’s
ruling.
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DISCUSSION
I. STANDARD OF REVIEW
On a motion to revise a commissioner’s ruling, “the superior court reviews both the
commissioner's findings of fact and conclusions of law de novo based upon the evidence and issues
presented to the commissioner.” State v. Ramer, 151 Wn.2d 106, 113, 86 P.3d 132 (2004). Where
the superior court denies the motion to revise the commissioner’s ruling, it adopts the
commissioner’s findings of facts and conclusions of law. Tedford v. Guy, 13 Wn. App. 2d 1, 12,
462 P.3d 869 (2020). We then review the superior court’s decision on revision, as opposed to the
commissioner’s decision. Ramer, 151 Wn.2d at 113.
We review the trial court’s decision on involuntary commitment to determine whether the
findings are supported by substantial evidence “and, if so, whether those findings support the
conclusion of law and judgment.” In re Det. of T.C., 11 Wn. App. 2d 51, 56, 450 P.3d 1230 (2019).
The State has the burden of proving that a person is gravely disabled by clear, cogent, and
convincing evidence. In re Det. of M.W., 185 Wn.2d 633, 656, 374 P.3d 1123 (2016). We do not
review a trial court’s decision regarding witness credibility. In re Det. of H.N., 188 Wn. App. 744,
763, 355 P.3d 294 (2015).
II. SUBSTANTIAL EVIDENCE OF GRAVE DISABILITY
Where a trial court has determined that a person is incompetent to stand trial for felony
charges, the charges must be dismissed without prejudice and that person must undergo evaluation
for civil commitment under chapter 71.05 RCW. Former RCW 10.77.086(4) (2019). The
professional person in charge of a treatment facility may then petition for 90 days of involuntary
treatment based on grave disability under RCW 71.05.280(4). Former RCW 71.05.290(3) (2017).
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A person is “gravely disabled,” as defined under former RCW 71.05.020(22) if, “as a result
of a mental disorder” that person:
(a) Is in danger of serious physical harm resulting from a failure to provide for
his or her essential human needs of health or safety; or (b) manifests severe
deterioration in routine functioning evidenced by repeated and escalating loss
of cognitive or volitional control over his or her actions and is not receiving
such care as is essential for his or her health or safety.
Either of the two alternative definitions of “‘gravely disabled’” set forth in former RCW
71.05.020(22) provide a basis for involuntary commitment. In re Det. of LaBelle, 107 Wn.2d 196,
202, 728 P.2d 138 (1986) (quoting former RCW 71.05.020(1) (1979)).
KC argues that the State failed to set forth clear, cogent, and convincing evidence sufficient
to support the trial court’s findings that he is gravely disabled as defined under former RCW
71.05.020(22)(a) and .020(22)(b). We agree with KC that the trial court’s finding that KC was
gravely disabled as defined under former RCW 71.05.020(22)(a) was not supported by substantial
evidence. However, clear, cogent, and convincing evidence supported the trial court’s finding that
KC was gravely disabled under former RCW 71.05.020(22)(b).
A. GRAVELY DISABLED UNDER FORMER RCW 71.05.020(22)(A)
1. Legal Principles
To satisfy its evidentiary burden of demonstrating a grave disability under former RCW
71.05.020(22)(a),
the State must present recent, tangible evidence of failure or inability to provide for
such essential human needs as food, clothing, shelter, and medical treatment which
presents a high probability of serious physical harm within the near future unless
adequate treatment is afforded. Furthermore, the failure or inability to provide for
these essential needs must be shown to arise as a result of mental disorder and not
because of other factors.
LaBelle, 107 Wn.2d at 204-05 (discussing former RCW 71.05.020(1)(a)).
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No. 54600-1-II
It is not enough that the State show a person faces uncertain living arrangements or lacks
financial resources. Id. at 210. To justify involuntary commitment, the State must demonstrate that
the person’s mental health condition renders that person “unable to make a rational choice with
respect to his [or her] ability to care for his [or her] essential needs.” Id. Relevant considerations
include whether an individual has an ability to “form realistic plans for taking care of himself [or
herself] outside the hospital setting,” and whether the individual has an “awareness of hygiene and
routine care.” Id.
2. Application
Although the State presented evidence showing that KC’s living arrangements and
financial circumstances upon release were uncertain, the State did not set forth clear, cogent, and
convincing evidence that such uncertain circumstances would lead to a high probability of serious
physical harm to KC. In Labelle, the supreme court cautioned against erroneous commitment of
individuals whose chosen lifestyles do not necessarily fit within “majoritarian values.” Id. at 204.
Rather, the potential for physical harm from an inability to meet basic needs must be sufficiently
severe to justify the “‘massive curtailment of liberty,’” that follows involuntary commitment. Id.
(internal quotation marks omitted) (quoting In re Det. of Harris, 98 Wn.2d 276, 283, 654 P.2d 109(1982)).
KC did not describe a concrete plan for release when speaking with Dr. LaLiberte, and he
stated vaguely that he would “just go back to Spanaway,” VRP (Nov. 15, 2019) at 12. KC also
made statements regarding several houses and a business that he owned, which Dr. Laliberte
classified as “possibly grandiose,” and “delusional.” Id. at 14. But the State did not specify any
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No. 54600-1-II
physical harm that would follow from KC’s uncertain living circumstances, much less demonstrate
a risk of serious physical harm.
Here, KC presented with adequate hygiene and grooming during his interview with Dr.
LaLiberte. KC exhibited mumbled speech that was difficult to understand, but he was also alert
and polite during the meeting. The petitioners’ determination that KC would be unable meet his
basic needs on release was largely due to KC’s lack of an adequate discharge plan and several
statements KC made on intake that indicated delusional thoughts regarding his living and financial
circumstances. But the petitioners did not mention or otherwise reference any discrete physical
harm that KC would face as a result of his inability to meet his essential human needs. In Labelle,
the court cautioned that evidence of uncertainty in living or financial circumstances does not alone
warrant involuntary treatment. 107 Wn.2d at 204. Therefore, the trial court’s finding that KC was
gravely disabled under former RCW 71.05.020(22)(a) was not supported by substantial evidence.
B. GRAVE DISABILITY UNDER FORMER RCW 71.05.020(22)(B)
1. Legal Principles
To find that an individual continues to be gravely disabled within the meaning of former
RCW 71.05.020(22)(b), the evidence must show: (1) a severe deterioration in routine functioning
and (2) failure to receive treatment that is essential for health or safety. Id.at 205 (discussing former
RCW 71.05.020(1)(b)). To satisfy the first requirement, the State’s evidence of a severe
deterioration in routine functioning “must include recent proof of significant loss of cognitive or
volitional control.” Id.at 208.
To satisfy the second requirement in former RCW 71.05.020(22)(b), the State must present
evidence that,
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No. 54600-1-II
the individual is not receiving or would not receive, if released, such care as is
essential for his or her health or safety. It is not enough to show that care and
treatment of an individual's mental illness would be preferred or beneficial or even
in his best interests. To justify commitment, such care must be shown to be essential
to an individual's health or safety and the evidence should indicate the harmful
consequences likely to follow if involuntary treatment is not ordered.
Id. (emphasis omitted). That is, the individual must be “unable, because of severe deterioration of
mental functioning, to make a rational decision with respect to his need for treatment.” Id.(emphasis in original). This requirement exists to establish the necessary causal nexus between
“proof of ‘severe deterioration in routine functioning’ and proof that the person so affected ‘is not
receiving such care as is essential for his or her health or safety.’” Id.Former RCW 71.05.020(22)(b) incorporates the definition of decompensation and thus
“permits the State to treat involuntarily those discharged patients who, after a period of time in the
community, drop out of therapy or stop taking their prescribed medication and exhibit “‘rapid
deterioration in their ability to function independently.’” Id.at 206 (quoting Mary L. Durham &
John Q. LaFond, The Empirical Consequences and Policy Implications of Broadening the
Statutory Criteria for Civil Commitment, 3 YALE L. & POL'Y REV. 395, 410 (1985)). This alternate
definition of grave disability was added by the legislature to “broaden the scope of the involuntary
commitment standards.” Id. at 205-06.
2. Application
The State presented clear, cogent, and convincing evidence that satisfied both requirements
in former RCW 71.05.020(22)(b) and thus supported the trial court’s finding that KC was gravely
disabled under that definition. With respect to the first requirement, the State set forth evidence
that KC experienced a recent loss in cognitive and volitional control. After law enforcement issued
a trespass notice to KC for his actions inside a pharmacy, he returned to the pharmacy several
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No. 54600-1-II
hours later and engaged in behavior that staff described as “erratic.” VRP (Nov. 15, 2019) at 15.
When police arrived on the second occasion, they noted KC’s hostile and agitated demeanor. KC
was found incompetent to stand trial for the charges associated with this incident.
During KC’s admission to Western State Hospital following dismissal of his felony
charges, staff noted that KC exhibited mood lability, “tangential thought processes, perseveration,
and delusional ideation.” Sealed Clerk’s Papers at 55. Although Dr. LaLiberte’s interview with
KC was brief, Dr. LaLiberte observed evidence of KC’s cognitive dysfunction or schizophrenia in
KC’s speech, which was difficult to understand.
The State also presented clear, cogent, and convincing evidence that satisfied the second
requirement in former RCW 71.05.020(22)(b). The petition for involuntary commitment described
KC’s extensive history of mental illness, including multiple competency evaluations and
admissions to Western State Hospital. However, during KC’s most recent intake interview at
Western State, KC denied that he had a mental health disorder.
Dr. LaLiberte testified that because KC lacked insight into his mental health condition, “it
would make it very difficult for [him] to independently keep up with his own health and welfare.”
VRP (Nov. 15, 2019) at 15. In particular, Dr. LaLiberte cautioned that if KC is transferred out of
a structured setting before KC had the ability to understand “the severity and extent of his severe
[sic] mental illness and some of his intellectual difficulties that he would, . . . not take medication
and start engaging in the behavior that was documented in that police report, which was kind of
odd, bizarre, not very goal directed.” Id. at 16.
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No. 54600-1-II
KC asserts that evidence that he displayed proper grooming and hygiene during his
interview with Dr. LaLiberte and that some of KC’s symptoms had remitted refutes the State’s
position that KC was gravely disabled under former RCW 71.05.020(22)(b). We disagree.
In Labelle, the Supreme Court held that the second definition of gravely disabled should
not be interpreted to “exclude those persons whose condition has stabilized or improved, even if
minimally (i.e., is not “escalating”) by the time of the commitment hearing.” 107 Wn.2d at 207.
Therefore, remittance of some of KC’s symptoms does not dispel the State’s evidence regarding
KC’s continued lack of insight and the risk that KC would deteriorate if he were released
prematurely. Taken together, the State’s evidence supported the trial court’s finding that KC’s
condition fell within the definition of grave disability under RCW 71.05.020(22)(b).
CONCLUSION
We hold that although the trial court’s finding that KC was gravely disabled under former
RCW 71.05.020(22)(a) was not supported by substantial evidence, its finding that KC was gravely
disabled under former RCW 71.05.020(22)(b) was supported by substantial evidence. Because the
finding that KC was gravely disabled as defined in former RCW 71.05.020(22)(b) supports the
commissioner’s conclusion that KC was gravely disabled, we hold that the trial court properly
denied KC’s motion to revise the commissioner’s ruling imposing 90 days of involuntary
treatment.
Accordingly, we affirm in part and reverse in part and remand for the superior court to
strike the gravely disabled finding under former RCW 71.05.020(22)(a).
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A majority of the panel having determined that this opinion will not be printed in the
Washington Appellate Reports, but will be filed for public record in accordance with RCW 2.06.040,
it is so ordered.
CRUSER, J.
We concur:
MAXA, P.J.
VELJACIC, J.
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