WPAS lawsuit brings improved conditions to Western State Hospital


Settlement Provides Improved Care, More Staff, Increased Protections to Residents of Western State Hospital

In December of last year, the Washington Protection and Advocacy System (WPAS) filed a federal class action lawsuit against the Center for Forensic Services at Western State Hospital (WSH) seeking improvements in the treatment and conditions of care provided to the patients. Specifically, the lawsuit claimed that the hospital provided inadequate protection from harm for many patients, inadequate psychiatric care, and inadequate medical and dental care. The suit addressed conditions in the Center for Forensic Services (CFS), which administers programs for people ordered to Western State Hospital by the courts to assess or restore competency, or to provide treatment as part of criminal court proceedings.

The conditions at CFS prior to the filing of the lawsuit were deplorable. For instance, men and women of varying physical and sexual aggressiveness were placed on the same ward; patients with individual needs were administered "one-size-fits-all" treatment programs; and civilly committed patients that should have been moved to the Adult Psychiatric Unit were still residing at CFS. The class action was filed on behalf of all current and future residents of CFS, and asked for immediate relief. It raised a variety of issues, including (but not limited to):

  • inadequate protection from harm;
  • inadequate psychiatric, medical and dental care;
  • excessive and inappropriate use of restraints;
  • overcrowding;
  • understaffing;
  • inadequate active treatment;
  • inadequate treatment plans;
  • inadequate discharge planning.

The conditions were deplorable enough that in March 2001, the federal judge hearing the case, Judge Robert J. Bryan, indicated that the information provided by WPAS warranted immediate relief and requested both sides submit information to assist in determining the scope and details of the relief that he would order. At that point, the Attorney General’s Office, representing WSH, and Deborah Dorfman, the Director of Legal Advocacy at WPAS, began intensive settlement negotiations. The parties quickly agreed to a comprehensive partial settlement that requires WSH to make extensive changes at CFS.

As part of the agreement, a monitoring committee comprised of experts supplied by parties to the suit will oversee the implementation of the settlement. The following list summarizes the major provisions of the partial settlement:

  • The hospital will create an all female ward;
  • WSH will administer a risk assessment of incoming patients in order to separate patients according to their vulnerability or propensity towards physical and/or sexual aggressiveness;
  • WPAS will receive copies of all CFS incident reports;
  • WSH will implement a policy that defines and sets forth a procedure to report the unexpected death of any patient to the appropriate committees, including notification to WPAS within seven days;
  • Patients who have been civilly committed and are currently residing at CFS will be relocated to the Adult Psychiatric Unit;
  • All CFS patients shall be afforded a minimum of one hour of fresh air per day at least five days a week;
  • WSH will follow the current Joint Commission on Accreditation of Hospital Organizations (JCAHO) standard on the use of seclusion and restraints;
  • Patients will receive individualized treatment programs;
  • Patients will receive a review of their medications at least every thirty days by attending physicians;
  • WSH will hire two additional Ph.D psychologists and two additional ward clerks;
  • WSH will ensure that all CFS patients participate in their discharge planning and are aware of the discharge criteria they must meet;
  • Patients will have access to timely and adequate medical and dental care; and
  • Patients will have their treatment plans reviewed regularly and ineffective plans will be modified.

On May 25, 2001, Judge Bryan, in order to include individuals affected by his ruling, held a fairness hearing at the CFS unit of Western State Hospital, inviting the patients of CFS to attend. The fairness hearing provided the patients of CFS an opportunity to voice objections and tell Judge Bryan how they felt about the settlement. Judge Bryan listened to comments and answered questions from attending patients. Upon closing the hearing, Judge Bryan ordered comprehensive changes at CFS, as provided in the partial settlement.

While the state and WPAS have agreed on many of the concerns expressed in the lawsuit, one issue still remains unresolved. At this time, the Attorney General’s office and WPAS are continuing to negotiate the issue of active treatment. If the parties cannot come to an agreement, WPAS will litigate the issue in front of Judge Bryan in December of this year.

If you have any further questions concerning this lawsuit, or would like more information concerning the settlement, please contact the Legal Advocacy Team at WPAS.