Andrew Biviano, Paukert & Troppmann PLLC, (509) 232-7760

Emily Cooper, Disability Rights Washington, (206) 324-1521

Kathy Spears, DSHS Office of Communications, (360) 902-7893,

SPOKANE – A settlement agreement has been reached that will lead to important reforms for patients found not guilty by reason of insanity (NGRI) and sent to the state hospitals for treatment.

“This settlement should provide significant benefits to both patients and staff at our state psychiatric hospitals,” said Andrew Biviano of Paukert & Troppmann, PLLC in Spokane, one of the lead attorneys in this lawsuit.

“It appropriately allows professional clinicians to make decisions regarding patient care with fewer bureaucratic obstacles. This should help patients recover faster and more fully. This should, in turn, help patients move out of the hospitals more quickly and make precious bed space available to treat acute patients waiting for care,” he said.

This agreement was reached after a lawsuit was brought by six current and former patients at Eastern State Hospital and Western State Hospital, as well as Disability Rights Washington (DRW), against the Department of Social and Health Services (DSHS) in August 2014.

The trouble began when patient treatment and release planning dramatically changed after an NGRI patient walked away from the state fair in Spokane. Although the patient was returned to the hospital without incident, a series of new state laws and policies restricted access to therapy and superseded the opinions of patients’ treating clinicians. Plaintiffs alleged this deprived patients of constitutional rights to adequate mental health treatment and the least restricted treatment available.

As a result of the law and policy changes, for example, NGRI patients were no longer allowed to take a walk on hospital grounds, even if accompanied by staff and even if doctors prescribed this for treatment and recovery. Under this agreement the grounds privileges process at the two state psychiatric hospitals will be improved and streamlined in a manner that respects current law, accreditation standards, patient rights, and public safety concerns.

For decades prior to the lawsuit, patients received treatment that gradually reintegrated them into the community as they recovered through supervised trips to visit family or to a store. According to state hospital data, this careful and deliberate release planning resulted in a rate of recommitment of less than 1% –showing both patient recovery and public safety are attainable.

“I, and so many others like me, spent years in the hospital after we had fully recovered and were ready to go,” said plaintiff Ketema Ross. “We need to go back to when our doctors – not an outside panel of lawyers or politicians — made treatment decisions.”

“We have confidence that this agreement will balance the treatment needs of our patients and the public safety needs of the community,” said Carla Reyes, Assistant Secretary for DSHS’ Behavioral Health Administration. “We look forward to continuing to improve our discharge and treatment processes for the patients we serve.”

While the court retains the authority to determine when NGRI patients should be released or have unsupervised access to the community, the settlement provides for a more streamlined treatment and risk assessment process. Settlement provisions also address appropriate use of personal restraint devices, patients’ personal property, strip search policies, and retaliation.

As both a former mental health case manager and federal prosecutor, Biviano states that he knows firsthand that appropriate mental health care is critical to both patient recovery and public safety. The patients are also represented by attorneys from Disability Rights Washington (DRW), the federally mandated protection and advocacy agency designated by the governor to protect the rights of people with disabilities across the state. In addition to co-counseling with Biviano to provide legal representation to the named plaintiffs in this lawsuit, DRW has joined as an organizational plaintiff in the case in order to ensure the court considers the needs of all patients facing these conditions.

Additional Sources:

Ketema Ross and Jesus Martinez, plaintiffs and former Eastern State Hospital patients, coordinated by Andrew Biviano (509) 232-7760