Powell v. Maryland Department of Health, 168 A.3d 857

Background

Four criminal defendants in Baltimore City (Appellants) were found incompetent to stand trial and dangerous; circuit court commitment orders directed MDH to admit them as inpatients at Clifton T. Perkins Hospital “no later than” the day after each order.
MDH implemented an admission policy and waiting list for state psychiatric beds; defendants were not admitted by the one‑day deadlines and remained in pretrial detention for 12–36 days before eventual admission.
Appellants sued MDH and the Secretary, alleging (Count One) violation of CP § 3‑106(b) by failing to comply with the commitment orders and (Count Two) substantive due process violations under Article 24 of the Maryland Declaration of Rights.
The circuit court dismissed both counts; the Maryland Court of Appeals granted certiorari to review whether courts may set admission deadlines, whether MDH’s policy violated the statute, and whether delays could violate due process.
The Court held Count One (statutory claim) failed: the statute neither prescribes nor authorizes court‑set admission deadlines, so violating a court deadline may breach the order (contempt) but is not itself a statutory violation.
The Court held Count Two (due process) cannot be resolved on the limited record: a facial challenge to MDH policy fails, but an as‑applied due process claim survives — delays must be reasonable under the totality of circumstances and may violate Article 24 depending on case‑specific facts. Case remanded for further proceedings on Count Two.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether CP § 3‑106(b) authorizes a court to set a deadline for MDH admission	Court may order commitment to facility by a date; failure to comply violates statute	Statute does not set or authorize a deadline; MDH designates facility and statute is silent on timing	Statute does not authorize court‑set admission deadlines; courts may impose deadlines in orders but noncompliance violates order (contempt), not the statute
Whether MDH’s failure to meet court‑set admission deadlines constitutes a violation of CP § 3‑106(b)	Missed deadlines show statutory noncompliance	Missing a court‑imposed date breaches the order but is not per se a statutory violation	Failure to meet order deadline may violate the order but is not a violation of CP § 3‑106(b) itself
Whether MDH policy is facially unconstitutional under Article 24 (substantive due process)	Policy’s waiting list unlawfully confines incompetent defendants pretrial	Some delay is inevitable; policy is not per se unconstitutional	Facial due process challenge fails — some delay can be constitutionally tolerated
Whether MDH policy, as applied to these defendants, violated substantive due process	The specific delays (12–36 days) were unreasonable and punished defendants pretrial	Delays may be reasonable given bed scarcity and operational constraints; need case‑specific inquiry	As‑applied due process claim survives; reasonableness of delay is fact‑dependent and remanded for further proceedings

Key Cases Cited

Drope v. Missouri, 420 U.S. 162 (recognizing competency to stand trial as fundamental to fair trial due process)
Jackson v. Indiana, 406 U.S. 715 (due process limits on indefinite commitment for incompetency; commitment must relate reasonably to restoration goal)
Allmond v. Dept. of Health & Mental Hygiene, 448 Md. 592 (discussing State interest in restoration to competency)
State v. Ray, 429 Md. 566 (analysis of restorability framework under Maryland competency statutes)
Oregon Advocacy Ctr. v. Mink, 322 F.3d 1101 (upholding trial court injunction requiring short transfer deadline in light of legislative benchmarks)
Trueblood v. Washington State Dep’t of Social & Health Servs., 822 F.3d 1037 (addressing deadlines for evaluations/admissions in competency contexts)
Advocacy Ctr. for the Elderly & Disabled v. La. Dep’t of Health & Hosp., 731 F. Supp. 2d 603 (finding extended waits for admission likely violated due process and imposing remediation deadlines)