273 P.3d 1017
Wash. Ct. App.2012Background
- DSHS found that Raven, a court-appointed limited guardian, neglected Ida by failing to provide needed medical services.
- The Board reversed the ALJ, concluding Raven neglected Ida by inattention and by failing to meet medical needs under RCW 74.34.020(12).
- Superior Court reversed the Board and awarded Raven attorney fees; DSHS appealed.
- Ida, a frail ward with stage IV ulcers and multiple conditions, required constant adjustment of in-home care and potential residential placement.
- Raven argued her duties were constrained by substitute decision-making, prohibition on involuntary detention, and nurse delegation limits.
- Court affirms the Board, holds Raven had a general duty to provide the care Ida needed to the extent reasonably possible.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Did Raven have a duty of care to ensure Ida received necessary care? | Raven: duty limited to substitute decisions and non-detention; not to guarantee care. | DSHS: guardian must ensure medical needs are met; failure constitutes neglect. | Yes; guardian must provide the care Ida reasonably needed. |
| Is causation required to prove neglect under the Act, or is a pattern of conduct enough? | Raven: neglect requires causation of harm. | DSHS: pattern of conduct depriving care suffices, causation not required. | Pattern of failure to provide care supports neglect without proving causation. |
| Must neglect be proven by clear and convincing evidence or preponderance of the evidence? | Raven: higher standard due process; claim should require clear and convincing evidence. | DSHS: preponderance of the evidence standard applies. | Preponderance of the evidence standard applies. |
| Was Raven's pattern of inaction from late 2005 to 2006 neglect? | Raven contends obstacles explain inaction. | DSHS: inaction despite clear medical needs constitutes neglect. | Yes; two-and-a-half year pattern of inaction constitutes neglect. |
Key Cases Cited
- In re Eisenberg, 43 Wash.App. 761 (1986) (guardian owes fiduciary duty to ward and must act in the ward's best interests)
- Cummings v. Guardianship Servs. of Seattle, 110 P.3d 796 (2005) (guardianship duties and rights; statutory framework for guardians)
- In re Schuoler, 723 P.2d 1103 (1986) (independence of guardianship and involuntary treatment statutes)
- Kraft v. Dep't of Soc. & Health Servs., 187 P.3d 798 (2008) (preponderance standard for neglect under RCW 74.34; no license revocation equivalence)
- Kabbee v. Dep't of Soc. & Health Servs., 192 P.3d 903 (2008) (administrative standard of proof for neglect; precedent for standard)
- Bond v. Dep't of Soc. & Health Servs., 45 P.3d 1087 (2002) (application of RCW 74.34 negiect framework; pattern of conduct)