In the Matter of the Detention of C.E.
No. 40409-9-III
THE COURT OF APPEALS OF THE STATE OF WASHINGTON DIVISION THREE
SEPTEMBER 9, 2025
STAAB, J.
FILED In the Office of the Clerk of Court WA State Court of Appeals, Division III
STAAB, J. — This appeal concerns the boundaries of a superior court‘s authority under Washington‘s Involuntary Treatment Act (ITA),
At a hearing for recommitment, several witnesses testified that C.E.,† a person diagnosed with developmental disabilities, remained in need of continued confinement but had made dramatic improvements during her three years of involuntary commitment. Witnesses testified that she was stable in her treatment and would benefit from less restrictive alternatives to treatment. Nevertheless, because C.E. had been previously placed in DDA‘s Community Protection Program (Program), an alternative program for persons who need enhanced supervision but pose a physical risk to others, C.E.‘s discharge options were severely limited. While C.E.‘s treatment team questioned whether her placement in the Program was still appropriate, the court was advised that she could not graduate from the Program or be reassessed while she remained in custody, but she could not leave custody because the Program restricted her housing options.
The superior court granted the petition for recommitment but ordered a less restrictive alternative treatment. Recognizing that C.E.‘s designation in the Program was resulting in her perpetual commitment, and in an effort to effectuate its less restrictive alternative order, the court ordered DDA to reassess C.E.‘s designation in the Program to determine if C.E. could qualify for additional discharge options.
DDA appeals this order, arguing that the superior court exceeded its subject matter jurisdiction and authority by directing actions under
We conclude that the superior court was not reviewing or overturning a final agency action but instead was acting within its original subject matter jurisdiction under the ITA,
BACKGROUND
DDA Services and C.E. ‘s CPP Status
C.E. is an individual who has been diagnosed with both an intellectual disability as well as psychiatric disorders and is receiving services from DDA under
In 2016, C.E. was admitted and later discharged from Eastern State Hospital (Hospital) after it was determined that a less restrictive alternative treatment through DDA was in her best interest. She was transferred to Lakeland Village, a residential habilitation center1 for individuals with developmental disabilities, where she remained until October 2021. At that time, she was readmitted to the Hospital following incidents of assaultive and aggressive behavior toward her caregivers.
Around the time of her readmission, DDA determined that C.E. posed a risk to the community and classified her in the Program, which provides the highest level of supervision for individuals deemed a risk to public safety. See
Involuntary Commitment Proceedings
In January 2024, the Hospital filed a petition2 in Spokane County Superior Court seeking to recommit C.E. for an additional 180 days of involuntary inpatient treatment under the ITA. By the time of the hearing on the petition, C.E.‘s diagnoses had been updated to bipolar II disorder, mild intellectual disability, and post-traumatic stress disorder.
Present at the hearing were the DDA mental health liaison, C.E.‘s attending psychiatrist, C.E.‘s social worker, and counsel for both C.E. and the Hospital. C.E.‘s guardian did not appear at the hearing.
DDA‘s mental health liaison testified first. She regularly worked with C.E. to assist her with placement options but noted C.E.‘s options for placement were limited by her Program classification. For example, it was DDA‘s policy that adult family homes were not an option for C.E. due to her classification in the Program. The only way to get out of the Program was to graduate, get reassessed, or decline the assistance. The liaison testified that it was not possible for C.E. to graduate from the Program while she was hospitalized. If an updated assessment determined that C.E. no longer posed a risk to the community, she could potentially be discharged from the Program. Otherwise, if C.E. were to decline community protection, her only option would be independent living in her own apartment.
C.E.‘s attending psychiatrist testified that C.E. had made significant progress in her treatment; her mood had stabilized, and she understood her updated diagnosis and need for medication. The psychiatrist noted that C.E. had engaged in some self-harming behavior. According to the psychiatrist, C.E. could be considered for discharge when she demonstrated four weeks without aggressive behavior, achieved psychiatric stability, and had a viable discharge plan. He testified that, at the time of the hearing, C.E. met approximately 90 percent of the discharge criteria.
The psychiatrist went on to testify that DDA was pursuing a discharge plan that C.E.‘s treatment team did not support. He noted that discharge to Lakeland Village would be “tragic,” posing a risk to C.E. and the staff. He added that C.E. was experiencing increased stress related to the possibility of being returned to Lakeland Village, and that her treatment team did not support that placement. The psychiatrist testified that he supported releasing C.E. to an adult family home or residential-type treatment center. He did not support release to the community either unconditionally or on a less restrictive alternative treatment.
C.E.‘s psychiatric social worker, who was part of C.E.‘s treatment team, testified that she served as the primary point of contact between the treatment team and DDA. She emphasized that C.E. is doing very well and has been for a long time. She testified that the discharge plan for C.E. involved identifying a facility within the Program that was accepted by DDA.
The social worker testified that in an effort to find C.E. viable living arrangements, numerous referral packets were sent to facilities across Washington State. While DDA did not let her know the exact number, she could count at least 61 packets having been sent out. Of those 61 referral packets, 31 facilities declined and 30 did not respond.
According to the social worker, DDA considered Lakeland Village a viable placement option for C.E. even though the treatment team did not support this option, and the mere possibility of discharge to Lakeland Village was causing C.E. increased anxiety. She also noted that while other viable facilities existed outside the DDA system, C.E. was not eligible for them due to her enrollment in the Program. In light of the rejected referral packets, C.E.‘s ineligibility for an adult family home, rejection by two of the three residential treatment centers, and Lakeland Village‘s incompatibility, the social worker was not sure what DDA was planning for C.E.‘s discharge but noted that DDA was taking the lead on discharge planning.
Regarding the Program, the social worker testified that C.E.‘s last assessment was completed in 2020 when she was admitted into the Program. She believed a new assessment would be beneficial due to C.E.‘s progress but noted that the social worker‘s prior request for a reassessment was denied by DDA “because [C.E.] hasn‘t been in the community” and therefore DDA did not think anything had changed. Clerk‘s Papers (CP) at 111, 114. The social worker indicated that the process for a new assessment would include sharing her notes with the DDA psychologist who would process the assessment internally and prepare a new recommendation. She noted that if C.E. was not in the Program, her options for placement would increase significantly.
C.E. testified briefly and stated she did not want to remain at the Hospital and would go to a shelter if discharged.
In closing, the Hospital‘s attorney requested the court grant the petition but noted that it would move for a less restrictive alternative if a viable placement became available. C.E. opposed the petition or, alternatively, sought a less restrictive alternative. Her attorney pointed out that under the circumstances, it could be years before a placement alternative became available for
The Superior Court Commissioner‘s Order
A superior court commissioner granted the petition for 180 days of involuntary impatient treatment at the Hospital, finding that C.E. was gravely disabled. The commissioner also found that discharge to a less restrictive treatment alternative would generally be in C.E.‘s best interest, but that no viable setting was available at that time. The commissioner further found that C.E.‘s Program classification was “stale and no longer appropriate” as the last assessment was conducted approximately four years earlier, in 2020. CP at 5.
The commissioner concluded the court had subject matter jurisdiction and personal jurisdiction over DDA and the Hospital as subagencies of DSHS, and issued an order under the ITA,
DDA‘s Motion for Revision
DDA moved for revision of the order, arguing that the superior court lacked authority and jurisdiction to review DDA‘s service decisions under
A superior court judge denied the motion for revising and adopted the commissioner‘s findings and conclusions, with the following additional findings:
- Superior Courts have personal jurisdiction and authority to direct Department of Social and Health Services’ agency actions for the provision of public benefits under
RCW 71A ,RCW 74.08 ,RCW 74.09 , and federal Medicaid law in the manner directed by paragraph 15 of the Court‘s January 12, 2024 order pursuant toRCW 71.05 and In [re] the Detention of J.S. - The Court‘s directions to DDA to in Paragraph 15(A)-(D), including the directions to re-assess [C.E.] in consultation with Eastern State Hospital employees notwithstanding DDA‘s policies, to resend referrals for services to providers, and that Lakeland Village be the discharge location of last resort are within the Court‘s authority under
RCW 71.05 and are not too specific under In [re] the . . . Detention of J.S. - The Court has authority to and waives the requirements of the Administrative Procedure Act,
RCW 34.05 , pursuant toRCW 34.05.534(3)(c) . [C.E.] would be subject to grave irreparable harm if required to comply with the Administrative Procedure Act. - Paragraph 15(C), requiring [C.E.] to be discharged to an adult family home or residential habilitation center within 60 days, is subject to DDA finding her eligible for services in those settings pursuant to state and federal Medicaid law.
CP at 156-57.
DDA timely appeals.
ANALYSIS
DDA contends that the superior court‘s order exceeded the court‘s subject matter jurisdiction and statutory authority in an involuntary treatment proceeding under
In response, C.E. maintains that the court acted within its authority under
We conclude the superior court did not exceed its authority under the ITA,
1. Standard of Review
Under
2. Legal Framework
a) Agency Action Under Title 71A.10 RCW and the APA
DDA administers long-term care services to eligible individuals with developmental disabilities, including through the Program, which serves individuals who pose a risk to themselves or others. See
DDA decisions affecting eligibility for services, Program enrollment, or level of restriction constitute agency action under the APA. See
In general, a party must exhaust all available administrative remedies before seeking relief from an agency action in superior court. See
Importantly, when reviewing agency action under the APA, the superior court acts under its appellate jurisdiction, not under its general or original jurisdiction. Diehl v. W. Wash. Growth Mgmt. H’rgs Bd., 153 Wn.2d 207, 216, 103 P.3d 193 (2004).
b) Chapter 71.05 RCW—The ITA
By contrast, this case arose under
Unlike proceedings under the APA, the superior court has original subject matter jurisdiction and authority to entertain an involuntary commitment petition and proceeding. See WASH. CONST. art. IV, § 6 (“The superior court shall also have original jurisdiction in all cases and of all proceedings in which jurisdiction shall not have been by law vested exclusively in some other court.“); see generally
The legislature has explicitly articulated its intent for the ITA: timely access to appropriate treatment, protection of individual rights, promotion of community-based services, and avoidance of unnecessary institutionalization. See
Under
The Legislature has emphasized the importance of less restrictive treatment and has, in fact, directed the court to consider less restrictive treatment at each stage of involuntary commitment proceedings. Restricting the court‘s ability to order less restrictive treatment would not be consistent with this clear legislative intent.
J.S., 124 Wn.2d at 698 (emphasis added).
3. Analysis
This case concerns the interplay between superior court authority under Washington‘s ITA,
We conclude the superior court properly exercised its original subject matter jurisdiction under the ITA,
a) The superior court acted within its original subject matter jurisdiction and authority under ch. 71.05 RCW 3
DDA argues that the superior court lacked subject matter jurisdiction
This case did not arise from a petition for judicial review under the APA. There was no final agency decision before the court under
Having found that C.E. remained gravely disabled but no longer required inpatient care, the superior court entered a less restrictive treatment order. In doing so, it directed DDA to reassess C.E.‘s status in the Program using updated clinical input and, subject to DDA finding C.E. eligible for services and pursuant to state and federal Medicaid law, to pursue placement options in a residential habilitation center or adult family home. These directives did not adjudicate any agency action under
The court thus acted under its original subject matter jurisdiction, not its appellate jurisdiction. This distinction is dispositive. The APA‘s procedural framework—including exhaustion and petition requirements—applies only when a court reviews “agency action” under
b) The superior court did not engage in judicial review of an agency action
DDA contends that the superior court engaged in improper judicial review by directing a new Program assessment and setting a 60-day placement timeline, claiming this fell within the APA‘s definition of reviewing the “granting or withholding of benefits.”
The superior court‘s order did not invalidate a prior agency decision, nor did it compel DDA to approve a particular service or eligibility outcome. Instead, it required DDA to engage its own internal reassessment process using current clinical information—something that, according to the DDA mental health liaison‘s testimony, was becoming more common under updated agency practices. The liaison testified that agency policy had recently shifted toward encouraging more frequent reassessments. Furthermore, the order explicitly conditioned any discharge on C.E.‘s eligibility under state and federal Medicaid law, preserving DDA‘s role in determining services.
In substance, the superior court acted within its authority under
c) The APA does not apply, so waiving the exhaustion requirement was unnecessary
DDA argues that the superior court erred in invoking
As discussed above, the superior court was not reviewing a final agency action under
The court‘s reference to waiver under
d) The superior court‘s order did not run afoul of In re Detention of J.S.
DDA argues that the superior court‘s order went further than what the Washington Supreme Court permitted in In re Detention of J.S., 124 Wn.2d 689, and that, even if J.S. remains good law,4 it does not authorize courts to compel agency action or override programs administered under
In J.S., the Washington Supreme Court reviewed three consolidated civil commitment cases involving the involuntary treatment of adults with developmental disabilities. Particularly relevant to this appeal was the petition of C.P., who had been diagnosed with developmental disabilities and organic personality disorders that caused C.P. to present a likelihood of harm to others. Appellant‘s Br. at *5; In re Det. of J.S., No. 61551-9 (Wash. Sept. 22, 1994). C.P.‘s case manager testified that while Western State Hospital was not the optimum placement for C.P., there were no other alternatives. C.P.‘s behavior ruled out placement in a group home or congregate care facility, the residential treatment facilities did not have openings, and there were no funds to create an “Intensive Treatment Support” placement. Appellant‘s Br. at *6, No. 61551-9.
In each case, the trial court found that the respondents remained gravely disabled and needed continued confinement but that less restrictive treatment alternatives were in their best interest. 124 Wn.2d at 696. The trial court ordered that each respondent should be removed from the hospital and placed in less restrictive treatment over the State‘s protest that such placements were not available due to funding allocations. Id. at 698.
The J.S. court emphasized that while trial courts may order treatment in a less restrictive setting, they may not dictate placement at a specific facility. See id. at 696-98. Only one portion of one order—requiring temporary placement at Rainier School, a particular DDA facility—was found to be impermissibly specific. Id. at 696-97. The other orders, which simply directed removal from the hospital to an appropriate less restrictive community setting, were upheld. Id.
Nevertheless, in J.S. the State maintained that the trial court‘s order requiring less restrictive treatment improperly required the State to incur expenditures beyond appropriations and was an attempt “to modify policy choices made at the legislative level.” Id. at 698. The court disagreed, noting that under
[t]he Legislature has granted the court the power to determine the best interests of the individual and in so doing, to consider less restrictive treatment. The statutory framework represents a legislative policy choice to create this role for the court. We find that because the court has the power under the statute to order less restrictive
treatment, it necessarily has the power to compel compliance with its order.
Id. at 699 (emphasis added).
Here, the superior court‘s order did not require specific treatment, specific placement, or even a specific outcome; it simply required DDA to reassess whether C.E.‘s continued placement in the Program was appropriate in light of the change in circumstances since she was last evaluated. The court found that the reassessment was necessary to compel compliance with its order for less restrictive treatment because DDA had a policy of not performing reassessments so long as a person was committed to a hospital, but C.E. had no options for placement outside the hospital so long as she remained in the Program. The result was C.E.‘s perpetual commitment contrary to the legislative intent to consider and impose less restrictive treatment and avoid unnecessary institutionalization.
Importantly, the court‘s order preserved and respected DDA‘s authority to determine eligibility, make referrals, and coordinate with providers. The court did not direct any particular outcome or override agency rules. The court simply ensured that its own less restrictive alternative order—authorized by
To the extent DDA reads J.S. as barring any coordination between the court and DDA under
We also reject DDA‘s argument that the superior court failed to consider other laws and regulations. The court‘s order requiring C.E. to be discharged to an adult family home or residential habilitation center within 60 days was subject to DDA finding eligible services pursuant to state and federal Medicaid laws. DDA fails to point to any authority, other than its own policy, which prevents reassessment while a person is in custody.
This narrow tailoring highlights the legality of the superior court‘s approach and its consistency with legislative intent. The legislative intent statutes explicitly state the legislature‘s preference for timely, community-based treatment whenever appropriate, and directs courts to avoid unnecessary institutionalization, safeguard individual rights, and promote continuity of care.
The superior court did not exceed its authority or act outside of its jurisdiction in directing DDA to take certain actions necessary to effectuate its less restrictive alternative order.
Affirmed.
Staab, J.
WE CONCUR:
Cooney, J.
Lawrence-Berrey, C.J.