Opinion
Civil Action No. 18876-NC
Date Submitted: March 20, 2002
June 25, 2002
Marybeth Putnick, Esquire, Daniel G. Atkins, Esquire, Disabilities Law Program of Community Legal Aid Society, Inc., Wilmington, DE.
Phebe S. Young, Esquire, Deputy Attorney General, Wilmington, DE.
Dear Counsel:
Pending is a motion to dismiss this action brought by the plaintiff, Community Legal Aid Society, Inc. ("CLASI"), a Delaware non-profit corporation that is statutorily empowered to enforce the rights of mental health patients set forth in the Delaware Mental Health Patients' Bill of Rights. The defendants are certain State officials who are named in their then-official capacities. The facts recited below are derived from the well-pled allegations of the amended complaint.
Those defendants are Vincent P. Meconi, Secretary of the Department of Health and Social Services; Renatta J. Henry, Director of the Division of Alcoholism, Drug Abuse and Mental Health; and Michael Talmo, Director of the Delaware Psychiatric Center.
In 1986, the United States Congress enacted the Protection and Advocacy for Mentally Ill Individuals Act ("PAMII" or the "Act"). PAMII provides funding for states to establish independent organizations (referred to in the Act as "eligible systems") to monitor and protect the mentally ill. The purpose of those independent state organizations is to "investigate incidents of abuse and neglect of individuals with mental illness" and to take appropriate action to "protect and advocate the rights of such individuals." PAMII does not, in and of itself, create substantive rights for mentally ill persons. Those rights are created by state law.
4 Pub.L. No. 99-319, 100 Stat. 478 (codified at 42 U.S.C.A. §§ 10801-10905).
42 U.S.C.A § 10801(a).
Id. § 10803.
The specific Delaware law that grants substantive rights to Delaware mental health patients is the Delaware Mental Health Patients' Bill of Rights, 16 Del. C. § 5161-5162 (the "Patients' Bill of Rights"). Among the rights granted by that statute is the right of "[e]ach patient to receive care and treatment suited to the patient's needs, skillfully, safely and humanely administered," and the right to be free from "[a]buse, mistreatment and neglect." CLASI qualifies as an "eligible system" under PAMII and has been designated to enforce the rights of Delaware's mental health patients.
Id. § 5161(b)(6)(a).
In May 1999, William Sheinfeld, a patient at the Delaware Psychiatric Center ("DPC"), died from choking while eating in a DPC day lounge. In its amended complaint, CLASI claims that Mr. Sheinfeld's death resulted from "serious and dangerous under-staffing problems [at DPC] which may have impacted the availability of appropriate supervision of Mr. Sheinfeld," and also from "the disregard of doctor's orders, and the disregard of evaluation recommendations." CLASI further claims that because of DPC's understaffing, "patients who are dependent on staff for feeding or one-to-one supervision are at risk of imminent injury." In its role as an advocate for the mentally ill, CLASI seeks certain declaratory and injunctive relief in this action, namely, to increase staffing levels and establish a task force to review staffing patterns at DPC.
Amended Complaint ¶ 29. The amended complaint also alleges that at least one other patient has died as a result of DPC's staffing problems. Id. ¶ 41.
Id. ¶ 31. After oral argument, the Court ruled from the bench that no viable claim for declaratory or injunctive relief could be asserted by CLASI on behalf of Mr. Sheinfeld or his estate. December 13, 2001 Oral Argument, Tr. at 46. The Court requested further briefing on the question of whether CLASI may bring suit under its own name, or whether it must name a specific patient as plaintiff or bring a class action. Id. at 46-47. The issue of whether the injunctive relief sought by CLASI would represent an improper exercise of the Court's powers was raised on the defendants' original motion to dismiss, and is decided by the Court in this Opinion.
The defendants' motion to dismiss rests on three grounds. The first is that CLASI lacks standing to bring this action. The second is that even if CLASI has standing, it has failed to state a claim alleging a violation of a patient's rights under the Patients' Bill of Rights. Last, the defendants argue that even if the amended complaint does state a legally cognizable claim, the relief that CLASI requests is impermissible, because it would require the Court to supervise and enforce staffing levels and patient care at a mental health hospital — an enforcement task the General Assembly has not entrusted to the judicial branch.
For the reasons next discussed, the defendants' motion to dismiss will be granted in part and denied in part.
I. ANALYSIS
A. Whether CLASI Has Standing To Sue
1. CLASI's Standing
The defendants contend that the amended complaint must be dismissed because CLASI lacks standing to bring suit in its own name on behalf of its mentally ill constituents. Because CLASI alleges no harm to itself as an organization, the defendants argue that CLASI must satisfy the test for "organizational standing" articulated by the Delaware Supreme Court in Oceanport Industries v. Wilmington Stevedores, Inc. I conclude that the Oceanport analysis is unnecessary, however, because the Patients' Bill of Rights itself confers standing upon any "interested citizen" to enforce the provisions of that statute. That statute defines an "interested citizen" as "any individual, voluntary association of individuals or corporate body having a bona fide interest in furthering the enforcement of the rights created by this subchapter." Under PAMII, the Governor of Delaware authorized CLASI to act as the "Protection and Advocacy System" to protect the rights of Delaware residents with mental illness. That advocacy role necessarily provides CLASI with a "bona fide interest" in enforcing the Patients' Bill of Rights. CLASI, therefore, is an "interested citizen" with standing to enforce the Patients' Bill of Rights.
636 A.2d 892, 902 (Del. 1994). Under Oceanport, an organization may sue on behalf of its members only if: (i) the interests to be protected by the suit are germane to the organization's purpose; (ii) neither the claim asserted nor the relief requested requires the participation of individual members; and (iii) the organization's members would otherwise have standing. Id. (citing Hunt v. Washington State Apple Advert. Comm'n, 432 U.S. 333 (1977)).
Even if the Court were to conduct the standing analysis prescribed by Oceanport, the result would be the same. The defendants' only contention under Oceanport (the third prong) is that CLASI's constituents — Delaware mental health patients — would not have standing on their own to sue. In other words, the defendants argue that CLASI has not alleged that its constituents' rights were violated under the Patients' Bill of Rights. As discussed in this Opinion, the Court finds that CLASI has adequately alleged that its constituents' statutory rights are being violated by DPC.
No Delaware court has directly addressed the question of whether an advocacy group without members (such as CLASI) would have organizational standing. Some federal courts have found that advocacy groups designated under PAMII have organizational or associational standing to bring suit on behalf of their constituents (as distinguished from their members), so long as the organization and its constituents satisfy the three-part standing test articulated in Hunt and adopted in Oceanport. Doe v. Stincer, 175 F.3d 879, 886 (11th Cir. 1999). If the organization satisfies the Oceanport test, it is not required to name the individual members on whose behalf it acts. Id. at 885. Thus, if the Oceanport standing test were applicable and were satisfied in this case, CLASI could bring this action in its own name, without identifying a specific patient or a class of patients.
16 Del. C. § 5162.
Id.
B. Whether The Amended Complaint Adequately Alleges A Violation Of The Patients' Bill of Rights
1. Whether CLASI Has Stated A Claim With Respect To Current DPC Patients
Because CLASI has standing, the question then becomes whether the amended complaint alleges facts that, if true, would establish that DPC has and is violating mental patients' rights as set forth in the Patients' Bill of Rights. The defendants argue that CLASI has failed to plead facts from which the Court could conclude that the defendants are violating the statutory rights of specific DPC patients. Rather, the defendants urge, CLASI makes only vague allegations of hospital understaffing, as distinguished from the specific factual allegations from which one could infer that DPC's understaffing constitutes a violation of the Patients' Bill of Rights.
I disagree. The amended complaint is not artfully drafted, but in my opinion it does allege facts sufficient to infer that the CLASI constituents identified in the amended complaint are not receiving the "care and treatment suited to the patient's needs," free from "neglect," as mandated by the Patients' Bill of Rights. The amended complaint avers specific examples of patient neglect resulting from hospital understaffing that allegedly led to the deaths of two patients. Based on those examples, CLASI claims that "[t]o the extent that understaffing continues to exist at DPC, patients who are dependent on staff for feeding or one-to-one supervision are at risk of imminent injury." The amended complaint identifies two such patients.
Initials were used in the amended complaint to protect the confidentiality of the patients, because those patients are not competent to authorize the release of their identities and do not have guardians.
Id. § 5161(b)(6)(a).
Amended Complaint ¶¶ 9-31 (relating to the affixation death of William Sheinfeld); ¶ 41 (relating to the suicide of Camellia Washington).
Id. ¶ 31.
To claim in a legally sufficient manner that the statutorily created rights of CLASI's constituents are being violated, the amended complaint must plead facts from which the Court can reasonably infer that (1) because two patients died from understaffing at DPC, current DPC patients requiring constant supervision are "at risk of imminent injury" resulting from the continued understaffing; and (2) the understaffing continues to violate the rights of DPC patients to "treatment suited to the patient's needs, skillfully, safely and humanely administered." I find that those inferences can reasonably be drawn from the amended complaint. Accordingly, CLASI has pled a legally cognizable claim that because of DPC's understaffing, DPC patients have suffered and are continuing to suffer violations of their rights under the Patients' Bill of Rights
2. Whether CLASI Can Assert A Claim On Behalf Of Mr. Sheinfeld
Following oral argument on the original motion to dismiss, the Court determined that "no viable claim can be asserted [by CLASI] on behalf of the estate [of Mr. Sheinfeld] for the type of declaratory and injunctive relief being sought here. . . . [T]he only cognizable interest the estate and Mr. Sheinfeld would have would be for a claim of damages." The amended complaint nonetheless persists in seeking declaratory relief relating to the care of Mr. Sheinfeld. Because Mr. Sheinfeld has no viable claim for such relief, CLASI's claims for an injunctive or declaratory remedy relating to Mr. Sheinfeld will be dismissed.
December 13, 2001 Oral Argument, Tr. at 46.
Amended Complaint at Relief Requested, ¶¶ A, B, C.
B. Whether CLASI's Claims Are A Proper Subject Of Injunctive Relief
The defendants next contend that the injunctive relief CLASI is seeking — an order directing the defendants to maintain "adequate staffing levels," and to create a "task force" to review staffing patterns — would necessarily and improperly "involve the Court in operating DPC in derogation of the rights and obligations legislatively delegated to the Secretary of the Department of Health and Social Services." Stated differently, the defendants claim that the requested injunction would constitute an improper exercise of the Court's powers as a matter of law. Therefore, (the defendants say) the claim seeking that relief is legally insufficient and must be dismissed.
Def. Op. Br. at 9; see also Folks v. Scott, 1998 WL 781846, at *4 (quoting State v. Cubbage, 210 A.2d 555, 564 (Del.Super. 1965)) ("`Courts cannot invade or transgress into fields of government [such as the prison system] which the Constitution of this State has vested in the Executive Branch of our State Government.'").
This argument labors under two difficulties. The first is that it overlooks the fact that the General Assembly has specifically vested the Court of Chancery with "jurisdiction over all actions . . . to enforce or resolve disputes concerning the rights arising out of" the Patients' Bill of Rights. Among those statutory entitlements is the right to "receive care and treatment suited to the patient's needs," and to receive treatment free from neglect. To be sure, in an appropriate case judicial enforcement of those rights could require injunctive relief compelling DPC to provide the statutorily guaranteed level of service. That is because although the Department of Health and Social Services is charged with operating DPC, this Court is charged with assuring (again, in appropriate cases) that DPC and the Department are accountable, i.e., exercise their authority in conformity with the Patients' Bill of Rights. On that basis, CLASI's claim for injunctive relief is legally cognizable.
19 Del. C. § 5162 (emphasis added).
Id. § 5161(b)(1).
Id. § 5161(b)(6)(a).
The second difficulty is that it is far from clear that a grant of injunctive relief would inevitably entangle the Court in DPC's daily operations, as the defendants posit. That determination certainly cannot be made as a matter of law because at this stage, the scope of any ultimately-granted injunctive relief cannot be determined. The defendants' argument presupposes as a legal matter that the Court would inescapably become enmeshed in those operations. Because that is far from certain, the defendants' position must be rejected on this ground as well.
II. CONCLUSION
For the reasons set forth above, the motion to dismiss claims A, B, and C of the amended complaint, which seek declaratory relief relating to the death of Mr. Sheinfeld, is granted. The defendants' renewed motion to dismiss the remaining claims (D through H) is denied. IT IS SO ORDERED.