Court rules against state in emergency room boarding case

Psychiatric patients being held involuntarily in emergency rooms must be given a chance to contest their detention within three days of their arrival, the state Supreme Court ruled Tuesday. State law requires probable cause hearings for such patients within three days of an “involuntary emergency admission,” but the state has argued the clock doesn’t start until someone is transferred to an inpatient facility. However, those facilities often have no available beds, leaving patients “boarding” in emergency departments for weeks at a time. Tuesday’s decision reaffirms a lower court ruling in favor of a woman who spent more than two weeks at Dartmouth-Hitchcock Medical Center’s emergency room before being transferred to the state psychiatric hospital. Justices agreed with the lower court, which said the state has a duty to provide hearings within three days of when a doctor signs off on an involuntary emergency certificate. “Nothing in the statutory scheme allows a person to be held indefinitely pending delivery to a receiving facility,” the court said in Tuesday’s ruling. In recent days, more than 80 mental health patients, including record numbers of children, have been waiting in emergency departments for inpatient beds, said Ken Norton, executive director of the New Hampshire chapter of the National Alliance on Mental Illness. Such boarding often aggravates rather than helps mental health conditions, he said, and stands in contrast to the quick treatment provided to those suffering from other illnesses. Norton said he hopes the state sees the ruling as a call to rapidly improve a mental health system that is overburdened at every stage, from entry to treatment to re-entry into the community. “During the past eight years thousands of Granite Staters have experienced ED Boarding. When justice is denied to one person it is denied to all,” he said. “Today’s decision on behalf of Jane Doe is a decision in favor of all Granite Staters. We are all Jane Doe.” A spokesperson for Health and Human Services Commissioner Lori Shibinette did not immediately respond to a request for comment. The department had argued in part that requiring hearings within three days of the signing of certificates would result in either court hearings being held in private hospitals or courts ordering patients to be released when such hearings do not occur. That would increase the risk that mentally ill people would hurt themselves or others, they said. The court, however, said such public policy arguments should be made to the Legislature, not the judicial branch. “We do not opine as to how the defendant should comply with its statutorily-mandated duty as our system of government entrusts such decisions to our coordinate branches,” the court said. The ACLU-NH, which has filed a separate class action lawsuit in federal court over the issue, praised the ruling. “Today’s historic decision is a major victory for mental health advocacy: it recognizes that those being boarded in hospital emergency rooms are human beings entitled to prompt due process,” said legal director Gilles Bissonnette.

Justices consider hearing a case on ‘most offensive word’

Robert Collier says that during the seven years he worked as an operating room aide at Parkland Memorial Hospital in Dallas, white nurses called him and other Black employees “boy.” Management ignored two large swastikas painted on a storage room wall. And for six months, he regularly rode an elevator with the N-word carved into a wall. Collier ultimately sued the hospital, but lower courts dismissed his case. Now, however, beginning with a private conference that was scheduled for Thursday, the Supreme Court is considering for the first time whether to hear the case. (Although the court did not comment, the case remained on its calendar, which likely means it was discussed Thursday.) Focusing on the elevator graffiti, Collier is asking the justices to decide whether a single use of the N-word in the workplace can create a hostile work environment, giving an employee the ability to pursue a case under Title VII of the landmark Civil Rights Act of 1964. Already, the court’s two newest members, both appointed by President Donald Trump, are on record with seemingly different views. The case is also a test of whether the justices are willing to wade into the ongoing, complex conversations about race happening nationwide. The public could learn as soon as Monday whether the court will take Collier’s case. Jennifer A. Holmes, a lawyer with the NAACP Legal Defense and Educational Fund, which has urged the court to take the case, says she hopes the conversations taking place nationally will push the justices in that direction. Doing so gives the court an “opportunity to show that they’re not insensitive to issues of race,” Holmes said. And courts are “all the time” confronting workplace discrimination claims involving use of the N-word, she said. The question for the justices, she said, is just whether someone who experiences an isolated instance of the N-word can “advance their case beyond the beginning stage.” Two of the court’s nine justices have experience with similar cases.