A Baltimore circuit judge is holding Maryland's acting health secretary and other top Health Department officials in contempt of court and ordering them to open dozens of beds at state psychiatric hospitals by the end of the year.
Retired Judge Gale Rasin ruled Thursday that acting Health Secretary Dennis Schrader and his top staff had failed to follow court orders to place criminal defendants in state psychiatric hospitals. In some cases, Rasin said, mentally ill defendants have languished in jails for weeks waiting for a bed at a state hospital.
"Secretary Schrader: I say, 'Fix this problem and do it now,' " Rasin said from the bench. She said the Department of Health, which is responsible for treating mentally ill defendants, hasn't been doing its job.
"It has failed miserably to meet its responsibility," Rasin said. She said the evaluation and treatment system for potentially mentally ill defendants is "in a shambles."
Schrader told The Baltimore Sun that Rasin is ignoring steps he is taking to add 95 psychiatric beds in a variety of locations.
"I don't agree with it and it's inaccurate," Schrader said.
Asked what was inaccurate in the ruling, he responded: "She's stuck in the past. I've got to be worried about the future."
In a blistering 42-page order, Rasin systematically picked apart explanations given by Schrader and his staff for the delays in getting defendants into hospital beds.
Rasin wrote that state health officials had failed to heed warnings of a need to expand state hospitals as far back as 2012, when Martin O'Malley was governor and a consultant recommended "a very significant increase in hospital beds." Subsequent reports and promises of action have fallen short, she wrote.
Rasin said the department's confusing estimates of waiting lists and wait times represented "a sort of shell game" that impeded progress.
"If the Department lacks important data, it has been a conscious and intentional choice not to gather it," she wrote.
Rasin said Schrader seemed to be "disconnected from the process."
"Mr. Schrader seems to lack a basic grounding in the issues, and clearly misapprehends whatever has been reported to him," she wrote.
Schrader said he's worried about how criticism of the department will affect the staff, but he's not taking it personally.
"I'm a big boy," he said. "I can take the criticism."
In order to lift the contempt finding, Rasin said, Schrader and his deputies must fully staff 20 beds that were added recently to the Clifton T. Perkins Hospital Center in Jessup and open and staff 20 more beds in a new admissions unit there, and open and staff 20 more beds in a new admissions unit at Spring Grove Hospital Center in Catonsville.
The new units must be opened and staffed by the end of December, Rasin said.
In her contempt order, she named Schrader, Barbara J. Bazron, the deputy health secretary; Erik Roskes, director of forensic services for the department's Behavioral Health Administration; Ina Taller, clinical director of Clifton Perkins Hospital; and Danielle Robinson, clinical director of pretrial services at Clifton Perkins Hospital.
Sharon Bogins Eberhart, a public defender who represents defendants who were awaiting mental health treatment, called the ruling a good start toward fixing the problem — if the state complies.
"If they were to do it, it would be a tremendous step forward," she said.
Del. Erek L. Barron, who attended the hearing Thursday, said the ruling could be the motivation the state needs to finally solve the problems.
"I wish this would have come sooner," the Prince George's County Democrat said. He sits on the House of Delegates committee that oversees state hospitals.
Barron said the Department of Health has been "flagrantly ignoring" court orders to put people in treatment. He said Hogan should be able to find the money to comply with the judge's order.
"Money comes flying out of everywhere when it's a priority of his," he said. "It's a shame we can find money and resources for constituencies that can be a squeaky wheel, but for the voiceless? For the marginalized groups? Who is going to stand up for them?
"Finally we have a judge who has."
Hogan spokesman Doug Mayer said the state has increased the budget for psychiatric hospitals.
"Heated and misleading rhetoric won't help those in need," Mayer said.
Mayer declined to comment on the case or the judge's order.
University of Baltimore law professor Kimberly Wehle said Rasin's order could be a "shot across the bow" aimed at forcing the state to get defendants into mental health treatment.
In contempt cases, Wehle said, judges usually have a variety of options for enforcing their orders, including fines, jail time, requiring progress reports or taking an active role in managing the agency, Wehle said. She said fining or jailing a government official would be "extraordinary."
Wehle suggested there may be an element of public shaming behind the judge's order.
"It's really embarrassing and she knows that," Wehle said.
Schrader outlined a plan to open 95 mental health beds across the state, including 18 at Potomac Center in Hagerstown, 40 at Clifton Perkins Hospital and 24 at the Eastern Shore Hospital Center in Cambridge. He said another 13 beds will be provided by Bon Secours Hospital in Baltimore and Washington Adventist Hospital in Takoma Park.
Those plans don't meet Rasin's order to add beds at Perkins and Spring Grove.
"We are going to do what is medically necessary and clinically indicated, OK?" Schrader said.
Schrader has been embroiled in a separate controversy over his appointment as secretary. He has been working without pay since July.
Schrader was not confirmed by the state Senate, as is required for Cabinet secretaries. Hogan withdrew Schrader's nomination and then re-appointed him after the General Assembly session in April.
The Assembly put language in this year's budget saying unconfirmed nominees could not be paid. Schrader is challenging that in court.
Another Cabinet nominee in the same situation, Wendi Peters, was moved last week from acting secretary of planning to a role as special secretary of smart growth, which does not require Senate confirmation.