Title: State ex rel. Riley v. Rudloff, Administrator

State: west-virginia

Issuer: West Virginia Supreme Court

Document:

IN THE SUPREME COURT OF APPEALS OF WEST VIRGINIA September 2002 Term FILED RELEASED December 6, 2002 December 6, 2002 RORY L. PERRY II, CLERK No. 30725 RORY L. PERRY II, CLERK SUPREME COURT OF APPEALS SUPREME COURT OF APPEALS OF WEST VIRGINIA OF WEST VIRGINIA STATE EX REL. JESSE H. RILEY Petitioner, V. EDWARD RUDLOFF, ADMINISTRATOR OF THE EASTERN REGIONAL JAIL; DARRELL V. MCGRAW, JR., ATTORNEY GENERAL OF THE STATE OF WEST VIRGINIA; AND JEROME LOVRIEN, COMMISSIONER, WEST VIRGINIA DEPARTMENT OF HEALTH AND HUMAN RESOURCES, BUREAU FOR BEHAVIORAL HEALTH AND HEALTH FACILITIES, Respondents. PETITION FOR WRIT OF PROHIBITION WRIT GRANTED AS MOULDED John P. Adams Deborah A. Lawson Public Defender Corporation Charleston, West Virginia Attorneys for the Petitioner Submitted: October 9, 2002 Filed: December 6, 2002 Chad M. Cardinal General Counsel Charleston, West Virginia Attorney for the Respondent Regional Jail Authority Darrell V. McGraw, Jr. Attorney General Stephen J. Small Senior Assistant Attorney General Charleston, West Virginia Attorneys for the Respondent Jerome Lovrien, Commissioner West Virginia Department of Health and Human Resources Bureau for Behavioral Health and Health Facilities Pamela Jean Games-Neely Berkeley County Prosecuting Attorney Christopher C. Quasebarth Assistant Prosecuting Attorney Martinsburg, West Virginia Attorneys for Amicus Curiae State of West Virginia CHIEF JUSTICE DAVIS delivered the Opinion of the Court. JUSTICE STARCHER concurs and reserves the right to file a concurring opinion. SYLLABUS BY THE COURT 1. “‘“Where the language of a statute is free from ambiguity, its plain meaning is to be accepted and applied without resort to interpretation.” Syl. Pt. 2,Crockett v. Andrews, 153 W. Va. 714, 172 S.E.2d 384 (1970).’ Syl. pt. 4, Syncor Int’l Corp. v. Palmer, 208 W. Va. 658, 542 S.E.2d 479 (2001).” Syllabus point 4, Charter Communications VI, PLLC v. Community Antenna Service, Inc., 211 W. Va. 71, 561 S.E.2d 793 (2002). 2. “‘Inconsidering the constitutionality of a legislative enactment, courts must exercise due restraint, in recognition of the principle of the separation of powers in government among the judicial, legislative and executive branches. Every reasonable construction must be resorted to by the courts in order to sustain constitutionality, and any reasonabledoubt must be resolved in favor of the constitutionality of the legislative enactment inquestion.Courtsarenotconcernedwithquestions relating to legislative policy. The general powers of the legislature, within constitutional limits, are almost plenary. In considering the constitutionality of anactof the legislature,the negation of legislative power must appear beyond all reasonable doubt.’ Syllabus Point 1, State ex rel. Appalachian Power Company v. Gainer, 149 W. Va.740,143S.E.2d351(1965).” Syllabus point 4, McCoy v. Vankirk, 201 W. Va. 718, 500 S.E.2d 534 (1997). 3. Insofarasthe“incarceratedpersons”languageofW.Va.Code§27-5­ i 2(a)(2002)(Supp.2002) operates to wholly exclude pretrial detainees in state custody from participatingintheapplicationprocessforinvoluntary hospitalization, it is unconstitutional as it violates the due process right of such detainees to receive medical care. ii Davis, Chief Justice: In this original proceeding in prohibition, 1JesseRiley,apretrialdetaineeof the state who suffers from mental illness, complains that he has been denied his due process right to medical care by virtue of a provision in W. Va. Code § 27-5-2(a) (2002) (Supp. 2002) prohibitingapplicationsforinvoluntaryhospitalizationtobefiledonbehalfofincarcerated persons. Because we agree that the challenged provision of W. Va. Code § 27-5-2(a) is unconstitutional, we grant the writ as moulded. I. FACTUAL AND PROCEDURAL HISTORY Thepetitioner,JesseRiley,isadiagnosed paranoid schizophrenic. In mid-2002, Mr. Riley became noncompliant with his treatment program and, resultantly, grew increasingly violent toward family members, including his seventy-seven year old mother. Mr. Riley refusedtovoluntarilyadmithimselfintoahospital. On June 30, 2002, Mr. Riley was arrested for domestic battery. Because he resisted arrest, he was also charged with two counts of obstructing an officer. He was transported to the Eastern Regional Jail. His mother, Mrs. Riley, then attempted to initiate an involuntary hospitalization 1Although thiscasewasbroughtasa petition for writ of mandamus, we have concluded that this matter should be treated as a writ of prohibition. See infra Section II of this Opinion discussing standard for writ of prohibition. 1 proceedingseekingto have her son placed in an appropriate mental health facility. However, respondent Jerome Lovrien, Commissioner (hereinafter “Commissioner Lovrien”), West VirginiaDepartmentof Health and Human Resources Bureau for Behavioral Health and Health Facilities(hereinafter“BHHF”),refusedtoaccept her petition. He refused based upon W. Va. Code § 27-5-2(a) (2002) (Supp. 2002), 2asMr.Rileywasthenincustodyasapretrial detainee. AfterarrivingattheEasternRegionalJail(hereinafter “the Jail”), members of thejail’sstaffobserved Mr. Riley exhibiting bizarre behavior. Consequently, they contacted psychologist Harold Slaughter. 3 Mr. Slaughter examined Mr. Riley and determined that he was 2In2002,theWestVirginiaLegislatureamended W. Va.Code § 27-5-2(a) to apparently exclude from involuntary commitment proceedings any adult who is incarcerated. The current statute states, in pertinent part, (a) Any adult person may make an application for involuntaryhospitalization for examination of an individualwho is not incarcerated at the time the application is filed when the person making the application has reason to believe that: (1)Theindividualtobeexaminedisaddicted, as defined in section eleven, article one of this chapter; or (2) The individual is mentally ill and, because of his or her mental illness,the individual is likely tocause serious harm to himself or herself or to others if allowed to remain at liberty whileawaitinganexamination and certification by a physician or psychologist. (Emphasis added). 3Mr.Slaughterisaclinical psychologist who is under contract to provide mental health services at the Eastern Regional Jail. 2 athreattohimself and others, and that he required specialized treatment and diagnosis that was unavailableattheJail. Based upon this determination, Mr. Slaughter also attempted to file an application for involuntary hospitalization. As with Mrs. Riley’s application, Commissioner LovrienrefusedMr.Slaughter’sapplication citing W. Va. Code § 27-5-2(a). Later, on July 11, 2002, and after a public defender had been appointed to represent Mr. Riley, an order was entered directing that Mr. Riley be evaluated at the Forensic Unit of the South Central Regional Jail. At the time of the filing of the instant petition, Mr. Riley was sixth on the waiting list for the Forensic Unit. It was estimated that it may take forty to forty-five days beforeaspacebecameavailableforhim. Mr. Riley asserts in his petition that his condition has not improved since his incarceration and, as of the date his petition was filed, he remained “floridly psychotic.” CommissionerLovrienprovidessome background information relevant to the issues Mr. Riley raises. Commissioner Lovrien explains that “treatment” is provided at two locations for individuals who are only indicted for a crime, or who may be incompetent to stand trial,or who are guilty by reason of mentalillness–WilliamR.SharpeJr.Hospitalin Weston(hereinafter “Sharpe”), and the Forensic Evaluation Unit at the South Central Regional Jail (hereinafter “the FEU”). Both facilities are restricted as to the number of patients they may serve. Commissioner Lovrien contends that, due to a variety of factors, courts have been committing more patients to both of these facilities in recent years. He also contends that courts have been reluctant to discharge patients from Sharpe before the end of the release 3 period4 for reasons of public safety. Consequently, Sharpe has been operating at or above capacity and the FEU has a waiting list. When a court orders a defendant to Sharpe, Commissioner Lovrien explains, Sharpe must transfer one of its existing non-forensic patients toanotherpsychiatricfacility. Sharpe must also pay for the individual’s care. Commissioner Lovrien asserts that BHHF is attempting to deal with the problem of the increased number of patients at Sharpe in several ways. For example, on May 3, 2001, BHHF sent a letter to all West Virginia judges urging them to renounce civil commitment as a means for jails and correctional facilities to satisfy their duty to provide mental health treatment to inmates. BHHFhasalsoassembledataskforcetoaddresstheincreasingforensic service needs of the State. On August 5, 2002, Mr. Riley filed with this Court an “EMERGENCY PETITION FORWRITOFHABEAS CORPUSAND/ORMANDAMUS.” Subsequently, we entered an order in Vacation on August 16, 2002, awarding a writ of habeas corpus directing the Administrator of the Eastern Regional Jail to transfer Mr. Riley to the custody of CommissionerLovrien,anddirectedhimtoadmitMr.Rileyfortreatmentatanappropriate psychiatric hospital. In addition, we awarded a rule to show cause in mandamus, returnable on October 9, 2002. As noted below, however, we choose to treat the issues remaining in this case as arising in prohibition. 4Therelease period is the longest period for the offenses for which a patient was indicted. 4 II. STANDARD FOR WRIT OF PROHIBITION This case was initially brought as a petition for writ of habeas corpus and/or mandamus. We granted the writ of habeas corpus, leaving for resolution only issues related to mandamus. Upon further consideration of the issues herein raised, however, we choose (as wehavedonein many appropriate cases) to treat this matter as a writ of prohibition. See,e.g., State ex rel. Conley v. Hill, 199 W. Va. 686, 687 n.1, 487 S.E.2d 344, 345 n.1 (1997) (“Althoughthiscasewasbrought and granted as a petition for mandamus, we choose to treat this matter as a writ of prohibition. See State ex rel. Ranger Fuel Corp. v. Lilly, 165 W. Va. 98, 100, 267 S.E.2d 435, 436 (1980); see also Carr v. Lambert, 179 W. Va. 277, 278 [n.1], 367 S.E.2d 225, 226 n.1 (1988).”), overruled in part on other grounds by State v. Hulbert, 209 W. Va. 217, 544 S.E.2d 919 (1002). Viewed in the context of a petition for writ of prohibition, Mr. Riley’s argument maybeinterpretedasasserting that Commissioner Lovrien has exceeded his legitimate powers by refusing to accept applications seeking involuntary commitment of pretrial detainees. Accordingly, we apply the standard for prohibition set forth by this Court in syllabus point four of State ex rel. Hoover v. Berger, In determiningwhethertoentertainandissuethewritof prohibitionforcasesnotinvolvinganabsenceofjurisdiction but only where it is claimed that the lower tribunal exceeded its legitimate powers, this Court will examine five factors: (1) whetherthepartyseekingthewrit has no other adequate means, 5 suchasdirectappeal,toobtain the desired relief; (2) whether the petitioner will be damaged or prejudiced in a way that is not correctable on appeal; (3) whether the lower tribunal’s order is clearly erroneous as a matter of law; (4) whether the lower tribunal’s order is an oft repeated error or manifests persistent disregard for either procedural or substantive law; and (5) whether the lower tribunal’s order raises new and important problems or issues of law of first impression. These factors are general guidelines that serve as a useful starting point for determiningwhetheradiscretionarywritofprohibitionshould issue. Although all five factors need not be satisfied, it is clear that the third factor, the existence of clear error as a matter of law, should be given substantial weight. 199 W. Va. 12, 483 S.E.2d 12 (1996). III. DISCUSSION Mr. Riley argues that W. Va. Code § 27-5-2(a) is unconstitutional in that it violateshisrighttodueprocessoflaw5by preventing him from receiving necessary medical treatment,intheformofinvoluntaryhospitalizationatanappropriate mental health facility, for his severe mental illness.6 5Mr.Rileyhasraised several arguments asserting that his constitutional rights havebeenviolatedbytheCommissioner’s refusal to provide him with adequate medical care forhissevere mental health condition. Because we find that this case may be resolved on due process grounds, we need not address his remaining arguments. 6Thiscasearisesinaratherpeculiarposture. It appears contradictory that Mr. Riley asserts that his constitutional rights have been violated because he has been denied involuntary hospitalization. Due to Mr. Riley’s impaired mental condition, however, he has beenrenderedunabletoconsent to mental health treatment. Consequently, the instant petition wasfiledonhisbehalfseekingtherighttohave him involuntarily hospitalized. For purposes (continued...) 6 Commissioner Lovrien responds that W. Va. Code § 27-5-2(a) is not unconstitutional. He explains that the West Virginia Code provides two distinct articles for the involuntary hospitalization of individuals with behavioral health problems. The commitmentofpersonschargedorconvictedofcriminal activity is covered under Chapter 27, Article 6A, 7whiletheinvoluntaryhospitalizationofpersonsnotsocharged or convicted is laid out in Chapter 27,Article5. He contends that the legislature has demonstrated its intention that there be no “mixing” of these two separate procedures by precluding, in W. Va. Code 27-5­ 2(a),thefiling of an involuntary hospitalization application of a person who is incarcerated. CommissionerLovrienfurtherassertsthatW.Va.Code§27-5-2(a)ismerely a clarification oftheprior code wherein an involuntary application could be filed only against a person who was likely to cause serious harm to him or herself “if allowed to remain at liberty.” The clarificationof§27-5-2(a)was required, Commissioner Lovrien submits, due to a common practice of ignoring the “at liberty” clause of the earlier version of the statute, which resulted 6(...continued) of clarity and ease of reference, however, we will refer to all arguments asserted on Mr. Riley’s behalf as if they were his own. 7Chapter 27, Article 6A addresses forensic mental health examinations, the commitment of persons who have been adjudicated not competent to stand trial, and commitment of those who have been found not guilty by reason of mental illness, mental retardationoraddiction. We find Commissioner Lovrien’s reliance on Chapter 27, Article 6A to be misplaced. Article 6A allows a circuit court to enter an order of commitment upon recommendation by an examining mental health professional only after a defendant has completedtheprocedureestablishedfordetermining whether he or she is competent to stand trial. This potentially lengthy procedure does not account for the acute needs of a pretrial detaineewhorequiresimmediatehospitalizationbecauseheorshehasbeendeemedtobea threat to him or herself or to others. 7 in a significant number of incarcerated persons being sent to Sharpe under questionable circumstances and caused concern among the local community. The Regional Jail and Correctional Facility Authority (hereinafter “the Jail Authority”) responds that, although its medical unit generally provides state-of-the-art care, Mr.Rileyrequiresspecializedtreatment and diagnosis that is simply beyond its capabilities. According to the Jail Authority, because Mr. Riley is a pretrial detainee the procedure for hospitalizingaconvictedperson pursuant to W. Va. Code § 28-5-31 (1980) (Repl. Vol. 2001) doesnotapply. Moreover, since Mr. Riley is unable to consent to treatment, the only available procedure for hospitalizing him is through the state’s mental hygiene system as set forth in W.Va.Code§27-5-2(a). The Jail Authority agrees with Mr. Riley’s contentions in this matter andjoinshiminaskingthisCourttofindW.Va.Code§27-5-2(a)unconstitutional. 8 The Jail Authoritysubmitsthatdueprocessrequirespretrialinmatestobeprovidedaccesstohealth care. In this case, argues the Jail Authority, it tried to provide needed medical attention to Mr. Riley,butitsattemptswerethwartedbytheprovisionsofW.Va.Code§27-5-2(a). Finally, 8The Jail Authority is a state agency having the responsibility, inter alia, of incarcerating pretrial detainees. See W. Va. Code § 31-20-2(o) (2001) (Supp. 2002) (“‘Regional jail facility’ or ‘regional jail’ means any facility operated by the authority and used jointlybytwoormorecountiesfortheconfinement,custody,supervisionorcontrol of adult persons...awaitingtrial....”). Thus, we pay particular attention to its arguments before us. Cf. Appalachian Power Co. v. State Tax Dep’t, 195 W. Va. 573, 582, 466 S.E.2d 424, 433 (1995) (“An inquiring court–even a court empowered to conduct de novo review–must examinearegulatoryinterpretation of a statute by standards that include appropriate deference to agency expertise and discretion.”) 8 the Jail Authority submits that W. Va. Code § 27-5-2(a) creates an arbitrary third class of citizenswhoaredeniedtotalaccessto mental health care facilitiessimplybecausetheyare incarcerated and, in most cases, too poor to post bond. Because Mr. Riley holds the status of a pretrial detainee in state custody, his federal constitutional challenge arises under the due process clause of the Fourteenth Amendment to the United States Constitution.9 See Olabisiomotosho v. City of Houston, 185 F.3d521,525-526 (5thCir.1999)(“Theconstitutionalrightsofapretrialdetaineeflowfrom both the procedural and substantive due process guarantees of the Fourteenth Amendment . . . which provides that no state shall ‘deprive any person of life, liberty, or property, without due process of law. . . .’ U.S. Const. amend. XIV, § 5.” (citing Bell v. Wolfish, 441 U.S. 520, 99 S. Ct. 1861, 60 L. Ed. 2d 447 (1979)); Syl. pt. 8, Rush v. Wilder, 644 N.W.2d 151 (Neb. 2002) (“While a convicted prisoner’s claim alleging inadequate medical care is brought under the Eighth Amendment, apretrialdetainee’s claim alleging inadequate medical care is a due process claim.”). Cf. Loe v. Armistead, 582 F.2d 1291, 1293-94(4thCir.1978)(“Attheoutset,we note thatLoewasnotaprisonerdetainedundera judgment of conviction; rather, he was a pretrial detainee. Under such circumstances, the protectionsthatapplytohimare found in the due process clause of the fifth amendment, since 9While we analyze this case under the due process clause of the Fourteenth Amendment to theUnitedStatesConstitution,wenotethatouranalysisalso applies to due process rights arising under Article III, Section 10 of the Constitution of West Virginia. 9 hewasafederalprisoner, rather than in the eighth amendment’s prohibition against cruel and unusual punishment.” (citations omitted)). It has been explained that a constitutional challenge raised by a pretrial detainee may be classified as an attack upon either a “condition of confinement,” or an “episodic act or omission.” As one court has explained: We noted [in Hare v. City of Corinth, 74 F.3d 633 (5th Cir.1996)(enbanc)]thatdeterminingwhich standard to apply in analyzing constitutional challenges by pretrial detainees hinges upon the classification of a challenge as an attack on a “condition ofconfinement”orasan“episodicactoromission.” 74 F.3d at 644. A “condition of confinement” case is a “[c]onstitutional attack[]ongeneralconditions,practices,rulesorrestrictions of pretrial confinement.” Id. Scott v. Moore, 114 F.3d 51, 53 (5th Cir. 1997) (en banc). See also Olabisiomotosho, 185 F.3d at 526 (“We begin by deciding whether to classify the ‘challenge as an attack on a “conditionofconfinement”orasan“episodicactoromission.”’ The former category would include such claims as ‘where a detainee complains of the number of bunks in a cell or his television or mail privileges.’ The latter category, on the other hand, occurs ‘where the complained-of harm is a particular act or omission of one or more officials.’”). Mr. Riley complains of a deprivation of adequate medical care that was not necessarilyinflictedbyaparticularindividual or on a particular occasion, but rather that W. Va. Code§27-5-2(a)operatestosystematicallydeprive him, as it would other pretrial detainees, 10 ofanychanceofreceivingmedicalcareintheformofinvoluntary hospitalization. We find this complaint amounts to a challenge of his conditions of confinement. See,e.g.,Fredericks v.Huggins,711F.2d31,33(4thCir.1983)(treatingclaimbypretrialdetaineesthatthey were unconstitutionally deniedmethadonedetoxificationasa “condition of confinement” claim). BecauseMr.Rileyhereinchallengesaconditionof confinement,weapply“thereasonable relationship test of Bell v. Wolfish, 441 U.S. 520, 99 S. Ct. 1861,60 L. Ed.2d 447 (1979).” Scott, 114 F.3d at 53. As a foundation for its so called “reasonable relationship test,” Bell v. Wolfish first explained that pretrial detainees may not be subjected to punishment. In evaluating the constitutionality of conditions or restrictions of pretrial detention that implicate only the protectionagainstdeprivationofliberty without due process of law, we think that the proper inquiry is whether those conditions amount to punishment of the detainee. . . . A person lawfullycommittedtopretrialdetentionhasnotbeenadjudged guiltyofanycrime. He has had only a “judicial determination of probable cause as a prerequisite to [the] extended restraint of [his]libertyfollowingarrest.... Under such circumstances, the Government concededly may detain him to ensure his presence attrialandmaysubjecthimtotherestrictionsandconditionsof thedetentionfacilitysolongasthoseconditionsand restrictions do not amount to punishment, or otherwise violate the constitution. 441 U.S.520,535-37,99 S.Ct.1861,1872-73,60 L. Ed.2d447,466-67(emphasisadded) (internal citations omitted) (footnote omitted). See also Frake v. City of Chicago, 210 F.3d 779,781 (7thCir.2000)(“Inthiscaseit is Robert Frake’s due process rights with which we 11 are concerned. He was a pretrial detainee, not found guilty of a crime, and therefore he could not be ‘punished.’ For that reason, his treatment in the detention facility is analyzed undertheDueProcess Clause, rather than the Eighth Amendment’s prohibition against cruel and unusual punishments.” (emphasis added) (citing Bellv.Wolfish,.. .)); Duran v. Elrod,542 F.2d 998, 999 (7 th Cir. 1976) (“Strictly speaking, pre-trial detainees may not be punished at all because they have been convicted of no crime. The sole permissible interest of the stateistoensuretheirpresenceattrial. Following this reasoning, courts have held that suits bypre-trial detainees alleging conditions amounting to cruel and unusual punishment are better analyzedasdueprocessattacksonconditionsthatexceedthesolepermissiblestateinterest of ensuring presence at trial. . . .” (emphasis added)). Afterclarifyingthatpunishmentmaynot be imposed upon pretrial detainees, Bell thendescribedthetesttraditionally used in determining whether a governmental actis punitive in nature, or is merely a regulatory restraint that may be imposed prior to a determination of guilt: “Whether the sanction involves an affirmative disability or restraint, whether it has historically been regarded as a punishment, whether it comes into play only on a finding of scienter,whetheritsoperation willpromotethetraditionalaims of punishment–retribution and deterrence, whether the behavior to which it applies is already a crime, whether an alternative purposetowhichitmayrationallybeconnectedis assignable for it,andwhetheritappearsexcessivein relation to the alternative purpose assigned are all relevant to the inquiry, and may often point in differing directions.” 12 441 U.S.at 537-38, 99 S. Ct. at 1873, 60 L.Ed.2d at 467-68 (quoting Kennedy v. Mendoza- Martinez, 372 U.S. 144, 168-69, 83 S. Ct. 554, 567-68, 9 L. Ed. 2d 644, 661 (1963)). The Supreme Court in Bell went on to explain that [t]he factors identified in Mendoza-Martinez provide usefulguidepostsindeterminingwhether particular restrictions and conditions accompanying pretrial detention amount to punishment in the constitutional sense of that word. A court must decide whether the disability is imposed for the purpose of punishment or whether it is but an incident of some other legitimate governmental purpose. . . . Absent a showing of an expressed intent to punish on the part of detention facility officials,thatdeterminationgenerallywillturnon“whether an alternativepurposetowhich [therestriction]mayrationallybe connected is assignable for it, and whether it appears excessive in relation to the alternative purpose assigned [to it].” . . . Thus, if a particular condition or restriction of pretrial detention is reasonably related to a legitimate governmental objective, it does not, without more, amount to “punishment.” Conversely, if a restriction or condition is not reasonably related to a legitimate goal–if it is arbitrary or purposeless–a court permissibly may infer that the purpose of the governmental action is punishment that may not constitutionally be inflicted upon detainees qua detainees. 441 U.S. at 538-39, 99 S. Ct.at 1873-74,60 L. Ed.2d at 468 (emphasis added) (footnotes omitted) (internal citations omitted). Another court, interpreting Bell, explained thusly: The standard applicable to conditions of confinement claims by pretrial detainees was enunciated in Bell v. Wolfish, . . . . The proper inquiry is whether those conditions amounttopunishment of the detainee, for, under the Due Process 13 Clause,adetaineemaynotbepunishedprior to an adjudication of guilt. Id. at 535, 99 S. Ct. at 1871-72[, 60 L. Ed. 2d at 466]. However,noteverydisability imposed during pretrial detention amountsto“punishment”intheconstitutionalsense. Id. at537, 99 S. Ct. at 1873[, 60 L. Ed. 2d at 467]. Thus, if a particular condition or restriction of pretrial detention is reasonably related toalegitimategovernmental objective, it does not, without more, amount to “punishment.” Id. at 539, 99 S. Ct. at 1874[, 60 L. Ed. 2d at 468]. The Government has legitimate interests that stemfromitsneedtomanage the facility in which the individual is detained. Id. at 540, 99 S. Ct. at 1874-75[, 60 L. Ed. 2d at 469]. Furthermore, there is ademinimis levelofimposition with which the Constitution is not concerned. Id. at 539 n.21, 99 S. Ct. at 1874 n.21[, 60 L. Ed. 2d at 469 n.21]. Smith v. Copeland, 87 F.3d 265, 268 (8th Cir. 1996). Analyzing W. Va. Code § 27-5-2(a) under the forgoing framework, we must determine if the complained of state action bears a rational relationship to a legitimate governmental purpose. Before deciding whether there is a legitimate purpose for the state action at issue, we more closely examine what exactly is that action. “‘Where the language of a statute is free from ambiguity, itsplainmeaningistobeacceptedandappliedwithoutresortto interpretation.’ Syl. Pt. 2, Crockett v. Andrews, 153 W. Va. 714, 172 S.E.2d 384 (1970).” Syl. pt. 4, Syncor Int’l Corp. v. Palmer, 208 W. Va. 658, 542 S.E.2d 479 (2001). Syl. pt. 4, Charter Commun. VI, PLLC v. Community Antenna Serv., Inc., 211 W. Va. 71, 561 S.E.2d 793 (2002). The Language of W. Va. Code § 27-5-2(a) is plain in expressly excluding incarcerated persons from those who may be the subject of an involuntary hospitalization application: 14 (a) Any adult person may make an application for involuntary hospitalization for examination of an individualwho is not incarcerated at the time the application is filed when the person making the application has reason to believe that: . . . (Emphasis added).10 In practical application, however, this exclusion is limited to pretrial detainees, as there are other provisions in the Code providing for the involuntary hospitalization of incarcerated convicts. See W. Va. Code § 28-5-31. Moreover, this provisioncategoricallyexcludespretrialdetaineesfromaccesstothistype of medical care regardlessofhowserioustheirmentalhealthcondition may be, or how urgent their need for care. Itisclearlyestablishedthat,due to the limited purpose for which onemaybe detained prior to a conviction, which is merely to ensure presence at trial, the protections afforded pretrial detainees are at least as great as those afforded convicts under the Eighth Amendment. “[Fourteenth Amendment] due process isat least co-extensiveastheguarantees of the eighth amendment.” Loe, 582 F.2d at 1294 (emphasis added) (citation omitted). See also Duran, 542 F.2d at 999-1000 (“We hold that as a matter of due process, pre-trial detainees may suffer no more restrictions than are reasonably necessary to ensure their presenceattrial. While the decisions that have interpreted the Cruel and Unusual Punishment Clausemaybevaluablebyanalogy as defining that which may never be imposed on any inmate, 10See supra note 2 for complete text of W. Va. Code § 27-5-2(a). 15 whether convicted prisoner or pre-trial detainee, a more stringent standard controls the treatmentbythestate of pre-trial detainees. Since they are convicted of no crime for which they may presentlybepunished,thestate must justify any conditions of their confinement solelyonthe basis of ensuringtheirpresenceattrial. Any restriction or condition that is not reasonably related to this sole stated purpose of confinement would deprive a detainee of libertyorpropertywithoutdueprocess,incontraventionoftheFourteenthAmendment.”); Rush,644 N.W.2d at 157 (“While a convicted prisoner’s claim alleging inadequate medical careisbroughtundertheEighth Amendment, a pretrial detainee’s claim alleging inadequate medical care is a due process claim. . . . In general, however, the claims are analyzed in the same manner, . . . . Thus, the analysis to be conducted would be the same regardless of whether [the] claim is brought under the 8th or 14th Amendments.” (citations omitted)). Thefactthattheprotectionsafforded pretrial detainees undertheFourteenth Amendmentareatleastcommensurate with Eighth Amendment protections granted convicts is significant as the [United States] Supreme Court has held that the eighth amendmentprohibitionagainst cruel and unusual punishments, applicable to the states via the fourteenth amendment, requires states to provide medical care for those whom it is punishing by incarceration. Estelle v. Gamble, 429 U.S. 97, 103, 97 S. Ct. 285, 290, 50 L. Ed. 2d 251 (1976). . . . Wideman v. Shallowford Comm. Hosp., Inc., 826 F.2d 1030, 1034 (11th Cir. 1987) (emphasis added). Thus, the State may not deprive pretrial detainees of adequate medial care. Here, 16 however,W.Va.Code§ 27-5-2(a) plainly deprives pretrial detainees of adequate medical care when their mental health condition is so severe as to require involuntary hospitalization. Uponfindingdeprivationof medical care, we must next consider whether the provision of W. Va. Code § 27-5-2(a) excluding pretrial detainees from access to involuntary hospitalizationproceduresisreasonably related to a legitimate governmental objective. See Bell, 441 U.S. at 538-39, 99 S. Ct. at 1873-74, 60 L. Ed. 2d at 468-69. See also Scott, 114 F.3d at 53 (“Under Wolfish, 441 U.S. at 539, 99 S. Ct. at 1874[, 60 L. Ed. 2d at 468-69], a constitutional violation exists only if we then find that the condition of confinement is not reasonably related to a legitimate, non-punitive governmental objective.” (citation omitted)); Duran,542 F.2d at 1001 (“Pre-trial detaineesarebydefinitiondeprivedoftheirliberty,and suchdeprivationiswithoutdueprocessexcepttotheextentitisnecessaryto serve important state interests.”). Commissioner Lovrien appears to assert that the purpose behind the exclusion ofpretrialdetaineesfromaccesstoinvoluntaryhospitalization procedures under W. Va. Code §27-5-2(a)isameasure to combat overcrowding ofthementalhealthcarefacilities,andto prevent involuntary hospitalization to be improperly used to send “a significant number of incarceratedpersons”to“SharpeHospitalunder somewhat doubtful circumstances.” We do not find these purposes rationally related to the exclusion of pretrial detainee’s from involuntary hospitalization procedures. First, simply allowing an application for the 17 involuntary hospitalization of a pretrial detainee to be filed does not mean that the detainee will automaticallyhehospitalized. Rather, the application merely initiates a gatekeeping process wherebytheCommissionercan then evaluate whether the detainee should be involuntarily hospitalized. It is this evaluation process that is the proper avenue for reducing the number of improper involuntary hospitalizations. Furthermore, while Commissioner Lovrien contends that W. Va. Code § 27-5- 2(a) is a measure to combat overcrowding of the mental health care facilities, the Jail Authorityinformedusduringoralargumentthat,althoughtherewerethirty-three thousand inmateshoused in the Regional Jails during the last calendar year, only twenty requests were madefor transfer to a psychiatric facility. The Jail Authority also opined that it anticipated the samelownumbers for the next calendar year. 11 Thus, we do not find Commissioner Lovrien’s overcrowding argument persuasive. We are likewise unpersuaded by Commissioner Lovrien’s assertion that the Jail Authority is required to provide psychiatric services for those in its custody, and, correspondingly, to the extent that Mr. Riley has been deprived of medical care, that culpability lieswith the Authority. It is undisputed that the State has a duty to provide medical care–which includes necessary and adequate psychiatric and psychological services. See Gibson v. 11TheJailAuthoritynotedthatthese numbers did not include the various county jails. 18 Countyof Washoe, 290 F.3d 1175, 1187 (9th Cir. 2002) (“Th[e] duty to provide medical care encompasses detainees’ psychiatric needs.”); Rodney v. Romano, 814 F. Supp. 311, 312 (E.D.N.Y. 1993) (“[A] pretrial detainee, has at least as great a right to adequate medical treatmentasthatofasentencedinmate. In addition, pretrial detainees, like sentenced inmates, are entitled to psychiatric and psychological care.”) (emphasis omitted). See also Riddle v. Mondragon, 83 F.3d 1197,1202 (10thCir.1996)(findingthatunderthe Eighth Amendment “[t]he states have a constitutional duty to provide necessary medical care to their inmates, including psychological or psychiatric care.”); Partridge v. Two Unknown Police Officers, 791 F.2d 1182,1187(5thCir.1986)(“Under the Bell v. Wolfish standard, the defendants had aduty, at a minimum, not to be deliberately indifferent to Partridge’s serious medical needs. A serious medical need may exist forpsychologicalorpsychiatrictreatment,justasit may existforphysicalills.” (footnoteomitted)). Indeed, as the Fourth Circuit has said in a holding with which we are in agreement, “[w]e see no underlying distinction between the right to medical care for physical ills and its psychological or psychiatric counterpart.” Bowring v. Godwin,551F.2d44,47 (4thCir.1977). “The key factor in determining whether a system for psychological or psychiatric care in a jail or prison is constitutionally adequate is whether inmateswithseriousmentaloremotional illnesses or disturbances are provided reasonable accesstomedicalpersonnelqualifiedtodiagnoseandtreatsuchillnesses or disturbances.” Inmates of the Allegheny County Jail v. Pierce, 612 F.2d 754, 763 (3d Cir. 1979). In short, “wheninmateswithseriousmentalillsareeffectivelypreventedfrombeingdiagnosedand treated by qualified professionals, the system of care does not meet . . . constitutional 19 requirements . . . and violates the Due Process Clause.” Id. Weunderstandandrecognizethatoccasionswillarise where the Jail Authority issimplyillequippedtoprovide for the medical needs of a given inmate. In this case, the Jail Authority, through its evaluating psychologist, determined that Mr. Riley’s needs were beyond itscapabilities. Under review of an application for involuntary hospitalization, Commission Lovrien could have considered whether the Jail’s determination was accurate. However, becauseMr.Rileyisstatutorily denied the opportunity to even make an application, no such review can occur. Finally, we note that the Prosecuting Attorney who is trying the underlying criminal case filed an amicuscuriae briefinthis case,asserting that the exclusion of pretrial detaineesfromtheapplication process for involuntary hospitalization is rationally related to the government purpose of ensuring the public safety by removing from the public those individuals who have been alleged to pose a danger of serious harm because of a mental illness. TheProsecutingAttorneycontendsthatbecauseamentally ill pretrial detainee is in custody, thedetaineedoesnotposeariskofseriousharmtoothers. This argument ignores the fact that the State has an affirmative duty to provide medical care to those in its custody. Courtshave recognized that generally a state is under no affirmative obligation to provide protective services. 20 Several court of appeals decisions have addressed the issue of whether a state or municipality has a duty under the fourteenthamendmenttoprovidevarious protective services to its citizens. Almost without exception, these courts have concludedthat governments are under no constitutional duty to provide police, fire or other public safety services. Wideman, 826 F.2d at 1033-34. Indeed, in an authoritative ruling on this issue, the United StatesSupremeCourt said, “our cases have recognized that the Due Process Clauses generally confer no affirmative right to governmental aid, even where such aid may be necessary to securelife,liberty,orproperty interests ofwhichthegovernmentitselfmaynotdeprivethe individual.” DeShaney v. Winnebago County Dep’t of Soc. Serv., 489 U.S. 189, 196, 109 S. Ct.988,1003,103 L.Ed.2d249,259(1989).12 However, it has been recognized that where there is a special relationship between an individual and the state, certain rights may arise, such as the right to medical care: BoththeSupremeCourtandvarious circuit courts have indicated that the existence of a “special custodial or other relationship” betweenanindividualandthestate may trigger a constitutional duty on the part of the state to provide certain medical or other services. In these special circumstances, the state’s failure to providesuchservicesmightimplicate constitutionally protected rights. Wideman, 826 F.2d at 1034. Elaborating on this “special relationship” principal, Wideman 12Thedueprocess clausestowhich DeShaney refersarethefifthamendment’s clause (applicable to the federal government) and the fourteenth amendment’s clause (applicable to the states). See Rutherford v. City of Newport News, 919 F. Supp. 885, 893 n.10 (E.D. Va. 1996) (“The Fifth Amendment’s due process clause applies to the Federal Government. The clause in the Fourteenth Amendment applies to states and municipalities. The rights protected by the two clauses are co-extensive.” (citation omitted)). 21 explained: The primary thread weaving these special relationship cases together is the notion that if the state takes a person into custody or otherwiseassumesresponsibility for that person’s welfare,a“specialrelationship” may be created in respect of that person, and the fourteenth amendment imposes a concomitant duty on the state to assume some measure of responsibility for the person’s safety and well-being. 826 F.2d at 1035 (citation omitted). Wideman also provided examples of when the special relationship has been deemed to arise. Notably, it has been found to arise in the context of a pretrial detainee: Courts have . . . recognized the existence of a special relationshipimposingadutyonastateormunicipality to provide care and treatment for persons in its custody in situations less extremethanpermanentincarcerationor institutionalization. In Hamm v. DeKalb County, 774 F.2d 1567 (11th Cir. 1985), cert. denied, [475] U.S. [1096], 106 S. Ct. 1492, 89 L. Ed. 2d 894 (1986), this court concluded that the due process clause of the fourteenth amendment mandates that pretrial detainees must be provided with at least minimally adequate levels of food, living space, and medical care, just as the eighth amendment requires such standards for convicted prisoners. Id. at 1573. 826 F.2d at 1034 (emphasis added). In the instant case, Mr. Riley was taken into custody by the State,which created aspecialrelationshipgivingrisetoadutyupontheStatetoassume responsibility for Mr. Riley’s welfare, namely -- to provide him with at least minimally adequatelevelsof,inter alia, medical care. Moreover,Wideman concludedbyexplainingthat “aconstitutionaldutycanariseonly when a state or municipality, by exercising a significant 22 degreeofcustody or control over an individual, places that person in a worse situation than he would have been had the government not acted at all.” 826 F.2d at 1035. By virtue of excluding pretrial detainees from participating in the process for involuntary hospitalization, the State has worsened the situation for those in its custody who suffer from severe mental health conditions. We are mindful that, “Inconsideringtheconstitutionality of a legislative enactment, courts must exercise due restraint, in recognition of the principle of the separation of powers in government among the judicial, legislative and executive branches. Every reasonable construction must be resorted to by the courts in order to sustain constitutionality,andanyreasonabledoubtmustberesolved in favor of the constitutionality of the legislative enactment in question. Courts are not concerned with questions relating to legislative policy. The general powers of the legislature, within constitutional limits, are almost plenary. In considering the constitutionality of an act of the legislature, the negation of legislative power must appear beyond all reasonable doubt.” Syllabus Point 1, State ex rel. Appalachian Power Company v. Gainer, 149 W. Va. 740, 143 S.E.2d 351 (1965). Syl. pt. 4, McCoy v. Vankirk, 201 W. Va. 718, 500 S.W.2d 534 (1997). However, we also recognizethat,“[p]risoners are no one’s constituents and weld little,ifany,politicalclout. Consequently,societyfrequently forgets about, or even ignores these people, its unfortunate charges. It is therefore incumbent upon this Court ever to be vigilant in the protection of their legalrights.” Ray v. McCoy, 174 W. Va.1,4,321S.E.2d90,93(1984). Thus, based upon our analysis,weare constrained to hold that insofar as the “incarcerated persons” language of 23 W.Va.Code§27-5-2(a)(2002)(Supp.2002)operatestowhollyexclude pretrial detainees instatecustodyfromparticipatingintheapplicationprocess for involuntary hospitalization, itisunconstitutional asitviolatesthedueprocessrightofsuchdetaineestoreceivemedical care. IV. CONCLUSION Having found that the provision of W. Va. Code § 27-5-2(a) excluding “incarcerated persons” from participating in the application process for involuntary hospitalizationisunconstitutional, we accordingly grant the requested writ as moulded and order that Commissioner Lovrien is prohibited from rejecting applications for involuntary hospitalization submitted on behalf of pretrial detainees based solely on the fact of the detainees’ incarceration. Writ granted as moulded. 24