IN THE SUPREME COURT OF APPEALS OF WEST VIRGINIA
 

September 2015 Term FILED 

October 7, 2015 

released at 3:00 p.m. 

Nos. 14-0664 and 14-0845 RORY L. PERRY II, CLERK 

SUPREME COURT OF APPEALS 

OF WEST VIRGINIA 

WEST VIRGINIA DEPARTMENT OF HEALTH AND HUMAN RESOURCES,
 

BUREAU FOR BEHAVIORAL HEALTH AND HEALTH FACILITIES,
 

Respondent Below, Petitioner
 

v. 

E.H., et al.
 

Petitioners Below, Respondents
 

Appeal from the Circuit Court of Kanawha County
 

Honorable Louis H. Bloom, Judge
 

Civil Action No. 81-MISC-585
 

AFFIRMED, IN PART, AND REVERSED, IN PART
 

Submitted: September 2, 2015
 

Filed: October 7, 2015
 

Patrick Morrisey, Esq. Lydia C. Milnes, Esq. 

Attorney General Jennifer S. Wagner, Esq. 

Elbert Lin, Esq. Mountain State Justice, Inc. 

Solicitor General Charleston, West Virginia 

Daniel W. Greear, Esq. Attorneys for the Respondents 

Chief Counsel 

Julie Marie Blake, Esq. 

Assistant Attorney General 

Charleston, West Virginia 

Attorneys for the Petitioner
 

JUSTICE LOUGHRY delivered the Opinion of the Court.
 

JUSTICE DAVIS dissents and reserves the right to file a dissenting opinion.
 
 

 

 

 

 

 

 

 

 

 

SYLLABUS BY THE COURT
 

1. In the context of institutional reform litigation, this Court may choose to 

exercise its appellate jurisdiction over an order entered by the circuit court that it deems to 

approximate a final order by its nature and effect. 

2. “Inherent in the republican form of government established by our State 

Constitution is a concept of due process that insures that the people receive the benefit of 

legislative enactments.” Syl. Pt. 1, Cooper v. Gwinn, 171 W.Va. 245, 298 S.E.2d 781 (1982). 

3. “It is the obligation of the State to provide the resources necessary to accord 

inmates of State mental institutions the rights which the State has granted them under W.Va. 

Code, 27-5-9 [1977].” Syl. Pt. 3, E.H. v. Matin, 168 W.Va. 248, 284 S.E.2d 232 (1981). 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LOUGHRY, Justice: 

This case is before the Court on the consolidated appeals of the petitioner, the 

West Virginia Department of Health and Human Resources, Bureau for Behavioral Health 

and Health Facilities (the “DHHR,” unless otherwise indicated), seeking relief from the June 

3, 2014, and August 13, 2014, orders of the Circuit Court of Kanawha County. As grounds 

for this appeal, the DHHR asserts: (1) this Court has appellate jurisdiction to consider these 

appeals despite the circuit court’s failure to certify the challenged orders as partial final 

judgments; (2) the circuit court exceeded its authority under the separation of powers 

doctrine and our West Virginia precedent by compelling compliance with an Agreed Order 

entered on July 2, 2009, through the immediate implementation of a pay raise restructuring 

plan at two state mental health hospitals; and (3) it reasonably believed the 2009 Agreed 

Order only required an increase to the salaries of existing direct care employees. Following 

a careful review of the briefs, the arguments of counsel, the lengthy appendix record 

submitted, and applicable law, we reverse the circuit court’s refusal to declare the particular 

rulings on appeal as partial final judgments, but we otherwise affirm the orders at issue. 

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I. Facts and Procedural Background1 

In order to fully appreciate the circuit court’s rulings on appeal, it is necessary 

to review the history of this institutional reform litigation that began in 1981 when a group 

of patients at the Mildred Mitchell-Bateman Hospital (“Bateman”)2 filed a mandamus action 

in this Court seeking judicial intervention for deplorable conditions described as the 

“‘Dickensian Squalor’ of unconscionable magnitudes of West Virginia’s mental institutions.” 

E.H. v. Matin, 168 W.Va. 248, 249, 284 S.E.2d 232, 233 (1981) (internal citation omitted) 

(“Matin I”). The Court stated that it was only being asked “to order the executive branch to 

fulfill its obligation under clear and unambiguous statutory provisions[,]” recognizing that 

the Legislature had previously “acknowledged its concern for both humane conditions of 

custody and effective therapeutic treatment . . .” through its passage of West Virginia Code 

§ 27-5-93 in 1977. Matin I, 168 W.Va. at 257, 284 S.E.2d at 237. The Court transferred the 

case to the Circuit Court of Kanawha Countyfor the purpose of monitoring compliance while 

bearing in mind the following: 

(1) W. Va. Code, 27-5-9 [1977] creates specific enforceable 

rights in the entire inmate population of the State’s mental 

1

The facts and procedural history set forth herein have been gleaned from the parties’ 

briefs, the appendix record filed in the instant consolidated appeals, as well as the prior 

opinions of this Court entered in this institutional reform litigation. 

2

At the time this litigation was instituted, Bateman, which is located in Huntington, 

West Virginia, was known as Huntington State Hospital. 

3

West Virginia Code § 27-5-9 sets forth the rights of patients involuntarily committed 

to our state mental health hospitals. 

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hospitals. (2) W. Va. Code, 27-5-9 [1977] requires a system of 

custody and treatment which will reflect the competent 

application of current, available scientific knowledge. Where 

there is a good faith difference of opinion among equally 

competent professional experts concerning appropriate methods 

of treatment and custody, such differences should be resolved by 

the director of the West Virginia Department of Health and not 

by the courts. (3) It is the obligation of the [S]tate to provide the 

resources necessary to accord inmates of mental institutions the 

rights which the State has granted them under W. Va. Code, 27­

5-9 [1977]. 

Matin I, 168 W.Va. at 259-60, 284 S.E.2d at 238. In 1983, the parties agreed to the West 

Virginia Behavioral Health System Plan, which the circuit court accepted. This Plan, which 

was designed to address the problems identified by the parties, was to be implemented by the 

DHHR with oversight by the circuit court and a court monitor. 

Ten years later, the matter was again before this Court. See E.H. v. Matin 

(“Matin II”), 189 W.Va. 102, 428 S.E.2d 523 (1993). The circuit court had enjoined the 

construction of a new mental health hospital to replace the Weston State Hospital.4 

Concluding that the circuit court exceeded its authority, the Court held that “[w]here the 

legislature, through the budget process, expressly provides for funding to build a new public 

facility, absent some constitutional challenge or an express statutory provision to the 

contrary, the courts are not authorized to interfere with the legislative mandate.” Matin II, 

4

The circuit court was concerned that the proposed new psychiatric facility would 

endanger the overall funding of the Behavioral Health System Plan. Matin II, 189 W.Va. at 

104, 428 S.E.2d at 545. 

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189 W.Va. at 103, 428 S.E.2d at 524, syl. pt. 1. Thereafter, the William R. Sharpe, Jr. 

Hospital (“Sharpe”) was built. Following additional briefing by the parties regarding 

whether continued court monitoring was necessary, the Court issued its opinion in E.H. v. 

Matin (“Matin III”), 189 W.Va. 445, 432 S.E.2d 207 (1993), retaining the court monitor for 

at least eighteen additional months, or longer if shown to be necessary. 

In 2002, the parties and the circuit court agreed to dissolve the office of the 

court monitor and removed the case from the circuit court’s active docket, although 

jurisdiction to reopen the case was retained to address various unresolved issues. In fact, the 

circuit court continued to hold periodic hearings to assess the parties’ progress in that regard. 

Around this same time, the position of “Ombudsman for Behavioral Health” was developed 

by the DHHR.5 Regular reports were issued by the Ombudsman to both the circuit court and 

the DHHR and, in the annual report for 2007-2008, several issues were identified, including 

those involving the provision and coordination of case management services and the 

treatment of persons with traumatic brain injuries. 

On July 3, 2007, the circuit court adopted and entered the parties’ mediated 

Consent Order on Services To Individuals With Traumatic Brain Injuries. During hearings 

5

The Ombudsman served to oversee the DHHR’s compliance with its statutory duties 

relating to the rights of patients confined to state mental health facilities. See W.Va. Code 

§ 27-5-9. 

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held in 2008, the circuit court addressed the continuing problem of the DHHR’s compliance 

with this consent order. Based upon the significant issues raised in the Ombudsman’s 

reports, including non-compliance with the consent order and possible violations of West 

Virginia Code § 27-5-9, the circuit court entered an order on August 28, 2008, reopening the 

case and scheduled an evidentiary hearing. 

Thereafter, the DHHR sought a writ of prohibition in this Court to prevent the 

lower court from reopening the case. In addressing the DHHR’s request for extraordinary 

relief, the Court recounted the contents of the July 3, 2008, Ombudsman report that identified 

violations of patients’ rights that were first identified decades earlier in Matin I. The Court 

noted that this report detailed 

staff related issues including a practice called “Freezing”, in 

which staff members are required to work an additional eight 

hour shift on top of the eight hour shift they have just finished. 

This “Freezing” process is mandatory and those that refuse to 

follow the practice are given written reprimands.6 The staff also 

stated that the “90 day temp” employee system does not work. 

These 90 day temporary workers are often, if not always, 

unqualified and inexperienced staff assigned to deal with violent 

and aggressive patients. One of these 90 day temporary 

employees was fired for drinking on the job and the regular staff 

generally does not feel comfortable working with them. 

6

As discussed, infra, the refusal of mandatory overtime can be a basis for termination 

of employment, according to evidence presented during the hearings held before the lower 

court in April 2014. 

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Matin v. Bloom (“Matin IV”), 223 W.Va. 379, 383-84, 674 S.E.2d 244-45 (2009) (footnote 

omitted) and (footnote added). In summarizing the situation existing then, the Court stated 

that 

[i]n general, the portrait that emerges from the 

Ombudsman’s reports is that of a hospital that is overcrowded 

with patients, most of whom are frustrated by living on top of 

each other, being denied privacy and not having daily access to 

basic grooming needs. The regular staff suffers from extremely 

low morale due to forced overtime and working with unqualified 

temporary workers with questionable backgrounds. 

Specifically, the term ‘Dickensian Squalor’ that Justice Neely 

used to describe the hospital in 1981 is an apt description of the 

hospital that emerges from the Ombudsman’s July 3, 2008 

report. 

Id., 223 W.Va. at 384, 674 S.E.2d at 245 (emphasis added). The Court refused to issue the 

writ on the grounds that the circuit court had “the power to ensure that patients are receiving 

the treatment guaranteed to them under W.Va. Code § 27-5-9[,]” as well as the “power to 

enforce a Consent Order it previously issued.” See id. at 381; 674 S.E.2d at 242. 

Following Matin IV, the circuit court held an evidentiary hearing in April 

2009. Dr. Shahid Masood, the clinical director at Bateman, testified that staffing vacancies 

were causing unsustainable working hours for clinical staff; that use of temporary employees 

was an inefficient use of resources because “by the time they are trained[,] it is time for them 

to leave[;]” and that increasing salaries would be an “extremely effective” method for 

recruiting additional full-time employees. Dr. Masood further testified that patients were 

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being administered increased amounts of medication, a side effect of which is sedation, to 

treat their increased levels of anxiety attributable to understaffing and patient overcrowding. 

During this same hearing, the chief executive officer for Bateman at that time, 

Mary Beth Carlisle, testified that “consistent vacancies in nursing and in direct care” at the 

hospital necessitated the use of employee overtime and the employment of temporary staff. 

She agreed and/or suggested that increasing staff salaries to the local prevailing wage, 

increasing the number of full-time employees, discontinuing the use of ninety-day temporary 

employees, and eliminating mandatory overtime could all aid in improving the staffing 

problems. Ms. Carlisle indicated that patients were not receiving communityintegration trips 

as required by West Virginia C.S.R. § 64-59-14.47 due to the chronic vacancies in direct care 

positions. Other evidence showed that the DHHR’s failure to reimburse community service 

7

West Virginia C.S.R. § 64-59-14.4 provides, as follows: 

14.4. Community Integration. Unless specifically 

contraindicated by a client’s interdisciplinary program plan or 

physician, each client, other than acute psychiatric and 

out-of-contact geriatric clients, shall be provided the opportunity 

to: 

14.4.1. Shop in the community at least monthly; 

14.4.2. Eat in a public place in the community at least monthly; 

14.4.3. Participate in a major recreational activity in the 

community at least monthly; 

14.4.4. Attend a public event in the community at least four (4) 

times annually; 

14.4.5. Worship in the community on a regular basis; and 

14.4.6. Visit the local public library on a regular basis. 

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providers resulted in decreased community-based services, including day treatment, which 

contributes to patient overcrowding. 

Based on the evidence presented during the April 2009 evidentiaryhearing, the 

circuit court directed the parties to participate in mediation, which resulted in agreements that 

were memorialized in an Agreed Order entered by the circuit court on July 2, 2009 (the 

“2009 Agreed Order”). This order provided, in part, as follows: 

10. Facilities: 

(a) DHHR shall provide for increased pay for direct care 

workers at Bateman and Sharpe in order to (i) be able to recruit 

staff and retain existing staff and (ii) preclude the practices of 

mandatory overtime and reliance on temporary workers (except 

in exceptional and infrequent contexts). (See Attachment B.) 

(b) DHHR will use only full time employees working regular 

shifts or voluntaryovertime except in exceptional and infrequent 

contexts. 

Attachment B, which is a part of the 2009 Agreed Order, is a chart setting forth the various 

classifications of direct care employees, the number of employees for each classification, the 

salary increase for each classification, and the total funding necessary for the DHHR to 

implement the increase. The direct care positions designated to receive increased 

compensation were psychiatrists, seven different nursing classifications, as well as Health 

Service Trainees (“HSTs”), Health Service Workers (“HSWs”), and Health Service 

Assistants (“HSAs”), all of which have responsibilities similar to those of a nurse’s aide. In 

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addition to the 2009 Agreed Order, the circuit court entered an order on August 7, 2009,8 in 

which it concluded that 

[w]ithout the provision of community services, Bateman and 

Sharpe Hospitals will continue to suffer from overcrowding and 

violations of patients’ rights established by W.Va. Code § 27-5­

9 will continue to occur. . . . The evidence presented reflects that 

clients’ rights are being violated because individuals are being 

kept in inpatient, locked institutional facilities, despite readiness 

for discharge into the community, based on the lack of 

community services.9 (Footnote added). 

During an extraordinary session of the Legislature held in 2009, West Virginia 

Code § 5-5-4a was enacted. This statute provides, in part, as follows: 

(a) The Legislature finds that Mildred Mitchell-Bateman 

Hospital and William R. Sharpe, Jr. Hospital have extreme 

difficulty in recruiting and retaining physicians, physician 

specialists, nurses, nursing directors, health service workers, 

health service assistants, health service associates and other 

employees who assist in the direct provision of medical care to 

patients in those facilities. 

8

In this same order, the circuit court found that the DHHR had violated consent orders 

entered in 2001 and 2007 by failing to make “good faith efforts” to secure funding for a 

Medicaid Traumatic Brain Injury(“TBI”) Waiver, failing to applyfor that waiver, and failing 

to develop a dedicated source of state funding for TBI services. Accordingly, the circuit 

court ordered the DHHR to apply to the federal government to obtain a TBI Medicaid waiver 

by January 2010 and to request that the Legislature establish a TBI trust fund to meet 

additional unfulfilled needs. The DHHR appealed the circuit court’s order, arguing that the 

lower court had usurped its authority and violated the separation of powers doctrine. In E.H. 

v. Matin, No. 35505 (W.Va. Sup. Ct. Apr. 1, 2011) (Memorandum Decision) (“Matin V”), 

we concluded that the separation of powers doctrine was not implicated because the case 

involved the enforcement of prior consent orders to which the DHHR had been party. 

9

This language was quoted in the circuit court’s order entered June 27, 2014. 

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(b) The West Virginia Division of Personnel and the Department 

of Health and Human Resources jointly shall develop pay rates 

and employment requirements to support the recruitment and 

retention of physicians, physician specialists, nurses, nursing 

directors, health service workers, health service assistants, 

health service associates or other positions at Mildred 

Mitchell-Bateman Hospital and William R. Sharpe, Jr. Hospital. 

Pay rates shall reflect the regional market rates for relevant 

positions . . . . 

(c) Funding for the payrates and employment requirements shall 

be provided from the appropriation to the Department of Health 

and Human Resources . . . . 

W.Va. Code § 5-5-4a (emphasis added). 

Following an evidentiary hearing held before the circuit court in July 2011, the 

court found that Bateman and Sharpe continued to have staffing vacancies and continued to 

use voluntary and mandatory overtime “to maintain a minimum level of staffing[.]”10 The 

circuit court further found that both hospitals continued to be overcrowded, causing patients 

to be housed on temporary cots in small, windowless classrooms with no access to bathrooms 

or closets, and that “[o]vercrowding of the state psychiatric facilities continues to violate 

state law, regulations, and the Orders entered in this case.” Five months later, the circuit 

court received evidence indicating that between January and November of 2011, Bateman 

averaged twenty-eight vacancies in direct care positions on any given day. Similarly, Sharpe 

10These findings were made in the circuit court’s order entered August 19, 2011. 

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had persistent vacancies in direct care workers during this same time period and had required 

approximately 40,000 hours of overtime from its direct care staff. 

On August 29, 2012, the respondents filed a request for resolution seeking 

enforcement of the DHHR’s increased salary commitments as set forth in the 2009 Agreed 

Order. Evidence presented during a hearing held on October 12, 2012, demonstrated that the 

DHHR had increased salaries for registered nurses and psychiatrists at or above the amounts 

set forth in the 2009 Agreed Order and had implemented special hiring rates for these 

classifications to aid in recruiting new employees. However, Victoria Jones, then-acting 

Commissioner for the Bureau of Behavioral Health and Health Facilities, testified that the 

other categories of health service employees had not received the pay increases required 

under the 2009 Agreed Order.11 Consequently, by order entered December 11, 2012, the 

circuit directed the DHHR to comply with paragraph 10(a) of the 2009 Agreed Order 

11During the October 2012 hearing, Ms. Jones testified that minutes from a meeting 

with the court monitor reflected the DHHR’s compliance with the 2009 Agreed Order. The 

circuit court judge interjected, noting that regardless of what persons may or may not have 

correctly or incorrectly represented during an administrative meeting, the DHHR had just 

conceded that it was not compliant with the 2009 Agreed Order. Other evidence presented 

at this hearing showed that the DHHR had worked with the West Virginia Division of 

Personnel and the Legislature to establish a three percent raise for those health service 

employees who had been in their positions for three years or longer, effective July 1, 2010. 

For those who qualified, this three percent raise was far less than what was required under 

the 2009 Agreed Order. Direct care workers employed less than three years received no 

raise. Ms. Jones testified at a subsequent hearing that the DHHR eliminated this three 

percent retention incentive after the circuit court directed its compliance with the salary 

increases set forth in the 2009 Agreed Order in orders entered on December 11 and 18, 2012. 

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increasing the compensation for the direct care positions at Bateman and Sharpe by no later 

than January 1, 2013, in the amounts set forth in Attachment B to the 2009 Agreed Order.12 

The circuit court subsequently denied the DHHR’s motion to alter or amend judgment, 

finding in its December 18, 2012, order that “employees in the LPN and Health Service 

Trainees, Workers, and Assistants classifications employed on or after January 1, 2013, are 

entitled to pay raises . . . as provided in the Order entered December 11, 2012.” 

The current appeal arises out of concerns raised by the respondents during the 

Fall of 2013 and the Spring of 2014 regarding the DHHR’s noncompliance with prior orders 

and commitments. In their requests for resolution filed in the circuit court, the respondents 

cited, inter alia, an increase in staffing vacancies at Sharpe and Bateman and its 

corresponding adverse impact on patient care. On April 24 and 29, 2014, the circuit court 

held evidentiary hearings to address these issues. 

The circuit court heard testimony regarding the adverse impact that the 

hospitals’ staffing shortages were having on employees and patient care. A direct care 

employee at Bateman testified that an employee’s refusal of overtime could be a basis for 

termination and that requiring employees to work consecutive twelve- to sixteen-hour shifts 

12The circuit court did not require retroactive compensation. 

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affects staff morale. As a result, patient care is adversely impacted when the employees work 

at less than their full capabilities.13 

Craig Richards, the chief executive officer at Bateman, testified that substantial 

amounts of money are being paid for the significant overtime that is routinely being required 

of direct care employees. Mr. Richards agreed that Bateman is “habitually short of staff,”14 

explaining that recruiting efforts do not produce a sufficient number of qualified candidates. 

He added that the DHHR ultimately expends far more funds for contract workers from outof-state agencies than what it would cost to hire full-time, permanent employees with 

benefits.15 Failing to offer a competitive salary in the market place was identified by Mr. 

Richards as the primary reason for the staffing issues,16 although he added that the inability 

to offer “flexibility in terms of the availability of different [work] schedules” for employees 

13There was also testimony indicating that during a three-month period in 2014 at 

Sharpe, 3,000 to 4,000 hours of overtime were worked each month in each unit of the 

hospital. 

14DHHR documents show that Bateman and Sharpe averaged between fortyand fortyeight vacancies in the direct care employee classifications during February and March 2014. 

15The record reflects the DHHR is paying out-of-state contracting agencies millions 

of dollars to employ short-term contract workers. These workers typically work five months, 

one of which is spent in training. The need to train these contract workers further impacts 

the staffing situation by removing employees from their regular duties. 

16The circuit court heard this same testimonyin 2009 when Bateman’s clinical director 

testified that increasing salaries would be an “extremely effective” method for recruiting 

additional employees. 

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had a negative effect on hiring. After acknowledging that policies and procedures allow for 

proposals to be made to the West Virginia Division of Personnel (“DOP”) to be able to offer 

raises and flexible work schedules,17 Mr. Richards conceded during the April 2014 hearing 

that the DHHR had not made any such proposals to the DOP. 

Regarding the community integration required under West Virginia Code of 

State Regulations § 64-59-14.4, both Mr. Richards and Commissioner Victoria Jones18 

testified that this requirement was not being met due to lack of staff.19 Consistent with Mr. 

Richards’ testimony, Ms. Jones agreed that the DHHR’s cost for contract workers is 

significantly higher than what it would expend on full-time employees in the same positions. 

She further testified that the DHHR “failed to implement the [2009] Agreed Order[;]” had 

not taken any action on the health service worker classifications to keep the DHHR in 

compliance with either the 2009 Agreed Order or West Virginia Code § 5-5-4a; and had not 

conducted any salary analysis since 2009. According to Ms. Jones’s testimony, the DHHR 

17Mr. Richards testified that Bateman must maintain compliance with DOP policies 

and rules in relation to the hiring process. Although he was aware of DOP’s open fora during 

which the DHHR could make suggestions or requests of the DOP in order to meet patient 

obligations, he had never participated. 

18At the time of this hearing, Ms. Jones had become the commissioner for the Bureau 

of Behavioral Health and Health Facilities, rather than its acting-commissioner. 

19Mr. Richards testified that the staff position responsible for coordinating community 

integration had been vacant since April 2012, and that community integration was being 

overseen by the hospital’s clinical director. It appears that sometime after the April 2014 

hearing, a person was hired for the position in charge of community integration. 

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had not requested either hiring incentives or special hiring rates from the DOP for the direct 

care employees during the last four years, other than for nursing classifications, and perhaps 

psychiatrists, even though the DHHR has the ability to seek “step rate” increases or wage 

increases from the DOP within budgetary allocations. While agreeing that all direct care 

classifications at Bateman and Sharpe are not competitive, Commissioner Jones viewed 

competitive salaries as a temporary solution to the chronic recruitment and retention issues, 

suggesting that the use of sick and annual leave and attendance issues need to be addressed 

at the policy level. 

Based upon all of the evidence received, the circuit court entered an order on 

June 3, 2014,20 in which it observed that many of the problems that existed in 2009 continued 

to exist in 2014. The circuit court noted that Bateman and Sharpe continue to require direct 

care workers to perform significant, routine, and consistent amounts of mandatory overtime, 

in addition to voluntary overtime, due to the persistent and chronic understaffing issues; that 

the refusal of mandatory overtime can be a basis for termination; that some direct care 

employees are required to work “twelve to sixteen hour shifts, two to three days in a row”; 

20The parties refer to this order as having been entered on June 2, 2014. This order 

was entered by the circuit court clerk on June 3, 2014, which is the date that will be used by 

this Court. See Syl. Pt. 4, State v. Mason, 157 W.Va. 923, 205 S.E.2d 819 (1974) (“In a 

proceeding governed by the Rules of Civil Procedure, a judgment rendered in such 

proceeding is not final and effective until entered by the clerk in the civil docket as provided 

in Rule 58 and Rule 79(a) of the Rules of Civil Procedure.”). 

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and that an Executive Summary generated by Sharpe states that “[t]he use of mandatory and 

voluntary overtime is causing turn-over and morale issues.”21 The circuit court specifically 

noted that chronic understaffing has meant that patients are unable to access community 

integration opportunities, which is “an essential component of patient care that ensures that 

patients do not become institutionalized and are able to reintegrate into a community-based 

setting as quickly as possible.”22 

Regarding the DHHR’s continued failure to offer competitive wages to the 

direct care workers at Sharpe and Bateman as required by prior orders and West Virginia 

Code § 5-5-4a, the circuit court found that recruitment of fulltime staff is greatly hindered 

by the DHHR’s internal policies.23 The circuit court recounted the evidence demonstrating 

21The circuit court found that “[r]ather than hiring additional full-time employees, the 

[DHHR] employ[s] large numbers of temporary employees and contract workers to fill the 

vacancies at Sharpe and Bateman.” The circuit court explained that temporary employees, 

who are also required to work overtime, typically work three to five months, one of which 

is spent in training. In addition, the circuit court found that the DHHR pays out-of-state 

contracting agencies millions of dollars each year for contract workers, paying a significantly 

higher hourly wage than what the DHHR expends on full-time employees in the same direct 

care positions, even when including benefits. 

22Specifically, the lower court found that the DHHR had “violated the standards of 

patient care, as required byWest Virginia Code State Regulations sections 64-59-1 to -20 and 

the 2009 Agreed Order paragraph 10(d), by failing to provide community integration 

activities as required by West Virginia C.S.R. § 64-59-14.4.” 

23DHHR officials testified regarding its internal policy that a new employee’s starting 

salary can never be more than the average salary of other employees in the same positions, 

regardless of the new hire’s experience. Therefore, a salary increase for current employees 

(continued...) 

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that Cabell-Huntington Hospital, a regional market competitor to Bateman, pays its similar 

classes of employees significantly higher starting salaries, a cost of living increase each year, 

and raises tied to years of service,24 in addition to conducting an annual review and increase 

of its average wages. 

Rather than the DHHR seeking permission from the DOP to be able to offer 

special hiring rates, including rates in excess of the “market rate,” hiring incentives, and 

retention incentives,25 the circuit court further found that the base starting rates for three 

classes of direct care employees–HSTs, HSWs, and HSAs–were the same as those in effect 

prior to the 2009 Agreed Order. Consequently, the circuit court concluded that the DHHR 

was in violation of the 2009 Agreed Order because it had taken “no steps to offer competitive 

23(...continued) 

raises the average salary, which can mean a higher salary for new hires. 

24As the circuit court recounted in its order, the evidence showed that in 2013, the six 

major hospitals in the Huntington, West Virginia, area paid an average hourly wage of 

$13.34 for a nursing assistant (compared to Bateman’s base starting salary of $9.37 per hour 

for a HSW); $17.06 for an LPN (compared to Bateman’s base starting salary of $12.40 per 

hour); and $27.29 for an RN (compared to Bateman’s base starting salary of between $16.47 

and $22.03 per hour for its RN classifications). 

25Various DHHR employees, as well as the assistant director of classification and 

compensation for the DOP, testified concerning the interaction between the DHHR and the 

DOP on employment related issues. For example, while the DOP has sole authority to 

determine employee position classification and the salaries for each pay grade, classification 

determinations are made with input from the DHHR. Further, the DOP’s “pay plan 

implementation policy” allows the DHHR flexibility in hiring and establishing minimum 

staring salary rates. 

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market wages in order to recruit and retain full time employees, as required by paragraph 10 

of the 2009 Agreed Order and West Virginia Code § 5-5-4a.” The court further found that 

the DHHR had failed to comply with the December 18, 2012, Order, which requires a 

“special starting salary for the three classes of direct care employees, as set forth in 

Attachment B to the 2009 Agreed Order.” 

Upon concluding that the DHHR’s “violation of patient care requirements is 

caused by the [DHHR’s] failure to maintain adequate and appropriate fulltime staffing at 

[Bateman and Sharpe],” the circuit court directed the DHHR to develop a plan,26 in 

consultation with the court monitor and the respondents, that will 

(1) significantly reduce the number of staff vacancies at Sharpe 

and Bateman, (2) discontinue the practice of mandatory 

overtime except in exceptional and infrequent contexts; and (3) 

discontinue the reliance on temporary employees and contract 

workers to fill the vacant positions. Among other things, the 

plan should utilize the currently available options, as set forth in 

the policies of the Division of Personnel, to implement special 

hiring rates and incentives in order to recruit fulltime direct care 

employees. In doing so, the [DHHR] shall consider prevailing 

market wages in the respective market areas for the two 

Hospitals. The Plan must further include requests to the 

Division of Personnel for retention incentives to encourage 

retention of existing hospital employees. The plan must provide 

a schedule for future proposals to the Division of Personnel to 

26At the conclusion of the April 29, 2014, hearing, the circuit court verbally directed 

the DHHR to prepare this plan in consultation with the respondents, the Governor’s Office 

and the DOP, warning against a subsequent return to court with a plan requiring legislative 

approval given its years of delay to act on these matters. 

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ensure that base salaries remain competitive and that additional 

retention incentives are distributed. 

The circuit court further ordered the DHHR to “immediately implement a special starting 

salary for the three categories of health service workers as reflected in Attachment B to the 

2009 Agreed Order.”27 Lastly, the circuit court ordered the DHHR to provide community 

integration opportunities to all eligible patients at both Sharpe and Bateman and to develop 

policies and procedures for community integration that adhere to West Virginia C.S.R. § 64­

59-14. 

On June 11, 2014, the parties appeared before the circuit court during which 

the DHHR presented three proposals, each requiring years to implement as well as legislative 

approval.28 After hearing the proposed plans, the circuit court held the DHHR in contempt, 

which finding was confirmed in its June 27, 2014, order.29 To purge itself of contempt, the 

27This was also part of the directive in the circuit court’s order entered December 18, 

2012, which was not appealed. 

28These three proposals were: (1) privatization of Bateman and Sharpe; (2) a 

“contracted employee option” where all direct care workers would be contracted out to 

private companies; and (3) a “hybrid” approach where current employees would be phased 

in as “classified-exempt.” The effect of the hybrid approach would be to remove current 

employees from civil service classification and the protections afforded by such 

classification. 

29In its June 27, 2014, order, the circuit court found that Bateman and Sharpe had 

“failed to recruit and retain direct care staff, failed to comply with Court Orders regarding 

pay raises for direct care workers, failed to offer community integration services, and have 

consequently failed to provide adequate direct care to patients at the Hospitals.” 

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DHHR had only to present a remedial plan that could be implemented immediately utilizing 

current DOP policies and procedures. 

The DHHR returned to the circuit court on August 1, 2014, for a hearing 

during which it presented its proposed plan. The plan provided, inter alia, for increased 

salaries for direct care workers at Sharpe and Bateman that are competitive with prevailing 

market wages in the hospitals’ respective geographical areas based upon regional market 

surveys, and for periodic retention incentives for employees who remain employed in their 

job classification for three or more years. Commissioner Jones testified that the DHHR could 

implement its plan using existing DOP policies and procedures, and that nothing in the plan 

required legislative approval. Monica Robinson, the interim director of the DHHR’s Office 

of Human Resources Management, testified that potential sources of funding for the plan 

included “various funds . . . within the [DHHR] . . . as controlled by the Secretary” and that 

if these proved insufficient, the DHHR would seek additional funding from the Legislature. 

Near the conclusion of this hearing, the circuit judge commented on the 

DHHR’s proposed plan as being the “appropriate method,” adding that 

[i]f there are other solutions that the [DHHR] wishes to proceed 

to look at with the legislature, . . . they are free to do that, but 

that’s not to delay or cause any disruption in the implementation 

of this plan until such time as the legislature and executive 

decide some other plan is more appropriate, and then the Court 

will review that based on wherever we are at that time. 

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. . . this is the plan that you all developed. I don’t intend 

to usurp the authority of the executive or the legislative branch. 

. . . I want to solve the immediate problem that we have for the 

care of this very vulnerable population. And moving in the 

direction as the [DHHR] has outlined appears to be within their 

means and within their power to begin to move on at a 

deliberate pace, and I think that solves the problem that I have 

with the prior plans. 

The DHHR’s counsel responded that this plan was not preferred by the DHHR, at which 

point the court reiterated that it was “not foreclosing [the DHHR from] pursuing other plans 

if that’s what you want” but emphasized that “this one needs to be implemented with 

deliberate speed.” 

On August 13, 2014, the circuit court entered an order finding the DHHR had 

purged itself of the contempt “so long as [it] execute[s] [its] proposed plan.” In this same 

order, the circuit court echoed comments it previously expressed during the August 1, 2014, 

hearing: 

13. The [DHHR] may wish to pursue other solutions 

which would require legislation to implement. Nothing in this 

Order or any prior Orders of this Court impedes the ability of 

the Legislature to change the manner in which the Hospitals are 

operated, nor do the Orders prohibit the [DHHR] from seeking 

such legislative action. 

14. Until such time as the Legislature changes the law, 

however, the current plan, which utilizes the current legal 

structure to address the ongoing violations of the 2009 Agreed 

Order, should be implemented without delay or disruption. 

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Through a second order entered on August 13, 2014, the circuit court refused the DHHR’s 

motion for a stay of the court’s orders entered on June 3 and 27, 2014, as well as its oral 

ruling made during the August 1, 2014, hearing approving the DHHR’s proposed plan;30 it 

also refused to declare those rulings to be partial final judgments. 

The appendix record reflects that additional hearings were held during the Fall 

of 2014 to monitor the DHHR’s progress on its plan, which was approved by the State 

Personnel Board on October 10, 2014. During the hearing held on October 14, 2014, the 

DHHR advised that the requisite regional market studies had been completed; that new salary 

ranges had been established; and that new starting salaries and raises for existing employees 

were expected to be implemented by January 1, 2015. The DHHR further advised that it 

anticipates funding for the increased salaries to be obtained, in part, through savings in 

expenditures currently being paid to short-term contract employees.31 

The DHHR appeals the circuit court’s June 3, 2014, and August 13, 2014, 

orders.32 The Court has consolidated these appeals for consideration. 

30The DHHR also sought a stay in this Court, which was refused by order entered on 

August 26, 2014. 

31The DHHR again indicated that additional funding could be sought from the 

Legislature. 

32Two orders were entered by the circuit court on August 13, 2014. One purged the 

(continued...) 

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II. Standard of Review 

In reviewing the challenged orders issued by a lower court, we will review the 

“ultimate disposition under an abuse of discretion standard. We review challenges to 

findings of fact under a clearly erroneous standard; conclusions of law are reviewed de 

novo.” Syl. Pt. 4, in part, Burgess v. Porterfield, 196 W.Va. 178, 469 S.E.2d 114 (1996). 

Under these well-established precepts, we proceed to address the parties’ arguments to 

determine whether the lower court committed error. 

III. Discussion 

A. Appellate Jurisdiction 

We first address the parties’ arguments regarding the Court’s appellate 

jurisdiction over the rulings subject to this appeal. In one of its August 13, 2014, orders, the 

circuit court refused to declare its June 3 and 27, 2014, orders as a partial final judgment 

under Rule 54(b).33 The lower court similarly ruled with regard to its oral ruling made during 

the August 1, 2014, hearing, which approved the DHHR’s proposed plan for immediate 

32(...continued) 

DHHR of contempt and confirmed the oral ruling made during the August 1, 2014, hearing 

approving the DHHR’s proposed plan, and the other refused the DHHR’s request for a stay 

and for entry of partial final judgments. Both of these orders are attached to the DHHR’s 

notice of appeal for case number 14-0845. 

33Rule 54(b) of the West Virginia Rule of Civil Procedure provides, in part, that “ the 

court may direct the entry of a final judgment as to one or more but fewer than all of the 

claims or parties only upon an express determination that there is no just reason for delay and 

upon an express direction for the entry of judgment.” 

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implementation. The circuit court reasoned that these orders were not final because they 

continued to address the same problems that had existed since 2009. Both parties offer 

varying theories under which this Court should exercise its appellate jurisdiction,34 as the 

DHHR contends,35 or should refuse to do so, as the respondents assert. 

Although not cited by the parties, in syllabus point five of Riffe v. Armstrong, 

197 W.Va. 626, 477 S.E.2d 535 (1996), we held that 

[a]n order dismissing fewer than all of the parties or 

fewer than all the claims in a civil action which contains a 

determination by a circuit court that the order not be considered 

final will be reviewed by this Court only upon application for a 

writ of prohibition. The party seeking such a writ must show 

any such abuse clearly and convincingly, because this Court 

greatly favors having before it all matters in controversy when 

reviewing the issues raised before it. 

Id. (emphasis added). At first blush, Riffe would suggest that we decline to consider the 

instant appeals because the DHHR should have sought our original jurisdiction by seeking 

34Our appellate jurisdiction extends to “civil cases at law where the matter in 

controversy, exclusive of interest and costs, is of greater value or amount than three hundred 

dollars” and we “shall have such other appellate jurisdiction, in both civil and criminal cases, 

as may be prescribed by law.” W.Va. Const. art. VIII, § 3; see also W.Va. Code § 51-1-3 

(2008) (“[the Supreme Court of Appeals] shall have appellate jurisdiction in civil cases 

where the matter in controversy, exclusive of costs, is of greater value or amount than one 

hundred dollars” as well as “such other appellate jurisdiction . . . as may be prescribed by 

law.”). 

35One of the theories offered by the DHHR in support of our appellate jurisdiction is 

the collateral order doctrine. We find that this doctrine cannot be applied because the orders 

on appeal do not resolve issues that are “completely separate from the merits of the action.” 

Credit Acceptance Corp. v. Front, 231 W.Va. 518, 523, 745 S.E.2d 556, 561 (2013). 

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extraordinary relief in prohibition. While we could consider these appeals as seeking relief 

in prohibition, as we have done in other matters,36 we find that course of action unnecessary 

for the reasons set forth below. 

The case at bar is distinct from the personal injury action in Riffe,37 or any other 

civil action, where the litigation is likely to reach its finality within an indefinite, but 

generally reasonable amount of time. In contrast to the typical litigation matter such as that 

involved in Riffe, it is essentially impossible for this Court, or even the lower court, to have 

“all matters in controversy when reviewing the issues raised before it” in the context of this 

institutional-centered litigation. Moreover, unlike a typical civil action, institutional reform 

litigation involves court orders requiring prospective action by the government. 

The institutional reform undertaken in the case at bar has been, and is being, 

achieved through the circuit court’s entry of a variety of orders over the course of decades. 

As reflected in the procedural history set forth above, we have already reviewed numerous 

36See State ex rel. Register-Herald v. Canterbury, 192 W.Va. 18, 19 n.1, 449 S.E.2d 

272, 273 n.1 (1994) (“In this case, it is logical to treat the appeal . . . as a prohibition. . . .”). 

37Although the claims asserted in Riffe arose in the context of an involuntary 

commitment, it was a civil action seeking damages for false imprisonment and for medical 

malpractice arising out of a physician’s certificate for the involuntary commitment 

proceedings. 

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orders entered in this matter.38 Most recently, we ruled on the DHHR’s appeal in Matin V, 

notwithstanding the absence of any language expressly providing that the order at issue was 

a “final” ruling. Because the process of formulating and implementing various remedies in 

this proceeding has required extraordinary expenditures of time and funds by the parties; the 

circuit court; and this Court, we must necessarily assume a practical approach to our 

appellate jurisdiction. At the same time, we must act in recognition of the circuit court’s 

discretion to ensure efficient judicial administration and justice for the parties. During the 

pendency of this litigation, the circuit court has clearly gained an intimate understanding of 

the parties, the subject hospitals, and the changes required to achieve the goals initially 

identified in Matin I and the litany of commitments made by the DHHR through the 2009 

Agreed Order. 

Certainly, we do not intend to exercise our appellate jurisdiction over every 

order entered in this matter. Nonetheless, this Court must be able to review orders that are 

properly demonstrated to have the necessary degree of finality in the context of this longstanding institutional reform litigation to warrant review, and certainly those which 

necessitate the expenditure of significant state monies. Otherwise, a state agency may be 

denied timely appellate review. As we have previously explained, where “an order . . . 

38Similarly, we reviewed various circuit court orders over a period of years in the 

long-term prison reform litigation that began with Crain v. Bordenkircher, 176 W.Va. 338, 

342 S.E.2d 422 (1986). 

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completely disposes of any issues of liability . . . the absence of language prescribed by Rule 

54(b) . . .’directi[ng] . . . entry of judgment’ will not . . . bar appeal provided that this Court 

can determine from the order that the trial court’s ruling approximates a final order in its 

nature and effect.” Syl. Pt. 2, in part, Durm v. Heck’s, Inc., 184 W.Va. 562, 401 S.E.2d 908 

(1991). Accordingly, we now hold that in the context of institutional reform litigation, this 

Court may choose to exercise its appellate jurisdiction over an order entered by the circuit 

court that it deems to approximate a final order by its nature and effect. 

The record reflects that subsequent orders have been entered with regard to the 

DHHR’s progress on implementing its plan, and that further rulings are contemplated. 

Notwithstanding the possibilityof subsequent decrees, we find that the orders being appealed 

establish responsibility on the DHHR for a remedy that requires administrative action and 

the expenditure of significant funds to meet obligations ineluctably established by prior 

orders, statutes, and regulations. Accordingly, we conclude that the DHHR has demonstrated 

that appellate review is warranted; therefore, we reverse the circuit court’s August 13, 2014, 

order to the extent it refused to certify its prior rulings on appeal as partial final judgments. 

B. Separation of Powers 

In the current consolidated appeals, the DHHR argues, as it has in prior 

appeals, that the circuit court wrongly decided questions entrusted to the legislative and 

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executive branches. Specifically, the DHHR argues that the “parameters” set by the lower 

court for the DHHR’s plan required more than working towards a reduction in the use of 

overtime and temporary employees, as contemplated under paragraph 10(b) of the 2009 

Agreed Order.39 Instead, the DHHR contends that the lower court directed it to increase the 

pay of direct care workers to market rates and to “restructure”40 employee salaries and job 

classifications, without providing it with an opportunity to develop any necessary, remedial 

plan to solve overtime and permanent staffing issues. Citing various institutional reform 

cases, including Swann v. Charlotte-Mecklenburg Board of Education, 402 U.S. 1 (1971), 

the DHHR asserts that a court can devise its own plan in institutional reform cases only if the 

executive branch agency has been given multiple opportunities to devise a plan or 

mechanism to correct its past violations in prisons, schools, and other state-operated 

facilities. The DHHR adds that whether the plan currently being implemented is better than 

the proposals it made during the June 11, 2014, hearing is irrelevant because where there is 

a good faith difference of opinion, “differences should be resolved by the direction of the 

[DHHR] and not by the courts.” Matin I, 168 W.Va. at 259-60, 284 S.E.2d at 238. 

Given the DHHR’s admitted failure to comply fully with either the 2009 

Agreed Order or the December 18, 2012, order, the respondents argue that the circuit court 

39Paragraph 10(b) provides that the “DHHR will use onlyfull time employees working 

regular shifts or voluntary overtime except in exceptional and infrequent contexts.” 

40This term is used by the DHHR; it is not included in the circuit court’s order. 

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had the authority to act, just as it did regarding the implementation of a TBI Medicaid waiver 

program and trust fund in Matin V.

41 The respondents emphasize that despite the DHHR’s 

agreed upon commitments made in 2009 to discontinue its use of mandatory overtime and 

temporary workers, as well as its agreement that the best way to meet that commitment was 

through competitive salaries realized through wage increases, it failed to honor either of these 

obligations. The respondents cite evidence in the record demonstrating how DOP policies 

and procedures could be used to correct these problems and how the DHHR admittedly made 

no effort to work with the DOP to achieve these objectives.42 Upon receiving all of this 

evidence, the respondents assert that rather than mandating a specific remedy, the circuit 

court simply ordered the DHHR to develop a plan to ensure compliance with its prior 

agreements and the law. Because increased salaries were again cited by the parties during 

the April 2014 hearings as a solution to employee recruitment and retention issues, the 

respondents argue that the circuit court’s guidance in this regard was appropriate and did not 

encroach on the authority of either the executive or the legislative branch. In particular, the 

respondents note that the circuit court made clear that none of its orders preclude the DHHR 

from working with the Legislature to develop a different plan for the court’s consideration. 

41See supra note 8. 

42There was evidence that through the DHHR’s efforts with the DOP, the salaries of 

RNs and psychiatrists at Bateman and Sharpe were increased to rates that actually exceeded 

what was required under the 2009 Agreed Order. However, the DHHR did not work with 

DOP to raise the salary rates for the other direct care workers–the HSTs, HSWs, and 

HSAs–as required under the 2009 Agreed Order. 

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In addressing the parties’ arguments, we first observe that the separation of 

powers doctrine states, in part, that “[t]he legislative, executive and judicial departments shall 

be separate and distinct, so that neither shall exercise the powers properly belonging to either 

of the others; nor shall any person exercise the powers of more than one of them at the same 

time[.]” W.Va. Const. art. V, § 1. As we concluded in Matin I, IV, and V and as discussed 

below, we again find that this doctrine is not implicated in the instant appeals. 

In Matin IV, we found that “[t]he regular staff suffers from extremely low 

morale due to forced overtime and working with unqualified temporary workers with 

questionable backgrounds.” Matin IV, 223 W.Va. at 384, 674 S.E.2d at 245. We further 

observed that “many of the same issues that were present in 1981 at the time of the Matin I 

decision continue to be problems today, according to the Ombudsman’s report. . . . 

includ[ing] . . . the numerous staffing issues . . . .” Id. at 285, 674 S.E.2d at 246. We also 

observed that “the term ‘Dickensian Squalor’ . . . used to describe the hospital in 1981 [was] 

an apt description . . . that emerges from the Ombudsman’s July 3, 2008 report.” Id. 

Thereafter, the parties were directed to participate in mediation that resulted in several 

agreements, subsequently memorialized in the 2009 Agreed Order. 

Despite the 2009 Agreed Order, the DHHR exhibited an extraordinary lack of 

initiative to oversee that its commitments were met. Had it actually undertaken to develop 

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a formal plan of action in 2009, there would likely have been no need for the parties’ return 

to the circuit court in 2014 on these very same issues. Indeed, the circuit court’s frustration 

with the DHHR was surely exacerbated upon learning of the DOP policies and procedures 

that could aid the DHHR in achieving compliance—tools that were untouched during the 

intervening years.43 

Compelling the DHHR to develop a plan to meet its previous commitments and 

the law, after years of delay, does not demonstrate an encroachment on executive branch 

authority. Instead, it supports the DHHR’s decision to enter into the contractually binding 

2009 Agreed Order. Given the DHHR’s failure to correct problems that have existed for 

more than thirty years, the institutional reform cases cited by the DHHR44 would arguably 

support the circuit court crafting a plan for the DHHR’s implementation. Nonetheless, the 

lower court’s June 3, 2014, order directed the DHHR to develop a plan to “(1) significantly 

reduce the number of staff vacancies at Sharpe and Bateman, (2) discontinue the practice of 

mandatory overtime except in exceptional and infrequent contexts; and (3) discontinue the 

reliance on temporary employees and contract workers to fill the vacant positions.” What 

cannot be overlooked is the fact that the DHHR had already committed itself to accomplish 

43Again, the DHHR worked with the DOP to raise the salaries for RNs and 

psychiatrists pursuant to the 2009 Agreed Order, including special hiring rates, but not for 

the other direct care worker classifications. 

44See, e.g., Swann, supra. 

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each of these goals during the mediation, as reflected in the 2009 Agreed Order. The circuit 

court also mandated the DHHR to “consider prevailing market wages in the respective 

market areas for the two Hospitals.” This requirement, along with the “special hiring rates 

and incentives” for the direct care workers, were clearly intended to bring the DHHR into 

compliance with prior orders, as well as West Virginia Code § 5-5-4a.45 Given the stark 

absence of any constructive planning to date, let alone any demonstration of long-range 

planning efforts, the circuit court reasonably acted within its discretion by directing the 

DHHR to create a schedule for future proposals to the DOP to ensure that base salaries 

remain competitive and that additional retention incentives are distributed46 to remain 

compliant with agreed to commitments, prior orders, and statutory obligations. 

45As indicated previously, the Legislature expressly recognized in this statute the 

“extreme difficulty” that Sharpe and Bateman have in recruiting and retaining direct care 

workers; mandated the DHHR and the DOP to develop “pay rates and employment 

requirements to support the recruitment and retention” of psychiatrists, nurses, HSTs, HSWs, 

HSAs, or other positions at Bateman and Sharpe; and required those pay rates to reflect 

“regional market rates for relevant positions.” W.Va. Code § 5-5-4a. 

46The DHHR asserts that West Virginia Code § 5-5-4a does not create a continuing 

obligation to keep pay rates in line with regional market rates for the direct care employees 

at the subject hospitals. We find no language in that statute supports this argument. See 

Martin v. Randolph Cty. Bd. of Educ., 195 W.Va. 297, 312, 465 S.E.2d 399, 414 (1995), 

quoting Connecticut Nat’l Bank v. Germain, 503 U.S. 249, 253-54 (1992) (“‘[C]ourts must 

presume that a legislature says in a statute what it means and means in a statute what it says 

there.’”). Moreover, it is unclear how the DHHR believes that its chronic staffing issues can 

be resolved on a long-term basis without competitive pay rates. 

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Based on our review, the only “new” directive included in the June 3, 2014, 

order is the requirement that the DHHR comply with its earlier agreements by utilizing 

methods and procedures previously established by the legislative and executive branches to 

address the personnel problems at Bateman and Sharpe. See W.Va. Code § 5-5-4a; W.Va. 

Code §§ 29-6-1 to -28 (establishing civil service system and requiring DOP to create system 

of classification and compensation for civil service employees); W.Va. C.S.R. §§ 143-1-1 

to -26 (adopting DOP rules for purpose of implementing W.Va. Code §§ 29-6-1 to -28.). 

Consequently, we find this requirement to be well within the circuit court’s authority 

considering the DHHR’s prior unfulfilled agreements, the pertinent statutory and regulatory 

mandates discussed herein, and the continued adverse impact that the DHHR’s delay has had 

on patient care.47 

That the DHHR can be compelled to act in accordance with its prior 

agreements, as well as prior court orders, is beyond dispute. See Matin IV, 223 W.Va. at 381, 

674 S.E.2d at 242 (“The circuit court . . . has the power to enforce a Consent Order it 

47As indicated above, Bateman’s clinical director testified in 2009 that patients were 

being administered increased amounts of medication, a side effect of which is sedation, to 

treat their increased levels of anxiety attributable to understaffing and patient overcrowding. 

In 2014, the chief executive officer at Bateman could not “rule out” the possibility that 

patients were continuing to be sedated for these same reasons. The patient overcrowding is 

partiallyattributable to the failure to provide patients with the communityintegration services 

required under West Virginia C.S.R. § 64-59-14.4. The evidence showed that patients were 

not being evaluated to determine whether they would be eligible to receive community 

integration services because no such services were planned due to the chronic understaffing. 

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previously issued.”). Furthermore, “a trial court always has inherent authorityto regulate and 

control the proceedings before it and to protect the integrity of the judicial system.” Clark 

v. Druckman, 218 W.Va. 427, 435, 624 S.E.2d 864, 872 (2005); see also Beto v. Stewart, 213 

W.Va. 355, 362, 582 S.E.2d 802, 809 (2003), quoting Bartles v. Hinkle, 196 W.Va. 381, 

389, 427 S.E.2d 827, 835 (1996) (“[A] trial court has broad authority to enforce its orders . 

. . .”). Indeed, it is axiomatic that a circuit court has the inherent power to do those things 

necessary to compel a party’s compliance with prior agreements, to enforce its prior orders, 

and to protect the court from acts obstructing the administration of justice, including the use 

of its contempt powers. 

The instant, and prior, appeals in this litigation depict an agency that is either 

well-intended, or one that makes agreements as the exigencies demand; in either case, its 

follow-through efforts are abysmal. The DHHR’s pattern of failing to fulfill its commitments 

and obligations undermines the efficacy of such agreements and further serves to discourage 

negotiation-based resolution. Despite being held in contempt for its failure to develop a plan 

for immediate implementation after years of noncompliance, the DHHR continues to assert 

that the plan it developed was offered only to purge the contempt, but it was not its preferred 

course of action.48 Certainly, the executive branch should lead reform efforts, but courts are 

48The appendix record reflects that all parties agreed in 2009, 2012, and 2014 that 

offering competitive market rate salaries to direct care workers would aid in correcting the 

chronic staffing issues. While there was some testimony from the DHHR suggesting that the 

(continued...) 

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by necessity required to intervene when those efforts fall short. See, e.g., State ex rel. Smith 

v. Skaff, 187 W.Va. 651, 655, 420 S.E.2d 922, 926 (1992) (directing Division of Corrections 

to develop plan to provide “some temporary arrangement to meet its obligation to house and 

detain all those lawfully sentenced to a state penal facility until such time as the new prison 

[the Mt. Olive Correctional Complex] is completed.”); Crain v. Bordenkircher, 180 W.Va. 

246, 248, 376 S.E.2d 140, 142 (1988) (addressing prior rulings that conditions of 

confinement violated constitutional prohibition against cruel and unusual punishment and 

concluding that if Court failed to act “after more than eight years of waiting for the 

legislative and executive branches to act to solve the problem, we would be abdicating our 

responsibility to uphold and guard the Constitutions of the United States and West 

Virginia[;]” and compelling construction of new prison by July 1, 1992); Crain v. 

Bordenkircher, 176 W.Va. 338, 342 S.E.2d 422 (1986) (finding Department of Corrections’ 

compliance plan devised under consent decree to be inadequate and ordering future remedial 

48(...continued) 

state’s leave policies also contribute to the staffing problems, favorable leave policies could 

arguably be used by the DHHR as an additional recruitment incentive. Moreover, the 

problem appears not to be the leave policies, per se, but the pervasive and routine use of 

mandatory overtime due to habitual understaffing. Even the DHHR agrees that mandatory 

overtime is harming employee morale; is contributing to employee turnover; and is probably 

causing employees to use their leave to avoid being required to work a sixteen-hour, rather 

than a scheduled eight-hour, work day. If recruitment of individuals for permanent direct 

care positions can be achieved through competitive market salaries, and perhaps favorable 

leave policies, as well, then the need for temporary and contract workers, as well as 

mandatory overtime, would be reduced to “exceptional and infrequent contexts.” 

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action by directing Department of Corrections to revise its compliance plan to include 

development of new facilities). 

In the case at bar, the DHHR seemingly ignores the fact that when it appeared 

before the circuit court in 2014, five years had elapsed during which it essentially sat idle. 

It certainly had not formulated any concrete plan to meet its commitments and other courtordered, regulatory, and statutoryobligations. Although the circuit court certainlymade clear 

that the DHHR could move forward with developing another plan for the court’s 

consideration, either with or without legislative involvement, it made equally clear that 

additional years of noncompliance would not be condoned. We agree. 

It is both inexcusable and disheartening for the DHHR to be before this Court 

on some of the same issues that were identified more than thirty years ago—issues that 

continue to adversely impact the very vulnerable patient population committed to our state 

mental health hospitals. “[W]hen the executive persists in indifference to, or neglect or 

disobedience of court orders . . . it is the executive that could more properly be charged with 

contemning the separation principle.” Perez v. Boston Housing Auth., 400 N.E.2d 1231, 

1252 (Mass. 1980). Consequently, we are compelled to find that requiring the DHHR to 

develop a plan for immediate implementation, which would allow it to comply with courtordered, statutory, and regulatory obligations–obligations previously consented to by the 

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DHHR–does not transform the DHHR’s plan into the circuit court’s plan. Neither does it 

violate the separation of powers doctrine. 

C. Paragraph 10(a) of the 2009 Agreed Order 

Paragraph 10(a) of the 2009 Agreed Order states, in part, that the “DHHR shall 

provide for increased pay for direct care workers at Bateman and Sharpe in order to (i) be 

able to recruit staff and retain existing staff . . . .” (emphasis added.). The DHHR argues 

that it did not view paragraph 10(a) as contemplating increased staring salaries for future 

hires in direct care positions; rather, this language only applied to increased salaries for 

existing employees. To the extent there is any doubt as to the meaning of paragraph 10(a), 

the DHHR asserts that constitutional considerations require resolution in its favor. The 

DHHR adds that requiring the state to expend additional funds not previously approved or 

anticipated raises questions concerning the circuit court’s power to limit the Legislature’s 

authority over the DHHR’s budget. 

The respondents argue that the circuit court’s unappealed order entered 

December 18, 2012, settled any issue as to whether increased salaries for new employees was 

required. The respondents assert that the lower court compelled the DHHR’s compliance 

with the 2009 Agreed Order in its December 18 ruling by ordering that HSTs, HSWs, HSAs, 

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and LPNs employed “on or after January 1, 2013” were entitled to pay raises. Because this 

language clearly contemplates new employees, the respondents maintain the issue is moot. 

The DHHR’s extreme difficulty in recruiting persons to permanent positions 

at Bateman and Sharpe is undisputed.49 Consequently, the DHHR’s argument that paragraph 

10(a) does not require it to increase base salaries for new employees is simply unsupportable 

when considering the impetus behind both the 2009 Agreed Order and West Virginia Code 

§ 5-5-4a. Testimony offered by the DHHR during the hearings held in 2009, 2012, and 2014 

clearly demonstrated a unanimous belief that increasing salaries would aid in employee 

recruitment, as well as retention. 

The plain language of paragraph 10(a) of the 2009 Agreed Order expressly 

requires the DHHR to increase pay for direct care workers in order to “be able to recruit 

staff[.]” By common definition, “recruit” means to “enroll (someone) as a . . . worker in an 

organization,”50 or to “secure the services of: engage, hire.”51 Further, West Virginia Code 

49The appendix record reflects that when a DHHR official was questioned concerning 

the recruitment tools currently being utilized to attract employees, he responded by reciting 

traditional methods, such as advertising, attending employment fairs, and maintaining 

relationships with schools. The circuit court noted that these were the same tools being used 

when the parties were before the court in 2009. 

50See New Oxford American Dictionary 1460 (3rded. 2010). 

51See Merriam-Webster’s Collegiate Dictionary 1041 (11thed. 2005). 

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§ 5-5-4a provides that the DHHR, in conjunction with the DOP, “shall develop pay rates and 

employment requirements to support the recruitment and retention of” direct care workers 

at Bateman and Sharp. Id. (emphasis added). It is axiomatic that “the word ‘shall,’ in the 

absence of language in the statute showing a contrary intent on the part of the Legislature, 

should be afforded a mandatory connotation.” Syl. Pt. 1, Nelson v. West Virginia Pub. 

Employees Ins. Bd., 171 W.Va. 445, 300 S.E.2d 86 (1982). 

Consequently, we find no merit to the DHHR’s argument that paragraph 10(a) 

of the 2009 Agreed Order did not contemplate an increased salary rate for new direct care 

employees. Further, we agree with the respondents that to the extent the DHHR had any 

doubt in that regard, it was resolved and clarified through the circuit court’s order entered 

December 18, 2012,52 stating: “employees in the LPN and Health Service Trainees, Workers, 

and Assistants classifications employed on or after January 1, 2013, are entitled to pay raises 

. . . as provided for in the Order entered December 11, 2012.” Evidence presented during the 

April 2014 hearings indicated that the DHHR provided the required raises to those employed 

on January 1, 2013, but failed to increase the starting salaries for those individuals hired after 

that date. 

52The DHHR conceded during a hearing held in October of 2012 that the HSTs, 

HSWs, and HSAs did not receive the salary increases required under the 2009 Agreed Order. 

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Notwithstanding the DHHR’s clear obligations under the 2009 Agreed Order, 

the December 2012 orders, and West Virginia Code § 5-5-4a, the evidence demonstrated that 

in 2014, the base starting salaries for the HSTs, HSWs, and HSAs remain at the same rates 

in effect prior to the 2009 Agreed Order. Consequently, we find that the circuit court did not 

abuse its discretion by compelling the DHHR to develop a plan that included the means to 

accomplish what it agreed to do five years earlier: increase salaries of direct care workers 

at Bateman and Sharpe in order to be able to recruit staff and retain existing staff and 

eliminate the pervasive and excessive use of mandatory overtime and temporary workers.53 

See Matin IV, 223 W.Va. at 381, 674 S.E.2d at 242 (“The circuit court also has the power 

to enforce a Consent Order it previously issued.”); Syl. Pt. 1, in part, Seal v. Gwinn, 119 

W.Va. 19, 191 S.E. 860 (1937) (“ A court may . . . enter such orders and decrees as may be 

necessary to enforce [prior] decrees[.]”). 

Turning to the DHHR’s budgetary argument, as we explained in Matin I, 

“[w]hen the Legislature enacts a law giving a group of individuals a clear and explicit right, 

there is also created an implicit corresponding duty on the part of the State to grant or enforce 

that right.” Matin I, 168 W.Va. at 257, 284 S.E.2d at 237. Indeed, “[i]nherent in the 

republican form of government established by our State Constitution is a concept of due 

process that insures that the people receive the benefit of legislative enactments.” Syl. Pt. 

53Under West Virginia Code § 5-5-4a, the salaries of direct care workers at Bateman 

and Sharpe must be at “regional market rates.” 

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1, Cooper v. Gwinn, 171 W.Va. 245, 298 S.E.2d 781 (1982). Consequently, “[a] legislatively 

conferred right is an entitlement that cannot be arbitrarily abrogated by an executive officer. 

Such a course of action, or in this case inaction, abhors the concept of rule of law.” Cooper 

v. Gwinn, 171 W.Va. 245, 256, 298 S.E.2d 781, 792 (1981). In the context of inmates in our 

state prisons, we stated that 

the lack of funds is not a valid excuse for denying inmates, and 

society as a whole, the constitutional right to the benefit of 

legislative enactments which clearly establish the duty of the 

Department of Corrections to rehabilitate individuals charged to 

its care, and the concommitant [sic] right of those individuals to 

demand the benefit of those laws. 

Id., 171 W.Va. at 255, 298 S.E.2d at 791-92. 

The Legislature has provided certain rights to patients confined in our state 

psychiatric hospitals. W.Va. Code § 27-5-9. Accordingly, “[i]t is the obligation of the State 

to provide the resources necessary to accord [patients] of State mental institutions the rights 

which the State has granted them under W.Va. Code, 27-5-9 [1977].” Matin I, 168 W.Va. 

248, 284 S.E.2d 232, syl. pt. 3. To that end, the appendix record reflects the DHHR’s intent 

in the fall of 2014 to fund its court-approved plan within its current budget by using “various 

funds . . . within the [DHHR] . . . controlled by the Secretary” and through savings on 

expenditures that were otherwise paid to short-term contract employees. If those means 

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proved insufficient, then it planned to seek additional funding from the Legislature.54 

Consequently, we find no merit in the DHHR’s contention that the circuit court has limited 

the Legislature’s authority over the DHHR’s budget. 

IV. Conclusion 

The circuit court has conscientiously and with great care presided over this 

institutional reform litigation since 1981. It is our fervent hope that the DHHR will assume 

a proactive, rather than its customary reactive, role in this matter, and that through strong 

leadership and innovation, it will move forward with alacrity in meeting its statutory and 

regulatory obligations without the continuing need for judicial oversight. 

For the reasons expressed herein, the June 3, 2014, and August 13, 2014, orders 

of the Circuit Court of Kanawha County are hereby affirmed, in part, and reversed, in part. 

AFFIRMED, in part, and REVERSED, in part. 

54If additional funding from the Legislature became necessary, presumablythe DHHR 

undertook the steps to secure that funding. 

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