Appeal from Superior Court of King County. Docket No: 93-1-00573-0. Date filed: 10/24/95. Judge signing: Hon. Michael J. Fox.
Authored by Ronald E. Cox. Concurring: Susan R. Agid, C. Kenneth Grosse.
The opinion of the court was delivered by: Cox
COX, J. -- While in custody and awaiting sentencing on convictions for delivery and possession with intent to deliver cocaine, Robert Wallace received two liver transplants. The second was successful. Due to his medical condition, Wallace's sentencing hearing was continued twice over a period of 19 months. Wallace sought either a mitigated exceptional sentence or confinement at the University of Washington Medical Center. He also sought confinement under Washington's home detention statute, claiming that denial of this alternative to him violated equal protection of the law. The trial court ultimately sentenced Wallace to concurrent 36-month sentences on both counts, the low end of the standard range, at the Washington State Reformatory in Monroe. Wallace appeals the sentence.
We hold that the home detention statute does not violate the constitutional guaranty of equal protection of the law. Because we also reject Wallace's other challenges, we affirm.
At the time of Wallace's first scheduled sentencing hearing in March 1994, he was on a list for a liver transplant. He had been diagnosed with end-stage liver failure and had successfully completed the six-month alcohol and drug abstinence period required before the operation. According to Dr. Carithers, Wallace's physician, Wallace would have to report to the University of Washington Medical Center (UWMC) within two hours of notification to receive a new liver. The operation would be followed by two to three weeks of hospitalization and three months of follow-up at UWMC's outpatient clinics. The doctor expected Wallace to stabilize three to six months after surgery. Following stabilization, Wallace would require medication two to three times daily and would also need to see his physician every two weeks.
Dr. Carithers expressed concern that Wallace not facethe same situation a previous liver transplant patient at Monroe had faced. According to the doctor, the other patient had received inadequate care. The clinical transplant coordinator at UWMC expressed similar concerns. She added that a previous liver transplant patient housed at Monroe suffered two episodes of rejection following mismanagement of his medications by prison authorities.
The director of nursing services at the Washington State Reformatory indicated in a phone conversation with Wallace's counsel that Wallace would not have direct access to his UWMC physicians, but would need to go through four levels of approval to contact them. She stated that the prison hospital had no prior experience with liver transplant patients.
Wallace sought to serve his sentence at UWMC. Alternatively, he sought a mitigated exceptional sentence. The trial court continued sentencing for one year. It concluded that incarceration at that time or during Wallace's immediate post-operative care was insupportable. Noting that patients usually stabilize after approximately six months, it delayed the proceedings to hear expert opinion regarding the stability of Wallace's health after the operation.
In April 1995, the court once again heard the parties. Since March 1994, Wallace had undergone two liver transplants, the second of which was successful. He requested another continuance of the scheduled 1995 sentencing hearing so that he could collect the medical information necessary to present his case. The court granted this request.
The third and final hearing was in October 1995. Wallace presented several letters from Dr. Carithers expressing essentially two concerns. First, the doctor noted that Wallace was taking medication to suppress his immune system to reduce the chances of organ rejection. The medications render exposure to infections life-threatening. Second, Dr. Carithers reemphasized past difficulties communicating with prison officials to ensure that patients received their prescribed medicines and that prison staff sent the required blood samples to UWMC for monitoring. The doctor again referred specifically to a liver transplant patient at Monroe as well as a federal prisoner who "developed life threatening complications because they were not given their immunosuppressive medications in a timely manner." He indicated that if Wallace's medicines are not administered as prescribed, his body will reject the liver within a few days. In addition, staff at UWMC must review Wallace's laboratory tests once a month. His liver and kidney functions must be closely monitored.
Dr. Brent Saetrum, the Medical Director for Monroe, testified for the State. He testified that there are University of Washington physicians on the staff, including two who work with Dr. Carithers on a regular basis, and one who does follow-ups on kidney transplants. These doctors do not work at the prison full-time, but are there on a regular basis. Although Dr. Saetrum has no experience working with liver transplant patients, another physician has such experience.
Since Dr. Saetrum joined the staff at Monroe, there have been no liver transplant patients. Moreover, the records do not show there ever have been any liver transplant patients at Monroe.
Dr. Saetrum noted that Monroe follows the University of Washington's state-of-the-art guidelines in caring for its immunosuppressed patients. UW physicians come in to see the patients one to four times per month. If any patient becomes endangered as a result of immunosuppression, Monroe's staff consults with inside and outside specialists. If necessary, the patient can be stabilized at Providence or UWMC, then returned to Monroe and isolated there as necessary.
Dr. Saetrum reviewed the materials from Dr. Carithers and addressed the latter's concern regarding the treatment Wallace might receive at Monroe. He indicated that communication between Monroe and UWMC is very direct. He testified that in the event of any deterioration in Wallace's condition, Monroe's staff would send him directly to UWMC "without hesitation."
Dr. Saetrum further indicated that Dr. Carithers' concerns regarding Wallace's medications were unwarranted. Dr. Saetrum could arrange, under certain circumstances, for Wallace to keep all of his medications with him except for two drugs that are considered contraband. He stated that because Wallace would be monitored at Monroe, he would be more certain to take his medications than he would be at home.
While Dr. Saetrum does not have authority to ensure that Wallace will be placed at Monroe, he could place Wallace in protective isolation once at Monroe. Inmates in the isolation facility wear protective gear if they have an infectious disease.
The court decided that Wallace could reject the transplanted liver no matter where he is, even if his medical care is perfect. It could not conclude that the State is unable to provide appropriate medical care. The court therefore sentenced Wallace to 36 months, the low end of the standard range. Wallace appeals.
Equal Protection of the Law
Former RCW 9.94A.030(36), which was recodified in 1995 as RCW 9.94A.185, provides for a program of partial confinement that is available to certain offenders who are confined in a private residence. The statute states in pertinent part:
Home detention may not be imposed for offenders convicted of a violent offense, any sex offense, any drug offense, reckless burning in the first or second degree as defined in RCW 9A.48.040 or 9A.48.050, assault in the third degree as defined in RCW 9A.36.031, assault of a child in the third degree, unlawful imprisonment as defined in RCW 9A.40.040, or harassment as defined in RCW 9A.46.020. Home detention may be imposed for offenders convicted of possession of a controlled substance (RCW 69.50.401(d)) or forged prescription for a controlled substance (RCW 69.50.403) if the offender fulfills the participation conditions set forth in this subsection and is monitored for drug use by treatment alternatives to street crime (TASC) or a comparable court or agency-referred program.
The home detention program may also be made available to offenders whose charges and convictions do not otherwise disqualify them if medical or health-related conditions, concerns or treatment would be better addressed under the home detention program, or where the health and welfare of the offender, other inmates, or staff would be jeopardized by the offender's incarceration. *fn1 Participation in the home detention program for medical or health-related reasons is ...