Trueblood v. DSHS — federal court issues third contempt order, $100M in fines for decade of unconstitutional competency-services delays

A federal class action established in 2015 that DSHS was unconstitutionally delaying competency evaluations and restoration services for people held in jails. Three contempt orders and more than $180M in fines later, the state paid $100M in FY2024 — the third contempt payment — and reported first-time compliance in some counties in 2025, a decade after the original court order.

What happened

A.B. by and through Trueblood et al. v. Washington State DSHS is a federal class action filed in 2014 on behalf of people with mental illness or intellectual disabilities who were held in Washington jails awaiting court-ordered competency evaluation or restoration services. After a trial in 2015, U.S. District Court Judge Marsha J. Pechman found that DSHS was violating class members’ constitutional rights — specifically their Fourteenth Amendment due process rights — by failing to provide timely competency evaluations (required within 14 days of a court order) and competency restoration services (required within 7 days of a court order for inpatient services).

The timeline of contempt:

• 2016. First contempt order. The court imposed over $80M in fines based on DSHS’s failure to meet the 7-day and 14-day timelines. Fines were directed to diversion programs under a 2016 court order.
• 2018. Contempt settlement agreement. DSHS and plaintiffs negotiated a settlement that established a five-part implementation plan covering competency evaluations, restoration services, crisis diversion, education and training, and workforce development, to be phased in by region across multiple years.
• December 2022. Plaintiffs filed a motion for material breach of the 2018 settlement. The specific allegation: DSHS had allowed over 180 forensic beds to be occupied by long-term civil commitment patients (“civil conversions”), displacing Trueblood class members who needed those beds for competency restoration services.
• July 7, 2023. Third contempt order. After a week-long hearing in June 2023, Judge Pechman found DSHS in breach of the settlement agreement and in further contempt of court. The ruling imposed $100 million in contempt fines — to be paid within 30 days (with installment plan available) — and ordered DSHS to transfer or discharge civil conversion patients from forensic beds within 60 days. Judge Pechman wrote: “The primary reason [class members] suffered was DSHS’s own lack of foresight, creativity, planning, and timely response to a crisis of its own making.” The ruling also noted: “DSHS has never once been in compliance.”
• FY2024. DSHS paid the $100M fine. The state requested an installment plan from the court; funding was appropriated by the Legislature through a decision package requesting $100,318,000 GF-State.
• 2023–2025. Phase III rollout of the settlement implementation (Thurston, Mason, Kitsap, Jefferson, and Clallam counties). DSHS reported first-time compliance in some counties in 2025.

As of the most recent reporting, Disability Rights Washington noted that class members continue to wait weeks and months in some jurisdictions despite Phase III implementation.

What the primary source says

Disability Rights Washington, the class counsel, summarizes the case and its current status on its case page. Judge Pechman’s July 2023 ruling is the operative primary document; the Seattle Times quoted it at length on the ruling date: “The Court is unpersuaded that DSHS adequately planned for and took reasonable measures to address the bed shortage.”

The OFM budget decision package confirms that the $100M was paid in FY2024 as a direct court-ordered expenditure with no corresponding policy benefit — it was a fine, not a service investment.

Status

The $100M contempt fine was paid in FY2024. Phase III of the settlement implementation is complete. DSHS reports first-time compliance in some counties in 2025. Disability Rights Washington continues to monitor compliance. The court monitor (Dr. Danna Mauch) remains active. The case is not closed — plaintiffs retain the right to return to court if compliance lapses.

Why it’s in the registry

This case documents a constitutional violation that persisted for a decade across three contempt proceedings because the agency responsible for the violation was also the agency responsible for designing the remedy. The state paid more than $180M in court-ordered fines over the life of the litigation; none of that money went directly to the individuals who waited unconstitutionally in jail. The fines went to diversion programs — a systemic remedy rather than individual relief. The decade-long trajectory is the accountability record.

The structural pattern also connects to the broader DSHS oversight gap: behavioral health capacity is a state-level responsibility, and when the state fails to meet it, the costs cascade to counties, jails, emergency departments, and community service providers. The Trueblood fine is the most visible dollar figure in that cascade, but it does not capture the full cost of a decade of unconstitutional delays.

Reform implication

The three-contempt trajectory of Trueblood is the structural case for an independent behavioral health oversight function. The court monitor provided external oversight, but monitoring and compliance-flagging is not the same as operational authority. An independent inspector general — reporting to the Legislature rather than the executive branch — with proactive authority over capacity planning and the ability to flag the civil conversion bed conflict before it became a breach would have identified the specific mechanism of the 2023 contempt order years earlier. See [reform: behavioral_health_capacity] and [reform: independent_inspector_general].