State v. Crawford

Panel: Meredith, Graeff, Beachley, JJ. * Graeff, J. ⁹⁰ In this appeal, the Maryland Department of Health ("the Department" or the "State"), appellant, challenges the order of the Circuit Court for Baltimore City finding it, and several of its officials, in constructive civil contempt. 1 The contempt findings were based on the failure to comply with court orders to admit the 11 appellees, individuals who had been charged with a crime, to a Department hospital. The court found that the Department and its officials violated: (1) orders to commit some of the appellees for inpatient competency evaluations; and (2) orders to commit appellees after a finding that they were not competent to stand trial. On appeal, the State presents the following questions for this Court's review, which we have modified slightly as follows: 1. Did the circuit court err in refusing to dismiss the show cause orders as moot because all appellees had been admitted to the Department facility before the court's contempt finding on August 24, 2017, and the entry of the court's corrected order on October 4, 2017? 2.

Did the circuit court err in finding the Department and five of its officials and employees in contempt when (a) all of defendants had been admitted to a Department facility before the finding of contempt; (b) the Department had no ability to comply with the commitment orders before the date of the defendants' admissions because it did not have available beds; (c) the Department did not act willfully; and (d) the orders were not sufficiently specific to support a contempt finding? 3. Did the circuit court err in imposing purging provisions that were unrelated to the underlying commitment orders and that would not have the effect of bringing the Department into compliance with those orders? ⁹¹ 4. Did the circuit court err in entering orders that violated Article 8 of the Maryland Declaration of Rights? 5. Did the circuit court err by questioning all the witnesses extensively as if the court were the prosecutor rather than a neutral decision maker?

For the reasons set forth below, we shall reverse the judgments of the circuit court. COMPETENCY TO STAND TRIAL Before addressing the specifics of the case, we will briefly address the procedures governing competency evaluations ⁵ and commitment orders. As the Court of Appeals recently explained: A criminal prosecution may not proceed against a defendant who is not competent to stand trial. For that reason, a defendant may not be continued in pretrial detention unless the government is taking steps to provide treatment to restore the defendant to competence or to have the defendant civilly committed.

Maryland law provides for a trial court to determine whether a defendant is competent, is dangerous to self or others, and, if competent, has the potential to be restored to competence. Powell v. Md. Dep't of Health , 455 Md. 520 , 527, 168 A.3d 857 (2017). A person is "not competent to stand trial" if he or she is unable "(1) to understand the nature or object of the proceeding; or (2) to assist in one's defense." Md. Code (2017 Supp.), § 3-101(f) of the Criminal Procedure Article ("CP"); State v. Dixon , 230 Md. App. 273 , 282, 146 A.3d 1223 (2016). When a defendant "appears ... to be incompetent," the court "shall determine, on evidence presented on the record," whether the defendant is "incompetent to stand trial" ("IST").

CP § 3-104. To aid in this determination, a court may "order the [Department] to examine the defendant," and it "shall set ... the conditions under which the examination is to be made." CP § 3-105(a). ⁹² A defendant may be "confined in a correctional facility until the [Department] can conduct the [competency] examination." CP § 3-105(c)(1). If, however, "the court finds that, because of the apparent severity of the mental disorder ..., a defendant in custody would be endangered by confinement in a correction facility," the court may order that the Department confine the defendant at a "medical facility that the [Department] designates as appropriate" or "immediately conduct a competency examination of the defendant by a community forensic screening program or other agency that the [Department] finds appropriate." CP § 3-105(2)(i). See Dixon , 230 Md. App. at 285 -87 , 146 A.3d 1223 (Where a court determines that a defendant needs to be confined in a psychiatric facility for his own safety pending a competency evaluation, it may order that the Department admit the defendant to such a facility.).

Accord Powell , 455 Md. at 529 , 168 A.3d 857 (A trial court is "charged with determining whether a defendant is in fact incompetent to stand trial and, if so, what to do about it."). CP § 3-106(b) governs the process for committing a defendant to a Department facility. It states, in pertinent part, as follows: (1) If, after a hearing, the court finds that the defendant is incompetent to stand trial and, because of mental retardation or a mental disorder, is a danger to self or the person or property of another, the court may order the defendant committed to the facility that the Health Department designates until the court finds that: (i) the defendant no longer is incompetent to stand trial; (ii) the defendant no longer is, because of mental retardation or a mental disorder, a danger to self or the person or property of others; or (iii) there is not a substantial likelihood that the defendant will become competent to stand trial in the foreseeable future. Thus, "the three criteria for commitment and retention of a criminal defendant in a psychiatric hospital under this provision ⁹³ can be understood as incompetence, dangerousness, and restorability." Powell , 455 Md. at 530 , 168 A.3d 857 . ⁶ Once a defendant is committed to a Department facility, the court is required to hold a hearing to determine whether the defendant continues to meet the criteria for commitment: (i) every year from the date of commitment; (ii) within 30 days after the filing of a motion by the State's Attorney or counsel for the defendant setting forth new facts or circumstances relevant to the determination; and (iii) within 30 days after receiving a report from the [Department] stating opinions, facts, or circumstances that have not been previously presented to the court and are relevant to the determination.

CP § 3-106(c). The Department is required to issue periodic reports on the condition of a defendant who has been committed. CP § 3-108. As the Court of Appeals has explained, Maryland has several psychiatric hospitals.

Powell , 455 Md. at 532 , 168 A.3d 857 ; Md. Code (2017 Supp.), § 10-406 of the Health General Article ("HG"). Four of the hospitals are regional hospitals. Id. 2 Persons charged with serious crimes "generally are committed to Clifton T. Perkins Hospital Center ("Perkins"), regardless of the location of the court that ordered the commitment." Id. With this background in mind, we turn to the specific facts and issues presented in this case. ⁹⁴ FACTUAL AND PROCEDURAL BACKGROUND The contempt findings at issue here were based on orders relating to each of the 11 appellees.

The circuit court ordered that appellees be committed to the Department: (1) for a competency evaluation; or (2) based on a finding that the defendant was IST and dangerous to self or another. 3 We summarize below the orders for each appellee. I. Individual Commitment Orders Siyyaha Crawford was charged with first degree arson, second degree malicious burning, and second degree assault. On April 5, 2017, the court, finding good cause to believe that Mr. Crawford might be IST, ordered him committed to the Department for a competency examination, providing that he be confined at the Department of Public Safety and Correctional ⁷ Services ("DPSCS"), and be seen by the Circuit Court Medical Office ("CCMO"). 4 On April 19, 2017, based on the preliminary report it received, the court ordered that the commitment to the Department be continued, and based on a finding that Mr. Crawford would be endangered by confinement in a correctional facility, it ordered that DPSCS transport ⁹⁵ Mr. Crawford to a facility of the Department's choice on April 24, 2017, for an inpatient competency evaluation. On April 26, 2017, the court issued an order stating that, because Mr. Crawford had been found incompetent to stand trial ("IST") and dangerous, he be committed to the Department for confinement until he was no longer IST. 5 It further ordered that, "upon receipt of the order," DPSCS transport Mr. Crawford immediately to Perkins or "such other facility" designated by the Department.

Mr. Crawford was not admitted to a Department hospital until June 29, 2017. Walter Randle was charged with robbery with a dangerous weapon, wearing and carrying a dangerous weapon, robbery, and theft. On May 24, 2017, the circuit court found Mr. Randle to be IST and a danger. The court ordered that Mr. Randle be committed to the Department, and that, upon receipt of the order, DPSCS transport him immediately to Perkins or another facility the Department designated.

He was not admitted until June 28, 2017. 6 Corey Carroll was charged with attempted murder and related offenses. On May 10, 2017, the circuit court ordered that the CCMO conduct a competency evaluation of Mr. Carroll. On May 24, 2017, based on the report of the CCMO, the court ordered that the Department conduct an extended, inpatient competency evaluation of Mr. Carroll at Perkins or "such other facility" designated by the Department. It further ordered that DPSCS "shall immediately transport" Mr. Carroll to Perkins.

The Department failed to admit Mr. Carroll, and on May 31, 2017, the court issued an order stating that, because Mr. Carroll had been found IST and dangerous, he be ⁹⁶ committed to the Department for confinement until he was no longer IST. It further ordered that, "upon receipt of the order," DPSCS transport Mr. Carroll immediately to Perkins. He was not admitted until July 24, 2017. Ronald Merriken was charged with robbery, second degree assault, and theft.

On May 31, 2017, the court found Mr. Merriken to be IST and dangerous and committed him to the Department. It ordered DPSCS, on receipt of the order, to transport Mr. Merriken immediately to Spring Grove. He was not admitted until August 2, 2017. Brian Johns was charged with second degree murder and related offenses.

On May 3, 2017, the court found good cause to believe that Mr. Johns may be IST, ordered ⁸ him committed to the Department for a competency examination, and provided that he be confined at DPSCS and seen by CCMO. On May 17, 2017, based on the preliminary report it received, the court ordered that the commitment to the Department be continued and the Department commit Mr. Johns to a facility of its choice on May 22, 2017, for an inpatient competency evaluation. On May 31, 2017, the court issued an order stating that, because Mr. Johns had been found IST and dangerous, he be committed to the Department for confinement until he was no longer IST. It further ordered that, "upon receipt of the order," DPSCS transport Mr. Johns immediately to Perkins or "such other facility" designated by the Department.

Mr. Johns was not admitted to a psychiatric facility until July 5, 2017. Darnell Hines was charged with child abuse, second degree assault, and reckless endangerment. On May 10, 2017, the court found good cause to believe Mr. Hines may be IST, and it ordered that he be confined at Baltimore County Detention Center ("BCDC") and that the BCDC transport him to the Department for a competency examination. On May 31, 2017, the court issued an order stating that, because Mr. Hines had been found IST and dangerous, he be committed to the Department for confinement until he was no longer IST.

It further ordered that, "upon receipt of the order," DPSCS ⁹⁷ transport Mr. Hines immediately to Spring Grove or "such other facility" designated by the Department. Mr. Hines was not admitted until July 30, 2017. Lamont Knight was charged with assault, reckless endangerment, and wearing and carrying a dangerous weapon. On May 24, 2017, the circuit court ordered that the CCMO conduct an initial competency evaluation of Mr. Knight.

On May 31, 2017, the circuit court found him IST, committed him to the Department, and ordered that DPSCS, upon receipt of the order, transport him to Spring Grove or "such other facility" designated by the Department. He was not admitted until July 30, 2017. Tony Wardlow was charged with robbery with a dangerous weapon, assault, and related offenses. On May 25, 2017, the court found good cause to believe Mr. Wardlow might be IST, and it ordered him committed to the Department for a competency examination, providing that he be confined at DPSCS and seen by CCMO. 7 On June 7, 2017, based on the preliminary report it received, the court ordered that the commitment to the Department be continued, and that DPSCS transport Mr. Wardlow immediately to Perkins on June 12, 2017, for an inpatient competency evaluation.

On June 21, 2017, the court issued an order stating that, because Mr. Wardlow had been found IST and dangerous, he be committed to the Department for confinement until he was no longer IST or a danger to self or others. It further ordered that, upon receipt of the order, DPSCS transport Mr. Wardlow immediately to Perkins or "such other facility" designated by the Department. He was not admitted to Perkins until July 21, 2017. ⁹⁸ Ronald Meddings, on May 31, 2017, was charged with first and second degree assault. On June 7, the District Court for Baltimore City ordered that Mr. Meddings be evaluated by CCMO.

On June 15, the District Court ordered that Mr. Meddings ⁹ undergo an inpatient competency evaluation at a Department facility. On June 21, 2017, Mr. Meddings was indicted in the Circuit Court for Baltimore City for offenses that included first and second degree attempted murder. On June 28, 2017, the circuit court issued an order stating that, because Mr. Meddings had been found IST and dangerous, he be committed to the Department for confinement until he was no longer IST and dangerous. It further ordered that, upon receipt of the order, DPSCS transport Mr. Meddings immediately to Perkins or "such other facility" designated by the Department.

On July 1, 2017, he was admitted to Bon Secours hospital. On July 18, 2017, after discharge from Bon Secours Hospital, Mr. Meddings was admitted to Spring Grove, and on August 7, 2017, he was transferred to Perkins. Zionnes Spencer was charged with armed carjacking and related offenses. On July 12, 2017, after the court ordered a competency evaluation and the CCMO requested an evaluation at Perkins, the court ordered that Mr. Spencer's commitment to the Department be extended and DPSCS transport him to Perkins on July 17, 2017, for an inpatient competency evaluation.

Mr. Spencer was not admitted until August 4, 2017. Santee Taylor was charged with attempted murder and related offenses. On July 12, 2017, after the CCMO requested an evaluation at Perkins, the court ordered that Mr. Taylor's commitment to the Department be extended and that DPSCS transport Mr. Taylor to Perkins on July 17, 2017, for a competency evaluation. Mr. Taylor was not admitted until August 8, 2017.

II

Show Cause Orders In June 2017, nine of the appellees who had been found IST and committed to the Department for confinement filed a ⁹⁹ petition requesting that the court issue orders to the Department and its officials to show cause why they should not be found in constructive civil contempt for failing to comply with the court's orders that they be transported and admitted to a hospital. 8 The court granted the petitions in a series of show cause orders that it issued in June and July 2017. The initial show cause orders, signed on June 7-8 and July 6, 2017, ordered the Department to answer the petitions. 9 On July 12, 2017, the court issued additional show cause orders in these cases. Six of the show cause orders directed Dennis R. Schrader, Secretary of the Department; Barbara J. Bazron, Ph.D, Deputy Secretary of the Department; Erik Roskes, M.D., Director of Office of Forensic Services, Behavioral Health Administration ("BHA"); Kim Bright, M.D., Clinical Director, BHA; Inna Taller, M.D., Clinical Director, Perkins; Danielle Robinson, M.D., Clinical Director, Pretrial Services, Perkins, to show cause why they should not be held in contempt for failure to comply with commitment orders relating to appellees Crawford, Carroll, Randle, Wardlow, Meddings, and Johns. 10 Three of ¹⁰ the show cause orders directed Secretary Schrader; Deputy Secretary Bazron; Dr. Roskes; Dr. Bright; Elizabeth Tomar, M.D., Clinical Director, Spring Grove; and Bevin Merles, Ph.D., Forensic Office, Spring Grove, to show cause why they should not be held in contempt ¹⁰⁰ for failure to comply with commitment orders relating to appellees Hines, Knight, and Merriken. On July 25, 2017, the circuit court issued two more show cause orders, directing Secretary Schrader, Deputy Secretary Bazron, Dr. Roskes, Dr. Bright, Dr. Taller, and Dr. Robinson, to show cause why they should not be held in contempt for failing to comply with an order for commitment for evaluation as to competency to stand trial relating to appellees Spencer and Taylor.

In response, the State argued that the show cause orders should be dismissed. In support, it asserted that, at the time of the response, the appellees had been committed to a psychiatric hospital, and therefore, the issue was moot, or alternatively, any contempt had been purged. Additionally, the State argued that: (1) the Department could not be found in contempt because there were no beds available at the state health facilities at the time the orders were issued, and therefore, it lacked the ability to comply with the orders; (2) the Department did not willfully violate the court orders; and (3) the show cause orders were "not sufficiently specific to support a contempt finding." The State subsequently filed an addendum response. It asserted that "a court's contempt power may not be used to require compliance with an unenforceable order," and the commitment order requiring the Department to admit an individual "immediately" was not within the authority of the court, and therefore, it was unenforceable.

The State further argued that "at the hearing on the show cause orders, evidence must be limited to the circumstances of the specific defendants, and not be permitted to encompass the administration of the State's mental health services, including the State hospitals." III. Show Cause Hearings The court held a hearing on the show cause orders during the course of nine days between July 25 and September 28, ¹⁰¹ 2017. During those hearings, several witnesses testified regarding: (1) the facilities at Perkins; (2) the facilities at Spring Grove; (3) the Department's competency evaluation policy; (4) the Department's admissions policy; and (5) the actions the Department had taken to attempt to solve capacity issues it had experienced at the hospitals. 11 We will briefly summarize the testimony elicited. A. Perkins Perkins is a maximum-security hospital reserved for patients who have committed ¹¹ violent felonies.

At the time of the July 25, 2017, hearing date, it had a budget for 250 beds, but it had 260 patients, "10 over census." 12 The hospital contained two maximum security admissions units: One West and Three South. One West had approximately 19 beds to house male patients, and Three South had 22 beds to house female patients. Another unit, One East, had approximately 26 beds. Dr. Lawrence Brown testified that the medical unit had 26 beds, and Dr. Taller testified that it had 28.

It was reserved for male patients, and occasionally, it was used as an admissions unit for medically compromised patients. There were two medium security units for males, one with 24 beds and the other with 29. There also were two ¹⁰² minimum security units in the North Wing, each with approximately 20 beds. On April 10, 2017, Perkins opened a 20-bed "step-down unit" that was staffed for 12 patients who were "on the cusp of discharge," i.e., waiting for community placement or court approval for conditional release. 13 Five patients had been discharged from the unit since its opening and three were nearing discharge. 14 John Robison, the CEO of Perkins, testified that he considered filling the remainder of the eight beds with medium-security patients, which he considered a "less risky" option than opening a new admissions unit.

The creation of the step-down unit had no direct effect on the admission of new patients. It took "four steps" for the addition of beds at the step-down unit to affect the discharge of people in the maximum security unit: (1) someone from a minimum security unit is moved to the step-down unit; (2) someone from medium security unit is moved to a minimum security unit; (3) someone from a maximum security unit is moved to a medium security unit; and (4) a court-committed defendant takes the bed of the person leaving the maximum security unit. There was another unit at Three North, but it was vacant. It previously had been under the control of the Developmental Disability Administration until it left the facility in November 2016.

Mr. Robison testified that the unit was undergoing renovations, and he anticipated it would be furnished in September 2017, housing medium security patients. Although there had not been discussion about changing this unit into an admissions unit, Mr. Robison testified that the opening of the unit would allow Perkins staff to use an existing medium-security unit as an admissions unit. ¹⁰³ B. Spring Grove At the time of the hearing, Spring Grove housed approximately 342 patients, 80% of whom were forensic. 15 Patients who were medically unstable or required more medical monitoring usually were sent to Spring Grove, which was better equipped to handle ¹² those cases. The hospital had a large geriatric population. There were four admissions units at the hospital.

Three had approximately 25 beds, and one, which was reserved for female patients, had approximately 10 beds. There were four long-term care units at Spring Grove, which each housed between 31-41 patients on a given day. Dr. Tomar testified that the hospital was understaffed. Andrea Braid, the CEO of Spring Grove, testified that, in 2016, the hospital spent $5 million in overtime.

She explained that the staffing at Spring Grove was at its "minimum," and there were 40 vacancies, due to budgetary reductions across the board. 16 Ms. Braid attributed staffing problems to the low salaries offered at Spring Grove and the security risks at the hospital. On May 31, 2017, the date that the court issued orders to admit Mr. Merriken, Mr. Knight, and Mr. Hines, there were 30 people on the waitlist at Spring Grove. 17 ¹⁰⁴ C. Competency Evaluation Policy The Department presented evidence that it had implemented procedures for conducting competency evaluations, which varied based on the severity of the crime with which a defendant was charged and whether the District Court or a circuit court ordered the evaluation. When the issue of a defendant's competency has been raised, a District Court or circuit court judge typically will order that a community evaluator, i.e., CCMO, render an opinion on the issue. In the case of a defendant charged with a Perkins level offense, a serious charge, the CCMO can find that the defendant is competent, but it is the Department's policy that CCMO cannot find someone IST.

For defendants who have committed "Spring Grove level" offenses, whether community evaluators can make definitive evaluations of incompetency depends on the court that ordered the competency evaluation. If the District Court ordered the evaluation, the community evaluator can make a definitive finding as to the competency of a defendant, but if the evaluator believes the defendant is incompetent, he or she does not make such a finding but requests further evaluation at Spring Grove. If the circuit court orders an evaluation, however, the community evaluator can state his or her finding that the defendant is competent or incompetent. Dr. Roskes stated that the rationale for not allowing CCMO to make a finding of incompetency in a Perkins-level offense is to maintain flexibility because a bed at Perkins is a "very valuable and limited resource." Given the limited number of beds, the Department needed to make the "clinical judgments about who requires admission and who doesn't." Dr. Roskes further explained that Perkins level cases generally are more complicated, and the evaluation often takes more time.

D. Admissions Policy Perkins and Spring Grove can admit patients only when there are available beds. Lawrence Brown, the admissions ¹⁰⁵ coordinator at Perkins, testified that he ¹³ received the transportation orders by email, within one to two days. If Perkins does not have a bed, he contacts the detention center and the court to so advise. 18 In response to a question whether the Department was required to admit someone upon receipt of a court order, Dr. Robinson responded: "Yes, if we're able to." 19 The Department prioritizes admissions based on bed and staffing availability. It considers the patient's legal status and clinical acuity, as follows: 1.

First priority : Conditionally released patients referred voluntarily or pursuant to a hospital warrant [ Criminal Procedure § 3-121(e)(1) ]. 2. Second priority : Patients committed as incompetent to stand trial and dangerous (ISTD) due to mental disorder or mental retardation [ Crim Proc § 3-106(b) ] or as not criminally responsible [ Crim Proc § 3-112 ], including pretrial released patients referred pursuant to a retake warrant. 3. Third priority : Patients certified for admission from jail; mandatory releases from DPSCS. 4. Fourth priority : Patients referred to the Department for evaluation as to their competency to stand trial ( Criminal Procedure § 3-105 ), criminal responsibility ( Criminal Procedure § 3-111 ), or a juvenile court order for evaluation and/or disposition ( Courts and Judicial Proceedings § 3-816, § 3-819, § 3-8A-17, § 3-8A-17.2, § 3-8A-19, Maryland Rule 11-115). 5.

Fifth Priority : Patients without court involvement who are referred for transfer from another state psychiatric hospital, a DDA facility, or a community/general hospital. ¹⁰⁶ Dr. Roskes testified that the priorities attempt to get the "sickest folks" and "the most legally urgent" people in first. Although patients generally are admitted when they become current on the waitlist, they can move to the top of the list if they are granted a clinical override. Clinicians at each regional hospital are charged with determining whether an override is warranted. 20 In determining whether an override is appropriate, psychiatrists look at several factors, including whether a patient: (1) is eating or drinking; (2) has engaged in physical altercations; (3) is able to follow directions; (4) is taking their medications; (5) is having significant medical problems; and (6) can be safely managed. The main criterion for deciding whether to grant a clinical override is whether the patient is a danger to themselves.

The mere fact that a patient may be psychotic is not enough to justify the clinical override. Between May 1 and July 25, 2017, there were approximately three to five patients who "jumped" the waitlist due to their clinical acuity and were admitted promptly for treatment. Once a patient has been admitted, he or she can be transferred to a residential unit for longer-term care. There needs to be an available bed in the residential unit, however, ¹⁴ and there often are difficulties discharging people from a residential bed due to court delays in their cases and treatment placement for patients.

E. Actions Taken to Solve Capacity Issues The Department detailed steps it had taken to reduce the waitlists at its regional hospitals. In addition to creating the step-down unit at Perkins, the Department had contacted other hospitals and programs to open up beds, and it had plans to renovate a unit at Eastern Shore Hospital to accommodate ¹⁰⁷ 24 additional patients. Dr. Bazron testified that the unit was expected to be opened "180 days" from August 15, 2017. The Department also was making efforts to create a data system for the entire behavioral health system.

Dr. Roskes testified that the waitlists were "chaotic," in part, because there was no centralized database for monitoring bed availability across hospitals. He testified that, under the system in place at the time, court orders often were ranked based on which judge "yelled the loudest." IV. Contempt Orders On August 24, 2017, the court issued an oral ruling from the bench. The court acknowledged that, at that point, after the issuance of the show cause orders, all of the appellees had been admitted to the hospital.

The court stated, however, that the Department had adopted policies "limit[ing] the numbers of beds available for the admission of court-ordered individuals," and that the problem was "likely to reoccur." It found that the Department had "willfully and intentionally violated the Court's order," and it was "highly likely [it would] continue to do so." Rather than issue a final judgment of contempt, however, it postponed the case for at least 30 days, at which time it would hear from the Department on efforts to address the problem of admissions. The court then heard testimony regarding "the show causes against the individuals." On October 4, 2017, the court issued a Corrected Order of Constructive Civil Contempt: Findings With Purge Provisions. 21 The court found that the Department and five of its individual officers "willfully, intentionally, and voluntarily violated" the court's orders. In so finding, the court stated that each of the court's orders, for inpatient competency evaluation ¹⁰⁸ or to commit based on a finding of IST, "dictated a date for admission," and "[a]ll admissions were after the dates ordered by the court" and all of the appellees "were held in pre-trial status in correctional facilities." The court devoted 12 pages to a discussion of the crisis in admissions at Maryland's psychiatric hospitals, and it detailed the policies and practices of the Department that the court believed contributed to the continued waitlist for beds. 22 In finding the Department in contempt, the court found that, although there may have been no available bed for any of the appellees "at the time the show cause orders ¹⁵ were issued and the contempt hearings commenced, the lack of beds is directly attributable to the actions, inactions, and omissions of the Department." In particular, the court noted that, instead of opening a new 20-bed admission unit at Perkins, as recommended and promised, Dr. Bazron decided to open a step-down unit, which was less costly but did not "solve the problem of admission delays." The court found that the "Department's conduct in failing to solve the problem of admissions delay [was] driven by budgetary concerns." It stated that the delay in competency evaluation or commitment deprived appellees, pretrial detainees who had not been convicted of a crime, of their liberty interest in " 'freedom from incarceration and [also] in restorative treatment.' " (quoting Oregon Advocacy Ctr. v. Mink , 322 F.3d 1101 , 1121 (9th Cir. 2003) ). The court then ordered the Department and its officials to take remedial actions, stating that it issued purge provisions "intended to eliminate the unjustifiable delay in admissions of defendants to the Department's hospitals." These purge provisions ¹⁰⁹ provided, among other things, that the Department and Secretary Schrader take the following actions: 1.

"[F]ully staff and admit patients to the [20]-bed unit opened at [Perkins] on April 10, 2017, with a patient mix to be determined by the CEO"; 2. By December 31, 2017, open and staff a "new" 20-bed admissions unit at Perkins; 3. By December 31, 2017, open and staff a "new" 20-bed admissions unit at Spring Grove; and 4. Obey all commitment orders issued by the court "by admitting defendants committed to Department facilities in accordance with the terms of the [court orders], including the dates of admission." This appeal followed.

On December 6, 2017, the court granted the State's motion to stay execution of the Corrected Order pending the resolution of the matter on appeal. DISCUSSION The State asserts multiple grounds of error by the circuit court in finding the Department and its officials in constructive civil contempt. Before addressing these specific claims, we will discuss generally the law regarding contempt. In Bradford v. State , 199 Md. App. 175 , 193, 21 A.3d 123 (2011), this Court explained that "the universe of contempt proceedings is divided into four quadrants: direct and constructive contempt; and criminal and civil contempt." Direct contempt occurs when the contempt is "committed in the presence of the judge presiding in court or so near to the judge as to interrupt the court's proceedings." Rule 15-202(b).

Direct contempts may be summarily punished to protect the orderly administration of justice and vindicate the dignity of the court. Smith v. State , 382 Md. 329 , 338, 855 A.2d 339 (2004) ; Espinosa v. State , 198 Md. App. 354 , 387, 17 A.3d 754 (2011). " 'Constructive contempt' means any contempt other than a direct contempt." Rule 15-202(a). In constructive contempt ¹¹⁰ proceedings, the accused contemnor must have "an opportunity to challenge the alleged contempt and show cause why a finding of contempt should not be entered." Fisher v. McCrary Crescent City, LLC , 186 Md. App. 86 , 119, 972 A.2d 954 (2009), cert. denied , 562 U.S. 1060 , 131 S.Ct. 637 , 178 L.Ed.2d 476 (2010).

Civil contempt proceedings are "intended to preserve and enforce the ¹⁶ rights of private parties to a suit and to compel obedience" with court orders and decrees. Dodson v. Dodson , 380 Md. 438 , 448, 845 A.2d 1194 (2004) (quoting State v. Roll and Scholl , 267 Md. 714 , 728, 298 A.2d 867 (1973) ). "Civil contempt 'proceedings are generally remedial in nature and are intended to coerce future compliance.' " Royal Inv. Group, LLC v. Wang , 183 Md. App. 406 , 447, 961 A.2d 665 (2008) (quoting Roll , 267 Md. at 728 , 298 A.2d 867 ), cert. granted , 408 Md. 149 , 968 A.2d 1064 (2009), appeal dismissed , 409 Md. 413 , 975 A.2d 875 (2009).

Regardless of the penalty imposed in a civil contempt action, it "must provide for purging." Dodson , 380 Md. at 448 , 845 A.2d 1194 . A purge provision offers the party "the opportunity to exonerate him or herself, that is, 'to rid him or herself of guilt and thus clear himself of the charge.' " Jones v. State , 351 Md. 264 , 281, 718 A.2d 222 (1998) (quoting Lynch v. Lynch , 342 Md. 509 , 520, 677 A.2d 584 (1996) ). Criminal contempt proceedings, in contrast, are intended to " 'punish for past misconduct, which may no longer be capable of remedy.' " Bradford , 199 Md. App. at 193 , 21 A.3d 123 (quoting Arrington v. Dep't of Human Res. , 402 Md. 79 , 93, 935 A.2d 432 (2007). The sanctions in these proceedings are "punitive in nature," and therefore, they do not require a purging provision.

Id. at 194 , 21 A.3d 123 (quoting Arrington , 402 Md at 83 , 935 A.2d 432 ). Unlike civil contempt, which generally must be proved by a preponderance of the evidence, the burden of proof in criminal contempt proceedings is beyond a reasonable doubt. 23 ¹¹¹ Gertz v. Md. Dep't of Env't , 199 Md. App. 413 , 423, 23 A.3d 236 , cert. denied , 423 Md. 451 , 31 A.3d 919 (2011). Additionally, as this Court has explained, "Before a party may be held in contempt of a court order, the order must be sufficiently definite, certain, and specific in its terms so that the party may understand precisely what conduct the order requires." Droney v. Droney , 102 Md. App. 672 , 684, 651 A.2d 415 (1995). Moreover, "one may not be held in contempt of a court order unless the failure to comply with the court order was or is willful." Dodson , 380 Md. at 452 , 845 A.2d 1194 .

Royal , 183 Md. App. at 447 -48 , 961 A.2d 665 . "[A] negligent failure to comply with a court order is simply not contemptuous in a legal sense." Dodson , 380 Md. at 452 , 845 A.2d 1194 . The decision to hold a party in contempt is vested in the trial court, and this Court generally will reverse such a decision only " 'upon a showing that a finding of fact upon which the contempt was imposed was clearly erroneous or that the court abused its discretion.' " Gertz , 199 Md. App. at 424 , 23 A.3d 236 (quoting Royal , 183 Md. App. at 448 , 961 A.2d 665 ). Where, however, "the order involves an interpretation and application of statutory and case law, we must determine whether the circuit court's conclusions are 'legally correct' under a de novo standard of review." Kowalczyk v. Bresler , 231 Md. App. 203 , 209, 149 A.3d 1247 (2016).

With this background in mind, we turn to the State's contentions of error. ¹⁷ I. Mootness The State initially contends that the circuit court erred in "refusing to dismiss the show cause orders as moot." ¹¹² It notes that, prior to the first contempt finding on August 24, 2017, and two months before the court issued the Corrected Order, appellees had "obtained the entirety of the relief they sought in the circuit court-admission to a Department hospital." 24 The State argues, therefore, that at the time of the contempt finding, "there was no longer a controversy before the circuit court regarding the Department's alleged failure to comply with the circuit court's orders, and there was no remedy that the circuit court could grant the individual defendants who were the subject of the underlying commitment orders." Accordingly, it contends that the court should have dismissed the proceedings as moot. Appellees argue that the show cause orders were not moot because,