Federal Court holds that independent contractor performing involuntary commitment determination is engaged in a public function

Timothy Carl sued Muskegon County and Katherine Jawor, a CMH-contracted physician, after Jawor allegedly performed a negligent assessment and denied Carl treatment while incarcerated.  Carl had been arrested for vulnerable adult abuse, while employed as an in-home healthcare provider, after he urinated on one patient and attempted to dispense liquid soap on another.  Needless to say, Carl's behavior was consistent with his previous history of mental illness:  CMH employees who interviewed him in jail described him as "floridly psychotic," suicidal, and requiring treatment, in part because his current medications were "ineffective."  They judged him to be "paranoid" and in need of "intensive psychiatric treatment."

Dr. Jawor was consulted and concluded that Carl did not require institutionalized psychotic care, as he did not represent a danger to himself or others.  On that basis, he remained in jail without intensive treatment.  He later sued the jail and Jawor, arguing that through state action he had been denied needed medical care in violation of the U.S. Constitution and federal statute 42 USC, section 1983.

The trial judge ruled that Dr. Jawor was not a "state actor" in performing the mental health assessment that denied him in-patient psychiatric care and left him in jail.  The Court of Appeals reversed.  It pointed to longstanding precedent holding that a state may not avoid its legal obligations by delegating them to private actors.  Since the state owed Carl a duty to provided adequate medical care while jailed, it could not evade its responsibility by suggesting that Jawor acted in a private capacity when she assisted the County in evaluating Carl's needs.  She was clearly a "state actor" under the law, and therefore the case was remanded for a determination of whether Carl's civil rights were violated.