Senate approves urgently-needed reforms to competency restoration system
Today, the Senate approved legislation requested by Gov. Jay Inslee that would spur urgent reforms to the state’s competency restoration system.
The issue has attracted attention because surging demand over the past several years has created long delays in defendants’ access to competency services. Many defendants wait in jail, or judges may dismiss the charges or release the defendant to wait in the community. Sometimes the defendant has no plan for housing, care or treatment.
SB 5440, sponsored by Sen. Manka Dhingra, does several things to expand pathways to meaningful treatment options, particularly for low-level, misdemeanor offenders.
· Many defendants awaiting inpatient competency services in jail are charged with misdemeanor charges — currently about 14 percent. SB 5440 creates a diversion program that uses forensic navigators to connect more misdemeanor defendants to diversion programs before a referral for competency services is made. The bill also encourages alternatives such as outpatient competency restoration and civil commitment. This would better allow hospital beds and inpatient services to be used for higher level offenders.
· People with dementia or a developmental or intellectual disability diagnosis are better served outside of the criminal legal system. This bill creates a program to divert these individuals into appropriate care and treatment instead of the criminal justice system. These people currently account for about 13 percent of people in jail awaiting competency services.
· The bill includes provisions to better ensure defendants receive proper medication as they move between state facilities and jails. It creates a “clinical intervention specialist” program to help more defendants receive enhanced behavioral health treatment support and oversight from the state while they wait in jail for competency services.
“We’re at a situation where we need every idea on the table,” Dhingra said from the Senate floor. “We need every city, county and the state working together to see how we can alleviate this wait list. We all recognize that we do have options coming online soon… in the interim we have to make sure to do all we can to make provide appropriate levels of treatment for the individuals who are dealing with competency evaluation and restoration services.”
“This is a meaningful step forward, and I appreciate the engagement of the legislators and stakeholders who have been working with my office on this bill,” Inslee said. “This is a complicated issue, and there are no easy, fast solutions. That’s why collaboration is so important, and why I’m hopeful we can come to agreement on these next steps.”
The state has invested more than $2 billion since 2015 to create hundreds of new forensic beds and programs for competency services, but the surge in judges and prosecutors calling for competency services has reached an unmanageable and unsustainable level.
In his State of the State address in January, Inslee talked about the hundreds of additional beds being created to evaluate and restore defendants, but noted that adding capacity will take time. He also cautioned that, even after adding hundreds of additional forensic beds, reforms are necessary.
“Even with all these investments, this exponential growth in court orders and referrals is not manageable or sustainable,” Inslee said. “Nor is our criminal justice system an effective way to connect people to the treatment they need. We should be prioritizing diversion and community-based treatment options rather than using the criminal justice system as an avenue to mental health care, particularly because competency services only treat people to be well enough for prosecution.”
“This has been a frustrating point of contention for families, lawyers, judges, patients, advocates, providers and for me,” he continued. “We must find a better way. Lawsuits and lawyers will not fix this. I will ask local leaders to join me in crafting a better plan, both for defendants’ mental health and for public safety.”
Competency services are different from what many people think of as mental or behavioral health care. Competency services do not treat all of a person’s symptoms, they simply ensure a person is competent to stand trial. Competency services begin with an evaluation to determine if a person is competent to stand trial. If a person is deemed not competent, they are admitted to a state facility to receive restoration services.
A 2015 court case known as Trueblood v. DSHS established constitutional timelines for the state to provide in-jail evaluation services within 14 days, or admission for evaluation at a state hospital within seven days. About 90 percent of evaluations take place in the jail. For defendants who are deemed to need restoration services, the court ordered the state to admit individuals to an inpatient program within seven days.
In 2018, the federal court signed off on a settlement agreement that not only calls for continued new beds, but also for expanded diversion opportunities, mobile crisis services, crisis stabilization, and a new forensic navigator program like the one included in Inslee’s request legislation.
Since 2016, the state has created nearly 200 new forensic beds with plans underway to create another 550 beds. This includes a new 350-bed forensic hospital, slated to begin construction later this year. In 2018, Inslee launched a behavioral health transformation plan that will dedicate the state’s two large hospitals — Western State Hospital and Eastern State Hospital — to forensic services and civil commitments.