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Judge gives Washington mental hospitals more time to fix programs

A federal judge has extended the deadline for state mental hospitals to fix the system of evaluating and treating criminal defendants with suspected mental illnesses.

The extension until May 27, issued Monday by Judge Marsha Pechman in U.S. District Court for Western Washington, came with scathing criticism of the state Department of Social and Health Services’ progress on reducing wait times for defendants, especially at Eastern State Hospital.

As of December 2015, mentally ill defendants waited an average of 94 days to be admitted to the hospital for treatment to make them competent to stand trial – a significant increase over the average 21-day wait from December 2014.

Across the board, wait times at Eastern State are far longer than at Western State Hospital, where DSHS averaged 49 days for competency restoration in December.

“Because the Defendants have demonstrated that they are unable to achieve anything resembling compliance when left to determine their own timeframes and priorities, the Court now sets a series of interim deadlines for the completion of specific discrete actions on the path to provision of timely competency services,” the order says.

The case began with a class-action lawsuit filed in late 2014 by Disability Rights Washington and the American Civil Liberties Union. They argued current wait times violate defendants’ due process rights by keeping them in jail for weeks or months pending evaluation of their competency to stand trial and treatment at state hospitals to restore competency.

Pechman last April ordered DSHS to complete evaluations and admit defendants for treatment within seven days, and set a Jan. 2 deadline for compliance. DSHS petitioned for an extension three days before the deadline, arguing that enforcement actions taken by the Center for Medicare and Medicaid Services following a federal investigation of Western State Hospital last fall prevented them from meeting the targets.

Since the April ruling, DSHS has opened 15 new treatment beds at Eastern State and hired three new forensic evaluators for the hospital, said Carla Reyes, the assistant secretary for the Behavioral Health Administration, the branch of DSHS that oversees state hospitals, in a January interview. The agency has also made plans to open new beds in the spring at alternative facilities in Yakima and at the Maple Lane School near Rochester, Washington.

“I firmly believe we have done everything within our ability to deliver the beds and meet the court’s orders,” Reyes said.

DSHS has struggled to hire enough staff, particularly in Eastern Washington, to meet deadlines. Reyes also said wait times for competency restoration have increased in part because DSHS has made progress in evaluating defendants for suspected mental illness more quickly.

Delays in promptly evaluating and treating inmates have led to sanctions from a number of state judges, including more than $300,000 in fines issued by Spokane County Superior Court Judge Sam Cozza for delays in 25 criminal cases. Cozza said the county hopes to use that money to pay for mental health staff at the county jail, but that plan is still in its early stages.

Pechman orders DSHS to complete 10 specific tasks by May 27, including eliminating the backlog of people waiting for in-jail evaluations and producing a plan to triage people based on the severity of their mental illnesses and seriousness of crimes. Currently, DSHS conducts evaluations on a first-in, first-out basis, a system Pechman said is “treating class members more like boxes on a warehouse shelf than human beings in need of care.”

Possible penalties for not meeting the new deadlines aren’t spelled out in the judge’s order.

Kari Reardon, a Spokane County public defender who has represented many defendants waiting for competency evaluations and restoration, said in an email she was hopeful the extra oversight would improve wait times for Eastern Washington defendants.

“The mentally ill in our state are no less deserving of timely treatment and quality of care,” she wrote.