Judge questions state’s efforts on competency services case

SEATTLE  — A federal judge on Monday questioned Washington state’s efforts to comply with her order requiring it to provide timely competency services to mentally ill defendants who have been forced to wait in jails for weeks or months.

“The bottom line is since last April I don’t see any change in the criteria you’re applying” when deciding who should receive competency evaluations, U.S. District Judge Marsha Pechman told Dr. Randall Strandquist, director of psychology at Eastern State Hospital, one of the state’s two forensic facilities.

Although Strandquist said he was optimistic about his hospital’s efforts to dramatically cut down on the amount of time the defendants must wait to receive competency evaluations, Pechman said people have died while waiting for services and the state’s efforts are questionable.

“I let you run for nine months and hoped you would come up with a plan,” Pechman told the agency representatives who attended the hearing. “To say I’m disappointed would be an understatement.”

At the end of the day-long hearing, Pechman struggled to come up with an appropriate order that would ensure that the state provides timely competency services. She said she could hold the state in contempt and issue a fine, or order the agency to follow a new timeline with strict rules and more aggressive oversight.

“Or jailing Mr. Quigley?” she asked, referring to Washington Department of Social and Health Services Secretary Kevin Quigley, who announced his resignation in early January but is still on the job until a replacement is named.

Pechman said she would issue a written ruling in about 10 days.

Under current state law, when a judge orders a competency evaluation for a defendant, the state has 14 days to complete the process. If the person is found incompetent to stand trial, the state has 14 days to provide treatment to restore competency. But a lack of bed space and staff has caused these defendants to wait weeks or months for the services.

Disability Rights Washington filed a lawsuit against the state in 2014 saying that forcing mentally ill people to wait in jails for extended periods violates their constitutional rights.

Pechman agreed and in April 2015 she ordered the state to provide competency services within seven days of a judge’s order. She gave the state until Jan. 2, 2016 to comply with the injunction.

But the Washington Department of Social and Health Services hasn’t been able to secure enough beds at its psychiatric hospitals to provide timely services and on Dec. 30 filed a motion asking for an extension.

Carla Reyes, assistant secretary of the Department of Social and Health Services’ behavioral health division, told the judge an inability to hire enough staff has hurt efforts to comply with the January deadline. The efforts were further thwarted when the Centers for Medicare and Medicaid Services threatened to cut federal funds over safety concerns at Western State Hospital.

The state is working to fix the problems to satisfy the federal authorities and hope to be able to comply with the judge’s order by May 27, Reyes said.

But Emily Cooper, a lawyer with the rights group, said the state has had plenty of time to make the changes needed.

The average number of days people had to wait to have an evaluation at Eastern State Hospital was 41 days in March 2015 and now stands at 86 days, according to the monitor’s latest quarterly report. At Western State Hospital, the average wait time for evaluations went down over the past year, but the wait times for restoration treatment increased from 29 days to 36, the monitor said.

Pechman questioned why the state waited until two days before the compliance deadline to ask for an extension. She also wanted to know how many times the state agency has been held in contempt by the judges who issued the competency rulings.

An Associated Press investigation in September found that state judges had issued more than $700,000 in fines against the state for failing to provide timely competency services.

Pechman pressed Strandquist about why he insists on only using psychologists to conduct evaluations, since they have struggled to fill those positions. She also questioned why he refused to conduct early reviews of the cases to decide quickly if some needed treatment and others could go back into the criminal justice system.

“I don’t understand why you’re not working on the front end to cut the pipeline in half,” she said.