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September 29, 2026 · Sacramento, CA

The ACLU announced that the court terminated oversight of Stiavetti v. Clendenin on September 21, 2026, finding the Department of State Hospitals in substantial compliance with the 28-day admission order, 11 years after the suit was filed.

September 16, 2026 · Tallahassee, FL

Disability Rights Florida and partners say average transfers take 124 days versus a 15-day legal limit, with at least three deaths documented among those waiting.

August 23, 2026 · San Antonio, TX

The judge found Bexar County defendants averaging 196 to 229 days in jail, longer than the maximum sentence for some underlying misdemeanors.

August 11, 2026 · Austin, TX

State officials argued the 21-day admission deadline is unworkable given current hospital bed capacity.

August 6, 2026 · Virginia Beach, VA

The Virginia Beach Sheriff's Office is starting a jail-based competency restoration program funded by a state grant, aiming to shorten waits for evaluation and ease pressure on state psychiatric hospitals such as Eastern State.

July 20, 2026 · Decatur, GA

The $409 million, 300-bed forensic hospital comes after more than 700 people accumulated on the waitlist for court-ordered evaluation or treatment.

July 15, 2026 · Annapolis, MD

In a 4-3 decision, the Supreme Court of Maryland held that circuit courts may impose monetary sanctions on the health department when it misses the 10-business-day deadline to admit defendants found incompetent and dangerous, and that doing so does not violate separation of powers.

July 9, 2026 · Austin, TX

The court found roughly 1,700 people waiting an average of six months, some over 500 days, and ordered the state to admit them within 21 days.

June 30, 2026 · Sacramento, CA

AB 46 removed a restrictive standard that had limited judges' ability to grant diversion to felony defendants found incompetent.

June 11, 2026 · Albany, NY

Two bill pairs add mandatory periodic judicial review and create a workgroup studying outpatient restoration, aimed at hospitalizations costing counties over $1,300 a day per person.

May 15, 2026 · Lincoln, NE

Lancaster County jail officials say waits for Lincoln Regional Center beds have grown sharply, leaving cases frozen while defendants wait. The average wait in March 2026 was 76 days, up from 20 days a year earlier.

April 26, 2026 · Columbia, SC

A Post and Courier investigation reports that restoration treatment orders in South Carolina take about eight months to fill, the lone forensic hospital has had a 165-person waitlist, and legal experts warn the delays could invite a class-action suit.

April 13, 2026 · Richmond, VA

The audit found gaps in how custody legally transfers from law enforcement to hospital staff, and connected the issue to a 2023 death during a hospital transfer.

April 6, 2026 · Atlanta, GA

Facing threatened litigation, Georgia agreed to hit 30-day evaluation and admission benchmarks by 2029, with roughly 697 people waiting an average of 187 days.

March 25, 2026 · Montpelier, VT

Vermont's Senate Judiciary Committee backed S.193 by a 4-1 vote, advancing a forensic facility inside an existing prison for people deemed unfit for trial or legally insane who face potential life sentences. State officials estimate three to five defendants a year would qualify.

February 21, 2026 · Columbus, OH

SB 295 extends the maximum restoration commitment from one year to five years for the most serious violent offenses.

February 11, 2026 · Jefferson City, MO

With 524 people waiting for services and only 8 outpatient beds statewide, the governor proposed $6.1 million to expand capacity to 50 beds.

February 10, 2026 · Las Vegas, NV

The fine was one of 32 sanction orders at $500 a day for continued delays moving Clark County defendants to state facilities within 7 days.

February 2, 2026 · Montpelier, VT

Vermont may be the only state with no locked facility for defendants found incompetent to stand trial or not guilty by reason of insanity, and S.193 would create one under the Department of Corrections. The bill's sponsor says it must protect victims without becoming prison-like, while Rep. Anne Donahue argues there is no gap to fill.

December 22, 2025 · Columbus, OH

The share of criminally involved patients in Ohio's state hospitals rose from about 50 percent in 2002 to about 90 percent today, even as total capacity shrank by half.

November 24, 2025 · Phoenix, AZ

An investigative report describes defendants found incompetent receiving inadequate or no restoration treatment while held in county jail for extended periods.

November 24, 2025 · Jefferson City, MO

The suit alleges 60-day evaluations are taking up to six months, and people found incompetent wait an average of 14 months for placement.

November 19, 2025 · Oklahoma City, OK

The state paid $928,400 in penalties for missing Briggs consent-decree benchmarks, at rates of $100 to $500 per person per day.

November 17, 2025 · Waukegan, IL

Khayla Evans, 24, died of cardiac arrest in Lake County Jail after Illinois saw a 450 percent surge in unfitness findings from 2020 to 2024.

November 12, 2025 · Montgomery, AL

An AP report found Alabama's waitlist for Taylor Hardin had grown to 273 men by August 2025, up from about 60 in 2017, despite the 2018 consent decree. It opens with a man who died in the Montgomery County jail while waiting for court-ordered treatment.

November 7, 2025 · Harrisburg, PA

The state relies on just two facilities, including Torrance State Hospital, for restoration services despite years of scrutiny.

October 16, 2025 · Boston, MA

Two unions told lawmakers that court-involved forensic patients occupy about two-thirds of Massachusetts state psychiatric hospital beds, and that court-ordered evaluations made up roughly 60 percent of state hospital admissions in 2023. They urged dedicated forensic units.

October 2, 2025 · Raleigh, NC

Using a high-profile murder defendant as its entry point, NC Health News explains how capacity-to-proceed evaluations work in North Carolina and why they take so long, with a 69-day average at Central Regional Hospital and rising demand.

October 1, 2025 · Denver, CO

A policy research report quantified the ongoing backlog and its costs to the state, years after Colorado settled earlier federal litigation over the same issue.

September 17, 2025 · Honolulu, HI

Civil Beat found that Hawaii's 2020 law for expedited fitness evaluations of people with petty charges has sent hundreds to the state hospital, many repeatedly, while the hospital runs well over licensed capacity. The two-week stay is long enough to assess fitness but not to treat.

August 21, 2025 · Farmington, UT

A 16-bed jail-based unit, funded at $4.1 million a year, is modeled on a Salt Lake County program that cut wait times from about 12 months to 14 days.

July 7, 2025 · Sacramento, CA

A Disability Rights California investigation of DSH's Early Access and Stabilization Services program found that about a quarter of participants in monitored jails were confined to cells 22 to 23 hours a day, and that restoration rates fell from 17.7 percent to under 5 percent.

July 2, 2025 · Las Vegas, NV

FOX5 reported that 121 Clark County inmates had waited more than 93 days for competency treatment as of June 2025, that the state paid $181,000 to the county in 2024 fines, and that a judge sought to dismiss at least one case over the delay. Twenty-one new beds opened at Stein on July 1.

July 1, 2025

The 2025 guidance document lays out concrete steps state courts can take to manage competency dockets and restoration timelines.

June 17, 2025 · Olympia, WA

DSHS submitted its Phase 4 implementation plan to the court monitor, extending the Trueblood rollout to additional counties.

June 11, 2025 · Carson City, NV

Nevada's Board of Examiners approved $753,500 in court-ordered fines after a Washoe County judge held the state in contempt over delayed treatment for nine defendants at Lakes Crossing. Average waits fell from 122 days in 2022 to 74 days in February 2025 but remained far above the state's 20-day goal.

June 6, 2025 · Salem, OR

The judge ordered $500-per-person, per-day fines for anyone held past the 7-day admission deadline, citing average waits around 20.7 days.

June 1, 2025 · Austin, TX

The state auditor's office evaluated program compliance, timeliness, and outcomes for jail-based restoration as an alternative to inpatient state hospital treatment.

June 1, 2025 · Olympia, WA

The state withdrew its Ninth Circuit appeal of the contempt rulings even as jail detainees awaiting evaluation rose roughly 300 percent since 2013.

May 16, 2025 · Las Vegas, NV

Residents near the Southern Nevada Adult Mental Health Services campus opposed a planned 298-bed, $381 million forensic facility meant to ease the wait for competency treatment. Officials cited about 130 people awaiting forensic services and daily court fines.

April 17, 2025 · Annapolis, MD

At a hearing he had ordered, Anne Arundel County Circuit Judge Ronald Silkworth said the Maryland health department's plan for jailed defendants awaiting hospital beds lacked specifics and called the situation a constitutional crisis. The department said about 235 people wait at any given time.

April 14, 2025 · Raleigh, NC

The NC RISE program's expansion is funded through part of an $835 million statewide behavioral-health investment; a Mecklenburg County pilot showed an 82 percent restoration success rate in about 50 days.

March 3, 2025 · Annapolis, MD

A record 240 defendants found incompetent were waiting in Maryland jails for a state hospital bed in February 2025, against a legal limit of 10 days for admission. The average wait across the four regional hospitals was 54 days, and about six months for the maximum-security hospital.

March 3, 2025 · Raleigh, NC

NC Health News describes the state's new detention-based RISE restoration programs in Mecklenburg, Pitt and (soon) Wake counties, with early results suggesting faster restoration at lower cost than state hospitals.

February 27, 2025 · Raleigh, NC

North Carolina Health News details how defendants found incapable to proceed wait an average of 173 days for a state hospital bed, with 157 on the waitlist, amid evaluator turnover and a pending federal lawsuit.

February 18, 2025 · Austin, TX

A data investigation found 54 people died, 30 in jail, while waitlisted for a Texas state hospital bed between 2018 and 2023; the waitlist peaked above 2,550.

February 4, 2025 · Santa Fe, NM

Roughly $3 million funds the state's first misdemeanor diversion pilot, connecting defendants unlikely to be restored to treatment and housing instead of dismissal with nothing.

January 7, 2025 · Salem, OR

Disability Rights Oregon said people found unable to aid their own defense were waiting up to 50 days in jail against a 7-day requirement, and that at least two had died waiting.

January 1, 2025 · Atlanta, GA

A toolkit developed between April 2024 and April 2025 by a retired judge, the state forensic director and the Center for Justice Innovation lays out how Georgia competency cases work and proposes ways to cut delays.

December 5, 2024 · Columbus, OH

Ohio's six state psychiatric hospitals were about 96 percent full, mostly with people from the criminal justice system, and long waits leave many defendants in jail; the governor's work group urged more beds, diversion and jail-based programs.

November 19, 2024 · Larned, KS

The state agreed to reopen 30 closed beds by January 2025 and add 52 more by January 2027, after the waitlist never fell below 160 people.

November 15, 2024 · Oklahoma City, OK

The state agreed to a consent decree with phased wait-time benchmarks expected to cost $26-45 million over three to five years.

October 8, 2024 · Oklahoma City, OK

Oklahoma's mental health commissioner told the attorney general to stop representing her agency in the competency class action after the state review board disapproved the proposed consent decree. The attorney general said she could not fire him.

October 1, 2024 · Whitfield, MS

The $36.5 million maximum-security building raises forensic bed capacity from 65 to 123 beds.

September 23, 2024 · Oklahoma City, OK

A federal judge gave preliminary approval to a consent decree requiring Oklahoma to provide restoration treatment within three weeks of an incompetency ruling. The governor and the mental health commissioner objected to the cost.

September 12, 2024 · Des Moines, IA

A 2023 law directed the state to stand up an outpatient restoration option, now run statewide by a West Des Moines nonprofit.

August 14, 2024 · Santa Fe, NM

A New Mexico legislative committee reviewed a Supreme Court commission's draft competency statute that would let judges pause cases while defendants complete court-ordered outpatient treatment. At the time the law offered only restoration or commitment to the state hospital in Las Vegas.

July 2, 2024 · Providence, RI

The Rhode Island Supreme Court held that a defendant committed to an unlocked outpatient facility is still subject to detention under the state's competency statute, so a finding that competency is nonrestorable requires discharge from the commitment order 30 days later. It quashed Superior Court orders that had kept a Newport County man in the group home for years.

June 17, 2024 · Oklahoma City, OK

Attorney General Gentner Drummond announced a negotiated settlement in the Briggs case over delays in competency restoration services. It would set a plan to speed treatment for jailed defendants.

May 10, 2024 · Towson, MD

A Baltimore County circuit judge imposed $608,000 in sanctions on the Maryland Department of Health for missing the 10-day deadline to admit five detainees found incompetent, at $1,000 per day past the deadline. The state said court admission orders had surged since the pandemic and its waitlist hit a record 202.

April 23, 2024 · Aiken, SC

The Aiken County detention center provides competency restoration to detainees on site, a role previously limited to the state Department of Mental Health, after a state law change enabled local programs.

April 21, 2024 · Raleigh, NC

Disability Rights North Carolina filed a federal suit alleging the state health department holds defendants in county jails for months awaiting capacity assessments and restoration treatment, violating due process and disability laws.

April 15, 2024 · Sacramento, CA

The ACLU filed a public-records suit saying the Department of State Hospitals has withheld how people declared incompetent to stand trial died in custody while awaiting beds. The complaint cites about 35 such deaths between 2018 and 2023.

April 3, 2024 · Columbus, OH

Ohio's governor convened a 21-member work group to recommend ways to ease crowding in the six state psychiatric hospitals, where forensic patients occupy about 93 percent of beds.

April 1, 2024 · Lansing, MI

A required legislative report shows the average wait from court order to admission at Michigan's Center for Forensic Psychiatry for people found incompetent to stand trial rose from 48 days in 2022 to 222 days in 2023.

March 21, 2024 · Lawrence, KS

Douglas County and the Bert Nash Community Mental Health Center planned to start an outpatient competency restoration program in April 2024 under a 2022 state law, because defendants declared incompetent faced waits of more than a year for admission to Larned or Osawatomie.

March 18, 2024 · Augusta, ME

A Maine bill would eliminate the sunset on a 2021 law letting the state transfer certain violent defendants found incompetent to stand trial from psychiatric hospitals to the Maine State Prison's Intensive Mental Health Unit. Between late 2021 and late 2023 courts issued 130 incompetence orders and only four defendants were moved to the prison unit.

March 13, 2024 · Las Vegas, NV

FOX5 reported that 127 Clark County inmates found incompetent were waiting an average of 123 days for transfer to Stein Forensic Hospital, with insufficient capacity blamed for the delay. One defendant waited 124 days.

February 27, 2024 · Las Vegas, NV

A planned $55.4 million, 44-bed forensic unit fell through when the city and state couldn't finalize a lease.

January 26, 2024 · Cheyenne, WY

A national Treatment Advocacy Center report found Wyoming had the highest rate of jailed people waiting for a state hospital bed, with an average wait of 203 days. The state health department disputed some of the report's bed figures.

January 16, 2024 · Baton Rouge, LA

As of January 11, 2024, 185 people were waiting in Louisiana parish jails for forensic hospital admission, with an average wait of 6.8 months. Prosecutors say the delays hold up cases for a year or more.

January 15, 2024

New Treatment Advocacy Center data showed bed counts at their lowest recorded level, with direct ties to forensic and competency-restoration bottlenecks.

December 28, 2023 · Anchorage, AK

Alaska's psychiatric hospital began a two-part restoration expansion, adding 10 jail-based beds for felony defendants and 10 outpatient slots for misdemeanor cases. Until then the state had 10 restoration beds, with about 50 people waiting an average of five months.

December 22, 2023 · Harrisonburg, VA

A shortage of qualified forensic evaluators in the region is delaying competency-evaluation turnaround and stalling criminal cases.

December 15, 2023 · Carson City, NV

Officials approved federal relief funds for a two-year jail-based restoration program and forensic-facility expansion, after the state faced $500/day fines for delays.

December 11, 2023 · Helena, MT

A Cascade County judge ordered the state health department to explain what it was doing about waits for fitness evaluations at Montana State Hospital. The Montana Supreme Court overruled him 5-0, but the department produced a report anyway.

December 5, 2023 · Olympia, WA

The state paid the $100 million Trueblood contempt fine months ahead of the court-ordered schedule.

November 19, 2023 · Honolulu, HI

After a staff member was fatally stabbed, Civil Beat reported the state hospital held 325 patients against a 297-bed license, with some housed in conference and therapy rooms. Admissions rose 45 percent in fiscal 2022, with most coming through the courts.

November 3, 2023 · Baton Rouge, LA

The waiting list for Louisiana's forensic hospital rose from 139 in December 2022 to 194 by late October 2023. The state has fallen out of compliance with its 2016 federal settlement, which sets a 15-day admission limit.

October 26, 2023 · Frankfort, KY

By August 2023 the waitlist for the Kentucky Correctional Psychiatric Center had grown to 353 people, inpatient evaluations were taking 10 to 12 months, and only 38 of 78 beds were in use.

September 22, 2023 · Salem, OR

After the 2022 stay limits and 2023 admission restrictions, Oregon State Hospital got back into compliance with the seven-day rule, with waits averaging about six days. Advocates warned that compliance could slip without more community restoration services and continued funding.

August 31, 2023 · Concord, NH

New Hampshire broke ground on a roughly $40 million, 24-bed forensic hospital beside New Hampshire Hospital in Concord, meant for people found unfit for trial or acquitted by reason of mental illness. State officials say it will also end the practice of sending some civilly committed patients to the prison system's unaccredited psychiatric unit.

August 31, 2023 · Carson City, NV

In a unanimous ruling, the Nevada Supreme Court upheld contempt fines of $500 a day per defendant against the state health division for transfers to psychiatric facilities that run past the seven-day requirement. At the time, 139 defendants were awaiting transfer to facilities with 199 beds.

August 23, 2023 · Olympia, WA

Counties allege DSHS used its Trueblood contempt exposure as a reason to stop evaluating and treating people whose charges were dismissed for incompetency.

July 25, 2023 · Nashville, TN

A NewsChannel 5 investigation found that 182 people in Davidson County were declared incompetent to stand trial over 18 months, with charges dropped and two-thirds re-arrested within three months, prompting a dedicated incompetency docket.

July 9, 2023 · Olympia, WA

Misdemeanor competency referrals rose from about 1,500 to 3,671 between 2013 and 2022, even as the state worked under a federal consent decree.

July 7, 2023 · Olympia, WA

Judge Pechman found DSHS had 'never once been in compliance,' citing average waits of 130 days for state-hospital admission.

July 3, 2023 · Salem, OR

Judge Mosman signed a modified order that restricts admissions for the lowest-level charges, lets prosecutors seek longer stays in serious cases and adds flexibility to discharge planning. The hospital was still missing the seven-day deadline.

June 7, 2023 · Denver, CO

The follow-on law removed the 'imminent danger' trigger for competency evaluations and set new protections for outpatient restoration.

June 1, 2023

A peer-reviewed review documents rising CST referral volume nationwide alongside stagnant evaluator and hospital-bed capacity.

May 15, 2023 · Olympia, WA

Gov. Inslee signed a second Trueblood-driven reform package after referrals rose roughly 40 percent year over year.

May 10, 2023 · San Diego, CA

About 77 percent of jailed defendants found incompetent received no restoration treatment while awaiting transfer, and women had no access to the county's restoration program at all.

April 28, 2023 · Las Vegas, NV

A plan to convert unused Las Vegas city jail units into 44 forensic beds with $55.4 million in federal funds was pushed back at least 18 months, to December 2024 at the earliest, while 102 people in Clark County custody awaited forensic psychiatric beds.

April 19, 2023 · Montpelier, VT

Two Senate-passed bills, S.89 and S.91, came before the Vermont House Judiciary Committee to set what should happen to people found incompetent to stand trial for serious crimes. S.89 would create a residential forensic facility at the Vermont Psychiatric Care Hospital in Berlin.

April 18, 2023 · Raleigh, NC

WFAE's analysis of state data found that half of North Carolina defendants accused of felonies and found incapable to proceed waited more than 313 days in custody for a state hospital bed, with 201 waiting at the time.

March 10, 2023 · Austin, TX

More than 2,500 defendants found incompetent were waiting in Texas jails in early 2023, averaging 323 days. About 800 of the system's 2,351 beds sat unused because of roughly 1,805 vacancies.

March 1, 2023 · Oklahoma City, OK

A federal class action filed on March 1, 2023 accuses Oklahoma of leaving defendants found incompetent to wait in county jails, sometimes up to a year, for treatment. It targets the state mental health agency and the Oklahoma Forensic Center backlog.

March 1, 2023 · Harrisburg, PA

An investigative series documented defendants sitting in county jails for months without required mental health treatment while awaiting evaluation or a hospital bed.

January 30, 2023 · Springfield, IL

A health care omnibus law signed in January 2023 extends from 20 to 60 days the time Illinois has to take custody of jailed defendants found unfit to stand trial or not guilty by reason of insanity, with 30-day extensions available. Officials told lawmakers the state has not met the 20-day limit for a long time and that more than 200 people had been waiting 60 days or more.

January 18, 2023 · Austin, TX

As of December 2022, 2,545 people were waiting for Texas state hospital beds, with maximum-security waits averaging 699 days. A bill would set a 21-day transfer deadline, and Williamson County planned a jail-based restoration program.

January 18, 2023 · Olympia, WA

Disability Rights Washington asked the court to impose previously suspended sanctions after wait times for hospital transport reached 8 to 10 months.

January 1, 2023 · Salem, OR

A forensic-psychiatry review examined how COVID-driven admission slowdowns strained a system already under a court order to speed up restoration.

December 22, 2022 · Austin, TX

Houston Public Media reported that 842 of Texas's state hospital beds were offline for lack of staff while the waitlist, mostly for forensic beds, exceeded 2,500 people held in jails.

December 21, 2022 · Baton Rouge, LA

The Lens reported that 139 Louisiana defendants found incompetent were sitting in parish jails waiting for forensic hospital beds, about 30 of them in Orleans Parish. That appears to breach the state's 2016 settlement requiring admission within 15 days.

December 15, 2022 · Sacramento, CA

CalMatters followed Lorenzo Mays, an intellectually disabled man held in Sacramento County jail for almost nine years on a murder charge without ever being tried, and reported 1,446 people in California jails awaiting state mental hospital placement in November 2022.

December 13, 2022 · Charlotte, NC

NCDHHS announced that its NC RISE program began on December 7, 2022 at the Mecklenburg County Detention Center, the state's first detention-center-based restoration program, to cut jail waits for defendants found incapable to proceed.

December 13, 2022 · Richmond, VA

A December 2022 briefing to Virginia's Behavioral Health Commission found that forensic admissions to state hospitals rose by nearly half between FY14 and FY22, driven by competency restoration, and that forensic patients now fill more than half of state hospital beds.

December 2, 2022 · Frankfort, KY

LEX 18 reported that 302 defendants across 71 Kentucky counties were waiting for competency or criminal-responsibility evaluations as of November 2022, with an average wait of 179 days and nearly all held in jail.

November 23, 2022 · Salem, OR

Judge Mosman heard prosecutors, hospitals and advocates argue over his September order setting maximum hospital stays for aid-and-assist patients. He indicated he would adjust the order rather than reverse it.

November 21, 2022 · Harrisburg, PA

A September 2022 Pennsylvania Supreme Court decision, Commonwealth v. Humphrey, overruled a 1988 precedent and allows trial judges to dismiss charges against defendants who will never regain competency, though people already serving prison sentences still have no route to restoration treatment.

November 15, 2022 · Concord, NH

New Hampshire's health department said its 24-bed forensic hospital would move forward with construction in 2023, though inflation had pushed costs about $6 million over the original budget. The facility will serve people unable to stand trial, insanity acquittees and patients deemed too dangerous for regular psychiatric settings.

October 31, 2022 · Norristown, PA

An Inquirer investigation reports that a dozen current and former patients and employees describe assaults by security staff in the Norristown State Hospital forensic unit, which treats defendants found incompetent to stand trial; state data show elevated injury and abuse-allegation rates there.

October 26, 2022 · Carson City, NV

Nevada approved more than $55 million in American Rescue Plan money for state forensic psychiatric hospitals to expand bed capacity, which the state health division said had been strained by staffing shortages and growing demand.

October 25, 2022

The National Judicial Task Force to Examine State Courts' Response to Mental Illness released recommendations including expedited competency processes and diversion.

October 19, 2022 · Frankfort, KY

WKYT reports that some Kentuckians in jail wait more than a year for a competency evaluation, which stalls their cases. Public defenders say the wait for an inpatient evaluation at the state's only forensic center is now about a year, with some clients waiting 10 to 18 months.

October 3, 2022 · Topeka, KS

Counties told Kansas lawmakers that Larned State Hospital's bed shortage leaves mentally ill people in jail for months. Sedgwick County reported an average wait of 5.5 months for 36 people and costs of about $89 a day per defendant.

October 1, 2022 · Phoenix, AZ

A task force created by the Arizona Supreme Court in May 2022 reported that Rule 11 evaluations are overwhelmingly done in superior court and that misdemeanor cases are almost always dismissed without restoration. It urged limiting restoration in favor of diversion.

September 15, 2022 · Jefferson City, MO

At a September 2022 legislative hearing, Missouri's Department of Mental Health reported 210 people waiting in jail for admission to its psychiatric hospitals and 266 more not yet seen by a forensic examiner. Officials tied the bottleneck to 1,743 vacant positions and heavy reliance on contract staff, mostly at Fulton State Hospital.

September 14, 2022 · Sacramento, CA

A Los Angeles Times report found 1,768 incompetent defendants waiting in California jails for state hospital or other placement as of June 2022, with average waits of 141 days, even as the state sought to relax court-ordered deadlines in the Stiavetti case.

September 4, 2022 · Salem, OR

Judge Mosman ordered Oregon State Hospital to discharge aid-and-assist patients on deadlines based on charge severity: 90 days for misdemeanors, six months for felonies and up to a year for violent felonies. The order was meant to free beds for the dozens of people waiting in jail.

August 16, 2022 · Sacramento, CA

DSH's August 2022 program update says funding for the IST Solutions workgroup strategies reaches $535.5 million in 2022-23 and $638 million a year by 2025-26, including $104 million a year for jail-based early stabilization and billions' worth of diversion and community restoration infrastructure.

August 12, 2022 · Montgomery, AL

An Alabama Department of Mental Health paper compares inpatient, jail-based, and community competency restoration, notes that Alabama currently offers only inpatient restoration, and describes plans to pilot the other two models.

August 4, 2022

KFF Health News examines what happens when charges are dropped because a defendant cannot be restored, finding that people frequently leave the system without stabilizing care and can cycle back into jail. A Montana man was jailed and hospitalized at least five times between 2014 and 2021 this way.

August 1, 2022

The task force report analyzes the inpatient psychiatric bed shortage, including forensic beds, and proposes a simulation-model approach for states to right-size capacity.

July 28, 2022 · Springfield, IL

In July 2022 sheriffs from five more downstate counties joined Sangamon County's lawsuit against the governor and the Department of Human Services over chronic delays in admitting jail inmates found unfit for trial to state hospitals.

July 26, 2022 · Dallas, TX

An editorial reprinted from The Dallas Morning News says Dallas County's waits for state hospital beds had grown from about 20 days for women in 2017 to nearly a year. It says roughly a third of state psychiatric beds were offline for lack of staff.

July 13, 2022 · Salt Lake City, UT

A federal judge lifted the stay and dismissed the Disability Law Center's claims with prejudice, ending the case over jail waits for competency restoration. The five-year monitoring period under the 2017 settlement had run its course.

June 30, 2022 · Springfield, IL

A Sangamon County judge found the state in civil contempt in June 2022 for not moving a jail inmate declared unfit for trial into a state facility within 20 days, imposing a $100-per-day fine until he was admitted.

June 15, 2022 · Springfield, IL

Sangamon County's state's attorney asked a judge in June 2022 to hold the Department of Human Services in civil contempt for failing to move jail inmates found unfit for trial into state hospitals, with about 150 people waiting statewide and an average wait of 64 days against a 20-day legal limit.

June 11, 2022 · Atlanta, GA

An 18-year-old's case produced a contempt finding after Georgia's behavioral health agency missed a court-ordered transfer deadline; 368 people were awaiting restoration statewide.

June 8, 2022 · Salem, OR

An independent psychiatrist's second report recommended that Oregon State Hospital cap aid-and-assist stays at six months, discharge patients when capable and build community services to meet the federal seven-day deadline by February 2023. About 70 defendants were waiting in jail, averaging 16 days.

June 2, 2022 · Denver, CO

HB22-1386 created a presumption of outpatient restoration for lower-level charges and appropriated roughly $29.4 million for bed capacity.

May 26, 2022 · Larned, KS

The suit alleged people waited over two years for a bed at Larned State Hospital.

May 23, 2022 · Denver, CO

Colorado lawmakers approved a bill spending $54 million in federal relief funds on new competency-restoration and step-down beds as the average wait for restoration reached about 89 days. The state expected to pay $12 million in consent-decree fines in 2022-23.

May 18, 2022 · Austin, TX

KXAN reported a record 2,309 people waiting in Texas jails for state hospital beds in March 2022, with the waitlist exceeding the 1,510 available beds since November 2021. A state senator and a county representative described it as a public health emergency.

May 10, 2022 · Indianapolis, IN

WRTV reported that Marion County's presiding judge and sheriff say defendants found incompetent are waiting months in the county jail for a Logansport State Hospital bed, with 18 people waiting on one day in May 2022. A lawsuit filed the day before put the statewide average wait at 121 days.

May 9, 2022 · Indianapolis, IN

The ACLU of Indiana and Indiana Disability Rights sued the state's mental health division over defendants left in jail for months without restoration treatment.

May 4, 2022 · Jackson, MS

A story from the Mississippi Center for Investigative Reporting found that staffing shortages left Mississippi State Hospital's forensic unit able to run only 39 beds, with defendants told to expect waits of up to a year in jail.

May 1, 2022 · Saint Paul, MN

The law established a State Competency Restoration Board to provide forensic navigators helping defendants get restoration placements and community connections.

April 25, 2022 · Columbia, SC

South Carolina's governor signed H. 3773 (Act 145) on April 25, 2022, defining restoration treatment, extending the hospitalization period for restoration to 180 days, and allowing the Department of Mental Health to deliver restoration in detention centers and, in some cases, on an outpatient basis.

April 14, 2022 · Nashville, TN

An April 2022 Davidson County task force report on 182 misdemeanor defendants found incompetent to stand trial reported average waits of 60 days for a 30-day evaluation at Middle Tennessee Mental Health Institute and called for funding evaluations, restoration options and community services.

April 13, 2022 · Norristown, PA

Pennsylvania's Department of Human Services committed $242 million to build a 420-bed forensic hospital on the Norristown State Hospital campus for court-ordered patients from five southeastern counties.

April 11, 2022 · Richmond, VA

A 2022 Virginia law lets courts dismiss certain low-level misdemeanor charges against incompetent defendants and send them to a community services board for a civil temporary-detention evaluation instead of ordering competency restoration.

April 8, 2022 · Lincoln, NE

Nebraska lawmakers advanced LB 921, which would reserve 15 percent of Lincoln Regional Center beds for defendants found incompetent and have the state pay counties after 30 days of waiting. About 69 people were waiting an average of 67 days in county jails.

April 5, 2022 · Kaneohe, HI

The state health department said the 144-bed, $160 million facility at Hawaii State Hospital would open in about two weeks, after delays attributed to missing policies, hiring difficulty and physical fixes. The hospital treats people committed by courts, including defendants awaiting fitness evaluations.

March 31, 2022 · Olympia, WA

Washington's 2022 law on forensic competency restoration required the state to place people in inpatient restoration within seven days after outpatient programs end, reset service time limits, let nurse practitioners perform evaluations, and made outpatient restoration costs a Health Care Authority duty. The bill report notes the state was averaging about 45 days to move defendants from jail to restoration.

March 26, 2022 · Lakewood, WA

The Seattle Times reported that Western State Hospital is winding down civil beds and planning a $612 million, 350-bed forensic hospital, while 365 people were waiting for forensic services there in December, nearly 60 percent more than in January 2020.

March 22, 2022 · Salt Lake City, UT

Utah enacted H.B. 277, which changes how juvenile competency law defines terms and treats statements a minor makes during a competency evaluation or while working to attain competency.

March 18, 2022 · Helena, MT

Montana State Hospital's 54-bed forensic unit had 71 people waiting on March 1, 2022, with defendants spending months in county jails. Some cases were dismissed because of the delay.

March 16, 2022 · Jackson, MS

The state's protection-and-advocacy group filed a second 2022 lawsuit against the Department of Mental Health after it refused to release records about who gets admitted to the forensic unit at Mississippi State Hospital, prompted by a man who stayed in jail for years after an incompetency finding.

March 8, 2022 · Lincoln, NE

At a legislative hearing, senators heard that jailed defendants in Nebraska waited an average of 128 days for competency restoration at the Lincoln Regional Center, with one waiting a year. A bill would have the state pay counties for long waits.

March 7, 2022 · Little Rock, AR

A north Arkansas outlet reported that people found unfit to proceed or not criminally responsible can wait a year or more in county jails for Arkansas State Hospital beds, with the state's human services department saying an old federal decree on the problem no longer applies.

March 1, 2022 · Sacramento, CA

In March 2022 the LAO assessed the governor's proposed $317 million one-time and $33.6 million ongoing IST solutions package, noting the felony IST waitlist had reached over 1,700 people with waits exceeding 100 days by December 2021.

March 1, 2022 · New York, NY

The city's quarterly report for January-March 2022 counts 92 incarcerated people who awaited transfer to state custody after being designated unfit to proceed. The longest wait after designation in its table was 69 days, and one person had spent 1,856 days in city custody.

February 28, 2022 · Anchorage, AK

An Anchorage case in which a man charged with multiple felonies was found incompetent and released, without the victim being told, illustrates what happens when charges end after an incompetency finding. Advocates and a clinician said funding and treatment gaps leave victims and defendants without recourse.

February 17, 2022 · Topeka, KS

At a February 2022 hearing on HB 2697, state officials, the ACLU of Kansas and county witnesses described competency waits of 11 months or more at Larned State Hospital. The bill would allow evaluation and restoration in community mental health centers and county jails.

February 17, 2022 · Jackson, MS

A Mississippi Center for Investigative Reporting story used a Jasper County murder suspect, found incompetent in March 2019 and still jailed, to show how limited state hospital forensic capacity strands defendants; the hospital completed 128 competency evaluations in fiscal 2021 and was planning a $26.4 million expansion to 83 forensic beds.

February 4, 2022 · Tallahassee, FL

The Florida Bar News reported on HB 1249 and SB 1600, which would let DCF provide restoration care in jail-based facilities; a Senate analysis counted 548 people awaiting state beds as of January 12, 2022, nearly 500 of them past 15 days, with a 59-day average wait.

February 2, 2022 · Austin, TX

Two Austin reporters describe their investigation showing that at least 12 people on Texas's competency waitlist died in jail over six years and that the state does not track such deaths. The waitlist roughly doubled from about 1,000 in late 2019 to over 1,900 by 2021.

February 1, 2022 · Kaneohe, HI

Hawaii's new 144-bed forensic facility at the state hospital had been finished for nearly a year but still had no patients, with fixes, missing safety policies and staff training outstanding. The hospital administrator said he could not give a firm opening date, and the first admissions would be existing patients.

January 26, 2022 · Austin, TX

A state advisory committee heard in January 2022 that more than 2,100 people were waiting in Texas jails for restoration and that 731 of 2,241 funded state hospital beds were offline for staffing and pandemic reasons. A committee member urged an emergency plan.

January 15, 2022 · Sacramento, CA

The Department of State Hospitals suspended new admissions system-wide for a second time during the pandemic, resuming the following month.

January 15, 2022 · Montpelier, VT

A work group created by Act 57 reported to legislative committees that Vermont has no competency restoration program, no diversion path for people found incompetent, and thin transition services, and floated a dedicated forensic hospital as one option. It met five times between July and December 2021.

January 1, 2022 · Yankton, SD

Three South Dakota jail inmates ordered to the Human Services Center for competency restoration sued in federal court as a class, saying they and others remain in jail because the understaffed state hospital cannot take them.

December 10, 2021 · Salem, OR

The Oregon Health Authority agreed to retain an independent expert to find ways to meet the federal seven-day admission rule, in exchange for the plaintiffs pausing contempt and injunction requests. The deal set deadlines for short-term and long-term plans in 2022.

December 8, 2021 · Austin, TX

KXAN's 'Mental Competency Consequences' project found the Texas competency waitlist reached a record 1,838 in October 2021, up about 150 percent from roughly 730 in 2018, and reported on the 'Eliminate the Wait' plan meant to reverse it.

December 7, 2021 · San Antonio, TX

A $550,000 DOJ grant expanded diversion and a new jail-based restoration track serving roughly 60 people a year.

December 1, 2021 · Longview, TX

A Dallas Observer profile of a 28-year-old held for nearly two years on misdemeanor charges shows how a 14-month delay for an evaluation and a statewide restoration waitlist of more than 1,900 can strand a person in jail.

November 22, 2021 · Oklahoma City, OK

A state senator filed Senate Bill 1113, which would require the mental health department to provide or arrange competency restoration if no forensic bed opens within 30 days of an incompetency finding, authorizing jail-based treatment.

November 9, 2021 · Richmond, VA

Virginia Mercury reports on University of Virginia research showing misdemeanor defendants are found incompetent at higher rates than felony defendants and are often sent to inpatient state hospital restoration. Evaluators, public defenders and hospital staff describe long waits and a revolving door.

November 7, 2021 · Pueblo, CO

Federal Medicare officials threatened to cut off payments to the Pueblo state hospital unless it fixed suicide-risk hazards, even as the competency waitlist reached a record 349 people. The state responded with emergency and pandemic-relief funding.

November 1, 2021 · Sacramento, CA

A state workgroup created by statute reported that more than 1,700 people were awaiting restoration in November 2021 and recommended short-, medium- and long-term steps, including diversion, community treatment and expanded evaluator pools. The 2021-22 budget already funded sub-acute capacity and diversion.

November 1, 2021 · Topeka, KS

A KDADS deputy secretary told a legislative special committee that in September 2021 male defendants waiting for Larned State Hospital competency services averaged 171 days, with 157 men and 14 women on the list. He cited bed capacity, staffing, COVID isolation and court orders as bottlenecks.

November 1, 2021

The survey profiles how each state structures its competency-restoration system across inpatient, community-based, and jail-based models.

October 21, 2021 · Queens, NY

A city evaluation of a Queens pilot found that 82.5 percent of court-ordered competency examinations were completed within target timeframes, with felony cases hitting the mark more often than misdemeanors. The report ties slow competency exams to longer jail stays.

October 19, 2021 · Austin, TX

The Dallas Observer reported that the Texas waitlist for competency restoration beds hit 1,813 in October 2021, up from 970 a year earlier, even as lawmakers had spent more than $1 billion on hospital rebuilds that added only about 350 beds.

October 15, 2021 · Pueblo, CO

Nursing shortages forced the closure of 70 beds at the Colorado Mental Health Institute at Pueblo, and reporting linked the resulting backlog to two jail suicides.

October 8, 2021 · Concord, NH

State officials presented a preliminary plan for a 24-bed forensic hospital on the state hospital grounds, expected to open by late 2023. It will house people found incompetent to stand trial or not guilty by reason of insanity who are now held in the prison's Secure Psychiatric Unit.

October 1, 2021 · Austin, TX

The Judicial Commission on Mental Health and the Health and Human Services Commission released an 'Eliminate the Wait' toolkit saying more than 1,800 people were waiting in Texas jails for inpatient restoration. It gives checklists for police, jails, courts, prosecutors, defense attorneys and hospitals.

September 30, 2021 · Salt Lake City, UT

A KUTV investigation used a pending Salt Lake City murder case to explain Utah's competency and restoration process, including 125 forensic beds at the Utah State Hospital and 22 at the Salt Lake County jail.

September 27, 2021 · Baton Rouge, LA

Louisiana acknowledged that it was no longer meeting several admission deadlines under its 2016 forensic-hospital settlement. A federal magistrate judge allowed limited discovery before deciding whether to hold the state in contempt.

September 1, 2021 · Albany, NY

A September 2021 report from the New York State Association of Counties argues that the state's competency restoration system under CPL Article 730 needs reform, noting that a budget change made counties outside New York City responsible for the full cost of restoration, estimated at about $22 million.

August 25, 2021 · Sacramento, CA

The California Supreme Court declined to review an appellate ruling in Stiavetti v. Clendenin, leaving in place the requirement that incompetent defendants be moved from county jails to treatment within 28 days. The waitlist had grown from 262 in July 2013 to 1,687 in February 2021.

August 18, 2021 · Salem, OR

The Ninth Circuit overturned a 2020 ruling that had suspended Oregon State Hospital's seven-day admission requirement during the early pandemic. The appeals court sent the question back for the district judge to reconsider.

August 10, 2021

The first published national estimate gives researchers and policymakers a badly needed baseline figure for the scale of the CST evaluation system.

July 28, 2021 · Austin, TX

At a July 2021 state committee meeting, officials said the Texas waitlist for state hospital competency restoration reached an all-time high of 1,508 in December 2020 and had stayed near 1,475, with maximum-security waits averaging 510 days in May.

July 21, 2021 · Salem, OR

As of July 2021, 16 people found guilty except for insanity were held in Oregon jails despite orders sending them to the state hospital, because the hospital must give priority to aid-and-assist defendants, who made up almost 90 percent of its admissions over the prior 15 months.

June 29, 2021 · Oklahoma City, OK

The Frontier followed a 24-year-old jailed for 171 days on a misdemeanor while waiting for a bed at the Oklahoma Forensic Center, using her case to show an 84-person waitlist, a death in the Oklahoma County jail, and a 16-bed expansion that was about to open.

June 24, 2021 · Olympia, WA

A June 2021 court filing summarizes what the first phase of the Trueblood settlement delivered despite the pandemic and sets out plans for Phase 2 in King County. It reports 18 additional evaluators, new beds, and outpatient restoration and forensic navigator programs that went live in mid-2020.

June 16, 2021 · Sacramento, CA

The Court of Appeal upheld a requirement that the state admit incompetent defendants for treatment within 28 days, with the statewide waitlist then exceeding 1,600 people.

June 7, 2021 · Montpelier, VT

Act 57 of 2021 separates competency and sanity examinations, requires a psychologist skilled in developmental disability evaluations in relevant cases, guarantees legal representation for people found incompetent or acquitted by insanity, and requires prosecutor notice before discharge. Section 6 created the Department of Mental Health forensic working group.

May 27, 2021 · Kaneohe, HI

Hawaii officials unveiled a $160.5 million, 144-bed building at the State Hospital, designed for patients committed by the courts and scheduled to take patients starting in August 2021. Lawmakers who toured it said it would not by itself fix the cycle of patients moving in and out of the system.

May 27, 2021 · Salem, OR

With about a third of its nursing staff out on COVID-related leave, Oregon State Hospital asked for 30 National Guard nurses. The article ties the strain to the growing share of beds taken by aid-and-assist defendants under a federal seven-day admission rule.

May 25, 2021 · Montpelier, VT

Vermont's S.3 passed the Senate unanimously, requiring prosecutors to get at least 10 days' notice before incompetent defendants or insanity acquittees move to less secure settings and letting them seek court-ordered competency reevaluations. It also created a forensic care working group.

April 27, 2021 · Columbus, OH

Gov. DeWine signed Senate Bill 2 on April 27, 2021, letting nonviolent misdemeanor defendants go through competency evaluation and restoration in outpatient settings so state hospital beds are reserved for people with serious mental illness.

April 10, 2021 · Charleston, WV

West Virginia's Senate Bill 702 (2021), passed April 10, rewrote the state's criminal competency and responsibility procedures. It sets time limits on restoration and requires release, with dismissal for nonviolent charges, once those limits run out.

April 1, 2021 · Frankfort, KY

Kentucky's House Bill 310 (2021), signed April 1, added a new involuntary-commitment procedure for defendants charged with the most serious violent offenses who are found incompetent and unlikely ever to regain competency.

March 25, 2021 · Santa Fe, NM

The New Mexico Supreme Court ruled that the commitment term for defendants found incompetent and dangerous can be extended because of aggravating circumstances, upholding a five-year extension for a man held at the state's Behavioral Health Institute.

March 23, 2021 · Phoenix, AZ

HB 2334 would let Arizona courts hold a jury trial on dangerousness for defendants found incompetent and not restorable, and commit them to a secure facility. It passed the House 45-14-1, and fiscal estimates ranged from about $5.7 million to $115 million a year.

March 22, 2021 · Montgomery, AL

In a March 2021 opinion, a federal judge said Alabama's wait times for competency evaluations and hospital admissions had barely improved since the 2018 consent decree and ordered the state to produce a new remedial plan.

March 1, 2021 · Lansing, MI

A March 2021 report required by the state budget says the average wait for defendants found incompetent to be admitted to the Center for Forensic Psychiatry was 157 days in 2019 and 137 days in 2020. The average number of people waiting there fell from almost 122 to 30.

February 26, 2021 · Washington, DC

A 2021 update on the DC outpatient restoration program analyzed four years of data on 345 people referred for competency evaluation and found 97 (28.1 percent) were restored.

February 1, 2021 · Sacramento, CA

DSH counted 3,653 inpatient days in 2020 beyond the 10-day return limit for restored defendants, about 2,600 of them in jail-based programs. Most of the state-hospital excess fell between March and May 2020, when the pandemic suspended hospital admissions and discharges.

February 1, 2021 · Saint Paul, MN

The Community Competency Restoration Task Force's February 2021 final report said competency examinations in Minnesota rose 73 percent from 2014 to 2018 and urged a new statute, certified forensic navigators and a three-tier continuum of restoration services.

January 22, 2021 · Columbus, OH

Sen. Theresa Gavarone introduced Senate Bill 2 to move nonviolent defendants' competency treatment away from state hospitals, where a former Ohio Supreme Court justice said about 70 percent of beds are held by defendants in restoration.

January 1, 2021 · Pierre, SD

A state oversight council's 2020 annual report says South Dakota's 2017 reforms cut typical competency evaluation waits from four to six months down to about 44 days in fiscal 2020, and that a 2020 law lets restoration happen outside the state hospital.

December 17, 2020 · Lakewood, WA

Western State Hospital, central to the Trueblood case, reported an outbreak topping 200 cases alongside staff layoffs.

December 15, 2020 · Middletown, CT

A Connecticut legislative task force recommended that the state begin planning to close and replace the aging Whiting Forensic Hospital. Members noted that defendants sent for competency restoration can end up in maximum-security beds beside long-term acquittees when the less secure unit is full.

December 3, 2020 · Baton Rouge, LA

Plaintiffs argued COVID-19 kept Louisiana from showing four straight years of compliance with its 2016 settlement over waits for forensic hospital admission, and the federal court granted continued reporting and jurisdiction.

December 2, 2020 · Salem, OR

Oregon's sole forensic psychiatric facility paused admissions after an internal outbreak, delaying transfers of jailed defendants awaiting restoration.

November 18, 2020 · Sacramento, CA

Jailed defendants found incompetent argued the state's psychiatric hospitals were unlawfully refusing to admit COVID-positive patients for restoration.

November 6, 2020 · Indianapolis, IN

Indiana's mental health division announced pilot programs in November 2020 aimed at defendants found unable to stand trial who were waiting in jail for a state hospital bed. They include jail-based restoration in Marion and Vanderburgh counties, a community program in Marion County, and a private-hospital placement effort called Project CREATE.

October 27, 2020

The Council of State Governments Justice Center synthesized state-level data and interviews showing systems overwhelmed nationwide, with recommendations several states have since used.

October 23, 2020 · Olympia, WA

Crosscut reported that 161 people found too ill to stand trial were waiting in Washington county jails, and that the share transferred to treatment within the court's seven-day limit had fallen below 7 percent since the pandemic began, from 24 percent before it.

September 10, 2020 · Hartford, CT

CT Mirror reported that competency evaluations in Connecticut rose from 1,089 to 1,299 between fiscal years 2015 and 2019 even as overall criminal cases fell about 10 percent. Most defendants evaluated were found competent, and observers tied the growth to thin community mental health services.

August 21, 2020 · Frankfort, KY

A state presentation to a legislative task force reported 132 people on the Kentucky Correctional Psychiatric Center wait list in August 2020, with a typical wait of six to eight weeks.

August 10, 2020 · Springfield, IL

In August 2020 the Illinois Department of Human Services posted a funding opportunity of about $1 million for community-based fitness restoration programs in central and southern Illinois, meant to reduce the number of people found unfit and speed access to outpatient restoration.

July 17, 2020 · Juneau, AK

The Alaska Court of Appeals held that a Juneau man's months in jail while waiting for a restoration bed at the state psychiatric hospital violated his constitutional rights and required dismissal of his misdemeanor case. The court did not set a firm deadline but noted Oregon and Washington's seven-day limits.

May 17, 2020 · Austin, TX

KXAN's analysis for its 'Locked in Limbo' investigation found 970 people waiting for 2,269 funded Texas state hospital beds at the start of 2020, and said a $1 billion rebuild adding about 350 beds would still leave demand 555 beds short. The story surveys outpatient, jail-based and tele-psychiatry alternatives.

May 15, 2020

An early-pandemic national piece described courts, jails, and state hospitals scrambling as COVID made congregate forensic settings unsafe.

May 12, 2020 · Salem, OR

Judge Mosman temporarily modified the 2002 order requiring admission within seven days, citing pandemic limits, after a backlog of 56 people built up in jails. Disability Rights Oregon and the Metropolitan Public Defender said they would appeal.

May 11, 2020 · Olympia, WA

At a telephone hearing, U.S. District Judge Marsha Pechman told Washington officials to reopen jail transfers to Western State Hospital despite COVID-19, warning that judges would otherwise release or dismiss cases against defendants who cannot wait in jail. About 177 people were waiting for transfer.

May 2, 2020 · Denver, CO

COVID-19 isolation rules slowed admissions to Colorado's Pueblo hospital and roughly doubled the competency waitlist, putting the state on course to exceed its projected fines under the 2019 consent decree. Officials had expected about $2.5 million in annual fines before the pandemic.

May 1, 2020 · New York, NY

The city's quarterly report for January-March 2020 lists 123 incarcerated people who awaited transfer to state custody after being designated unfit to proceed. In its table, the longest wait after designation was 62 days and the longest total stay in city custody was 1,049 days.

April 9, 2020 · Salem, OR

Oregon State Hospital restricted admissions on March 16, 2020 to limit COVID-19 spread, breaching the federal seven-day rule and leaving at least 34 people waiting in jail. The state asked the court for permission to suspend the requirement.

March 9, 2020 · Los Angeles, CA

California's Court of Appeal affirmed four sanctions totaling $370,000 imposed by a Los Angeles Superior Court judge on the Department of State Hospitals for ignoring orders in 247 cases to move defendants found incompetent from jail to a state hospital on time.

March 6, 2020

A JAAPL commentary says competency restoration in jails has grown over the past decade mainly because of cost and long waits for inpatient programs, and argues that a funded continuum of inpatient, residential and outpatient services would make jail-based restoration unnecessary.

February 20, 2020 · Frankfort, KY

Senate Bill 188, introduced Feb. 20, 2020, would send certain violent defendants who are incompetent and have no substantial probability of regaining competency into a new involuntary commitment process under a new chapter of state law. The legislative record shows it went to the Senate Health & Welfare Committee four days later and lists no further action.

February 12, 2020 · Lansing, MI

A Michigan sheriff's public plea about a mentally ill veteran held in his jail after an incompetency finding led Bridge Michigan to document average waits of 142 days for state hospital placement.

February 12, 2020

A JAAPL commentary examines what should happen to defendants charged with serious crimes who are found incompetent, cannot be restored and are considered dangerous. It describes California, Oregon and Ohio models and proposes using ABA-style procedures like those for insanity acquittees.

February 11, 2020 · Sacramento, CA

The LAO's analysis of the 2020-21 state hospital budget reports the incompetent-to-stand-trial waitlist rose from about 350 to over 800 between 2013 and 2018 before leveling off, with about 800 IST patients among 1,200 awaiting placement as of January 2020.

February 9, 2020 · Montgomery, AL

Gov. Kay Ivey's proposed budget includes $60 million for 96 additional beds at the Taylor Hardin Secure Medical Facility for criminally committed patients, which the Department of Mental Health called critical to meeting the Hunter v. Beshear settlement.

February 5, 2020 · Honolulu, HI

Hawaii legislators advanced bills to divert people with mental illness into fitness evaluations or brief health-department treatment instead of jail. A report cited nearly 150 misdemeanor detainees jailed about 12,000 days before reaching the state hospital in 2017-18, at a cost of about $2.18 million.

February 4, 2020 · Phoenix, AZ

The Arizona Supreme Court's mental health committee issued a guide setting staffing, instruction and monitoring standards for restoration-to-competency programs, which it described as among the first such state guides in the country.

February 1, 2020 · Saint Paul, MN

A February 2020 interim report to the Minnesota Legislature said the number of incompetent defendants in state-run facilities had more than doubled since 2013 while treatment capacity stayed flat, and laid out five areas for reform.

January 31, 2020 · Denver, CO

Rocky Mountain PBS reported that Colorado had failed for nearly a decade to give jailed defendants timely competency services and expected to keep paying fines under the 2019 consent decree through 2020. The state was adding hospital beds and jail-based restoration programs.

January 28, 2020 · Lansing, MI

A House Fiscal Agency analysis of House Bills 5325-5327, as introduced in January 2020, describes a rewrite of Michigan's competency and insanity-evaluation procedures, including a 30-day scheduling requirement for jailed defendants' court-ordered examinations (framed in the analysis around insanity-claim exams) and a county-paid route to outside examiners if the Center for Forensic Psychiatry falls behind. The fiscal note says the state budget already funds seven more forensic evaluators to work down the evaluation waiting list.

January 27, 2020 · Klamath Falls, OR

Oregon's Senate Bill 24 pushed counties to cut state hospital referrals in criminal cases. Klamath County responded with a behavioral health intervention court that dropped its referral ranking from seventh in the state to about thirtieth of 36 counties.

January 15, 2020

A national survey found rising numbers of people found incompetent are increasingly routed into long-term state hospital care, a pattern the authors call reinstitutionalization.

January 1, 2020 · Columbus, OH

A state agency briefing laid out that about three-quarters of patients in Ohio's six regional psychiatric hospitals are forensic, with jail-transfer admissions up 132 percent between fiscal 2015 and 2018.

December 12, 2019 · Atlanta, GA

At the December 12, 2019 board meeting, Georgia's forensic services director reported that defendants found incompetent to stand trial fill 35 percent of forensic beds with a 120-day average stay and 70 to 80 percent restoration, and listed waitlists and their continued growth as the first challenge.

November 18, 2019 · Salem, OR

An NPR report from OPB examined Senate Bill 24, the 2019 Oregon law meant to ease pressure on the state hospital. It found that some misdemeanor defendants with documented mental illness are now released without treatment because community services are thin.

October 31, 2019 · Salem, OR

Judge Mosman denied a request for further compliance hearings, ending the 2019 suit over Oregon State Hospital admission delays after the hospital resumed meeting the seven-day deadline in late July. The state credited a new 2019 law that tightened admission criteria for some misdemeanor defendants.

October 24, 2019 · Columbus, OH

An Ohio Legislative Service Commission fiscal note on Senate Bill 58, sponsored by Sen. Gavarone, says the bill would stop courts from ordering inpatient competency evaluations at state-run facilities for defendants charged with nonviolent misdemeanors unless immediate hospitalization is needed. About 15 such defendants were evaluated in state facilities in 2018 at an estimated cost of roughly $174,000.

October 10, 2019 · Lansing, MI

Using the case of a 19-year-old found incompetent to stand trial in a fatal assault, a Detroit News investigation showed Michigan struggling to place people in state psychiatric beds. It reported 138 people on a state hospital waiting list and an average 127-day wait for forensic evaluation among jailed defendants.

October 1, 2019 · Phoenix, AZ

A committee created by the Arizona Supreme Court recommended standard guidelines and forms for Rule 11 competency evaluators and statutory changes for defendants who are dangerous, incompetent and not restorable. The report went to the Arizona Judicial Council in October 2019.

September 30, 2019 · Jackson, MS

Mississippi's mental health department added forensic beds at the State Hospital and committed to a new 83-bed unit, and the wait for an initial evaluation fell sharply after years of defendants sitting in county jails.

September 24, 2019 · Saint Paul, MN

A Department of Human Services bulletin announcing the task force's third public meeting explains that a 2019 law created a Community Competency Restoration Task Force to study community-based restoration and recommend ways to address growing numbers of people found incompetent to stand trial. It is due to report by Feb. 1, 2020 and Feb. 1, 2021.

September 9, 2019 · Salem, OR

Oregon State Hospital faced contempt proceedings in both state and federal court in 2019 for missing the seven-day deadline to take defendants who needed competency services. A county judge imposed a daily sanction, which the article describes as too small to change behavior.

August 14, 2019 · Columbus, OH

In the wake of the August 2019 Dayton shooting, Gov. Mike DeWine proposed changing how Ohio handles competency restoration, which fills most state hospital beds with court-ordered patients, many of them misdemeanor defendants.

August 10, 2019 · Boise, ID

Idaho's state psychiatric hospitals routinely ask courts to try restored defendants quickly because jail conditions can undo their competency, a health department spokeswoman told the Idaho Press. Idaho has no insanity defense, so competency is the main legal route for defendants with serious mental illness.

July 11, 2019 · Montgomery, AL

Sixteen months after a federal consent decree took effect, Alabama's mental health department had met almost none of its benchmarks for evaluating and treating jailed defendants, according to court records the Alabama Political Reporter reviewed.

June 27, 2019 · Olympia, WA

A court filing lays out how Washington would carry out the first two-year phase of its 2018 Trueblood settlement in the Pierce, Southwest and Spokane regions. It lists targets for new evaluators, forensic navigators, outpatient restoration, forensic beds and crisis-triage capacity.

June 21, 2019

A peer-reviewed national study found a 76 percent increase in forensic patients in state psychiatric hospitals between 1999 and 2014, with defendants found incompetent to stand trial the largest group. More than half of responding states reported legal threats or contempt over restoration waits.

June 13, 2019 · Salem, OR

A federal judge acknowledged Oregon was violating the 2002 seven-day admission rule for defendants found unable to aid and assist but declined to find the state in contempt. He ordered a compliance hearing roughly 90 days out.

June 13, 2019 · Madison, WI

In State v. Fitzgerald, the Wisconsin Supreme Court held that the state's competency statute cannot be used to medicate a defendant against his will unless the four Sell v. United States factors are met. The ruling vacated an order that had been based only on the defendant's inability to make informed treatment decisions.

June 11, 2019 · Salem, OR

Disability Rights Oregon and the Metropolitan Public Defender asked a federal judge to order the state to move about 40 jailed defendants into Oregon State Hospital or release them. They argued that growing delays were breaking a 2002 rule requiring admission within seven days.

June 6, 2019

Using one woman's near two-year path through Pennsylvania's system, the Marshall Project describes how defendants wait in jail for competency restoration beds and notes similar legal fights in seven other states. Pennsylvania's average wait peaked around eight months in early 2017 and had fallen to about 24 days by April 2019.

June 1, 2019 · New York, NY

A quarterly report the city must publish under Local Law 84 of 2015 counts 145 incarcerated people who awaited transfer to state custody after being designated unfit to proceed in the April-June 2019 quarter. The table lists how long each waited, with the longest wait since designation at 35 days.

May 9, 2019 · Olympia, WA

SB 5444 created forensic navigator positions to connect class members to diversion and outpatient restoration, and expanded which charges qualify for diversion.

May 2, 2019 · Phoenix, AZ

A journal article describes how Arizona moved nearly all competency restoration out of its state hospital and into county jails, and examines what programs can do when defendants refuse treatment. Maricopa County lacked a clear procedure for overriding refusal outside civil commitment.

May 1, 2019 · Madison, WI

A May 2019 Legislative Fiscal Bureau paper reported that Wisconsin's wait for forensic hospital admission had crept back up to an average of 72 people in late 2018, with typical waits of 36 to 38 days spent in county jails. It laid out options for continuing a 20-bed forensic unit at Sand Ridge Secure Treatment Center that opened in early 2018.

April 10, 2019 · Atlanta, GA

A class-action complaint filed in federal court in Atlanta says women with psychiatric disabilities at the South Fulton jail were locked down nearly all day, and that women found incompetent to stand trial waited months, sometimes over a year, for a state hospital bed while being barred from the jail's male-only restoration program.

April 1, 2019 · Juneau, AK

With 45 people waiting in Alaska jails for forensic competency evaluations, the state's mental health trust redirected $150,000 so the health department could hire a contract forensic psychiatrist. The aim was to clear the backlog by mid-May 2019.

March 26, 2019 · Sacramento, CA

Alameda County Superior Court Judge Winifred Smith ruled that the Department of State Hospitals and the Department of Developmental Services violate due process when defendants found incompetent to stand trial wait in jail for months. She ordered admission within 28 days, phased in over three years.

March 15, 2019 · Denver, CO

An eight-year lawsuit ended in a consent decree setting new evaluation and treatment deadlines and a triage system.

March 13, 2019 · Jackson, LA

The Louisiana Department of Health called Eastern Louisiana Mental Health System in Jackson 'deplorable, antiquated and quickly deteriorating' in a $348 million, five-year request for a 750-bed replacement. Nearly all its patients come through the criminal justice system after being found incompetent or not guilty by reason of insanity, leaving virtually no long-term beds for civil patients.

March 9, 2019 · Juneau, AK

The Anchorage Daily News found Alaska's single psychiatric hospital could not keep up with court-ordered competency evaluations and restoration, leaving dozens of defendants in jail. A public defender habeas filing was already pressing the due process question, with Washington's Trueblood fines cited as a warning.

March 1, 2019 · Little Rock, AR

Arkansas human services officials announced a restructured system for the court-ordered mental evaluations of criminal defendants, citing frequent missed deadlines and adding roughly $1 million in costs, mostly through higher pay for examiners.

February 19, 2019

An ABA Journal feature argues that involuntary medication to restore competency, which the Supreme Court's Sell decision meant to confine to rare cases, has become routine and can prolong cases for years. It draws on Georgetown law professor Susan McMahon's research and the long-running Colorado Planned Parenthood shooting case.

February 8, 2019

A JAAPL review compares hospital, jail and outpatient settings for restoring defendants to competency, finding real advantages and disadvantages in each for restoration rates and time to restoration or to a finding of non-restorability. The authors aim to guide practice and future research as competency evaluation requests keep rising.

February 4, 2019 · Sacramento, CA

Part of a CalMatters mental health series, this piece reports that referrals of defendants found incompetent to stand trial to California state hospitals rose 60 percent over five years and that the jail waitlist more than doubled, from 343 to 819.

February 1, 2019 · Sacramento, CA

The Department of State Hospitals counted 535 inpatient days in 2018 beyond the 10-day return limit for restored incompetent defendants, nearly all of them, 479, from Los Angeles County. The total was more than double the 2017 figure.

February 1, 2019 · Harrisburg, PA

WHYY reports that the ACLU of Pennsylvania sees improvement three years after settling its competency-wait lawsuit, but the state still has not met the seven-day requirement. The Department of Human Services counted 140 people on wait lists with an average wait of about 74 days.

January 20, 2019 · Portsmouth, VA

The family of Jamycheal Mitchell, who died in a Hampton Roads jail in 2015 while waiting to be transferred to a state hospital after being found incompetent to stand trial, reached a $3 million settlement.

January 2, 2019 · Harrisburg, PA

Pennsylvania's Office of Mental Health and Substance Abuse Services published a six-part set of operating procedures covering competency evaluations, restoration, non-restorable defendants, statewide collaboration, and jail-based and outpatient restoration programs. The set was written to reduce the forensic waiting list.

January 1, 2019 · Salt Lake City, UT

A legislative briefing from the state hospital and human services department reported the average wait for forensic admission had fallen from 168 days to 11 days in a year. It described the jail-based and outreach restoration programs that grew out of the Disability Law Center settlement.

December 21, 2018 · Portland, ME

A Cumberland County judge refused to hold Maine's acting health commissioner in contempt after a defendant found incompetent waited about 25 days in jail for a Riverview bed, ruling the matter moot once he was admitted. The defense attorney cited four other cases with waits of 12 to 40 days.

December 12, 2018 · Boise, ID

The Idaho Press reported that Idaho's two state psychiatric hospitals had seen more than a 250 percent rise in defendants committed after being found unfit to stand trial over five years, within roughly 145 adult beds. A health department official said the people arriving were increasingly dangerous.

December 11, 2018 · Olympia, WA

The settlement set firm 14-day evaluation and 7-day restoration-admission deadlines, plus new diversion and workforce commitments.

December 1, 2018 · Olympia, WA

By the time of the 2018 settlement, the state had already paid roughly $83 million in accumulated Trueblood contempt fines.

October 31, 2018

The second NRI paper in its alternatives series describes how jail-based competency restoration programs work, which states run them, and the limited outcome data available. Reported restoration rates vary widely from program to program.

October 31, 2018

An NRI paper reviews states' outpatient competency restoration programs for defendants who do not need hospital-level care, which states have built them to cut waitlists and free state hospital beds. It counts at least 35 states whose statutes allow outpatient restoration and at least 16 with formal community-based programs.

September 20, 2018 · New York, NY

The Mayor's Office of Criminal Justice and NYC Health + Hospitals began a Queens pilot to finish court-ordered competency (CPL 730) evaluations within 14 business days for felonies and 7 for misdemeanors, citing city analysis that defendants given these exams stay in custody nearly three times longer than comparable defendants.

September 11, 2018 · Denver, CO

Colorado Public Radio reported that the state's competency restoration waitlist had grown from three people to 281 in about a year, with judges increasingly threatening or imposing contempt on state officials. The state had fallen out of compliance with a 2016 order requiring timely restoration.

September 7, 2018 · Concord, NH

State officials floated a roughly 100-bed forensic hospital that would consolidate care now split among the prison's Secure Psychiatric Unit, New Hampshire Hospital and a Laconia facility. It would serve patients including those found incompetent to stand trial.

September 6, 2018 · West Point, MS

A federal civil rights suit filed in September 2018 over a Mississippi man held 11 years in Clay County jail after being found incompetent to stand trial seeks at least $11 million, as the story notes Mississippi inmates wait months for a 15-bed evaluation unit and about ten months for restoration.

September 1, 2018

Two forensic psychiatrists argue in JAAPL that jail-based competency restoration programs and enforced medication in jail have become stopgap answers to states' failure to hospitalize pretrial detainees with serious mental illness promptly. They treat both as inadequate responses.

August 10, 2018 · Pittsburgh, PA

Allegheny County issued a request for proposals to run competency restoration inside its jail, up to $640,000 in state funding, because defendants found incompetent wait months for a bed at Torrance State Hospital. The ACLU of Pennsylvania, which won a 2016 settlement over such delays, questioned whether a jail pod can substitute for hospital treatment.

August 10, 2018 · Austin, TX

An August 2018 Health and Human Services Commission slide deck, hosted by the Texas Judicial Branch under a 'judicial commission' file name, reported 168 of 2,432 state hospital beds offline, 762 of 2,245 beds held by patients staying over a year, and an average of 296 days from arrest to hospital admission for non-maximum-security cases.

July 21, 2018 · Salt Lake City, UT

Six months into the settlement, Utah State Hospital had cut its competency-restoration wait to about 40 days and its waitlist to 15 patients. Admissions and discharge speed both improved, and the next deadline was 30 days.

June 25, 2018 · Lakewood, WA

Federal regulators announced they would end Western State Hospital's Medicare certification, costing Washington about $53 million a year. About a third of the 857-bed hospital's patients were forensic, and the state was by then accruing tens of millions in fines over late competency services.

June 13, 2018 · Denver, CO

Disability Law Colorado filed a motion asking a court to enforce its settlement after the state kept thousands of mentally ill defendants in jail without timely evaluations or treatment. The state blamed extraordinary demand and said litigation was not working.

June 7, 2018 · Bartow, FL

WFLA found that a 30-year-old woman a judge ruled incompetent to stand trial and ordered into Department of Children and Families custody in 2017 remained in the Polk County Jail for 14 months because no agency noticed the transfer had not happened.

June 2, 2018 · San Antonio, TX

The Express-News editorial board cited state figures of 675 defendants waiting for forensic beds and 100 hospital beds offline for lack of staff, and urged the newly formed Judicial Commission on Mental Health to find faster fixes.

April 24, 2018 · Annapolis, MD

Governor Hogan signed Senate Bill 233, which requires the Maryland Department of Health to admit committed incompetent defendants within 10 business days and authorizes courts to sanction the department for missing that deadline. The law took effect October 1, 2018.

March 31, 2018 · Salt Lake City, UT

Utah State Hospital met its first lawsuit-settlement benchmark by cutting waits for competency restoration beds from about six months to 60 days. A 22-bed jail unit and efficiency changes were credited.

March 29, 2018 · Raleigh, NC

In a March 29, 2018 report required by Session Law 2017-147, the state health department recommended replacing local forensic evaluators with regional pretrial evaluation programs at all three state psychiatric hospitals and piloting jail-based capacity restoration.

March 26, 2018 · Lincoln, NE

Sen. Matt Hansen introduced an interim study resolution (LR370) to examine long waits for Lincoln Regional Center beds for defendants ruled incompetent and the effect on county jails. The Judiciary Committee held its hearing on September 7, 2018.

March 14, 2018 · Saint Paul, MN

A March 2018 state memo to Minnesota senators said priority admissions of jail patients, including people receiving competency treatment, rose from 44 in 2013 to 227 in 2017 and now fill over half of Anoka's beds. It tied reduced bed availability to safety work, patient acuity, and staffing losses.

March 9, 2018 · Lansing, MI

Safe & Just Michigan reports that the state House passed bills on Feb. 28, 2018 setting strict timelines for mental health evaluations, including psychological exams within 45 days of a court order. The group says the average wait for a competency exam at the Center for Forensic Psychiatry is six months and urges more staffing money.

March 7, 2018 · Salt Lake City, UT

Utah State Hospital's 100-bed forensic unit was full and courts kept ordering more defendants there, leaving some in jail where a few had died by suicide. Hospital leaders asked for $5.3 million to reopen a closed 24-bed unit.

February 26, 2018 · Washington, DC

A report from the D.C. Auditor and the Council for Court Excellence found the Department of Behavioral Health struggled to admit defendants to Saint Elizabeths for competency evaluation and restoration, leading to an admissions waitlist and judicial threats of contempt.

February 26, 2018 · Lansing, MI

A February 2018 House Fiscal Agency analysis described House Bills 5244 and 5246, which would set a 45-day target for competency exams and limit report extensions to one 15-day delay. Michigan Votes records HB 5244 passing the House 107-2 two days later.

February 2, 2018 · Sacramento, CA

The Los Angeles Times reported that Gov. Jerry Brown's 2018 budget earmarked $117 million to expand beds and diversion for more than 800 defendants found incompetent to stand trial, a population up 33% in three years, while Sen. Jim Beall argued the statutes themselves need updating.

February 1, 2018 · Saint Paul, MN

A February 2018 follow-up from Minnesota's legislative auditor said defendants found incompetent mostly still waited in jail for commitment, and that the state hospitals were using only part of their capacity because of staffing gaps. It noted the 2016 Legislature had funded a St. Peter facility for competency restoration.

January 29, 2018 · Kaneohe, HI

The Hawaii Department of Health announced a $140 million design-build contract for a new 144-bed forensic psychiatric facility at the State Hospital in Kaneohe, with construction expected to finish by 2021. The release said the hospital's census keeps rising because it must accept forensic patients committed by the courts.

January 26, 2018 · Montgomery, AL

The Hunter v. Beshear decree capped waits at 30 days by late 2019 and added roughly 100 forensic hospital and community beds.

December 28, 2017 · Denver, CO

Colorado was out of compliance with its 28-day competency standard for the second time in six months, with some people waiting up to four times as long as allowed. Court orders for evaluation and restoration had risen sharply in a year, outpacing the Pueblo hospital's competency beds.

December 28, 2017 · Jackson, MS

A ProPublica investigation follows one defendant who waited 1,266 days in a county jail for a court-ordered evaluation, and uses the state's own waitlist to show Mississippi may have the longest such delays in the country.

December 5, 2017 · Honolulu, HI

Courts committed 331 defendants to Hawaii State Hospital in 2016, more than triple the 1997 figure, and nearly 70 percent were there over fitness to proceed. Civil Beat tied the growth to homelessness, community mental health cuts and more cautious courts.

December 5, 2017 · Norristown, PA

Pennsylvania's human services department fell behind again on court settlements requiring treatment beds for defendants found incompetent, halting a planned 50-bed conversion at Norristown State Hospital after community objections. The ACLU says the wait for a Norristown bed is around 14 months.

December 1, 2017 · Lansing, MI

An Associated Press brief, summarizing an MLive investigation, reports that a November state list showed 110 Michigan defendants awaiting mental health treatment, with many waiting three to four months. The health department says it added 34 beds at the Center for Forensic Psychiatry last year and is working on screening to prioritize cases.

November 21, 2017 · Little Rock, AR

KARK reported the Arkansas State Hospital's 160 beds were full and it had asked for 62 more positions, while the Pulaski County sheriff said 79 inmates were committed for pretrial mental evaluations and only 12 had been completed.

November 16, 2017 · Kaneohe, HI

In the wake of a high-profile escape, Civil Beat reported that Hawaii's only state psychiatric hospital now admits almost entirely court-committed patients, with nearly 70 percent sent for fitness-to-proceed issues. The hospital's design and security had not caught up.

November 9, 2017 · Lansing, MI

House Bill 5246, introduced in November 2017, would amend the Mental Health Code to cap competency examination periods at 45 days and push the state to certify more examination facilities.

November 9, 2017 · San Antonio, TX

Records obtained by Fox San Antonio showed 99 Bexar County inmates waited an average of 126 days for the San Antonio State Hospital and 37 waited an average of 375 days for the maximum-security hospital at Vernon.

October 31, 2017 · Annapolis, MD

Dr. Erik Roskes, who ran the Maryland health department's Office of Forensic Services, left his post after Judge Gale Rasin held him and four colleagues in contempt over court-ordered psychiatric admissions. The judge had faulted the data he gave legislators and an unwritten policy that delayed telling courts when defendants were found incompetent.

October 25, 2017 · Olympia, WA

A federal judge held Washington's social and health services agency in contempt over late in-jail competency evaluations and set daily fines of $750 and $1,500 per waiting person. The order followed an earlier contempt finding over restoration delays whose fines had passed $30 million.

October 10, 2017 · Houston, TX

More than 500 Texas jail inmates were waiting for state hospital treatment in fall 2017, including 60 to 80 a day in the Harris County jail, according to the Houston Chronicle. State forensic bed capacity had fallen by nearly 300 since the mid-1990s even as new money was approved.

October 1, 2017

A journal study of 486 patients with usable data, drawn from 837 admitted as incompetent to stand trial, found that a routine admission screen helped identify people who need a fuller feigning assessment. The authors frame it as one way for states under waiting-time litigation to make restoration systems more efficient.

September 29, 2017 · Annapolis, MD

Baltimore Circuit Judge Gale Rasin held Maryland's acting health secretary and four other officials in civil contempt for failing to place court-committed defendants in state hospitals. To purge it, they had to staff 20 new beds at Perkins and open 40 more across two admissions units by the end of December.

August 28, 2017 · Annapolis, MD

Maryland's Court of Appeals held that the health department's missed admission deadlines violate court orders but not the commitment statute, and that unreasonable delays in moving incompetent defendants from jail to a hospital can violate substantive due process. It sent the constitutional claim back for further proceedings.

August 14, 2017 · Lincoln, NE

The Lincoln Journal Star reported in August 2017 that nine defendants found incompetent to stand trial were in the Lancaster County jail in a single week, some held for more than 90 days while waiting for a bed at the Lincoln Regional Center.

August 9, 2017 · Jackson, MS

A Hinds County judge describes how a thin supply of forensic beds at Mississippi State Hospital keeps people with serious mental illness in jail far longer than other defendants.

August 8, 2017 · Springfield, IL

Illinois enacted HB 649 in August 2017 to speed placement of jailed defendants found unfit to stand trial, requiring courts to send orders to the state within five days and the Department of Human Services to determine placement within 20 days.

August 1, 2017

A NASMHPD assessment found forensic patients in state psychiatric hospitals grew 76 percent between 1999 and 2014 across 37 reporting states, with incompetent-to-stand-trial patients the main source of growth. It adds that waiting lists can lead courts to threaten or impose contempt on states.

July 13, 2017 · Salt Lake City, UT

A federal judge approved Utah's settlement of the lawsuit over jail waits for competency restoration, requiring shorter waits in stages and a court monitor for five years. The state also funded a 22-bed forensic unit at the Salt Lake County Jail.

June 15, 2017 · Salt Lake City, UT

A 2015 class action over months-long waits at Utah State Hospital ended in a settlement phasing wait times down to 14 days.

May 31, 2017 · San Luis Obispo, CA

A Santa Maria Sun investigation found San Luis Obispo County defendants declared incompetent to stand trial waiting from days to months in the county jail for county or state hospital beds, after one man died in a restraint-chair episode 12 days into such a wait.

May 29, 2017 · Austin, TX

An AP report found the average wait for a maximum-security state hospital bed in Texas had nearly doubled in two years to 127 days, with people who have both mental illness and intellectual disability waiting 417 days on average. A Disability Rights Texas class action over the waits was still pending.

May 25, 2017 · Salt Lake City, UT

A Deseret News investigation reported that Utah's average wait for a state hospital competency bed was about 149 days, far longer than in neighboring states, with dozens of people in jail awaiting treatment. It traced the growth to rising evaluation orders and a fixed 100-bed forensic unit.

May 22, 2017 · Harrisburg, PA

The ACLU of Pennsylvania said it is resuming its settled class action because jail waits for defendants found incompetent to stand trial have grown since the January 2016 settlement. It asked the court to order 100 new treatment beds within six months and to bring in independent consultants to study the delays.

May 11, 2017 · Harrisburg, PA

More than a year after an interim settlement, plaintiffs in J.H. v. Dallas asked the federal court to cap Pennsylvania's jail-to-hospital wait for competency restoration at seven days and to order 100 new beds. The filing cites state data showing the waiting list had grown to 258.

April 12, 2017 · Austin, TX

A Senate Research Center analysis of committee substitute S.B. 1183 (Perry), dated April 12, 2017, laid out a package of competency restoration changes aimed at shrinking the state hospital waitlist, including keeping low-level misdemeanor defendants out of state hospitals.

March 1, 2017 · Morganton, NC

A WLOS investigation found that defendants deemed incompetent to stand trial were taking up to 70 of the 100 male beds at Broughton Hospital in Morganton, leaving few beds for civil patients waiting in emergency rooms.

February 22, 2017 · Sacramento, CA

The LAO's review of the 2017-18 state hospital budget reports 601 defendants on the incompetent-to-stand-trial waitlist in January 2017, up sharply since mid-2015, and evaluates a proposed 60-bed jail-based treatment center in Kern County.

February 17, 2017 · Olympia, WA

Two years after her original order, Judge Pechman found conditions had worsened, noting the state had already paid $9.6 million in contempt fines.

February 8, 2017 · Little Rock, AR

Arkansas Times reported on Senate Bill 42, which would separate fitness-to-proceed evaluations from criminal-responsibility evaluations to reduce the time defendants spend in jail awaiting assessment; 1,542 defendants were referred to the State Hospital for evaluations in 2016.

January 10, 2017 · Columbia, SC

H. 3325, introduced January 10, 2017, would require the Department of Mental Health to reimburse sheriffs and local governments for the actual costs of detaining people found unfit to stand trial who wait in local jails more than 15 days for transfer.

January 1, 2017

A Treatment Advocacy Center report estimates that about 90,000 people held in U.S. jails in 2016 were pretrial defendants with serious mental illness awaiting or needing competency services. Using a mathematical model built on five states, it argues that modest changes in diversion or length of hospital stay could sharply cut waits for forensic beds.

November 16, 2016 · Columbia, SC

Prison Legal News reports on a South Carolina Supreme Court decision reversing an order that would have involuntarily committed a defendant found incompetent and unlikely to be restored, leaving him in jail because he did not meet the statutory definition for commitment.

November 3, 2016 · Little Rock, AR

KARK reported that jail inmates in Arkansas ordered to the State Hospital for evaluation often wait far longer than court deadlines, with a Pulaski County defendant ordered moved within 48 hours still jailed more than two weeks later and not scheduled for evaluation until December.

October 19, 2016 · Chicago, IL

In late 2016, about 20 Cook County defendants found unfit to stand trial were held in jail awaiting state placements, one of them for 77 days, because the Department of Human Services said it had no free beds. Downstate and suburban counties reported dozens more waiting.

September 30, 2016 · Montgomery, AL

Three men with serious mental illness who had been found incompetent to stand trial filed a federal suit alleging that Alabama's mental health department left them in county jails for roughly eight months before restoration treatment began. The case became the class action that produced Alabama's 2018 consent decree.

September 15, 2016 · Dallas, TX

The Dallas Morning News reported that the number of Texas jail inmates awaiting a maximum-security state hospital bed after being found incompetent had jumped about 86 percent in a year to a record 278, with an average wait near 150 days. Disability Rights Texas had just filed a class action over the waits.

September 6, 2016 · Baton Rouge, LA

The state agreed to transfer incompetent and insanity-acquittee detainees within 15 days after waits that had exceeded a year in some cases.

August 30, 2016 · Cheyenne, WY

A 2016 Wyoming Department of Health brief prepared for a legislative subcommittee diagnosed why court-ordered forensic evaluations at the Wyoming State Hospital run slowly and floated statute changes modeled on other states.

August 4, 2016 · Jackson, MS

Mississippi Today reported that the Mississippi State Hospital forensic unit had 35 beds for court-ordered commitments, 144 people on its waiting list and an average wait of about 11 months, just as state mental health budget cuts were closing more psychiatric beds.

August 2, 2016 · Denver, CO

Colorado's human services agency settled a dispute with Disability Law Colorado over delayed competency evaluations, agreeing to bring in an independent consultant and pay $196,000 in attorney fees. The deal came after the group said the state had missed the one-month deadline it set in 2012.

August 1, 2016

The ABA adopted a rewritten set of Criminal Justice Mental Health Standards in August 2016, including a part on competence to proceed that covers raising the issue, examinations, hearings, dispositions and handling of defendants who cannot be restored. The revision steers away from trying unrestorably incompetent defendants and toward release or hospitalization in a forensic facility.

July 18, 2016 · Baton Rouge, LA

A federal judge in Baton Rouge rejected Louisiana's bid to throw out a suit by the Advocacy Center and a detainee over long jail waits for restoration treatment at the state's forensic hospital. The ruling kept the case alive about two months before the state agreed to a settlement.

July 8, 2016 · Olympia, WA

Judge Pechman issued the case's first civil contempt finding against DSHS, with fines up to $1,000 per day per class member left waiting.

July 1, 2016

The Treatment Advocacy Center documented continued closure of state psychiatric beds, finding per-capita counts far below what it considers an adequate minimum.

June 14, 2016 · Jackson, MS

An AP story reports that a Clay County man found incompetent to stand trial in 2008 had been jailed nearly 11 years on a murder charge before a judge approved his transfer to a state hospital, with the sheriff saying every Mississippi sheriff faces the same question of what to do with such defendants.

June 8, 2016 · Annapolis, MD

The Baltimore Sun reported that Maryland's state hospitals lacked beds to take defendants judges had ordered into treatment, leaving 85 people on waiting lists as a lawyer sought an injunction against the health department.

May 4, 2016 · Denver, CO

A 2016 Colorado law directed that competency evaluations take place on an outpatient basis or where the defendant is held, with a short list of reasons for sending someone to the state hospital in Pueblo.

May 3, 2016 · Portsmouth, VA

An AP report on Virginia's inspector general findings about the death of a jailed man who was court-ordered to a state hospital but never transferred. The behavioral health department said its own probe was hampered by limited access to records and asked lawmakers for money and better coordination.

April 11, 2016 · Houston, TX

A Houston Press review of 145 Harris County misdemeanor cases from 2015 found people judged permanently incompetent spent about a week in jail, and sometimes more than a month, waiting for a civil commitment bed. The piece ties the delays to a statewide forensic-bed squeeze.

April 7, 2016 · Salt Lake City, UT

A federal judge rejected Utah's motion to dismiss the suit over long jail waits for competency restoration, finding the plaintiffs plausibly alleged a substantive due process violation. The ruling kept the case alive and set up the later class certification and settlement.

March 1, 2016 · Saint Paul, MN

A March 2016 evaluation by Minnesota's legislative auditor found that 63 percent of tracked defendants deemed incompetent stayed in jail while awaiting commitment, contrary to state law. It recommended a faster path into competency treatment and restoration options beyond high-security hospitals.

March 1, 2016 · Raleigh, NC

In 2016 North Carolina's mental health division proposed rules moving the roughly 220 community forensic evaluators who screen defendants for capacity to proceed from registration to certification, with required training and annual continuing education.

February 24, 2016 · Pueblo, CO

State officials said the Pueblo hospital had eliminated its waitlist for court-ordered competency evaluations after months of delays. Advocates who alleged a violation of a 2012 settlement said they would verify the claim in mediation.

February 9, 2016 · Olympia, WA

After the state missed a January 2016 compliance deadline, a federal judge extended it to May 27 but imposed ten interim tasks and sharply criticized how the state had managed its competency backlog. Average waits for restoration at Eastern State Hospital had grown from 21 days to 94 over a year.

February 1, 2016 · Augusta, ME

Maine's governor backed a bill to let the state transfer violent Riverview patients who were found incompetent to stand trial or not criminally responsible into the Intensive Mental Health Unit at the Maine State Prison. Advocates and civil liberties groups said the plan would criminalize mental illness.

January 28, 2016 · Harrisburg, PA

Pennsylvania's Department of Human Services settled the ACLU's class action over jailed defendants awaiting competency treatment, reached on the eve of trial. The deal adds 120 treatment slots and $1 million in Philadelphia housing funds.

December 18, 2015 · Tallahassee, FL

The fourth installment of the investigation analyzed a decade of state court data and found Florida courts declared defendants incompetent 30,000 times between 2004 and 2013, most for nonviolent charges, at an average restoration cost of $53,000.

December 16, 2015 · Tallahassee, FL

Following the Times and Herald-Tribune series, legislators said reform would take funding and time, and a state official said three-fifths of state hospital beds are held by forensic patients.

December 1, 2015 · Las Vegas, NV

Nevada opened the Stein Forensic Unit at Rawson-Neal Psychiatric Hospital on November 19, 2015, its second secure facility for mentally ill offenders. It started with six patients and was due to reach 47 beds by February 2016, while 67 people statewide were still waiting in jail.

November 14, 2015 · Portsmouth, VA

After a 24-year-old man died in a Portsmouth-area jail months after a judge ordered him to Eastern State Hospital for competency restoration, The Virginian-Pilot examined why court-ordered defendants wait so long for state hospital beds. Sheriffs, prosecutors and advocates described jails as stand-ins for the mental health system.

November 13, 2015 · Baton Rouge, LA

The Advocacy Center of Louisiana and the MacArthur Justice Center sued in November 2015, alleging delays in moving people found incompetent to stand trial from parish jails to the state hospital in Jackson had returned. State records cited in the suit showed 22 people waiting as of October 23, four for more than 40 days.

October 30, 2015 · Las Vegas, NV

U.S. District Judge Miranda Du ordered Nevada to meet its seven-day treatment commitment for jailed mentally ill defendants and warned she could appoint an independent monitor by the end of November. About 40 prisoners were then waiting in Las Vegas, with transfers taking 90 to 125 days.

October 29, 2015 · Tallahassee, FL

The first installment of a joint investigation reported that years of budget cuts and layoffs left Florida's state mental hospitals, where roughly 60 percent of patients are forensic, with violence at record levels.

October 22, 2015 · Harrisburg, PA

The ACLU of Pennsylvania filed a federal class action against the state Department of Human Services over defendants found incompetent who sit in county jails for a year or more before reaching a state forensic hospital. The suit says the wait averages 391 days, far past the roughly one-week limit other federal courts have used.

October 20, 2015 · Sacramento, CA

KQED reported that more than 300 mentally ill defendants were waiting in California jails for state hospital beds, some for eight to twelve months against a target of two to three. The piece centers on a man who took his own life in a county jail while awaiting transfer, the basis of a pending ACLU suit.

October 1, 2015 · Columbia, SC

An October 2015 Legislative Audit Council review found that only 41 percent of defendants referred to the Department of Mental Health were restored within the 60-day statutory limit and recommended extending it to six months.

September 22, 2015 · Kaneohe, HI

The Hawaii Department of Health unveiled a master plan to build a $160 million, 144-bed facility for high-risk patients at the overcrowded State Hospital, which is required to accept patients sent by the courts regardless of bed availability.

September 9, 2015 · Salt Lake City, UT

A federal lawsuit filed by Utah's Disability Law Center says defendants found incompetent are waiting months in county jails for beds at the Utah State Hospital. The suit describes the wait as a crisis, with one plaintiff held nearly 18 months.

August 25, 2015 · Denver, CO

Disability Law Colorado told the state it was violating a 2012 federal settlement by leaving jailed defendants waiting well beyond 28 days for admission to the Pueblo state hospital. The group cited nursing vacancies and surging court orders as drivers of the backlog.

August 7, 2015 · Las Vegas, NV

Las Vegas Justice Court's chief judge ruled his court cannot hear defense motions to dismiss charges for 24 mentally ill detainees stuck in jail awaiting transfer to Lake's Crossing, leaving the question of relief for delayed treatment in jurisdictional limbo.

July 29, 2015 · Sacramento, CA

The ACLU of Northern California and Sullivan & Cromwell sued the state hospital and developmental services departments in Alameda County, saying defendants found incompetent to stand trial sit in county jails for months awaiting treatment. The case grew into Stiavetti v. Clendenin, which produced California's statewide 28-day admission deadline.

July 20, 2015 · Minneapolis, MN

MinnPost reports that in Hennepin County more than half of the defendants ruled too impaired to face charges last year also failed the test for state-ordered civil treatment, so they were released without services and often cycled back through court. The piece ties the gap to a sharp rise in competency petitions and to a county effort to connect these defendants with help while still in custody.

July 9, 2015 · Las Vegas, NV

With Lake's Crossing unable to admit court-ordered patients within 14 days, the Clark County public defender filed dozens of motions to dismiss charges and free detainees who had waited 90 to 150 days. State officials conceded they could not meet the deadline and pointed to new Las Vegas forensic beds expected in the fall.

June 22, 2015 · Washington, DC

A 2015 paper describing the Washington, DC outpatient competence restoration program reported that over four years it restored 55 of 170 participants, about one-third.

April 24, 2015 · Augusta, ME

A York County defense attorney won subpoenas ordering Maine's health commissioner and the Riverview superintendent to appear for contempt over a defendant who sat in jail for a month after a judge ordered him admitted to Riverview Psychiatric Center. The dispute exposed how court-ordered admissions of defendants found incompetent were stalling at a hospital that had lost federal certification.

April 2, 2015 · Olympia, WA

A federal judge issued a permanent injunction finding Washington routinely left incompetent defendants isolated in jail for weeks to months, in violation of due process.

March 27, 2015 · Tulsa, OK

Oklahoma's mental health department said the Vinita forensic center was at capacity with about 100 inmates waiting, and was negotiating jail-based evaluations with Tulsa County after a similar deal in Oklahoma County following a contempt threat from a judge.

March 15, 2015 · Spokane, WA

A Spokane County judge repeatedly held Eastern State Hospital in contempt for taking too long to complete court-ordered competency evaluations of jailed defendants, with fines running to roughly $200 a day per delayed case. The Spokesman-Review reported dozens of felony defendants waiting weeks or months in jail while a federal class action over the same delays headed to trial.

October 29, 2014 · Olympia, WA

Individual Washington judges started holding the state in contempt and fining it over defendants stuck in jail awaiting competency evaluation, years before the federal Trueblood case would take over that role.