Staff numbers hinder Eastern State’s compliance with mental health evaluations

Eastern State Hospital continues to struggle with a federal judge’s order to evaluate criminal defendants for mental illness promptly.

Delayed evaluation means defendants who may have a mental illness wait months for resolution of cases that can’t move forward until an Eastern State evaluator decides whether they’re competent to stand trial.

“The person sitting in custody or waiting in the community might be completely innocent of the charges, but ethically we cannot go forward,” city public defender Kathy Knox said.

In an injunction issued in April, U.S. District Judge Marsha Pechman ordered the Washington Department of Social and Health Services to complete evaluations within seven days and set a January deadline for compliance. The order came as the result of a class-action lawsuit filed by Disability Rights Washington and the American Civil Liberties Union that argued current wait times violate due process rights.

An August quarterly report from court-appointed monitor Danna Mauch acknowledged that DSHS has made strides in improving performance but said, “to date, these steps have not impacted relief for class members, as demonstrated in the reports on wait times for competency services.”

As of Sept. 2, 136 people were still waiting for an evaluation at Eastern State, according to a waitlist the hospital provided to public defenders. Of those, 122 had been waiting for a week or longer, and 26 for more than three months.

Many defendants waiting to be evaluated have been released on personal recognizance, but 37 remain in jail. About half of them face misdemeanor charges.

Mauch’s report found Eastern State completed between 0 and 2 percent of evaluations on time for each month in the second quarter of 2015, versus 11 to 16 percent at Western State Hospital in Lakewood, Washington. At Eastern State, the median wait time in June was 45 days.

DSHS officials said they plan to hit Pechman’s targets but have had difficulty hiring people who want to work at Eastern State.

“We just struggle to find folks who want to live over in the Spokane area,” said Carla Reyes, the acting assistant secretary for the Behavioral Health and Service Integration Administration, the branch of DSHS that oversees state hospitals.

Pay for evaluators is the same regardless of whether they work at Eastern or Western State, but Reyes said evaluators often are recent graduates who find urban life in the Puget Sound area more appealing.

The budget approved by the Legislature in July included $40.9 million in forensic mental health funding for compliance with Pechman’s order. Nearly $27 million will be used to hire 129 new staff members and create 60 additional beds between both state hospitals. There’s also funding for five new evaluators at Eastern State.

To date, Eastern has filled three of those positions, Reyes said. Two evaluators at Western State have family in Yakima and may be assigned to split time between Western Washington and areas served by Eastern State Hospital in Central Washington. DSHS also is exploring other options, including temporarily bringing a team of Western State evaluators across the mountains to help clear case backlogs and creating an assignment pay system to coax evaluators, who do not receive overtime pay, to take on extra cases.

Another option is allowing social workers and nurses to complete evaluations, a step which would require renegotiating with the evaluator union, Reyes said.

The hospital also is hiring for a number of non-evaluator positions and will hold a job fair in Spokane in October, Reyes said.

Spokane County Superior Court Judge Sam Cozza has held Eastern State in contempt of court several times for delays in evaluating Spokane County Jail inmates. He said wait times seem to be improving slightly, and Cozza is hopeful the hospitals will meet the January deadline.

“They know what they have to do. I think they’re still struggling,” he said.