Update, 12 p.m. Friday
Following the publication of this story, a representative from the Department of State Hospitals sent an emailed statement regarding steps the agency has taken to increase its capacity to treat incompetent to stand trial (IST) patients.
Agency spokesman Ken August wrote that Department of State Hospitals does not comment on ongoing litigation or court proceedings, including the issue of possible sanctions in San Luis Obispo County.
August wrote that the state has increased its IST patient capacity by 609 beds since Fiscal Year 2012-13, including 411 state hospital beds and more than 200 beds in county jails. During the current fiscal year, the state budget included funding for additional beds for the treatment of IST patients including expanding the agency's jail-based restoration of competency programs and establishing a new 60-bed center for IST patients in the Kern County Jail.
He wrote that the proposed FY 2018-19 budget also includes funding for an IST diversion program as well as an additional 150 beds in Los Angeles County for community mental health treatment programs.
Fed up with the amount of time mentally incompetent County Jail inmates are waiting for treatment at a state hospital, a San Luis Obispo Superior Court judge on Thursday set a hearing to consider fining the state over the backlog.
During a progress hearing Thursday for five San Luis Obispo County Jail inmates who were ordered months ago to be treated at a state hospital before their criminal cases can proceed, Judge Ginger Garrett scheduled a hearing May 10 for the Department of State Hospitals to show cause why it shouldn't face sanctions for refusing to accept the inmates.
Garrett could find the agency in contempt of court and fine the state $1,500 per violation if she finds the agency has the ability but is unwilling to accept them as patients.
A report on a patient's progress is generally due back to the court 90 days after the inmate is ordered transferred to a facility.
Joanna Mupanduki, an attorney for the Department of State Hospitals at Thursday's hearing, referred questions from The Tribune to DSH's Office of Communications. She did tell Garrett, however, that the state will be represented May 10 by a deputy from the California Attorney General's Office.
A spokesman for the Department of State Hospitals did not return requests for comment.
Under California law, a judicial officer has the power to impose reasonable monetary sanctions, not to exceed $1,500, for any violation of a court order done without substantial justification. It is unclear whether that fine is enforced daily.
The issue of wait times for jail inmates deemed incompetent to stand trial is the subject of at least eight county, state and federal civil rights lawsuits against the Department of State Hospitals, and the agency won't discuss the issue because of the pending litigation, a spokesman previously told The Tribune.
But according to figures provided by the San Luis Obispo County Sheriff's Office in November, inmates facing felonies whose criminal cases have been suspended pending mental competency restoration waited between 18 and 133 days for transfer to a state hospital during the one-year period that ended Oct. 31, 2017.
The scenario isn't unusual. According to figures provided by SLO Superior Court, doubts of competency were declared by defense attorneys in 58 felony and 99 local misdemeanor cases between January and October 2017.
Patients at Atascadero State Hospital — where most local male inmates facing felonies are sent — are treated an average of 167 days before they were transferred back to a jail to face charges, according to a Department of State Hospitals spokesman.
In San Luis Obispo County, the issue of wait times for mental health treatment has been highlighted by the death of 36-year-old Atascadero resident Andrew Holland. In January 2017, Holland, who was diagnosed with schizophrenia, was deemed mentally incompetent to stand trial and was ordered by a SLO Superior Court judge to be transferred to the county's 16-bed psychiatric facility for treatment.
Despite the order, jail officials held Holland in a solitary cell for 10 more days, and ultimately strapped him to a full-body restraint chair for another 46 hours after he began hitting himself in his cell. Holland died of an embolism caused by a blood clot roughly an hour after being released from the chair.
His death led to a $5 million county settlement with his family, sparked an ongoing FBI civil rights investigation, and illuminated the plight of mentally ill inmates stuck in jail without treatment while they wait for a mental health bed to open up.
The backlog has gotten worse in recent years, local officials say.
At Thursday's hearing, Garrett's courtroom was packed with roughly a dozen public defenders, SLO County Deputy District Attorney Michael Frye, Deputy County Counsel Ann Duggan, DSH's Mupanduki, and newly hired County Chief Medical Officer Christy Mulkerin.
In one of the five inmates' cases, Garrett noted that Superior Court Judge Dodie Harman on April 4 ordered the man transferred to Atascadero State Hospital and a progress report be delivered to the court at his next hearing. The Sheriff's Office, in attempting to comply with Harman's order, bussed the man to the facility only to have him turned away and returned to the jail.
"That's 135 days that he's been sitting in jail with no treatment available to him," Garrett said of the inmate, adding that she was compelled to set a hearing for the Department of State Hospitals to argue why it should not be sanctioned and held in contempt of the court's order.
Following the hearing, Assistant District Attorney Eric Dobroth said that while the DA's Office won't have a direct role in that hearing, it's in everyone's best interest to make progress in the criminal cases, both for the defendants and for their alleged victims, who are also waiting for resolution.
"The jail is not a state hospital," Dobroth said. "Although (jail staff) make their best efforts, people (with severe mental illness) will generally decompensate in jail."
Steve Rice, a defense attorney working for the Public Defender's Office who represents one of the inmates at Thursday's hearing, said he was hopeful that the threat of sanctions will force the state to accept custody of his client and the four others currently at County Jail.
Rice, who's represented about 50 clients ruled incompetent to stand trial in his roughly 13 years as a public defender, said the problem has gotten progressively worse over the last eight years.
"It's very frustrating. First and foremost, they're not getting the necessary treatment that they need," Rice said. "Oftentimes the attorney is blamed for them languishing in jail when we're doing everything we can, but they're not usually well enough to understand. It really interferes with our relationship with them."
Rice said the state has long known it is in dire need of at least expanding its capacity to treat the growing number of mentally ill inmates in the criminal justice system, if not build more facilities.
"They’ve known that for years," Rice said. "It's really the judges that can take the action to get (inmates) the necessary treatment."