If you want something done right (and cost effective), then leave it to local government to get the job done---that’s essentially the conclusion of the LAO in a recently released report about a notable pilot program. In response to long waitlists at state hospitals, the Department of Mental Health began a pilot program in San Bernardino so that those deemed incompetent to stand trial (IST) could be treated in county jails as opposed to state hospitals for treatment. The wait list for such a transfer to state hospitals is often between 200 and 300 individuals a month, hence the creation of the pilot program. Many IST commitments are forced to remain in a county jail before transfer due to staffing and physical space at state hospitals.
In an update, the non-partisan LAO concluded that San Bernardino, in comparison to the state, provided greater flexibility, reduced costs, and those deemed incompetent to stand trial (IST) were restored to competency in a shorter amount of time than at state hospitals. Overall, treatment at the county level reduced waitlists and was more cost-efficient.
The LAO estimates that counties spend a combined annual total of at least $3.5 million to hold IST commitments in their jails beyond the 35-day period while they wait for a state hospital bed to become available. During the pilot program, the report notes that “San Bernardino County estimates that it has been able to achieve net savings of more than $5,000 for each IST commitment.”
The report concludes:
“We find the pilot program provides less incentive for potential malingerers, has greater flexibility to hold down costs, and is able to restore ISTs to competency in a shorter amount of time than the state hospitals. Additionally, the number of referrals from courts into IST treatment has decreased, possibly because treatment in a county jail is less appealing to defendants who may use a claim of incompetency as a defense strategy to keep out of prison.”
The LAO also advocates that the pilot should be extended into other counties. You can read the full report here. In addition, the LAO released the following video about its report:
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