More light was shed this week on the San Bernardino County Sheriff’s Department’s involvement in the provision of so-called mental competency restoration services for inmates.
Publicly disclosed this week is that the West Valley Detention Center in Rancho Cucamonga, where a pilot program for mental competency restoration was established in 2010, is now hosting a mental illness management facility that caters not just to county inmates but ones brought in from other locations throughout the state.
This week members of the county board of supervisors were informed that Los Angeles County had delayed sending inmates in need of psychiatric care to West Valley and that the department is now actively inviting 56 of the state’s other counties to ship its non compos mentis inmates to the Rancho Cucamonga facility.
Once a trial court finds a defendant mentally incompetent to stand trial and orders the defendant committed to a state mental hospital for care and treatment to restore competence in order to be processed through the justice system, the state mental hospital has 90 days to make a written report to the court concerning the defendant’s progress toward recovery of mental competence.
According to Kathy Wild, the sheriff’s department’s health care administrator, “The demand for restorative programming and treatment at the state hospital level has been increasing over the past decade so that many individuals are forced to wait in the county jail for months until a bed is available. This wait creates an extended period of incarceration for the inmate and excessive delays in the adjudication of their criminal charges.”
As part of an effort to clear the county’s jails of this backlog of inmates awaiting admission to the state mental hospital system, the county in 2010 hit upon the idea of bringing in a psychiatrist who would provide to those inmates in the county jail the same services those inmates would receive in a state mental hospital.
In recent years, dealing with mentally deranged and challenged criminals has become profitable to a limited set of medical professionals with expertise within the psychiatric sciences that can make competency certifications. Among those is Orange County-based psychiatrist Thomas C. Lester M.D., who has long been doing business as Liberty Healthcare of California, Inc.
In May of 2010, the California Department of Mental Health contracted with Liberty (State Agreement No. 09-79156-000) to establish a pilot program to provide restoration of mental competency services in a county jail. On June 22, 2010, the board of supervisors approved a revenue agreement with Liberty to allow West Valley Detention Center to be used as a site for a state pilot program to provide restoration of mental competency services to county inmates. The San Bernardino County Sheriff’s department allocated 20 beds in a sheltered housing unit for use by Liberty and assigned a deputy to provide security for Liberty’s staff. On June 4, 2013 the board approved Agreement No. 13-367 to continue the program until June 30, 2016.
The state of California has created economic incentives to promote the mental competency restoration concept, which has led to some questionable actions by governmental entities and psychiatric professionals in the scramble for the money.
In April, Lester, who has realized a substantial profit over the previous four years and nine months on a no-bid contract, was given another one-year, no-bid $4.7 million contract.
When Lester first obtained what was a relatively modest contract with the county of San Bernardino in 2010 under the auspices of the experimental “pilot program,” competitive bids were bypassed. Since that time, his contract has been renewed without any competitive bidding. That arrangement has proven highly lucrative for Lester.
While the first contract Lester’s company landed with the county for the three-year period between July 1, 2010 to June 30, 2013 specified a not-to-exceed $499,977 annual cost, not including the cost of medication, the contract approved in April zoomed to more than nine times the original cost, $4,756,536 for the period from June 1, 2015 to May 31, 2016.
San Bernardino County officials were disinclined, however, to limit Lester’s profit taking, as the county likewise has a financial interest in the program continuing. By utilizing a psychiatrist to provide mental competency restoration services to inmates deemed to be mentally incompetent within the jail setting as opposed to transferring them to a state mental hospital, the county stands to obtain reimbursement of $10,857,697.44 from the state this fiscal year. .
Currently, The California Department of State Hospitals has insufficient beds within the state hospitals, thereby creating lengthy waiting lists of inmates in county jails, including those in San Bernardino County, who are in need of mental competency restoration services. To address this shortage, the California Department of State Hospitals contracted with the sheriff’s department to provide access to portions of the West Valley Detention Center to administer the Jail Based Competency Treatment Program and provide inmates, from both Los Angeles and San Bernardino counties, with restoration of competency treatment services similar to those provided in state mental hospitals, for up to 76 patient inmates. It was his commitment to administer that program at West Valley Detention Center that netted Lester the current $4.7 million contract.
In April, sheriff’s captain Shannon Dicus, who was then the sheriff’s department’s official spokesman, said, ““This program would allow inmates to begin treatment faster and significantly decrease the time these individuals remain incarcerated due to a faster adjudication of their criminal charges.” At that time, Dicus did not address the consideration that a significant number of those being administered to under the program were not San Bernardino County inmates or awaiting trial in San Bernardino County courts but were rather inmates anticipated to come from Los Angeles County.
Dicus has now moved on to become the commander of the West Valley Detention Center. Taking his place as department spokesman is lieutenant Samuel Fisk. According to Fisk, “Administrative issues have delayed the referral of inmates from Los Angeles County into the program. As a result, the California Department of State Hospitals has requested the contract be amended to include participation by any California county in order to maximize the usage of the available treatment services. Currently, the California Department of State Hospitals has insufficient beds within its state hospital system.”