A man in an orange Larimer County jail jumpsuit grew defiant within moments of entering a Fort Collins courtroom — raising his voice as he spoke to a judge.
As he sat at a table beside a lectern, the man said he wanted to fire his attorney that day because he believed the lawyer was trying to kill him.
☀️ READ MORE
Each time he spoke, Chief Judge Susan Blanco calmly interrupted, and asked him to create a plan that could help him stabilize and stay out of jail.
“Whatever you think is going to make you the most successful after you leave, let’s work on that, please,” she said during the April 11 court hearing.
The man was one of 24 people on the competency docket that day at the Larimer County Justice Center, a unique and specialized court program that links defendants with debilitating mental health conditions accused of crimes in the county to rehabilitation and legal education services that hopefully stabilize them enough, so they can begin to understand their court proceedings and effectively aid in their defense.
The model is so promising, 10 Colorado judicial districts and Denver County Court have launched similar speciality courts. The goal is to help participants get community-based services as often as possible and the court aims to reduce recidivism while also improving public safety.
Before the 8th Judicial District became the first to launch the inaugural competency docket, people with severe mental illness languished for months in the Larimer County jail, waiting for psychiatric services and being detained for crimes for which they had not been convicted.
Just over 120 people are on the 8th Judicial District ’s competency docket at any given time and 20 to 30 people are scheduled to appear each Thursday — a relative handful compared to the 8,554 cases that were filed in the Larimer County District Court between July 2022 and last June.
“The spirit of competency dockets started to get everyone in the same room to discuss significant mental health issues such as dementia and intellectual disabilities and to pull together resources in the community to help them get away from the court system, or if they go through it, to give them resources, so they don’t return,” said Amanda Myers, criminal justice programs unit manager at the state court administrator’s office.
“But, with that, you have to have resources,” she said. “In some judicial districts, the barrier seems to be a lack of staff in order to run this. And some judicial districts might be waiting to see how some of these dockets roll out and what they can learn from them before implementing their own.”
A judge, attorneys, mental health providers, doctors, nurse practitioners, housing organizations and case managers are among approximately two dozen essential staff members who help run the 8th Judicial District’s competency docket, said Gene Klivansky, competency services team lead in the community justice alternatives division for Larimer County.
On Friday, Klivansky drove a man living near Greeley to Fort Collins and back so that he could receive an injectable medication for his mental illness.
“I was on the road for two and a half hours, but the guy is doing well and we want him to do well,” Klivansky said. “This is kind of a whatever-it-takes approach to provide stability and options to people, so they don’t have to be stuck in the jail languishing, especially on minor charges.”
It can take seven months for a psychiatric bed to open at the state hospital in Pueblo, Klivansky said.
More than 15 people in Larimer County who were ordered to receive inpatient restoration are currently waiting for those services that will likely occur at a state psychiatric hospital, he said.
On Friday afternoon, there were 313 people in Colorado waiting for a bed at an inpatient psychiatric facility, with an average wait time of 92 days, said Jordan Saenz, communications manager for the Office of Civil and Forensic Mental Health, which operates Colorado’s two mental health hospitals and provides pretrial restoration services, among other things.
The need for competency dockets across the state is increasing since the COVID-19 pandemic, which disrupted behavioral health services and exacerbated concerns about a rise in mental health conditions such as depression and anxiety, said Amanda Duhon, chief deputy district attorney for the 8th Judicial District, the Larimer County court, based in Fort Collins.
And now, Colorado courts are increasingly raising concerns about people’s ability to understand their court proceedings and aid in their own defense.
Courts statewide ordered restoration services, or basic legal education courses and case management, for people who were too ill to understand their court cases 2,737 times during fiscal year 2022-23, up from 1,054 times during fiscal year 2017-18, a 159.7% increase, Saenz said.
Competency, or an individual’s ability to function meaningfully or knowingly in court, is questioned in a small fraction of criminal cases statewide, Duhon and Myers said, and while that population is relatively small, their life circumstances are often dire and they usually need services immediately.
Before the docket originated in the 8th Judicial District in 2021, even more people who were “deemed incompetent” were held for long periods in jail while waiting for a bed at one of the state’s psychiatric hospitals, Duhon said.
Before the docket launched in the 8th Judicial District, most people who were deemed incompetent received legal education and other human services in jail while they waited for a bed at a state psychiatric hospital. But now, most people who are deemed incompetent by judges in the district receive those services at community-based mental health organizations, said Denise Cosgrove, forensic navigator at the Office of Civil and Forensic Mental Health.
The new trend is important, Duhon said, because the waitlist at the state hospital is so long.
In 2011, Disability Law Colorado filed a lawsuit against the state that alleged its delayed admissions to the state psychiatric hospital in Pueblo violated the constitutional rights of people who were incarcerated with disabilities.
The Colorado Department of Human Services, the state agency that conducts competency evaluations ordered by criminal courts statewide, settled the federal lawsuit in 2020, and was required to pay over $10 million per year until 2027.
“We believe that competency dockets are one of the tools that we need to have in our toolbox,” said Meghan Baker, facilities and community integration team leader at Disability Law Colorado.
“The competency dockets allow professionals working on this team to gain expertise in this very niche area, and it can be more efficient, which can result in people being in jail for a shorter period of time,” she said. “The potential con is, it’s still the court system. We want to intervene before someone gets arrested.”
Providing psychiatric and legal education services in the least restrictive environment
State competency laws determine how long a sick person can be held in jail while they wait for a hospital bed. Some of those stays can be monthslong — up to 255 days for someone accused of a class 1 misdemeanor, for example, Duhon said.
“There’s two things wrong with that,” Duhon said. “Someone going through a mental health crisis should not be sitting in jail for 255 days without getting treatment. But the state hospital waitlist was about a year long when the 8th Judicial District’s competency docket was started. So no one being held on a misdemeanor case was ever going to the state hospital to get restored.”
Their cases were dismissed, as required by law, before they made it to the hospital, she said, meaning they were not receiving the treatment they needed and the victims of their crimes were not receiving justice, Duhon added.
Many of those people became homeless and were soon arrested again, she said.
Now, mental health, disability, addiction and housing providers sit in the courtroom during competency docket hearings to help participants get swiftly linked to critical community-based services, Klivansky said.
“We’re trying to remove barriers and find options for them in the community, the least restrictive environment,” Cosgrove said. “The more we can connect them with mental health centers, brain injury providers, a host home — that’s going to match their needs and make our communities safer.”
In September 2021, 55% of people who were deemed incompetent were waiting in jail for inpatient restoration services at a state psychiatric hospital or at a jail-based program, Cosgrove said.
In December 2023, that number dropped to 49% and the remaining 51% of people were ordered to receive outpatient restoration services at community mental health centers approved by the state, Cosgrove said.
In September, 2021, 63% of initial competency evaluations happened in jail and 37% occurred in the community. Now, initial evaluations in jail occur 33% of the time and 67% of the time the exams are done in the community, she said.
Concerns about competency
Defense attorneys are often the court employees who raise concerns about a person’s ability to understand their court cases. When that happens, the person’s court hearings halt, and they are moved to the competency docket, where a state doctor evaluates them and offers an opinion on whether they can move forward in their proceedings, Duhon said.
If the judge rules the person is competent, the court case against them resumes. If they’re incompetent, or too ill to proceed, the judge mandates that they participate in inpatient restoration services at one of the state’s psychiatric hospitals or in jail-based programs at Boulder County Jail or Arapahoe County Detention Center through the RISE program.
Others who are court ordered to participate in outpatient restoration services receive the support from mental health providers in the community, Duhon said.
People can be reevaluated by the state doctor several times. After four evaluations, if a person is not restored, a defense attorney or judge could hold a hearing to determine if the person should continue engaging with restoration or if their cases should be dismissed, Duhon said.
People who have conditions that can’t be cured, such as traumatic brain injuries, are often considered “unrestorable” and their cases are dismissed.
These individuals often fall through the cracks and cycle in and out of jail because they need more specialized services outside of the criminal legal system, Duhon said.
“It would be helpful if we had some organization in the community, where when a police officer sees this person, instead of bringing them into court or arresting them, they were able to take them somewhere different that had nothing to do with jail or court,” she said.
“People on the competency docket are not criminal thinkers. They just have mental illness or some other condition that leads to them committing a crime,” she said. “If we’re able to get them long-term housing, that is usually what leads us to not see them again.”
By combining competency cases into one docket, under one judge in one courtroom, judicial staff become “subject matter experts,” who can better handle and resolve cases for some of the most vulnerable people in the criminal justice system, Myers said.
In 2023, 40 people who were deemed incompetent to proceed were restored and 23 people had their cases dismissed because they could not be rehabilitated enough to understand their court cases, Cosgrove said.
This year, 22 people on the docket, who were ordered to receive inpatient services at a state psychiatric hospital or jail, were diverted to other community-based services, Cosgrove said.
“We need all the jurisdictions to work to be more efficient with who they are sending to the state hospital,” Duhon said. “If every community were able to do something like this, we could decrease the waitlist at the state hospital. But smaller rural jurisdictions might not have all these resources.”
Three years after the first competency docket launched in the 8th Judicial District, similar programs are operating in the first, second, fourth, fifth, 10th, 12th, 16th and 18th judicial districts and Denver County. Those courts are helping more than 700 people on their dockets.
Three other large judicial districts in Colorado are in varying stages of implementing their own dockets, Myers said.
Once those dockets are implemented, every medium or large judicial district in Colorado will have a competency docket, she said.
Formalizing and improving Colorado’s competency dockets
The competency docket model is in its infancy, so data measuring its success is sparse, Myers said.
The state court administrator’s office applied for two federal grants to help it conduct a statewide evaluation of competency dockets. The evaluation would help the office understand the program’s effectiveness, create best practices and find areas for improvement, Myers said.
The state court administrator’s office is also receiving funding from the Colorado Fines Committee to hire a competency diversion analyst who will oversee the statewide evaluation process and help develop a data information analysis system, among other things.
“I don’t know that we have enough data to say jail wait times have decreased because of any of these dockets yet but we have enough data to suggest people are getting a lot more care and oversight during their stays in jail and while they transition from the state hospital and back into the community,” Myers said.
Alejandro Jaramillo, 28, cycles in and out of jail when he commits crimes to feed his drug addiction, his mother, Elia Estrada, said.
Jaramillo has intellectual and developmental disabilities, schizophrenia and bipolar disorder, Estrada said.
Last year, Jaramillo faced attempted first-degree murder charges for allegedly stabbing his caretaker, according to a Greeley Tribune article. The charges were dropped.
After his most recent arrest in Larimer County in 2020, his competency evaluation showed he was not able to understand his court proceedings.
Soon after, a public defender referred him to Foothills Gateway, which provides services to people with intellectual and developmental disabilities in Northern Colorado. He also receives medication management services from SummitStone Health Partners.
Foothills referred him to a host home provider in Weld County where he’s lived there for three weeks and because of his mental health status, his charges have always been dropped, his mother said.
“If I wasn’t for them, Alejandro would be on the street right now, again,” she said of the staff running the 8th Judicial District’s competency docket.
But even with the court’s help, Estrada still worries about her son’s well-being. He needs long-term services such as a day program that can keep him busy and out of trouble, she said.
As competency dockets gain popularity across Colorado, Duhon said she suspects the trend is in line with changing viewpoints about the criminal justice system nationwide.
“Historically there was a lot of emphasis on incarceration, and in the past few years there definitely has been an enlightenment about rehabilitation and trying to meet people where they are,” she said.
“Even if we’re not talking about a competency case, but we’re talking about any case where someone goes to prison, eventually, that person is going to be back in the community and they’re probably worse situated because they’ve been away and maybe have lost their job or housing,” she said. “If we’re able to meet people where they’re at, and help them in the community, I think that keeps the community safer in the long run.”