A settlement last January between the ACLU of Pennsylvania and the Pennsylvania Department of Human Services called for the state to reduce treatment delays for defendants ordered by courts to receive mental-health care.
The settlement followed an October 2015 lawsuit alleging that severely mentally ill defendants languished in Pennsylvania's county jails, sometimes for more than a year, while awaiting treatment to restore competence, so they could stand trial.
Not much has changed.
The latest statewide wait list for spots at two state hospitals, in Norristown and at Torrance State Hospital in Westmoreland County, had 222 people on it, compared with 220 around the same time a year ago, according to the ACLU.
An inmate who was recently transferred from jail in Philadelphia to Norristown waited 504 days, said Witold Walczak, legal director for the ACLU of Pennsylvania and one of the lawyers involved in last year's settlement.
"It hasn't improved," despite some progress in adding treatment capacity, Walczak said this week.
The average wait time for transfer from jail to Norristown or Torrance is 387 days, excluding expedited transfers for some who are "so much sicker than others," Walczak said.
The ACLU is contemplating a return to court in Harrisburg in the next month or so to ask U.S. District Judge Sylvia H. Rambo to put legal pressure on the state, Walczak said.
The state Department of Human Services did not respond to questions about what it had accomplished under the settlement. "We are limited on what we can say regarding the ACLU settlement," a DHS spokeswoman said.
In a bid to reduce the amount of time spent waiting in jail by mentally ill individuals declared incompetent to stand trial, the Jan. 27, 2016, settlement required the state to create 60 new treatment spots within 120 days and an additional 60 spots within 180 days.
Plus, within 90 days of the agreement, the state was supposed to make $1 million available for supportive housing in Philadelphia, the settlement said. Spent on housing vouchers, that money was expected to provide 50 to 80 beds.
Given the DHS's lack of transparency, it's unclear exactly how much of that has been done.
H. Jean Wright II, director of behavioral health and justice-related services at Philadelphia's Department of Behavioral Health and Intellectual Disability Services, said he is working on 60 of the treatment spots called for in the settlement.
"Right now, we have 29 up and running," Wright said last week.
Those treatment slots, Wright said, are at a Gaudenzia facility at 1306 Spring Garden St. and at a New Vitae site in South Philadelphia. A second New Vitae location, in West Philadelphia, was inspected Tuesday and is ready to go, Wright said Wednesday.
Luna Patella, chief of the mental-health special defense unit at the Defender Association of Philadelphia, said 20 beds at Girard Medical Center are also being used. The Girard beds do not count toward the treatment spots under the settlement, Wright said.
Wright said the additional 31 treatment spots he is working on are much more challenging because some of the patients have been at Norristown for years and need high levels of support to enter the community.
"It has to be thoughtful, it has to be done in a way that's supportive of the individuals that are coming back to the community, and not just meeting a time line or a deadline or anything like that," Wright said.