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  • Forensic Psychiatric Hospital Feasibility Study DRAFT Phase I Report, Contract # 0619-006 Submitted to Division of Behavioral Health, Alaska Department of Health and Social Services

    February 1, 2019

    By Agnew::Beck Consulting, Inc. Steve Fishback Architect Colston Consulting Group, LLC Dr. Patrick Fox

    www.agnewbeck.com | 441 West 5th Avenue, Suite 202 | Anchorage, Alaska 99501 | 907.222.5424

  • DRAFT Phase 1 Report: Forensic Psychiatric Hospital Feasibility Study 1

    Table of Contents Table of Figures ........................................................................................................................................ 2

    1. Executive Summary .............................................................................................................. 4

    Background ................................................................................................................................................ 4

    Key Findings .............................................................................................................................................. 6

    Summary of Recommendations ............................................................................................................. 9

    2. Defining the Project ............................................................................................................ 11

    Scope of Work .............................................................................................................................................. 11

    Data Sources ................................................................................................................................................. 11

    Alaska Psychiatric Institute ......................................................................................................................... 12

    Target Population ......................................................................................................................................... 14

    3. Backlog in the Competency Process ................................................................................... 15

    Overview of the Competency Process ...................................................................................................... 15

    Existing Backlog ........................................................................................................................................... 16

    Characteristics of Individuals in Competency Process .......................................................................... 18

    4. Competency to Stand Trial Evaluations ............................................................................. 21

    Current Competency Evaluation Process ................................................................................................ 21

    Number of Evaluations Ordered ............................................................................................................... 22

    Wait Times for Evaluations ........................................................................................................................ 23

    Court Disposition ......................................................................................................................................... 24

    Recommendations ........................................................................................................................................ 27

    Facility....................................................................................................................................................... 27

    Staffing ..................................................................................................................................................... 28

    Process ...................................................................................................................................................... 29

    Statute ....................................................................................................................................................... 30

    5. Competency Restoration ..................................................................................................... 32

    Current Process ............................................................................................................................................ 32

    Alaska Statute .......................................................................................................................................... 33

    Wait Times for Restoration ........................................................................................................................ 34

    Restoration Patients + Outcomes ............................................................................................................. 34

    Recommendations ........................................................................................................................................ 38

    Facility and Program .............................................................................................................................. 39

    Staffing ..................................................................................................................................................... 42

  • DRAFT Phase 1 Report: Forensic Psychiatric Hospital Feasibility Study 2

    Statute ....................................................................................................................................................... 42

    6. Non-Restorable After Treatment ........................................................................................ 44

    Current Process ............................................................................................................................................ 44

    Alaska Statute ................................................................................................................................................ 44

    Recommendations ........................................................................................................................................ 44

    Facility....................................................................................................................................................... 44

    Statute ....................................................................................................................................................... 44

    7. Not Guilty by Reason of Insanity ....................................................................................... 46

    Statute ............................................................................................................................................................. 46

    Current Process ............................................................................................................................................ 47

    Recommendations ........................................................................................................................................ 48

    Facility....................................................................................................................................................... 48

    Statute ....................................................................................................................................................... 48

    8. Interview Themes ............................................................................................................... 50

    Department of Law, Criminal Division .............................................................................................. 50

    Department of Corrections ................................................................................................................... 50

    Alaska Court System .............................................................................................................................. 51

    Alaska Mental Health Trust Authority ................................................................................................ 52

    Alaska Mental Health Board ................................................................................................................. 53

    Municipality of Anchorage .................................................................................................................... 53

    Department of Health and Social Services ......................................................................................... 53

    9. Appendices ............................................................................................................................ 0

    Table of Figures Figure 1: Continuum of Forensic Psychiatric Process in Alaska.................................................................. 5

    Figure 2: Delays in the Competency Evaluation and Restoration Process ................................................ 5

    Figure 3: Demand for Forensic Restoration Beds .......................................................................................... 7

    Figure 4: New Restoration Beds Needed ......................................................................................................... 7

    Figure 5: Data Sources .........................................................................................................