U.S. District Judge Marsha Pechman gave the Department of Social and Health Services until May 27 to fix the problems that have forced mentally ill defendants to wait in jails for months for competency evaluations and treatment.

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A federal judge said the only reason she won’t hold Washington state in contempt for failing to provide timely competency services is because state judges have issued dozens of contempt orders and imposed $1 million in fines, but it hasn’t altered the state’s conduct.

Instead, U.S. District Judge Marsha Pechman altered the permanent injunction and gave the Department of Social and Health Services until May 27 to fix the problems that have forced mentally ill defendants to wait in jails for months for competency evaluations and treatment, as long as a new set of interim deadlines and rules are met.

Pechman says it’s necessary to force the agency to follow a strict schedule because allowing it “to work according to a schedule of their choosing has resulted in an increase in wait times.”

Kathy Spears, spokeswoman for the agency’s Behavioral Health & Service Integration Administration, said the agency will respond to the judge’s order.

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Lawyers for the mentally ill defendants praised Pechman’s ruling, issued on Monday.

“The state has failed to provide leadership in addressing the serious problem of people with mental illness in jails awaiting competency services,” said La Rond Baker, lawyer for the ACLU of Washington. “We are gratified to see the court stepping in to provide a step-by-step road map of what the state needs to do to resolve this problem. People’s lives are at stake.”

Emily Cooper, a lawyer with Disability Rights Washington, said the conditions their clients face have been appalling.

“People have been spending months in jail while their health gets worse and worse, and some have died,” she said. “The state hasn’t met its responsibilities, so the court has made clear what it has to do. We’ll be watching very closely to see that the state actually complies with the court’s order.”

The lawyers filed a lawsuit against the agency in 2014, claiming that forcing the defendants to wait in jail for extended periods violated their constitutional rights. Pechman agreed and in April, she issued a permanent injunction saying the state must cut the wait times down to seven days after a judge’s order. She gave the state until Jan. 2 to comply.

Days before the deadline, the state filed a motion asking for another five months. They argued in part that inspections by the Centers for Medicare & Medicaid Services (CMS) found a list of violations and the agency had to focus its efforts on fixing those problems or risk losing millions of federal dollars.

Pechman said their excuses fell short.

“While the CMS actions have hindered compliance, failures by DSHS itself have prevented it from achieving compliance,” she said in her order.

The agency failed to hire and retain staff; failed to take appropriate emergency actions; failed to establish a forensic training program; failed to make evaluations available on weekends; failed to implement a data management system; and failed to address a list of other problems, she said.

Therefore, the court will step in and force action, she said.

Pechman created a list of changes based on recommendations from a court monitor who has followed the case since the injunction.

She also set a list of benchmarks.

By March 1, all competency evaluations must be completed within 14 days for both state hospitals. By April 1, those evaluations must be done within 10 days and competency restoration treatment must be provided within 26 days, she said.

By May 27, both evaluations and treatment must be done within a week of a judge’s order, she said.