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5/6/2014 2:40:00 PM
Yavapai County's Restoration to Competency Program sets the bar
Judge Celé Hancock, who presides over the county’s mental health court, said the county’s Restoration to Competency program, based at the Camp Verde jail, is a “much better alternative” than sending defendants diagnosed as incompetent to sending them to the Arizona State Hospital in Phoenix. Courier file photo
Judge Celé Hancock, who presides over the county’s mental health court, said the county’s Restoration to Competency program, based at the Camp Verde jail, is a “much better alternative” than sending defendants diagnosed as incompetent to sending them to the Arizona State Hospital in Phoenix. Courier file photo

Scott Orr
The Daily Courier


Like many major programs, Yavapai County's Restoration to Competency (RTC) program was borne of necessity.

In 2005, the Arizona State Hospital in Phoenix began to transfer the cost of treating prisoners deemed not competent to stand trial to local counties: Maricopa, first, then Pima, in 2007. As the economy, both nationally and statewide, began to falter, the hospital began to bill the rest of Arizona's counties in 2009.

At $670 a day for each inmate the county sent to the State Hospital, the bill, including inmate transportation to and from Phoenix, was in the neighborhood of $2.5 million a year.

That was the impetus for three county officials - YCSO Chief Deputy John Russell, who was then a commander; Becky Payne, RN, the jail's health services administrator; and Deputy County Attorney Jack Fields - to develop the county's own in-house Restoration to Competency program, to be conducted in the Camp Verde jail. The program would be an expansion of the mental health services already provided by Wexford Health Sources of Pittsburgh, Penn. The first inmate began treatment on April 5, 2010.

Now, four years and several national awards later, Sheriff Scott Mascher said the Yavapai RTC has attained holy grail status for a government program: it is better, faster, and cheaper.

There's no question that RTC is cheaper. The Yavapai version of RTC costs the county just $240 a day per inmate, and over half of Arizona's other counties now send their inmates to Camp Verde for treatment, generating a profit for the sheriff's office.

It's faster, too. Russell said, "It could take 60 to 90 days" after the judge's order "before we could get that inmate a bed in the state hospital. So they're going to sit in jail for that time period" without treatment. With the local RTC program, he said, once the judge orders treatment, "the very next day they're in the program in Yavapai County. There's no wait."

And Mascher said RTC was designed to be more effective. "We (realized) we could probably do a better treatment, a more personalized treatment - a more close, local treatment, where family and friends could visit and be a part of it - rather than ship them" to Phoenix, he said. "We can do this ourselves better."

It was very difficult to find defense attorneys in Prescott who were willing to talk on the record - or even off the record - about their views on the RTC program; even retiring Public Defender Dean Trebesch declined comment. Told that there was little enthusiasm for comment, one attorney said, "Well, why do you think that is?" apparently referring to the fact that the overwhelming majority of defense attorneys in the area are either employed by the county through the Public Defender's Office or work under contract for it.

Asked if there was room for improvement in RTC, Robert Gundacker, a public defender, chose his words carefully. "I would say 'yes.' But there's never been a restoration program, that in my opinion, I've ever been exposed to, that doesn't have room for improvement," he said.

"We have been approached by the jail to discuss issues related to the RTC program," he said. "We're interested in engaging in discussion about it."

Prescott Valley defense attorney Dan DeRienzo spoke highly of RTC. "I think they do a great job with that program. I have had several clients that have gone through it. I think they care about the patients and keep excellent notes and diagnoses. "

Superior Court Judge Celé Hancock, who now runs the county's mental health court, said the RTC program does good work, but can't restore every patient. "They do a great job over there getting them to the point of competency," she said, but "we've had several reports (of defendants) that come back that say they're not competent and they're not going to be restored."

What is Wexford?

Wexford Health Sources, Inc., of Pittsburgh, Penn., generates revenues of $125 million a year providing health care to inmates in county jails, state and federal prisons, juvenile detention centers, substance abuse treatment centers, psychiatric hospitals, and correctional centers for sex offenders. Founded in 1992, Wexford has about 2,000 employees and serves nearly 163,000 inmates and patients in 13 states.

Yavapai County paid Wexford $3.2 million for its health services at the Camp Verde jail in 2013.

Wexford was formerly the health care provider for the Arizona Department of Corrections' state prisons, but the $349 million contract was terminated in 2013, after allegations the Wexford personnel dispensed medication to inmates incorrectly, among other administrative problems. Wexford denied the allegations. The company and state of Arizona mutually agreed to the separation.

Taylor Waste
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