SPECIAL MASTER REPORT to JUDGE WANG 

May 28, 2024 

CENTER FOR LEGAL ADVOCACY, d/b/a 

DISABILITY LAW COLORADO, 

Plaintiff, 

v.

MICHELLE BARNES, 

in her official capacity as Executive Director of the Colorado Department 

of Human Services, and

JILL MARSHALL, 

in her official capacity as Chief Executive Officer of the Colorado Mental 

Health Institute at Pueblo, Defendants.

 

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May 28, 2024

Re: Civil Action No. 11-cv-02285-NYW 

The Honorable Judge Nina Wang

United States Magistrate Judge

District of Colorado

Alfred A. Arraj United States Courthouse

901 19th Street

Denver, CO 80294

Judge Wang, 

This report serves as our May 2024 quarterly status report mandated by the Consent Decree 

that was filed March 15, 2019 pursuant to Case No. 1:11-cv-02285-NYW. As you know, the 

Consent Decree requires us to monitor progress and provide recommendations to the Colorado 

Department of Human Services (CDHS; hereafter the Department) as they attempt to improve 

competency-related services for criminal defendants with psychiatric illness. Specifically, the 

Consent Decree (p. 24) indicates, 

(i) As part of the duties, the Special Master shall provide the Court and the Parties with status 

reports every other month for the first six months, and then quarterly thereafter. The Special 

Master’s status report was submitted on January 28, 2019. Dkt. 146. The next report shall be 

submitted to the Court and the Parties on March 28, 2019, and then May 28, 2019, and then 

quarterly thereafter. Such reports shall address the Department’s compliance with the 

timeframe requirements of the Consent Decree concerning Competency Services and shall 

provide a detailed summary of information and recommendations the Special Master believes 

the Court and Parties should consider relating to the Department’s compliance with the 

Consent Decree timeframes concerning Competency Services. 

(ii) The Special Master’s report shall include, but is not limited to, reporting on the number of 

Pretrial Detainees ordered to receive Competency Services, an assessment of the 

Department’s operations, systems, and admissions practices and policies relating to the 

Department’s ability to comply with the Consent Decree timeframes, and guidance to the 

Department for improvement and increasing efficiencies in these areas. 

The Consent Decree prescribed a variety of steps the Department must take to improve the 

competency assessment and restoration system in Colorado, and to comply with time frames 

and deadlines mandated in the Consent Decree. The Department initiated these steps and 

demonstrated meaningful progress. Both the wait list, and the time detainees spent waiting, 

were decreasing throughout the first year the Consent Decree was in effect. 

Exactly one year later, in the spring of 2020, the COVID-19 pandemic brought the Department 

unforeseeable challenges and their progress stalled. COVID-related complications slowed 

progress on most metrics, and put simply, all metrics moved in the wrong direction. Even after 

the pandemic relented, many setbacks remained. In particular, the Department faced 

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tremendous difficulties staffing their facilities, which left unused hospital units, and less capacity 

to serve the people in jail awaiting transfer and treatment in those units. Similar difficulties have 

been common across the country, and states vary in the timing and degree to which they have 

begun to improve. 

The prior quarter (ending November 2023) featured the first sustained pause in many of these

negative trends. The most recent quarter reflects continued steady progress, and the third

consecutive quarter of improvements on most metrics. After years of steady increases in the 

demand for competence services, there has been more of a plateau. Concurrently, most hospital 

units have reopened, and the Department has secured new beds, moving more people from the 

waitlist to inpatient beds. Indeed, the total number of people admitted to inpatient restoration 

this quarter (n=339) was the most since the onset of the Consent Decree. Newly opened Mental 

Health Transitional Living homes (MHTLs) have begun providing a crucial level of care that has 

long been lacking in Colorado. Overall, the waitlist continued to decrease. Less than one year 

ago (late June 2023) the waitlist peaked at 483 people, but by the end of this quarter, it dropped 

below 300 for the first time since 2021. More than at any other point since the pandemic, there 

is reason to anticipate continued improvement. 

Across the past three quarters we perceive increasing reason for optimism, though certainly no 

reason for complacency or decreased efforts. Although the Department has made tremendous 

progress in opening inpatient beds, it remains clear that Colorado’s “competency crisis” is not 

something the Department can solve alone. They must continue efforts with other stakeholders 

to enact legislation and strategies that decrease orders for competence evaluation and 

restoration, instead prioritizing mental health treatment over competence restoration. Indeed, 

this quarter featured one such example (HB 24-1355, described later) of an external, broad 

effort to address the competency crisis and related needs. Thus, we see important progress 

within and around the Department.

This Quarterly Report, like all prior reports, will review key metrics as required, and provide other 

updates on the functions prescribed in the Consent Decree. 

 

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TABLE OF CONTENTS 

 

CONTEXT for QUARTERLY METRICS ...............................................................................................5

KEY METRICS FOR PROGRESS:........................................................................................................9

COMPLIANCE WITH TIME FRAME REQUIREMENTS .......................................................................9

KEY METRIC: COMPETENCE EVALUATION TIME FRAMES ........................................................10

KEY METRIC: TIME FRAMES FOR ADMISSION TO COMPETENCE RESTORATION .....................11

KEY METRIC: THE WAITLIST FOR COMPETENCE RESTORATION SERVICES...............................14

CONSENT DECREE SECTION VI UPDATES......................................................................................17

ADMISSION OF PRETRIAL DETAINEES FOR INPATIENT COMPETENCY EVALUATIONS AND 

RESTORATION TREATMENT .....................................................................................................17

Wait Times for Inpatient Evaluation ....................................................................................18

Wait Times for Inpatient Restoration...................................................................................19

INTERIM JAIL MENTAL HEALTH TREATMENT ...........................................................................22

RELEASE OF PRETRIAL DETAINEES FOR COMMUNITY-BASED RESTORATION TREATMENT.....24

NOTIFICATION OF NON-COMPLIANCE WITH TIME FRAMES....................................................27

DECREE SECTION VII UPDATES.....................................................................................................30

CIVIL BED FREEZE .....................................................................................................................30

COMPREHENSIVE AND COHESIVE PLAN...................................................................................32

INCREASE COMMUNITY RESTORATION SERVICES ...................................................................35

CONCLUSION................................................................................................................................38

APPENDIX 1 ..................................................................................................................................39

APPENDIX 2 ..................................................................................................................................40

APPENDIX 3 ............................................................................................................................................. 42

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CONTEXT for QUARTERLY METRICS 

Historic Context: 

Longstanding vulnerabilities in Colorado’s public mental health system set the stage for the 

current “competency crisis.” For many years preceding the Consent Decree and the pandemic, 

Colorado had far too little inpatient hospital capacity for a state of its size, and it struggled to 

staff the largest inpatient hospital it did have. Colorado also had an unusual community mental 

health system that—unlike most other states—was able to operate selectively, routinely 

declining services to those involved in the criminal legal system. Finally, Colorado could 

anticipate that orders for competence evaluation and restoration would rise, just as they were 

rising across the United States, and other states were beginning to experience a “competency 

crisis.” Put simply, longstanding structural and contextual factors left Colorado with a precarious 

mental health system, vulnerable to any further strain.

Amid these longstanding vulnerabilities and escalating referrals for competence services, the 

parties (i.e., Disability Law Colorado and the Department) engaged in years of litigation to 

address the increasing number of detainees waiting for competency services, and the increasing 

time these detainees spent waiting. The litigation culminated in the 2019 Consent Decree that

prescribed many steps the Department must take, and the timelines it must meet, to improve 

competency services in Colorado. The Department initiated these steps in ways that were 

faithful to the details and the spirit of the Consent Decree. As you recall, we tend to summarize 

the overall spirit and provisions of the Consent Decree in three goals: 

a) Reducing the number of people on the waitlist for competence restoration services, 

b) Reducing the wait times for people on the waitlist, particularly people with the most 

acute psychiatric illness, and 

c) Reducing harm (by providing care) to people on the waitlist. 

Progress on the first goal was significant until the COVID-19 pandemic began in March 2020. The

number of detainees on the waitlist had finally dropped below 100. But as the pandemic 

persisted, the Department could not keep pace with court orders for competency services, and

the waitlist grew. At the Colorado Mental Health Hospital in Pueblo (CMHHiP) where inpatient 

restoration services occur, quarantine procedures slowed or stopped admissions, and the 

waitlist grew dramatically. Furthermore, CMHHiP became so short-staffed that it could not 

operate at full capacity, which further slowed admissions. For almost two years, over 80 beds1 at 

CMHHiP remained unused because there were not sufficient staff to operate the units. The

waitlist peaked at 464 people.2

1 This figure varied a bit, but for over one year, over 80 beds remained unusable. 

2 For example, the waitlist appeared to peak at 464 people at the end of May 2023, and was still 459 at 

the end of July 2023.

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The Department made great efforts to address this crisis. For example, they established 

contracts with private hospitals to accept Pretrial Detainees. In early 2022, Governor Polis (at the 

Department’s urging) and the Joint Budget Commission approved approximately $30 million in 

emergency funding to secure 64 additional private psychiatric beds to temporarily address the 

record demand for restoration services. Subsequent legislation devoted $60 million to fund 

another 96 beds through 2023. The Department continued to pay a premium for emergency 

treatment beds, while some of their own CMHHiP treatment beds remained unused because 

they lacked staff. But over the past few years, the Department opened new units at CMHHiFL

and reopened other units (at CMHHiP) that were closed for over one year. As of this quarter, the

Department has now reopened nearly all beds that were closed during the pandemic, and 

hospital capacity will match (or exceed) pre-pandemic capacity in the next quarter.

Progress on the second goal was also clear in the first year following the Consent Decree. 

Defendants with most severe treatment needs (i.e., “Tier 1”) were consistently admitted within 

the prescribed 7-day timeline, though delays remained for those with less acute needs (“Tier 2”). 

But COVID-19 created new sources of delay, even for those with most urgent needs. Staffing 

shortages (exacerbated by COVID-19) even further limited CMHHiP admissions. Therefore, 

almost all competency-involved Pretrial Detainees—whether designated Tier 1 or Tier 2—faced 

wait times that far exceeded those permitted by the Consent Decree. These delays continue, 

though less severely; average wait times still exceed those mandated by the Consent Decree.

Progress towards the third goal—providing care for those waiting—continued even amid 

significant barriers. The Department’s Forensic Support Team (FST) works to monitor detainees 

and provide care while these detainees await hospitalization. The FST has also worked to 

transition many of the less acutely ill detainees to restoration services in the community when 

judges allow bond. Still, amid slow admissions, many Detainees experience serious and severe 

distress in jails that are ill-prepared to treat severe psychiatric illness. 

Recent Context: 

Over the past few years, the Department worked with stakeholders to pass legislation and 

secure funds from the American Rescue Plan Act (ARPA). Although passed many months ago 

(and addressed in prior Quarterly Reports), many of initiatives have begun providing services. 

Indeed, the first Mental Health Transitional Living home (MHTL) has already altered the waitlist. 

Initiatives: Action: 

 

$65 million in ARPA funding to launch 125 

beds in group homes and an additional 16 

beds at CMHHIFL. 

The Department has awarded all contracts, 

and some of the first group homes have 

welcomed residents, including many who 

have transition from CMHHiP.

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$62 million to support grants for early 

intervention, deflection, and redirection from 

the criminal justice system among those with 

psychiatric illness.

The Department has awarded grants. None of 

these programs have begun operating to the 

degree that it would be possible to gauge 

their impact.

$61 million to improve Colorado’s clinical 

workforce, particularly addressing the 

shortage of nurses. 

The Department has adjusted salaries and 

bonuses to enhance recruitment and 

retention. These strategies have clearly 

improved staffing, with far more applicants 

and hires.

New legislation to limit inpatient restoration, 

among those with only misdemeanor charges, 

to those who meet emergency hospitalization 

criteria (those who do not must be ordered to 

outpatient restoration). 

CRS 16-8.5-111 allows for the dismissal of a 

misdemeanor charge and civil commitment 

among ITP defendants. Other legislation 

(HB22-1386) requires outpatient restoration 

as the default approach for defendants with 

only misdemeanor charges unless they meet 

commitment criteria.

 

These developments reflect movement towards the broader and more comprehensive steps 

that Colorado needs to take across the continuum of competency services: from diversion and 

deflection at the entry points to more restoration beds at the later points. 

All parties agree that the Department cannot solve the competency crisis alone, so the

Department has continued to cultivate collaborations with other stakeholders,. Although certain 

key services (e.g., evaluation quality, inpatient beds) are solely within the Department’s control, 

many causes of the competency crisis—such as the arrests of unhoused people with mental 

illness—are well outside of Department control. The Department has continued to:

• Convene the Judicial Taskforce with judges eager to help solve the competency crisis.

• Convene the multidisciplinary “Consent Decree Steering Committee” to meet with all 

parties (Department, DLC, and Special Master, as well as a national consultant) every 

other month, and address potential collaborative solutions.

• Support the Denver Competency Docket, led by two judges who are knowledgeable and 

motivated regarding competency matters.

• Pursue strategies to divert people with serious mental illness into community (civil) 

treatment rather than defaulting to the competency mechanism for forensic treatment.

One most recent step involved collaborating with other stakeholders who introduces HB1355, which attempts to divert certain detainees to treatment rather than competence 

evaluation and restoration. 

Unfortunately, many of these strategies require a more robust community mental health system 

that, as we’ve emphasized before, is an historic weakness for Colorado. The Department is 

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transitioning towards a Behavioral Health Administration system, a new cabinet-level agency, 

housed within the Department of Human Services, designed to be the single entity responsible 

for coordination and collaboration across state agencies to address behavioral health needs. This 

transition includes many promises relevant to the competency population: a true “safety net” to 

ensure mental health services for all who need them, decreasing opportunities to deny services 

to certain populations. Indeed, this requirement has now gone into effect. A BHA should benefit 

the competency population, and reduce the number of people entering competency services, if 

the BHS indeed creates significantly more access and availability of community mental health 

resources. But again, many of the BHA changes are quite new, and it remains too soon to gauge 

their actual effects. 

This Quarter 

This quarter follows three prior quarters of increasing bed capacity (e.g., re-opening 39 beds at 

CMHHiP, opening the second new 22-bed unit at CMHHiFL, expanding the Restoration 

Treatment Unit in the Denver Jail (DRTU) from 12 to 18 beds). They also began to transition 

some long-term patients into new Mental Health Transitional Living (MHTL) homes, which now 

serve a total of 30 patients. Once again, the Department has continued admitting more

detainees than in previous quarters, and the overall number of persons on the waitlist has 

generally declined for over nine months – the first time this has occurred since the beginning of 

the pandemic.3 

 

One Year After the Waitlist Peaked 

 

As we have mentioned many times, the waitlist—i.e., the list of people waiting for some form of 

inpatient competence restoration services—peaked at 464 people one year ago, at the end of May 

2023. There was little change over the summer, and the waitlist was still 459 at the end of July 2023. But 

by the end of October 2023, the Department reported a waitlist of 427 people, and by February 24, 2024

it had decreased to 343. As of this week—late May of 2023, which falls one year after the peak waitlist—

the waitlist has fallen to 297, which is the first time it has been below 300 in years. To be clear, this is still 

a larger list than the year preceding the pandemic. But most of the past year has featured a steady 

decline in the waitlist. Much of this decline reflects increasing capacity: particularly more inpatient 

hospital beds, but also capacity in the form of MHTL homes, and transitional housing that makes it more 

feasible to release detainees from jail into outpatient restoration. 

 

With this broad history and recent developments in mind, this Quarterly Report will review the 

key metrics that the Consent Decree requires us to monitor and report.

3 As of today (May 24, 2024), the waitlist has decreased to 297, the lowest point in the past 4 years.

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KEY METRICS FOR PROGRESS: 

COMPLIANCE WITH TIME FRAME REQUIREMENTS 

As prescribed in the Consent Decree, a primary focus of our quarterly reports must be the 

Department’s compliance with time frame requirements:

(i) As part of the duties, the Special Master shall provide the Court and the Parties with status 

reports ... Such reports shall address the Department’s compliance with the timeframe 

requirements of the Consent Decree concerning Competency Services and shall provide a 

detailed summary of information and recommendations the Special Master believes the Court 

and Parties should consider relating to the Department’s compliance with the Consent Decree 

timeframes concerning Competency Services. (Consent Decree p. 24)

(ii) The Special Master’s report shall include, but is not limited to, reporting on the number of 

Pretrial Detainees ordered to receive Competency Services, an assessment of the 

Department’s operations, systems, and admissions practices and policies relating to the 

Department’s ability to comply with the Consent Decree timeframes, and guidance to the 

Department for improvement and increasing efficiencies in these areas. 

Therefore, a primary focus of our review is the Department’s progress in meeting the time 

frames delineated in the Consent Decree. This includes both time frames for competence 

evaluation and for competence restoration. These will be the key metrics to gauge progress, so 

they are our starting point in the report, as well as a primary focus. Of course, performance in 

meeting these time frames depends greatly on enacting the other steps prescribed in the 

Consent Decree, so subsequent sections of the report review those steps in greater detail.

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KEY METRIC: COMPETENCE EVALUATION TIME FRAMES 

The Department historically met evaluation time frames, even before the 2019 Consent Decree 

and even through most of the pandemic. After staffing shortages caused delays during some of 

2020, the Department returned to almost perfect compliance with evaluation time frames. Court 

orders for jail-based competence evaluations had dropped to an all-time monthly low during the 

Spring of 2020 (e.g., 56 people in April 2020), with the onset of the COVID-19 pandemic. But 

arrests and orders for jail-based evaluations resumed dramatically peaking at an all-time monthly 

high two years after the pandemic began (i.e., 178 in March of 2022). Orders for jail-based 

evaluation have held steady the past year, averaging 133 defendants per month, albeit with an 

unusual spike (167) last month (April 2024). 

Average waiting time (in days) for a competence evaluation4

 

Nov 23 - 

Jan 24 

Feb 

2024 

Mar 

2024 

Apr 

2024 

Requirement 

Jail-based 

Competency 

Evaluations 

 11.3 11 10.7 10.9 21 days

 

Inpatient 

Competency 

Evaluations 

 

 24.7** n/a n/a n/a 14 days

** = most defendants waited longer than the maximum time frame for the evaluation

Even with a high volume of court orders the Department’s Court Services unit has generally 

remained responsive and efficient, maintaining near-perfect compliance with timelines for most 

of the past year. This quarter, they maintained perfect performance for the seventh month in a 

row; no Detainee waited more than 21 days for an evaluation in jail.

Regarding inpatient evaluations, there remain very few orders for inpatient competence 

evaluations (i.e., only one this quarter). All orders were resolved in ways other than hospital 

admission. Again, orders for inpatient evaluation remain rare (evaluations should usually be 

completed in jail) and often reflect severely ill Detainees. 

Orders for jail-based evaluations held steady. Court Services continues to keep pace amid the 

challenges and completed all jailed-based evaluations within the 21-day time limit. The one 

order for inpatient evaluation as resolved without admission. 

4 Information retrieved from the Department’s Special Master Compliance Plan report for April 2024, 

submitted May 15, 2024, pp. 26, 40. 

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KEY METRIC: TIME FRAMES FOR ADMISSION TO COMPETENCE RESTORATION

Historical context: Historically, the Department failed to provide timely restoration services, 

prompting the litigation that led to the Consent Decree. In the months preceding the Triage 

system, defendants who were admitted for inpatient restoration treatment at CMHHiP or RISE 

waited, on average, 71 days.5 This figure included all defendants referred for restoration, 

without distinguishing those with more, versus less, acute needs. Then the Department launched 

on June 1, 2019 the Consent Decree-mandated triage system,6 designed to prioritize the 

defendants with the most acute clinical needs (“Tier 1”) over those with less acute clinical needs 

(“Tier 2”). Tier 1 defendants must receive services within 7 days of the restoration order; Tier 2 

defendants must receive services within 28 days. Upon initiating the Triage system, the 

Department initially maintained excellent adherence to the 7-day deadline for Tier 1 for several 

months. The wait times for Tier 2 defendants also improved, though still exceeding the time 

frames prescribed in the Consent Decree. Wait times and the number on the waitlist were 

decreasing until the onset of the COVID-19 pandemic, but greatly increased thereafter. Those 

wait times have continued to remain far out of compliance even after the pandemic relented. 

But the past quarters have revealed meaningful improvement. 

This quarter, despite progress on many areas of the Consent Decree, both Tier 1 and Tier 2 wait 

times for inpatient restoration remained far beyond mandated time frames, as reflected below:

 

Average Wait Times for Inpatient Competence Restoration Services7 

 

Nov 2023 - 

Jan 2024 

Feb 2024 Mar 2024 Apr 2024 July 2021 

Requirement 

 

Tier 1 

 

92.0** 48.5** 58.1** 54.9** 7 days

Tier 2 129.7** 111.2** 132.5** 106.1** 28 days

** = most defendants waited longer than maximum time frame for restoration services

*** = ALL defendants waited longer than maximum time frame for restoration services

5 Average waiting period November 2018 - April 2019, as calculated from data provided by the 

Department (see p. 7 of their April monthly report filed May 7, 2019).

6 See Consent Decree paragraph 43.

7 Information retrieved from the Department’s Special Master Compliance Plan report for April 2024, 

submitted May 15, 2024, p. 9. 

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Pretrial Detainees are all still waiting far longer than Consent-Decree time frames allow:

• Tier 1 detainees wait nearly 8 times longer than allowed by the Consent Decree (i.e., 54 

days on average between February – April 2024, rather than 7 days).

• Tier 2 Detainees wait more than 4 times longer than allowed by the Consent Decree (i.e., 

115 days on average between February – April 2024, rather than 28 days). 

The Department remained mostly out of compliance regarding restoration time frames. Between 

February – April 2024, the Department was noncompliant with the 7-day time frame for all but 

four Tier 1 Detainees admitted. Of the 293 Tier 2 Detainees admitted in that same period, 230

were admitted or had their waits otherwise ended beyond their time frame of 28 days. Overall, 

this reflects only a 7.8% compliance rate. This rate is similar to the two previous quarters, which 

averaged approximately 7% compliance on this metric.

8

Despite these long wait times, there is some reason for optimism. The average Tier 1 and Tier 2 

wait times above—though certainly too long—are the shortest since 2022. Also, like last quarter, 

some Tier 1 detainees were admitted within the 7-day deadline. We see many Tier 1 detainees 

now admitted in a matter of days to weeks, rather than in weeks to months. All these improved 

metrics follow steadily improving metrics over the past several months, after the reopening of 

inpatient hospital units along with steadily expanding community placement options:

 

Average Wait (in days) for Inpatient Competence Restoration Services9 

 

 

May – Jul 23 Aug – Oct 23 Nov 23 – Jan 24 Feb – Apr 24 

Tier 1 

 

109.1 128.3 92.0 54.3

Tier 2 

 

131.5 138 129.7 115.1

This quarter reflects further improvements in both wait times and the number of Detainees 

waiting. This is certainly an encouraging pattern persisting over many months. In our last 

quarterly report, we estimated that those gains would continue into this past quarter, albeit at a 

slower pace. It appears, however, that progress is stronger than we expected, even over these 

many months. 

8 To be clear, some detainees originally designated as Tier 2 decompensate into severe illness, such that 

FST urges them for priority admission. Conversely, a few detainees originally designated as Tier 1 may 

stabilize, and need admission less urgently than originally anticipated, and less urgently than some Tier 2 

detainees. In this regard, tier designations are an imperfect (though generally helpful) proxy for the actual 

need for urgent admission. 

9 Information retrieved from the Department’s Special Master Compliance Plan report for April 2024, 

submitted May 15, 2024, pp. 11-12.. 

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The number of people awaiting restoration, and their wait times remain far out of compliance 

this quarter. On average, Detainees wait four to eight times longer than Consent Decree time 

frames allow. Only 8% were admitted within Consent Decree time frames. However, sustained 

progress is evident: wait times continue to decrease, admissions of Tier 1 Detainees occurred at 

a stronger pace (within days to weeks), and inpatient restoration capacity finally approximates 

pre-pandemic levels. While wait times remain far too long, we have been encouraged that they 

continue to decrease.

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KEY METRIC: THE WAITLIST FOR COMPETENCE RESTORATION SERVICES 

Historical context: One key metric for gauging the Department’s progress is the waitlist for 

competence restoration services. The Consent Decree aims not only to reduce wait times for 

defendants, but also to reduce the number of defendants waiting at all. In the months before

launch of the Triage system, the waitlist averaged around 150 to 180 defendants. By June 2020, 

the number on the waitlist dropped below 100. The Department projected that the waitlist 

would be minimal by December 2020, but the pandemic changed all projections. In late May of 

2023, the waitlist peaked at 464 Detainees and remained similar through last summer. The 

number has steadily decreased since then. 

Current realities: The number of court orders for competency restoration has remained 

generally stable for the past year. The past 12 months averaged 123 individuals ordered to 

inpatient restoration per month, with this past quarter averaging 120 per month. However, the 

number of people awaiting inpatient restoration at the end of this quarter (n = 297) continues to 

decrease. The waitlist has decreased in 10 of the past 12 months, with roughly 130 fewer 

individuals than April 2023. 

 

Number of Defendants Waiting for Inpatient Restoration10 

 March 2019 Nov 20 – Jan 24 Feb 2024 Mar 2024 Apr 2024 

Combined 157 384 329 324 297

Tier 1 N/A 31 15 22 30

Tier 2 N/A 353 314 302 266

Figures reflect the number of persons waiting for restoration services on the last day of the respective month. 

Prior to the summer of 2023, the wait list had grown steadily for more than one year, reaching

an all-time peak of 483 at the end of June 2023.

11 But during the past year, the Department 

reopened more than 70 previously closed restoration beds and began transitioning individuals 

into newly opened Mental Health Transitional Living (MHTL) homes. Consequently, the 

Department was able to admit many more detainees than in previous quarters, and the overall 

10 According to the Department’s Amended Special Master Compliance Plan report for April 2024, 

submitted May 24, 2024, p. 9. 

11 You may notice this “all time peak” number has changed since prior reports. We have historically 

described the peak wait list as 464 at the end of May 2023, but the Department recently corrected a 

data-reporting error, which thereby corrects figures across the past year. We now understand the “all 

time peak” to be a waitlist of 483 at the end of June 2023 (the Department’s Amended Special Master 

Compliance Plan report for April 2024, submitted May 24, 2024, p. 9.)

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number of persons on the waitlist has declined over the past year. One point in May 2024 

featured fewer than 300 people on the waitlist, for the first time since August 2021. This 

represents meaningful and sustained improvement. Further, the total number of all Detainees 

waiting reflects the lowest quarterly average overall in the past year. This quarter also had more 

Detainees admitted than any other quarter since the onset of the Consent Decree. In short, there 

are more than 100 fewer people on the waitlist than there were one year ago, with Tier 1 

Detainees once again prioritized for more prompt admission. 

 

Number of Detainees Waiting for Inpatient Competence 

Restoration Services at the end of the month12 

April 2023 456

May 2023 475

June 2023 483

July 2023 460

August 2023 444

September 2023 431

October 2023 429

November 2023 418

December 2023

January 2024

February 2024

March 2024

April 2024

350

383

329

324

297

12 According to the Department’s Amended Special Master Compliance Plan report for April 2024, 

submitted May 24, 2024, p. 9. Please note that these figures have changed slightly from those we have 

provided in prior Quarterly Reports, because the Department has recently identified a data error, and 

provided us with updated and corrected figures (spanning the past year) for this metric.

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Qualitative review and extraordinary cases: The waitlist is not simply a number, but rather a 

group of people with psychiatric illness awaiting critical treatment. Each week, we review the 

documented updates on each person in jail who has been waiting for inpatient restoration

longer than their time frames allow. In that review, we see dozens of acutely ill people remaining

in jails awaiting admission who might otherwise meet criteria for an involuntary mental health 

hold due to grave disability (living in cells soiled with urine or feces, neglecting hygiene, not 

eating, experiencing serious medical problems, and so on) or who languish with acute symptoms 

of inadequately managed psychosis. Several Detainees received new criminal charges while on 

the waitlist for behaviors that likely reflect symptoms of their illness. 

At the same time, we are encouraged that the number of people whom we categorize as the 

sickest and most vulnerable Detainees – those we suspect are most in need of an immediate 

hospital bed – was at its lowest in more than a year, as of our most recent weekly review (May 

25, 2024). While we emphasize to the Department the unacceptable plight of several Detainees 

who immediately need hospital-level care but who nonetheless remain housed in county jail 

cells, we also acknowledge that the overall number of these individuals has decreased

significantly over the past quarter. This reflects the influence of the Forensic Support Team and 

the inpatient hospital settings have in triaging Detainees for urgent admission, and we affirm 

these teams, their important work, and their achievements during the past quarter. 

The number of people waiting in jails for restoration services continued to decrease this quarter, 

down from an all-time high last summer. A record number of Detainees were admitted to 

hospitals this past quarter, all the while prioritizing the sickest and most vulnerable Detainees for 

admission. This suggests promising progress. While we affirm these improvements, we also 

recognize the waitlist is still much longer than it was at the start of the Consent Decree, wait 

times are still far out of compliance for most Detainees, and the waitlist includes many people in 

acute psychiatric crisis and vulnerable to self-harm, injury, violence, or suicide. There can be no 

decrease in effort amid this sustained progress. 

Case No. 1:11-cv-02285-NYW Document 290 filed 05/29/24 USDC Colorado pg 16 of 61
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CONSENT DECREE SECTION VI UPDATES 

ADMISSION OF PRETRIAL DETAINEES13 FOR INPATIENT COMPETENCY 

EVALUATIONS AND RESTORATION TREATMENT 

33. (a) Admission of Pretrial Detainees for Inpatient Competency Evaluations and Restoration 

Treatment. The Department shall Offer Admission to Pretrial Detainees to the Hospital for Inpatient 

Restoration Treatment or Inpatient Competency Evaluations pursuant to the attached table (Table 1). 

Compliance with this measure shall be calculated based on the number of Days Waiting for each 

Pretrial Detainee. 

The Consent Decree prescribed the following time frames for admitting defendants to inpatient 

competence restoration and for performing competence evaluations.

14 Admission time frames 

were longer at the start of the Consent Decree (June 1, 2019), but shortened every six months, 

with the final reduction in July 2021, establishing the current and ongoing time frames. 

 

 

Deadlines 

Tier 1: Maximum 

Time to Offer 

Admission for 

Inpatient 

Restoration 

Tier 2: Maximum 

Time to Offer 

Admission for 

Inpatient 

Restoration 

Maximum Time to 

Offer Admission for 

Inpatient 

Competency 

Evaluations 

Maximum time to 

Complete Jail 

Competency 

Evaluations 

June 1, 2019 7 days 56 days 21 days 28 days

January 1, 2020 7 days 49 days 21 days 28 days

July 1, 2020 7 days 42 days 14 days 21 days

January 1, 2021 7 days 35 days 14 days 21 days

July 1, 2021 

and onward 

 

7 days 28 days 14 days 21 days 

 

 

13 “Pretrial Detainee” means a person who is being held in the custody of a County Jail and whom a court 

has ordered to undergo competence-related services (i.e., competence evaluation or restoration 

treatment). Persons serving a sentence in the Department of Corrections and juveniles are excluded from 

this Consent Decree.

14 Fine amounts are tied to delays beyond each of the time frames listed. However, these fines are not 

applied for Pretrial Detainees designated ISC. 

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Wait Times for Inpatient Evaluation 

In the Consent Decree era, inpatient evaluations (those evaluations conducted at CMHHiP, 

CMHHiFL, or RISE) have been rare compared to the common practice of evaluating a defendant 

in jail. Historically, judges typically ordered inpatient evaluations only when defendants appeared

severely ill and in need of urgent admission (rather than waiting for an evaluation to determine 

whether they need admitted for restoration). The Department was generally successful in timely 

admission for inpatient competence evaluations before the pandemic, but they have exceeded 

timeframes since the pandemic began. The number of people ordered for an inpatient 

competence evaluation has remained quite low, and the number subsequently admitted upon 

order is even lower (often none), because the Department resolves such orders in other ways. 

 

Recent Wait Times for Inpatient Evaluations15 

 

Month People “admitted or 

ended” for inpatient 

evaluation16 

Average days 

waited before 

“admitted or 

ended” 

 

People who waited more 

than 14 days before 

“admitted or ended” 

Feb 2024 0 (0 admitted) n/a n/a

Mar 2024 0 (0 admitted) n/a n/a

Apr 2024 0 (0 admitted) n/a n/a

Nov 23 - Jan 2024

 

6 (6 admitted) 24.7 4**

March 2019 total 18 16.4 1

** = most defendants waited longer than maximum time frame for restoration services

“Admitted or ended” designates all ways these orders are resolved. In recent years, most orders for inpatient 

evaluation were not resolved with an actual inpatient evaluation, but through other means (such as dropped 

charges, ending or converting the order, etc.).

While last quarter saw an increase in the number of inpatient competence evaluations 

conducted, this quarter revealed a return to recent historical trends. No inpatient evaluations 

were ordered, and so no defendants were admitted for this purpose. 

15 According to the Department’s Special Master Compliance Plan report for April 2024, submitted May 

15, 2024, pp. 25-26.

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Wait Times for Inpatient Restoration 

Regarding wait times for inpatient restoration at CMHHiP, the Consent Decree established a twotier triage system. Defendants with the most urgent clinical needs (Tier 1) have an admission 

deadline of 7 days, while those with less urgent needs (Tier 2) have a deadline of 28 days. 

 

Recent Wait Times for Inpatient Restoration for Pretrial Detainees17 

Month Number 

“admitted or 

ended” for 

inpatient 

restoration 

Average days waited 

before “admitted or 

ended” on inpatient 

restoration order 

Number waiting more 

than the maximum days 

for admission to CMHHiP 

inpatient restoration 

 

Tier 1 Tier 2 Tier 1 Tier 2 Tier 1 Tier 2

Feb 2024 10 107 48.5 111.2 9** 94** 

Mar 2024 12 79 58.1 132.5 11** 73** 

Apr 2024 24 107 54.9 106.1 22** 63**

Nov 23 – Jan 24 

(average)

 18 90 92 129.7 17.3** 80**

March 2019

(before tiers)

44 58.2 31

* = at least one defendant waited longer than maximum time frame for inpatient evaluation services

** = most defendants waited longer than maximum time frame for inpatient evaluation services

*** = ALL defendants waited longer than maximum time frame for restoration services

The total number of people admitted to inpatient restoration this quarter (n=339) was the most

since the onset of the Consent Decree. The past three quarters have each represented larger 

quarterly totals than any other quarter since the beginning of the Consent Decree. In addition, 

the second-highest monthly number of Tier 1 Detainees – and the highest number of Tier 2 

admissions -- were admitted to inpatient restoration in April 2024. Consequently, average wait 

times for both Tier 1 and Tier 2 Detainees decreased this quarter. In short, admissions have 

returned to a strong, consistent pace. 

17 According to the Department’s Special Master Compliance Plan report for April 2024, submitted May 

15, 2024, pp. 9-12.

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However, despite this sustained progress, wait times remain exceedingly long, reaching four to 

eight times the prescribed Consent Decree time frames.

18 Although the number of people 

waiting in jail for inpatient restoration again decreased during the past quarter, wait times for 

admission remain far beyond mandated time frames. Approximately 80% of Detainees who were 

admitted exceeded their maximum allowable wait times in jail. 

Average wait times to admission far exceed the time frames mandated in the Consent Decree. 

The number of people waiting for restoration services—and the time they spend waiting—

remain unacceptable. But this quarter has again shown a sustained decrease in the number of 

Detainees waiting, as well as shorter average time frames waiting as compared to recent 

quarters, revealing sustained progress. This trend of increasing admissions, fewer Detainees, and 

shorter wait times reflect sustained and improved change. The Department must ensure that 

admissions continue at this strong pace, that inpatient capacity remains steady, and that 

community-based options for housing and care are prioritized for this population. 

18 Recall that wait times are ended upon admission to CMHHiP or RISE, or when ended for other reasons

(i.e., a case is dismissed or the court changes an order for inpatient restoration to an order for outpatient 

restoration when on-bond in the community). For example, among 339 “admitted or ended” between 

February 2024 and April 2024, only 222 defendants were actually admitted to an inpatient facility. The 

other 117 people were either dismissed, vacated, or released on bond. Still, the percentage of cases 

“admitted or ended” because of hospital policies remains encouraging. 

Case No. 1:11-cv-02285-NYW Document 290 filed 05/29/24 USDC Colorado pg 20 of 61
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PERFORMANCE OF JAIL-BASED COMPETENCY EVALUATIONS 

33. (b) Performance of Jail Competency Evaluations. The Department shall complete all Jail 

Competency Evaluations of a Pretrial Detainee pursuant to the attached table (Table 1), after the 

Department’s receipt of a Court Order directing the evaluation and receipt of Collateral Materials. 

This timeframe requirement shall apply to the following counties: Adams, Alamosa, Arapahoe, 

Boulder, Broomfield, Crowley, Custer, Denver, Douglas, El Paso, Elbert, Fremont, Huerfano, 

Jefferson, Larimer, Mesa, Otero, Pueblo, Teller, and Weld. Counties not specifically identified are 

counties that use the “Hold and Wait” court ordered process. Counties utilizing the Hold and Wait 

Evaluation process will be offered a meeting date within 30 days of the Department’s receipt of the 

Court Order and Collateral Materials, and the evaluation will be completed within 30 days of the 

meeting. Beginning January 1, 2020, counties utilizing the Hold and Wait Evaluation process will be 

offered a meeting date within 30 days of the Department’s receipt of the Court Order and Collateral 

Materials, and the evaluation will be completed within 14 days of the meeting. 

Historical context: Timely competence evaluations were a relative strength of the Department

until around November 2019, when performance deteriorated substantially. Many jail-based 

evaluations then exceeded the 28-day time frame—reaching peak delays in January 2020 (46%

delayed). Even through much of Spring 2020, roughly 30% of jail-based evaluations exceeded the 

28-day time frame. During the summer of 2020, referrals for jail-based evaluations again began 

to increase towards prior levels. At the same time, the Department improved Court Services. 

They hired new leaders, evaluators, and contractors; they increased compensation and 

prioritized jail-based evaluations. In short, Court Services underwent dramatic improvements 

sufficient to handle the increasing court orders and challenges they have faced. 

Recent history: As Court Services improved, far fewer Pretrial Detainees waited for evaluations 

beyond the required timeline. For roughly two years, the Department completed nearly all in-jail 

evaluations within the required time frames. Court Services leadership appeared to continually 

monitor challenges and adjust procedures accordingly, often in creative ways. Court orders for 

jail-based evaluations peaked at an all-time high (166) in March 2023. They then held fairly 

steady at high, but just-manageable, levels, before reaching a similar peak (164) recently in April 

of 2024.

This quarter, court orders for evaluations held steady (almost identical to the prior quarter) until

April. But Court Services remained timely in all respects. All jail-based evaluations occurred 

within 21 days, as required, for the seventh month in a row. 

For the past few years, Court Services has managed to meet timelines for jail-based evaluations, 

even amid substantial challenges, with only one brief period of significant noncompliance. Court 

services maintained perfect compliance with timelines this quarter, despite a spike in evaluation 

orders during April. Their ongoing challenge will be filling open positions sufficient to maintain a

team of evaluators, particularly amid a recent increase in orders. 

Case No. 1:11-cv-02285-NYW Document 290 filed 05/29/24 USDC Colorado pg 21 of 61
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INTERIM JAIL MENTAL HEALTH TREATMENT19 

34. Interim Jail Mental Health Treatment. If the court does not release the Pretrial Detainee to 

Community-Based Restoration Treatment and the Pretrial Detainee is awaiting receipt of Inpatient 

Restoration Treatment, the Department shall work with the County Jails to develop a program to 

assist in the provision of coordinated services for individuals in accordance with C.R.S. §§ 27-60-105 

et seq. to screen, treat, assess, and monitor for triage purposes Pretrial Detainees in the least 

restrictive setting possible. This paragraph does not toll or otherwise modify the Department’s 

obligation to Offer Admission to the Pretrial Detainees for Inpatient Restoration Treatment. Interim 

Jail Mental Health Treatment shall not replace or be used as a substitute for Inpatient Restoration 

Treatment but does not preclude the Department from providing Restoration Treatment. A member of 

the Forensic Support Team shall report to the Court Liaison every 10 days concerning the clinical 

status and progress towards competency of the Pretrial Detainee. 

Historical context: The Department is required to partner with county jails to develop a program 

of coordinated services for competency-involved detainees. The Department utilizes Jail-Based 

Behavioral Services (JBBS) as a hub for coordinating these subcontracted services across 

Colorado. These providers are tasked with providing adequate mental health services to inmates 

involved in competency matters until their transfer to competency restoration services. 

Current realities: The JBBS teams provide critical services across the state. They remain the

primary frontline mental health workforce for Pretrial Detainees, and Competency Enhancement 

Team (CET) staff are dedicated to enhancing services for Pretrial Detainees awaiting restoration. 

However, services, staffing, and quality vary greatly across Colorado jails. However, recent 

county budget cuts and staffing shortages have limited the size and impact of some JBBS teams. 

OCFMH’s mobile competency enhancement service contracts with a part-time forensic 

psychiatrist to meet with specific Detainees and treatment providers to discuss and encourage 

medication administration and management. Even as the funding for this psychiatrist has come 

to an end, the Department has identified a way to secure new funding for this service, which has 

proved valuable.

Also related to psychiatric medication in jail, we still suggest that involuntary medication orders 

(IMOs) can be useful in addressing mental health needs of some Detainees when appropriate. Of 

course, we share concerns that an overreliance on IMOs could shift treatment to jails that should

occur in the hospitals. We also know that many jails do not have adequate staff or conditions to 

appropriately provide IMOs and monitor their effects immediately after administration. 

However, we also see the dramatic improvements medications can bring to those suffering in 

19 “Interim Jail Mental Health Treatment” means mental health treatment of a Pretrial Detainee that is 

performed in the County Jail where the Pretrial Detainee is held while the Pretrial Detainee awaits 

Community-Based or Inpatient Restoration Treatment per Court Order consistent with the time frames in 

the Consent Decree. It is not a substitute for competency restoration services. 

Case No. 1:11-cv-02285-NYW Document 290 filed 05/29/24 USDC Colorado pg 22 of 61
Page 23

jails. We believe that Colorado could benefit from a thoughtful yet comprehensive IMO option, 

similar to other states that utilize IMO administration more regularly. Suitable legal and clinical 

safeguards, conditions, and policies must be implemented in such a system, but we believe 

Colorado could benefit if a viable IMO system were in place. 

We continue to suggest that IMOs, assertive community treatment, and broader criteria for 

involuntary evaluation and treatment could address unmet mental health needs among persons 

who lack the capacity to make informed choices about their care and who simultaneously are at 

risk for criminal justice involvement or worsening physical or mental health status. For example, 

perhaps in some situations, an acutely ill inmate could be transferred to a civil hospital for 

administration of an IMO and then return to their county jail after an appropriate monitoring 

period in the hospital.20 Additionally, these sorts of programs rely on a functional, accessible civil 

mental health system. Developing this type of robust, community (civil) mental health system is 

not solely within the Department’s control. We affirm their decision to pursue conversations

with leadership from other stakeholders (law enforcement, corrections, private mental health, 

judges, and persons with lived experience) to enhance Colorado’s civil mental health options. 

20 As always, we emphasize that Involuntary medication is often unnecessary because empathic, 

collaborative care is often sufficient to engage patients in voluntary medication. But in a small minority of 

cases, involuntary medication may be a necessary last resort for much-needed treatment.

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RELEASE OF PRETRIAL DETAINEES FOR COMMUNITY-BASED RESTORATION 

TREATMENT21 

 

35. Release of Pretrial Detainees for Community-Based Restoration Treatment. If the court releases 

the Pretrial Detainee on bond to commence Community-Based Restoration Treatment, the 

Department shall coordinate with the Court Liaison to develop a discharge plan (in a format approved 

by the Special Master) within seven days of the order to all parties involved in the Community-Based 

Services Recipient’s case, and the Court Liaison and community-based provider. 

The Department has continued to meet the requirement to develop discharge plans for people

identified as appropriate for Outpatient Competence Restoration programming (OCRP). Indeed, 

the waitlist would double in size were not for the persistent efforts to shift so many detainees 

into the Department’s robust outpatient competency restoration program and related 

community supports. The Department has continued these sorts of efforts in two broad areas:

Housing: The Forensic Support Team (FST) Navigators continue to facilitate transitions from jail 

to community housing across the state. Most community housing options are in the Denver and 

Colorado Springs metro areas, but the Fines Committee has recently funded more in northern 

and southern Colorado. The total number of housing placements and beds funded by the Fines 

Committee remains high. Most of these housing options offer additional treatment and 

supportive services. The launch of the Mental Health Transition Living homes has generated 

additional community housing and services as well, and these beds are reserved exclusively for 

those who are discharging from a state hospital or transitioning from the waitlist to the 

community. These Mental Health Transitional Living beds are critically important as they provide 

community housing and service options for people who have traditionally been very hard to 

discharge. Nearly 30 people are already living in the first MHTL homes (as of late May 2024), and 

nearly 150 beds are scheduled to open in 2024, including beds reserved for persons with even 

more intense clinical and supervision needs than those who are currently housed. Please see 

Appendix 3 for a description of these programs.

Forensic Support Team (FST): The FST filled most of their open positions; however, recent wellfunded job openings from the Bridges Program are likely to draw away Navigators from the FST. 

FST Navigators continued to monitor clinical status and restoration progress for those in jails 

awaiting transfer to CMHHiP. In April 2024, FST Navigators were assigned to 920 persons in

county jails waiting for competence evaluations and/or inpatient restoration services. For 

persons awaiting evaluations in jail, the FST recorded an average monthly total of 220 face-toface contacts and 604 contacts with care teams or other stakeholders during the past quarter. 

All of those numbers reflect historical highs. For individuals awaiting restoration services this 

21 “Community-Based Restoration Treatment” means Restoration Treatment of a Community-Based 

Recipient that is ordered to be performed out of custody and in conjunction with a community-based 

mental health center or community organization.

Case No. 1:11-cv-02285-NYW Document 290 filed 05/29/24 USDC Colorado pg 24 of 61
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quarter, Navigators logged an average monthly total of 688 face-to-face contacts with 

defendants in jail and 1,904 contacts with care teams or stakeholders (the highest average 

monthly total in more than a year).

22 These numbers meet or exceed those found in previous 

quarters, and they represent tremendous time and effort devoted to Detainees. To date, several 

thousand CMHHiP bed days have been “saved” since January 2020 through these combined 

efforts. 

The FST also continues to facilitate discharges and community transitions for many people on 

the waitlist. FST actions include changing the restoration setting from CMHHiP or CMHHiFL to 

the community, placing appropriate Detainees into community-based specialty programs (such 

as placement in the MHTLs or Fines-funded settings), working with competency dockets to 

facilitate quicker hearings and community restoration options, advocating for the dismissal of 

charges or resolution of competency for those who have stabilized, and more. For example, the 

“Momentum” Program provides dedicated case management, medication assistance, and peer 

support to persons transitioning from jails to community settings. Since early 2020, the FST has 

referred 621 people to the Momentum Program, resulting in 407 active current clients—people 

who would have otherwise remained in jails or a state hospital. This is just one example of many 

community service programs with which the FST works. 

Finally, Navigators continue to work closely with many specialized judicial programs, such as the 

Larimer County Competency Court, the Denver Competency Diversion program, the REACH 

docket in Denver County, and day reporting services in El Paso and Pueblo counties. Each of 

these is discussed in the “Notification of Non-compliance with Time Frames” section and 

Appendix 3. The FST is also partnering with many new competency dockets (see Appendix 2). We 

continue to affirm the Navigators collaborations with these innovative programs. 

Overall, the FST continues to be a strength within the Department as they collect information 

from JBBS providers, Competency Enhancement Teams, deputies, and others in the jails. 

Outcomes from the FST are again strong this past quarter, despite difficult conditions and 

overwhelming demand for their services. 

22 According to the Department’s Special Master Compliance Plan report for April 2024, submitted May 

15, 2024, pp. 43-46. 

Case No. 1:11-cv-02285-NYW Document 290 filed 05/29/24 USDC Colorado pg 25 of 61
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TRANSPORTATION OF PRETRIAL DETAINEES 

 

36. Transportation of Pretrial Detainees. If a Pretrial Detainee is transported to the Hospital for an 

Inpatient Competency Evaluation and the Department or a medical professional opines that the 

Pretrial Detainee is incompetent and the provisions of C.R.S. § 27-65-125 have been met, the 

Department shall not transport the Pretrial Detainee back to his/her originating jail. 

No defendants were admitted to inpatient facilities for inpatient competence evaluations this 

past quarter.

23 This follows a quarter in which the most Detainees (though only 5) were 

admitted to an inpatient facility for competence evaluation since 2021. Overall, very few of 

Colorado’s competence evaluations occur in a state hospital setting.

The Department has not reported any other delays or barriers to transportation with jails around 

Colorado. 

 

23 According to the Department’s Special Master Compliance Plan report for April 2024, submitted May 

15, 2024, pp. 25-26.

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NOTIFICATION OF NON-COMPLIANCE WITH TIME FRAMES 

38. Notification of Non-Compliance with Timeframes. The Department shall notify the Special 

Master and DLC weekly regarding any non-compliance with timeframes. 

(a) Only one notice per Pretrial Detainee shall be provided and should include: (i) The name of the 

Pretrial Detainee; (ii) The Pretrial Detainee’s location; (iii) The Pretrial Detainee’s charges based on 

information available to the Department; (iv) The Pretrial Detainee’s bond amount based on 

information available to the Department; (v) Whether a forensic assessment has been made on 

whether restoration in the community is appropriate; (vi) Whether the Pretrial Detainee has 

previously been found incompetent; (vii) What efforts are being made to provide timely Competency 

Services to the Pretrial Detainee, including communications with the court, Court Liaisons, and 

community mental health providers; 

(b) The Department shall accompany its Monthly Data Report (see Paragraph 52) with a separate 

“Fines Report” which will include the names of the Pretrial Detainees for whom the Department has 

accrued a fine during the preceding month, the number of days each Pretrial Detainee waited in the 

County Jails past the timeframes for compliance, and the total fines owed by the Department for the 

preceding month. 

(c) The Department shall pay the total fines owed on the date the Fines Report is submitted to the 

Special Master to be deposited in a trust account created for the purpose of funding non-Department 

mental health services. The account will be managed by a court-appointed administrator. Decisions 

concerning payments out of the account will be made by a committee consisting of a representative 

from the Plaintiff, a representative from the Department, and the Special Master. Any disputes 

regarding the fines shall be handled through the dispute resolution process identified in Paragraph 59. 

Historical context for calculating fines: The funds from fines should benefit the population served 

by the competency system. A small committee comprising Department administration, a DLC 

representative, and the Special Master meet regularly to address use of these fines. This 

committee has also added a team of two auditors (to review and support fines-funded 

programs), and a program-developer (to consult with potential programs submitting proposals). 

The broad goal is to use the funds in ways that help those involved in the mental health and 

criminal justice systems (i.e., those who are, or are likely to become, involved in competencyrelated services), and to address Colorado’s “competency crisis,” by providing new services or 

interventions that do not already fall within the Department’s responsibilities. In other words, 

funds from the fines should supplement, but not supplant, existing services. The Department has 

provided reliable notification of non-compliance of time frames on a weekly basis, as required by 

the Consent Decree since June 1, 2019. 

Current realities: Throughout the past four years that fines have accrued, the Department has 

routinely completed the “Fines Report,” as prescribed by the Consent Decree. Also, as prescribed 

by the Consent Decree, the Department continues to pay these fines into a trust account 

(managed by Cordes & Company, LLP), which is used to support additional special projects that 

complement the broad goals of the Consent Decree. 

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Projects funded by the Fines Committee

Currently, the top priorities for the fines committee are projects that address housing, diversion 

from the competency system, and specialized competency judicial programs (competency 

dockets and calendars). 

Housing is a priority because the lack of housing is a persistent barrier to community restoration; 

judges often remark that they would release a detainee for outpatient restoration if only the 

detainee had stable housing. Therefore, the Fines Committee continues to fund a variety of 

community-housing for those involved in outpatient restoration. The fines-funded Restoration 

Housing initiative continues to provide community placement options for some Pretrial 

Detainees. These individuals have shown clinical improvements and minimal public safety risk, 

making them appropriate for transition from jails or CMHHiP to Outpatient Competence 

Restoration programming (OCRP) with housing contracted through the Colorado Coalition for 

the Homeless (CCH). At the time of this writing, the Forensic Support Team has coordinated 241

completed referrals and placed 82 individuals in CCH housing units. To date, 40 people have had 

their cases either dismissed or resolved after moving into CCH Housing.24 These figures have 

held steady for months, because those admitted to CCH Housing have remained there, 

consistent with CCH’s priority on sustainable, permanent housing.

Since the initial housing projects through CCH, the Fines Committee has increasingly funded new 

housing such options, such as Ananeo’s supportive and sober housing, which serves roughly 20 

individuals at any time. Likewise, the Embark program provides sober-living housing and dayreporting center, while Monarch provides sober-living housing and wraparound services. Please 

see Appendix 3 for all the fines-funded housing projects.

The Committee has continued investigating a significant loss we mentioned in our last Quarterly 

Report. On January 11, 2024, the Fines Committee was devastated to learn that Joel Watts, 

owner of Integrated Insights Therapy in Delta, CO, whom the committee had funded for 

$1,178,000 over two years, had likely misappropriated the last $375,000 in funds the committee 

had approved to house and treat competency clients. The Committee promptly terminated 

future payments to this program, and hired an attorney to pursue legal means to recuperate the 

funds. The attorney's investigation into this matter discovered that Mr. Watts had likely also 

misappropriated over $2,000,000 from other funders. To prevent such incidents in the future, 

the Committee has implemented several additional measures, such as requiring organizations to 

produce financial information upon application submission, requesting detailed financial records 

on a quarterly basis, and the Committee has engaged a forensic accountant to perform audits on 

funded programs.

24 According to the Department’s Special Master Compliance Plan report for April 2024, submitted May 

15, 2024, pp. 45-46. 

Case No. 1:11-cv-02285-NYW Document 290 filed 05/29/24 USDC Colorado pg 28 of 61
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Diversion programs of course, divert people out of the competency system and into treatment, 

which can be provided outside the slow competence restoration system. Therefore, the Fines 

Committee has funded court-based diversion programs in Denver and Aurora counties. For 

example, the Denver “Competency Diversion Docket” diverts into community treatment 

defendants with less serious charges who would likely otherwise enter the competency system; 

if they successfully complete community treatment their charges are dropped. 

Competency Dockets and related efforts provide greater efficiency and better service to 

detainees because they centralize expertise among court personnel. The Fines Committee has 

funded specialized competency judicial programs including the competency court in Larimer 

County and the Denver competency docket. Indeed, there are several “competency dockets” 

emerging across Colorado as more jurisdictions recognize the strengths of this model; Colorado’s 

Court Services is beginning to study and support these, even aside from Department efforts. This 

quarter, an average of 336 people were actively participating in one of the 9 competency 

dockets statewide at any one point in time. 

Finally, this quarter featured further progress in the largest addition to the fines portfolio of 

projects. The Fines Committee has supported Embrave with $8,902,175 to develop the Valor 

Program, which will support individuals needing a level of care that does not currently exist in 

Colorado. Specifically, the Valor Program will provide residential care to people who need

intensive support and stabilization, including medication, which will address the gap between 

inpatient hospitalization and supportive and/or recovery housing. The 72-bed facility will offer 

24/7 care for individuals with moderately to highly acute psychiatric symptoms, who are not a 

danger to themselves or others but need 3 to 6 months of care to stabilize symptoms, receive 

case management, restoration education, peer support, and connect to the services and 

resources that will support their successful reintegration into their community. The Valor 

Program will serve any individual in Colorado who is in or at risk of being in the competency 

system, accepting referrals from the justice system and the community to support not only 

decreasing the waitlist but to also deflect and divert individuals from the justice and competency 

system. This large-scale service is scheduled to launch in June 2024, and our regular contact—

and particularly regular contact from our Fines Committee project development liaison Lynn 

Unger—suggests they are progressing well and on track to open on schedule.

A full info-graphic summary of fines-funded projects comprises Appendix 3. 

 

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DECREE SECTION VII UPDATES 

CIVIL BED FREEZE 

39. Civil Bed Freeze. The Department’s 2018 Plan included an effort to freeze civil admissions to its 

beds to devote Hospital beds to perform Inpatient Restoration Treatment services. On February 7, 

2019, the Department agreed to stop this practice. The Department will continue to leave the state’s 

civil and juvenile beds allocated as of the execution of this Consent Decree for civil and juvenile 

psychiatric admissions and will not freeze or convert those beds to provide competency services for 

Pretrial Detainees, unless the Department receives prior agreement from the Special Master to use 

unutilized beds for such purposes. This strategy to facilitate compliance with the Consent Decree 

shall only be re-implemented in the future upon agreement of the Special Master. 

Since the start of the Consent Decree, the Department has largely protected civil beds, even 

amid forensic pressures. Concurrently, the Department has opened more than 70 competence 

restoration beds over the past year, and it has pledged to open approximately 150 community 

beds in their system of MHTLs by the end of 2024 (see below). CMHHiP has just opened a third 

admissions unit and expects to be at full pre-pandemic restoration capacity by mid-June 2024. 

Finally, an additional 19 restoration beds are expected when the pending contract with Aurora 

Mental Health is finalized. Still, despite this critical increase in restoration beds, civil capacity 

continues to lag, offering few inpatient options for persons who might otherwise be deflected or 

diverted from the competence system. 

Thus, civil inpatient capacity remains precariously low throughout Colorado. Additional inpatient 

civil and forensic beds are critical to supplement Colorado’s creative outpatient efforts. The few 

states with reasonable wait times for forensic services all have strong inpatient and outpatient 

civil capacity. Successful and sustainable solutions to Colorado’s competency crisis will require a 

strong civil system that can manage the mental health needs of people with minor charges, 

reserving the criminal court competency system for defendants with serious charges. This broad 

strategy aligns with our other long-standing recommendations: diversion and deflection 

programs, long-acting injectable medications, assisted outpatient treatment, peer supports, 

robust case management, judicial supervision and monitoring, and involuntary medication 

orders. Without a strong civil system, incompetency remains the easiest route to mental health 

treatment among people without housing or resources—ultimately increasing the numbers of 

people ordered to the competence services system. We continue to encourage the Department 

to strongly pursue both civil and forensic funding and statutory changes that support both 

systems. We support the Department’s current short-term push to reduce the waitlist by 

prioritizing inpatient beds for competence restoration, but we continue to emphasize that any 

long-term solution must shift inpatient priority from forensic to civil beds. 

This quarter, the Department continued to open Mental Health Transitional Living (MHTL) 

homes, which serve as a critically important addition to Colorado’s civil service array. The 

Department originally funded 125 MHTL beds allocated to various providers around the state, 

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but cost savings should allow for the opening of nearly 150 beds by December 2024. To date, 

three of the contracted homes are open, with a total of 30 people either residing, enrolled, or 

pending admission in the homes. Two additional homes are scheduled to open soon, on June 4, 

2024. These homes prioritize step-down interim housing opportunities for people who are 

ready for discharge at a state hospital, pretrial Detainees in county jails, or people who are at 

substantial risk for entering inpatient competence restoration. These homes are one of the most 

critical components of a full civil service system, and a key step forward for the Department.

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COMPREHENSIVE AND COHESIVE PLAN 

40. Comprehensive and Cohesive Plan. The Special Master’s first recommendation was to revise the 

Department’s 2018 Plan into a more comprehensive and cohesive plan. Dkt. 146. By or about January 

2020, the Department will produce an initial plan resulting from a long-term visioning process with 

DLC, the Special Master, and stakeholders that will consolidate disparate pieces of the Department’s 

current plan, along with legislative initiatives, in a cohesive package for courts, administrators, 

service providers, and legislators to consider. As referenced in the Special Master’s Recommendation 

Number 7, the 2020 Plan will highlight the methods to prioritize quality amid quantity and time 

pressures. Dkt. 146 at 42. On an annual basis thereafter, the Department will review and revise the 

plan as appropriate based upon data provided by the Department. 

The Department first submitted a comprehensive, cohesive plan on February 27, 2020, as 

mandated by the Consent Decree. Given the unexpected challenges of the pandemic, they 

submitted subsequent plans in March 2021 and September 2021. The latter report reviewed 

much of the progress the Department made and identified some broader vision of adjacent and 

“upstream” strategies that can reduce the competency-involved population. 

As the pandemic continued, and as the competency crisis grew more dire, we increasingly 

advised the Department that emergency, crisis-management strategies, though necessary, were 

not sufficient. Rather, as we encouraged “a Comprehensive Plan for the competency system 

should include broad planning that diverts many people with mental illness away from the 

competency system before they enter it.” The Department made significant progress in this type 

of comprehensive approach. In April of 2022, the Department pushed forward new legislation, 

ultimately passing several bills designed to divert people from the competency system or limit 

their time in the competency system. Much of their progress involved securing millions of dollars 

in ARPA [American Rescue Plan Act] emergency funding to sustain existing services and support 

new resources. 

In the Fall of 2022, the Department submitted another Comprehensive Plan, which addressed 

these substantial developments in legislation and funding, along with other key plans. The

Department organized their efforts according to six key strategies or “levers:”

1. Number of inpatient beds;

2. Inpatient bed utilization (reducing waste);

3. Right sizing inpatient restoration beds;

4. Reduce the number of individual inpatient court orders;

5. Securing more beds in the community; and

6. Providing more services in the community. 

We agreed with the Department that these are the primary variables influencing the waitlist and 

wait times. But we also appreciated the efforts to expand the scope of their focus to beds and 

services in the community, for a much more comprehensive approach to the crisis. Indeed, 

addressing the first several (inpatient) variables will be crucial to decrease the current waitlist, 

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but vigorously addressing the last few (community) variables will be crucial for minimizing future 

additions to the waitlist. 

During the 2023 legislative session, the Department supported two competency bills. Though the 

first primarily addresses juvenile proceedings, the second (effective July 2024), HB 23-1138, 

improves the path to civil treatment for those involved in the competency system. However, this 

is tightly tied to the anticipated (but delayed) BHA system.

2023 Comprehensive Plan and Budget Requests:

The Department submitted their latest Comprehensive Plan in September 2023. The Department 

memorialized their efforts over the past year, including much greater collaboration with other 

stakeholders across various workgroups. The Department also memorialized their plans to: 

• Expand their use of community (private) hospital beds for the restoration population,

• Continue to reduce the proportion of misdemeanor charges that lead to inpatient 

restoration

• Better use existing inpatient beds, with increasing efficiencies, re-evaluations, and related 

measures

In line with the goals detailed in this Comprehensive Plan, the Department requested from the 

Governor’s office $57,967,379 in supplemental funds for FY 2023-24 to:

1. Maintain the 61 beds at private hospitals and add 19 more beds;

2. Staff and re-open 82 beds at the E2 and RNRU forensic units at CMHHIP, and staff and 

open the new F3 forensic unit at CMHHIFL by the end of 2023;

3. Add 6.8 temporary RNs and 17.2 temporary MHCs to ensure adequate staffing of the F2 

and F3 forensic units at CMHHIFL, open F3 in December 2023, and comply with Chartis’ 

recommendations; and

4. Fill direct care FTE vacancies by 12.5% while reducing agency direct care staff by 12.5%. 

Last quarter, the Governor granted this budget request. We consider the recently funded

inpatient beds absolutely necessary; they are a primary reason for recent improvements. 

Of course, the Department understands that inpatient beds should also prioritize civil, not just 

forensic, treatment. Further, the Department understands that inpatient beds are necessary, but 

not sufficient, to resolve the current crisis. They recognize the need for broad, collaborative 

solutions across the continuum of care, which remain crucial no matter how many inpatient beds 

open. Many defendants do not require this inpatient treatment and can be adequately served 

through outpatient restoration. Others only require inpatient treatment until they can “step 

down” to other types of facilities or housing (such as the recent Mental Health Transitional Living 

Homes). Thus, increases in inpatient beds should occur alongside improvements across the 

continuum of care. 

We are pleased to see the Department continue pursuing these other strategies, including 

collaboration with other stakeholders. For example, this quarter witnessed the passing of HB 24-

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1355 to establish a statewide mental health diversion program. Though the Department played a 

supportive—not leadership—role in this effort, it is a prime example of the type of collaborative 

“beyond the Department” initiative that will intervene “upstream” to reduce the demand on the 

competency system.

New Legislation: HB 24-1355 

The recently passed HB 24-1355 establishes a statewide mental health diversion program called

"Bridges Wraparound Care" for individuals with behavioral health disorders or neurocognitive

disorders who have been charged with low-level offenses. The key aspects of the bill:

• Requires each judicial district to establish a referral process through a memorandum of

understanding between judges, district attorneys, public defenders, and other stakeholders to

divert eligible individuals from competency proceedings and the criminal justice system into

the Bridges program.

• Eligible individuals would be those charged with misdemeanors or lower-level felonies who

are found incompetent to stand trial due to a mental health condition.

• If referred to Bridges, the defendant would be released on a personal recognizance bond and

assigned a care coordinator to create a treatment plan tailored to their needs, including

services like housing, insurance, therapy, and medication management.

• The judge would review progress and could dismiss the case if the treatment plan is followed.

• The program aims to reduce the backlog of defendants awaiting competency restoration,

decrease recidivism rates, and provide comprehensive community-based care instead of

incarceration for those with mental illnesses.

Amid these developments, we see more reason for cautious optimism for the third consecutive 

quarter. The Department has opened more beds, prompting the first sustained decrease in 

waitlist since the pandemic. Recent budget gains have created more available beds, and further 

decreased the waitlist, addressing a dire need. At the same time, we continue to encourage the 

broad and comprehensive changes—e.g., more diversion from the competence system, greater 

use of civil psychiatric treatment, etc.—that are crucial to help sustain any decrease in the 

waitlist. As the Department knows, this multi-causal, complex crisis requires multiple strategies 

for solution. 

Earlier this year, Department efforts targeted the pressing needs for staff and additional inpatient 

beds. This quarter revealed more progress in the form of MHTL homes, and collaborative 

legislation to divert people with mental illness into community care. We affirm all these efforts, 

which are necessary to address such a daunting challenge. The state certainly needs more 

inpatient beds, along with coordinated efforts that steer people with mental illness away from 

jails and forensic hospitals, and into regular community treatment. 

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INCREASE COMMUNITY RESTORATION SERVICES 

41. (a) Implement a coordinated wide-scale outpatient (community-based) competency restoration 

(OCR) system. This system shall be integrated and submitted with the “Comprehensive and Cohesive 

Plan” referenced in Paragraph 40 herein. This plan shall be approved by the Special Master. 

The Department’s formal competency restoration program (OCRP) began in March of 2018, and 

has grown steadily since then. Referrals for outpatient restoration were steady this quarter, 

ranging from 64 to 85 defendants per month, similar to prior quarters this year.

25 More than 

600 individuals participate in Colorado OCRP, and there still is no waitlist for OCRP services. As 

always, we affirm the Department’s success in building the largest, most robust statewide OCRP 

program in the country (only one other state offers statewide OCR). Of course, high OCR capacity 

ultimately reduces the restoration service demand on Colorado’s two state hospitals. In the past 

quarter, 219 people were placed in OCR (a minimal decrease from the past quarter). 

OCRP outcomes 

Data from February through April 2024 reveals a 29.5% restoration rate in the OCRP reevaluation reports that the Department reviewed (49 of 166 total opinions). An additional 16.9% 

were opined as unrestorable (28 out of 166). The remaining 37.5% were opined as remaining 

incompetent. This reflects a slightly lower but still reasonably steady OCRP restoration rate, 

which was 24% and 39% the past two quarters. Data from the same period shows that courts 

found 40.6% of defendants restored to competence (52 of 128 total adjudications), lower than

last quarter’s 47.7% rate. The court dismissed charges and/or otherwise terminated restoration 

services in an additional 27.3% of these re-evaluation cases. The Department again surmised 

that less positive may be attributable to increasingly ill defendants (i.e., more severe psychiatric 

symptoms) ordered to outpatient restoration. 

41. (b) The Department may utilize private hospital beds to meet the needs of Pretrial Detainees 

meeting C.R.S. § 27-65-105(a) civil commitment criteria and with prioritization to Pretrial Detainees 

already residing within the same geographic location. The Department shall create a plan to 

implement this subsection (b) to be approved by the Special Master. 

The Department continues to contract with local hospitals to provide inpatient beds for shortterm competency-related services. We provide a summary of these beds and programs as an 

appendix to this report (see Appendix 1). Currently, the Department contracts with Denver 

Health Hospital for 15 beds, and Peakview Hospital for 72 beds; beds were filled on average at 

more than 90% capacity over the past quarter. A pending contract with Aurora Medical Center 

should allow for the opening of 19 more beds. There will be some reduction in Front Range beds 

as some capacity is shifted to the Western Slope over the next few months; but total capacity 

will not change. 

25 All data in this section retrieved from the Department’s Special Master Compliance Plan report for April 

2024, submitted May 15, 2024, pp. 46-54. 

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There is no doubt that this increase in inpatient restoration capacity (along with a concurrent 

increase in the availability of state hospital restoration beds) has led directly to a substantial 

decrease in the number of people on the waitlist as well as the decreased average time to 

placement. Of course, inpatient restoration capacity cannot be the exclusive solution to 

Colorado’s competence crisis. Indeed, the 106 private beds currently “rented” are by definition 

short-term fixes. To reiterate our earlier concerns, while we affirm the Department securing 

these inpatient restoration beds at this critical time, civil inpatient capacity remains insufficient. 

The Department must ultimately prioritize civil inpatient capacity; this will help sustain the 

improvements in the waitlist as individuals receive civil (rather than forensic) treatment. We 

encourage the Department to continue to devote beds to civil patients, diversion programs, or 

similar programs designed to provide inpatient mental health services in lieu of restoration

services. 

41. (c) The Department currently estimates that 10-20% of Pretrial Detainees admitted for inpatient 

restoration do not need hospital-level care. Dkt. 146 at 29. The Department will make best efforts to 

reduce inpatient restoration hospitalizations by 10% and increase community restorations by 10% in 

six-month increments beginning June 1, 2019. The baseline for the preceding sentence will be 

determined by the Special Master by June 1, 2019, utilizing data provided by the Department. On 

June 1, 2020, the Special Master will establish a modification of this guideline based upon a survey of 

the data collection and implementation of the Department’s Plan.

OCRP baselines 

As prescribed in the Consent Decree, we established a baseline for improvement by calculating a 

six-month period (i.e., Nov 2018 - April 2019) prior to the June 1, 2019 deadline. We identified 

40% as an optimal proportion of defendants referred for outpatient (versus inpatient) 

restoration and we report progress towards that 40% OCR rate in the following table. 

 

Inpatient Restorations 

 

 

Outpatient Restorations 

 

Initial baseline Nov 2018 – April 2019: 69% Nov 2018 – April 2019: 31%

November 1, 2021 goal 60% maximum 40% minimum

Recent progress (past 6 months) Nov 1, 2023 – Apr 1, 2024:

61.4%

Nov 1, 2023 – Apr 1, 2024:

38.6%

For the past six months (November 2023 through April 2024), a total of 38.6% of all restoration 

orders were to outpatient restoration. This rate has remained at compliance or very near 

compliance for the past several quarters. Directing such a large portion of defendants towards 

outpatient restoration is a tremendous strength of the Colorado system—this is the highest rate

in the Unites States—and a crucial protection against an even greater “competence crisis.”

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We also monitor the numbers of persons found ITP in jails who are referred to OCRP (i.e., 

excluding those referred to OCRP after on-bond evaluations), because this is the population that 

the Consent Decree specifically addresses. Based on a similar historic review, we calculated a 

baseline of 20% and expected an increase of 10% for each subsequent 6-month period. 

The current figure, reflecting six months’ worth of data between October 2023 — March 2024 (a 

lag in data is unavoidable, as restoration orders are not always received within the month that 

the restoration hearing occurs), indicates a 24.7% OCR referral rate among all evaluations 

conducted in jails. Month-to-month averages have fluctuated substantially, dipping as low as 

15% in January 2024 but also exceeding the 30% threshold multiple times. The 24.7% rate 

reflects an all-time high, with previous six-months figures of 19% and 13%. Given the large 

fluctuations, we are exploring the accuracy of the data. But even if 24.7% is incorrect, the rates 

do seem to be trending closer to the 20% base rate goal (or perhaps beyond it). 

In summary, we continue to affirm the tremendous impact that OCRP has on the waitlist. The

combination of persons ordered to OCRP overall (38.6% of all persons adjudicated as ITP) and 

the proportion of persons ordered to OCRP after an in-custody evaluation (24.7%) suggests a 

very robust OCRP program. A total of 219 individuals were placed in OCRP this past quarter, 

many of whom would have otherwise been placed on the waitlist. Quarterly numbers of 

admissions to OCR have remained fairly steady across the past 12 months, diverting and 

deflecting hundreds of defendants from county jails and inpatient hospitals into community 

settings. Overall, the OCRP continues to be a critical component in Colorado’s competence 

services system. 

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CONCLUSION 

Like every quarter for the past two years, this quarter revealed wait times that far exceed the 

required timelines. However, the waitlist has decreased for the third consecutive quarter, and we 

see other metrics improving as well. With new units opened at the hospitals, there were more 

admissions this quarter than ever before. Of course, a backlog remains, and detainees continue 

to wait too long. But for another consecutive quarter, several key metrics trended in the right 

direction, for the first time in two years, revealing the best progress we have seen since the 

pandemic. We are increasingly optimistic that the Department can comply with the Consent 

Decree within the next two years.

As always, we appreciate the opportunity to serve the Court, and the state of Colorado, in these 

important efforts.

 

Neil Gowensmith, Ph.D. Daniel Murrie, Ph.D.

President, Groundswell Services Inc. Special Master, Civil Case 11-cv-02285-NYW

Special Master, Civil Case 11-cv-02285-NYW

 

 

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APPENDIX 1 

 

Summary of Inpatient Restoration Service Capacity 

 

 

Summary of Inpatient Restoration Service Capacity 

 

 

Setting Total future 

restoration 

beds through 

12/24 

 Funding Source 

CMHHiP* 218 CDHS

CMHHiFL* 44 CDHS

Arapahoe RISE 78 CDHS

Boulder RISE 0 CDHS

Denver County 

Restoration 

Treatment Unit 

(DRTU)

18 CDHS 

Denver Health 15 CDHS

Peakview Hospital 72 CDHS 

Medical Center of 

Aurora

19 CDHS

Total 464 

* All restoration beds at CMHHiP are now available. The Department has received preliminary approval for funding 

to maintain these beds throughout the next two fiscal years, continue privately contracted beds, and acquire 19 

new contracted beds in the next fiscal year. Boulder RISE is expected to end their contract on June 30, and 

Arapahoe RISE is considering expanding their program to accommodate those extra beds. Also, the Department 

will be transferring some bed capacity (approximately 10-15 beds total) from Front Range settings to Western 

Colorado in 2024. Specifics are as yet unknown. 

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APPENDIX 2 

 

Summary of Colorado’s Competency Dockets 

(compiled by the Department’s Forensic Support Team) 

 

Judicial District

Judicial Office 

Assigned Population Served

1st Judicial District

Judge Klein & 

Judge Miloud Low-level felony

2nd Judicial District

Judge Lisa 

Arnolds (1H) F6-F4 Cases (and higher w/ DA approval)

Denver County Court Comp 

Docket (Misdemeanor Charges) Judge Cherry Misdemeanor Cases Only

4th Judicial District - El Paso

Magistrate 

Gurney

F5&F6 Non-VRA cases (and case-by-case 

approval from DDA)

5th Judicial District Judge Shamis

Will eventually take all competency cases in the 

district

8th Judicial District - Larimer Judge Blanco Low-Level Felony and Misdemeanor

10th Judicial District - Pueblo Judge Ernst <F3 non-violent, judges make "referrals"

12th Judicial District - Alamosa 

Only

Judge CortezRodriguez >F2 clients that need “support”

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16th - Otero, Bent, Crowley

Magistrate 

Fouracre (Otero) Low Level Charges (in-custody cases)

17th Judicial District - Adams Judge Jimenez TBD

18th Judicial District Court -

Arapahoe Judge Volz

No crimes of violence,(assault vs peace officer 

case by case), both in and out of custody (capped 

at 10)

19th Judicial District - Weld TBD TBD

Other

2nd Judicial District (Pre-Comp 

Mini-Screener) Judge Arnolds Pre-Comp Cases

Denver County Competency 

Diversion Program

Jail Magistrate 

(rotating) Pre-Comp Clients in Denver

Case No. 1:11-cv-02285-NYW Document 290 filed 05/29/24 USDC Colorado pg 41 of 61
APPENDIX 3

Fines Committee Funded Program Master List 

Updated March 31, 2024

NAME/ORGANIZATION PROGRAM SUMMARY

1st Judicial District 

Competency Docket 

In June 2023, the Fines Committee approved $220,000 for two years of funding to the 1st Judicial District Court. 

Funding provides for a Docket Coordinator (1.0 FTE) to manage the competency docket, which provides a 

judicial venue for a multidisciplinary team to help acquire resources and monitor the progress of competency 

clients. The docket model enables clients to be released from custody during competency evaluation and 

restoration and enables clients to potentially be diverted to treatment and supportive housing, in lieu of 

prosecution. The MOU was fully executed in October 2023, and the Docket Coordinator started in January 

2024. Also in January, the competency docket began accepting clients. The docket is also available to clients 

referred from Gilpin County, the officials of whom were engaged with by the Docket Coordinator. In Quarter 1, 

2024, the 1st Judicial District Docket received 21 referrals, all from the Jefferson County Public Defender’s 

Office. It onboarded and began serving 17 clients. No client outcomes are yet available.

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2nd Judicial District 

REACH Docket 

In March 2023, the Fines Committee approved $220,000 for two years of funding to the 2nd Judicial District 

Court. The 2nd Judicial District operates a competency docket known as REACH (Review, Evaluate and Assist, 

Community-based behavioral Health). REACH hears cases for defendants who have charges in Denver District 

Court that are equal to or less serious than F3s or DF2s, with some exceptions, and have had competency 

raised in their case. The court works collaboratively with the Public Defender’s Office, the District Attorney’s 

Office, the Office of Civil and Forensic Mental Health, and numerous treatment agencies in the community to 

help defendants navigate the competency system and resolve cases in an effective manner. Funding provides 

for a Docket Coordinator to manage the competency docket, enabling clients to be released from custody 

during competency evaluation and restoration and potentially diverting clients to treatment and supportive 

housing, in lieu of prosecution. The Docket Coordinator position was filled during the 4th Quarter of 2023. The 

Coordinator has been working with the judge and stakeholders to establish best practices and procedures in 

the REACH docket. Since its inception, 604 defendants have been referred to the REACH docket, for a total of 

897 cases. The Docket Coordinator currently manages 376 cases; 380 of the 897 cases have been dismissed, 

and 141 were returned to the trial courtroom after a competent to proceed finding. 

2nd Judicial District 

Psychology Screener 

One-time funding in the amount of $17,850 was approved for Psychological Insight & Assessment to help 

clients in the 2nd Judicial District acquire competency evaluation screening in custody, with the work taking 

place in Quarter 2 of 2023. This program was approved to meet a specifically-identified need for screening at a 

time when state-funded screening was suspended. The suspension caused a backlog for the 2nd Judicial 

District, and this program was funded to relieve the backlog. The target population included pre-release 

incarcerated clients ordered for competency evaluation. Psychological Insight & Assessment received 62 

referrals and completed 52 evaluations. Of the 52 individuals, 25 met the threshold, 16 required further 

evaluation, and 11 individuals did not meet the threshold. 

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12th Judicial District 

Competency Docket 

In October 2023, the Fines Committee approved $69,555 for two years of funding to the 12th Judicial District. 

Funding provides for a Docket Coordinator to manage the competency docket, a judicial venue for a 

multidisciplinary team to help acquire resources and monitor the progress of competency-involved clients. The 

docket model enables clients to be released from custody for competency evaluation and restoration and 

enables clients to potentially be diverted to treatment and supportive housing, in lieu of prosecution. In 

January 2024, the program held its inaugural meeting. This quarter the program onboarded nine clients and 

had zero terminations. Additionally, in its service to its rural, mountain community, this program establishes a 

regularly meeting venue through which continued development of a community mental health system 

potentially may coalesce. A stakeholder MOU has been endorsed by the stakeholder parties. The program 

reports that the district attorney is currently considering a diversionary disposition for one case; this is notable 

because diversion was not a disposition the district attorney had been willing to take when first entering into 

the agreement to participate in the competency docket. 

AllHealth Network 

Bridges to Care 

In May 2023, the Fines Committee approved $134,000 for one year of funding to AllHealth Network. In March 

2024, a no-cost extension was granted to AllHealth Network to continue operating the Bridges program 

through June 2024. The program expands the capacity of the Bridges program in Arapahoe County to 

accommodate additional clients participating in that county’s competency docket. Funding supports two case 

managers (Bridges Liaisons) and equipment for both case managers, including laptops, phones, monitors, and 

docking stations. The Liaisons help clients acquire resources to support their needs and be successfully 

restored in the community. The Arapahoe County competency docket meets once a month, with two different, 

rotating attorneys representing the District Attorney’s Office and the Public Defender’s Office. In Quarter 1, 

2024, the competency docket approved three individuals to the Bridges program, for a total of 15 individuals. 

As of the end of the quarter, no client had been terminated. Each Liaison can carry a maximum caseload of up 

to 30 individuals; as such, the capacity of this program is 60.

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Ananeo Housing Funding ($387,480) was approved for Ananeo Housing in November 2022, with the formal launch in December 

2022. Additional funding in the amount of $156,870 was approved by the Fines Committee in February 2023 

for five female units; $60,000 of the additional funding was awarded as capital investment to make 

improvements to the Ananeo property. In September 2023, Ananeo received $290,610 for a 15-bed expansion 

to serve an additional ten males and five females. The MOUs between the Fines Committee and Ananeo

Housing were renewed and consolidated in December of 2023 totaling $1,847,630 to serve 40 competencyinvolved individuals; this amount includes $242,175 which had been previously awarded but not yet funded. 

The goal of this program is to provide housing and services associated with supportive monitored sober 

housing to clients referred by the Office of Civil and Forensic Mental Health for out-of-custody competency 

restoration. The Fines Committee funds two case managers, a mental health clinician, a psychiatric nurse 

practitioner (0.5 FTE), a clinical supervisor (40 hours a year), rent, utilities, referral management, urinalysis 

administration, and basic housing supplies for each client. Of the 40 beds that were contracted in December 

2023, 38 are now occupied with two additional clients who have been approved for beds but are awaiting jail 

release. Five individuals who were originally funded by Fines Committee funding have stabilized and are no 

longer occupying a Fines-funded bed but are in residence at Ananeo for additional support and continued 

sobriety. Ananeo is in the process of expanding the staffing of its Wellness Hub. A psychiatric nurse 

practitioner and a clinical therapist have been hired. With the oversight of the psychiatric nurse practitioner, 

Ananeo’s QMAP program has allowed for all Ananeo house managers to dispense and record medications. In 

Quarter 1 of 2024, this program served 57 unique individuals; three individuals absconded, one individual was 

removed due to a policy violation, and another was moved to independent housing. An additional five 

individuals successfully completed programing and were discharged. Since the program began, 114 referrals 

have been screened; 47 clients have terminated from the program, of those 26 have absconded, mostly due to 

substance use and medication management issues. 

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Assisted Living of 

Aurora Transitional 

Housing 

In March 2023, the Fines Committee approved $822,000 for one year of funding to Assisted Living of Aurora 

(ALA) Transitional Housing in Arapahoe County, within the 18th Judicial District. The MOU between the Fines 

Committee and ALA expires on May 31, 2024. ALA has informed the Fines Committee of its desire to terminate 

the program and will revert unspent funds back to the Fines Committee. ALA provides bridge housing so that 

competency-involved individuals can be released from custody and begin receiving out-of-custody restoration, 

while the program helps them acquire public benefits which will enable longer-term community housing 

placement. Funding supports monitored housing for ten dedicated beds reserved for individuals ordered 

competency restoration, referred by Bridges and the Forensic Support Team. This program includes a fund that 

will pay for Medicaid Home and Community Based Services to start immediately, which is reimbursed once the 

client is enrolled in Medicaid. The anticipated length of stay for clients to remain in ALA Transitional Housing is 

120 days. In Quarter 3, 2023, ALA began receiving referrals and conducting intakes. In that quarter, seven 

individuals were referred to ALA by the Forensic Support Team, and ALA conducted intakes for all seven 

referrals. In Quarter 4, 2023, ALA placed a hold on reviewing additional residents in order to focus on service 

provision to the seven residents with severe mental health and substance use needs. In Quarter 1, 2024, ALA 

onboarded one additional client. Two individuals have terminated the program; one was transferred to a 

higher level of care, and the other individual absconded. Transition planning for the remaining six clients is in 

place with the help of OCFMH and other Fines Committee-funded programs.

Aurora Sustained Aurora Sustained is operated by the Aurora Public Defender’s Office in partnership with Aurora Mental Health 

and Recovery. Funding, in the amount of $104,751, was approved for this program in October 2021, and 

supplemental funding in the amount of $18,600 was awarded in April 2022. Continuity of funding was 

subsequently approved in July 2022 in the amount of $372,433 to fund the program for the remainder of 2022 

and 2023. In July of 2023, the Fines Committee approved Aurora Sustained’s funding request of $223,500 to 

continue to operate through December 31, 2024. The goal of this program is to screen individuals booked in 

the municipal jail and to assess appropriate individuals for competency. The program attempts to connect 

clients to treatment out of custody and work toward prosecutorial diversion. Clients are referred to Aurora 

Mental Health and Recovery for homeless services, outpatient mental health and substance abuse treatment, 

and psychiatric medication. The Fines Committee funds a program administrator, pays for competency 

evaluations, and historically, provided cell phones for clients who had no other ability to stay connected with 

the program. In Quarter 1 of 2024, this program completed 417 behavioral health screens and 27 competency 

evaluations. Of the 27 competency evaluations that were completed, 5 individuals were deemed competent to 

proceed, 10 incompetent, and 12 did not appear for their evaluation.

Case No. 1:11-cv-02285-NYW Document 290 filed 05/29/24 USDC Colorado pg 46 of 61
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Behavioral Treatment 

Services Forensic Day 

Reporting 

In June 2023, the Fines Committee approved $265,814 for one year of funding to Behavioral Treatment 

Services (BTS) to establish a day reporting center. The program provides, or coordinates to provide, 

psychotropic medication, medication-assisted treatment, case management, peer support, and a warm, 

welcoming location for clients to receive competency-related services. Due to startup delay, the Fines 

Committee agreed to a no-cost extension, continuing funding until the end of 2024. The program intends to 

serve at least 40 clients referred in Boulder County. Having formally began in the 4th Quarter of 2023, this 

program is now fully operational. Fines Committee funds provide for direct client services, including 

transportation, training manuals, housing support, drug screens, and MAT. It also provides for the following 

staff: office administrator (0.25 FTE), restoration clinical supervisor (0.25 FTE), clinical case manager (1.0 FTE), 

peer support specialist (1.0 FTE), and Master’s level therapists (1.5 FTE). In Quarter 1 of 2024, BTS received 

two referrals and onboarded both. At the end of the quarter, it reports three new referrals pending. The 

program also had one unsuccessful termination. The program has acknowledged that it is not operating at 

capacity and is working to recruit more referrals.

Boulder County 

Community Justice 

Services 

Funding in the amount of $220,000 was approved for Boulder County Community Justice Services in October 

2022. The original MOU between the Fines Committee and Boulder County expired on September 30, 2023, 

and a renewal was approved for additional funding in the amount of $285,842 through December 31, 2024. 

This program expands the Bridges program in the county to serve more individuals whom the Bridges Liaisons 

can work with to acquire services out-of-custody. The objective is to improve access to Bridges Liaisons, as well 

as increase the capacity for appointments with the Liaisons. The funds cover two FTE positions and costs 

related to clients’ treatment needs (e.g. treatment, assessments, neuropsychological evaluations, and 

medication), as well as basic needs for clients, including cell phones, clothing, emergency supplies, and hotel 

vouchers. Funds have also been used for the completion of court-ordered neuropsychological evaluations and 

toward the purchase of a fleet vehicle for transporting clients. The Office of the State Court Administrator 

funds an additional FTE in Boulder County, and in the middle of Quarter 3, 2023, all three Bridges Liaisons had 

been hired. The Liaisons served 110 individuals in 2023 (an estimated 97% of the incompetent to proceed 

population in Boulder County, including both in-custody and out-of-custody). In Quarter 1 of 2024, this 

program received 29 new referrals and conducted intakes for 11 individuals. Eighteen individuals terminated 

the program in the first quarter; six were successful, one refused services, and the remaining eleven terminated 

for neutral or other reasons. Two court-ordered neuropsychological evaluations were completed in Quarter 1.

Case No. 1:11-cv-02285-NYW Document 290 filed 05/29/24 USDC Colorado pg 47 of 61
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Boulder County 

Sheriff’s Office Jail 

Competency Program 

In June 2023, the Fines Committee approved $130,000 for one year of funding to the Boulder County Sheriff’s 

Office (BCSO) to provide clients with long-acting injectable medication ($120,000) and assistance with housing 

support ($10,000). The medication serves clients who return to jail from the state mental health hospital, or 

who upon initial charge and booking, will likely end up in the competency system without the medication. 

Temporary housing support in the form of rent and ancillary items are provided to clients transitioning from jail 

to the community. Over the course of a year, the program expects to provide medication and/or housing 

support to at least 38 individuals. In Quarter 1, 2024, the program received five referrals and provided a total 

of seven long-acting injectables to those five clients.

City of Greeley 

Homeless Solutions 

In October 2023, the Fines Committee approved $111,835 for one year of funding to the City of Greeley 

Homeless Solutions to provide permanent supportive housing, employment support, education, job skills 

training, and benefits acquisition to three individuals involved in the competency system in Weld County. The 

program provides three permanent housing vouchers and will continue to support clients on a 24-hour, 7-daya-week basis for as long as the clients wish to maintain the vouchers. Funding supports a case manager (0.5 

FTE), usage of a fleet vehicle, bridge housing, wraparound services including transportation, tuition, iPads and 

other client needs, as well as technology for staff. In Quarter 4, 2023, the City of Greeley received all three 

referrals within the first few weeks of the case manager’s employment. Two of the referrals are now active in 

the program, while one terminated unsuccessfully due to failing to appear and not meeting his restoration 

requirements. The City of Greeley has accepted another client to fill the vacancy with an anticipated start date 

by the end of April 2024.

Colorado Coalition for 

the Homeless 

Colorado Coalition for the Homeless (CCH) was approved for funding in the amount of $1,500,000 in November 

2020. The MOU between the Fines Committee and CCH expired in October 2022 for the Crest program; 

however, the Fines Committee extended the MOU with CCH through March of 2025 for the Restoration 

program, and CCH will continue to report outcomes for that program. The goal of the Restoration program is 

to provide modified Assertive Community Treatment to clients who are referred through OCFMH’s Forensic

Support Team as appropriate for outpatient restoration. In Quarter 1 of 2024, this program continued to serve 

46 individuals with the goal of discharging clients who meet appropriate criteria for exit. Of these 46 clients, 

none ended their court involvement during the last quarter; one individual continues to be involved in 

restoration education. When the program was receiving new referrals and conducting intakes, the reported 

capacity of the program was 54.

Case No. 1:11-cv-02285-NYW Document 290 filed 05/29/24 USDC Colorado pg 48 of 61
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Community Based 

Enhanced Restoration 

(CBER) 

CBER was operated by WellPower from January 2022 through December 2023. Funding in the amount of 

$400,000 enabled WellPower to provide Assertive Community Treatment to individuals released on bond and 

being restored to competency out-of-custody. Short-term housing options were also funded for CBER clients 

who would have otherwise been homeless. The program served 68 individuals in the funding term; 27 were 

restored to competency or had their case dismissed, 39 were terminated unsuccessfully due to absconding, 

violating program policies, or acquiring a new charge, and two were transferred to other programs. 

Denver Competency 

Diversion and 

WellPower 

The Denver Competency Diversion program is operated by the Denver County Court. Funding ($1,029,996) 

was approved for this program in December 2021, with the formal launch on April 4, 2022. The MOU between 

the Fines Committee and the Denver Competency Diversion program expired in December of 2022, and the 

Fines Committee agreed to extend the terms of the MOU until February 22, 2024. The Fines Committee 

awarded $587,342 in September 2023 to WellPower to continue supporting the Denver Competency Diversion 

program through September 2024. In December 2023, the Fines Committee approved an additional $541,870 

to continue operations through 2024. The goal of this program is to divert from prosecution those defendants 

who are likely to be found incompetent to proceed. The Fines Committee funds a program administrator, a 

program coordinator (screening and release planner), a Denver district attorney, a Colorado public defender, 

six clinical case managers, one peer navigator, a clinical program manager (0.6 FTE), and a district attorney 

competency diversion officer. Funding also provides for direct wraparound client services, including 

emergency and temporary housing, transportation assistance, mobile phone, hygiene items, clothing, and 

nutritional assistance. In Quarter 1 of 2024, this program received 76 referrals and completed 30 intakes. The 

reported capacity of the program is 60, when all six case manager positions are filled. The Competency 

Diversion program continues to make progress in diverting individuals from the waitlist in Denver. By the end 

of this quarter, 69% of all individuals who have completed the Competency Diversion program have been 

successfully diverted; 15% have been unsuccessful due to new charges; 10% have been unsuccessful due to 

lack of engagement; and 6% had their case(s) closed. 

Denver County Court 

Competency Support 

Docket 

In March 2024, the Fines Committee approved $358,609 for 12 months of funding to the Denver County Court 

to operate a competency support docket. For cases that cannot be diverted from prosecution in the County 

Court Diversion Program, this docket will provide a second opportunity for clients to be diverted from 

confinement during the restoration process. The docket will serve as a forum where community resources may 

be brought in to help meet clients’ out-of-custody needs. 

Case No. 1:11-cv-02285-NYW Document 290 filed 05/29/24 USDC Colorado pg 49 of 61
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Douglas County 

Sheriff’s Office Mental 

Health Data Diversion 

Project 

In December 2023, the Fines Committee approved $683,300 for 18 months of funding to the Douglas County 

Sheriff’s Office. Funding provides for the implementation of a data-driven program to enable the 911 

emergency system of the county to connect callers with behavioral health resources more rapidly. The 

program will also generate data to better inform county agencies and partners on future resource 

development. This quarter the program acquired the software licensing and staff is currently undergoing 

training. A project manager was hired but is not expected to start until May. 

Embark Assisted Living 

Residence – 

Renaissance 

In May 2023, the Fines Committee approved $380,820 for one year of funding to the Embark Peer Coach 

Academy to open a Level 1 Mental Health Transitional Living facility, Embark Assisted Living Residence –

Renaissance. Throughout the funding year, Renaissance has promised to provide services to a total of 24 midto high-acuity individuals who are in the competency system referred from the 4th Judicial District. Renaissance 

also received funding from the State’s Mental Health Transitional Living (MHTL) grant program; in the 

upcoming months, Renaissance will receive $421,000 as a result of this award. In March 2024, the Fines 

Committee approved an additional $40,000 to continue operations until MHTL funding begins. Renaissance 

offers licensed transitional assisted living for up to eight individuals at a time with 24-hour staffing supervision 

for individuals requiring continuous care. Intensive case management, connection to physical and mental 

health community resources and competency restoration services, daily medication management, meals, 

benefit acquisition, transportation, peer support, life skills training, and scheduled social and recreational 

activities are also provided. A nurse practitioner provides medication prescriptions as necessary. Since 

opening in the third quarter of 2023, Renaissance has provided 24/7 housing and services to thirteen 

individuals. As of the end of Quarter 1, 2024, seven individuals continue to be housed, with an average length 

of stay of 138 days. The additional six individuals have been successfully discharged and transferred to longterm care assisted living residences.

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Embark Peer Coach 

Academy Recovery 

Residences 

In November 2022, the Fines Committee approved $306,150 for Embark Peer Coach Academy (Embark) to 

operate a Day Reporting Center and sober-living forensic housing (Embark Recovery Residences). In 2023, 

Embark received renewal funding for Embark Recovery Residences (ERR) in the amount of $335,550 through 

November 30, 2024 and chose not to seek additional funding for its Day Reporting Center due to a lack of 

referrals and ability to fund components of those services through Medicaid. The goal of the Day Reporting 

Center was to provide outpatient restoration clients with treatment, classes, peer support, and case 

management. ERR serves individuals released from confinement who are participating in competency 

restoration. The Fines Committee funds partial salaries for a certified addiction specialist, licensed addiction 

counselor, two peer coaches, receptionist, and housing managers. Funding also covers individual assessment 

and treatment planning, medication management, psychiatric services, daily classes, substance use monitoring, 

support groups, peer mentoring, vocational support, public benefit acquisition, transportation assistance, and 

competency restoration services. ERR provides sober-living housing with the capacity to house 15 clients at a 

time, with 24-hour management, transportation, and food and support services are available on site. In 

Quarter 1 of 2024, ERR received 9 referrals, completed 5 intakes, and served 20 individuals. Since the 

program’s inception, 26 clients have been restored to competency, and sixteen individuals have terminated; 

four were transferred to a higher level of care (including Embark’s Assisted Living Residence: Renaissance), two 

were discharged due to threatening behavior, two were remanded into custody, and eight abandoned the 

program. 

Fidelity Behavioral 

Health 

Funding, in the amount of $1,272,559 was approved for this program in February 2024, with formal launch in 

that same month. The goal of this program is to divert individuals on whom competency is raised, from 

confinement, by providing dedicated program housing with treatment and wraparound services. The Fines 

Committee funded three houses for clients to live in each housing ten clients, a van to transport clients, 

utilities, furnishings, food, toiletries, phones, operating costs, three house managers for 24/7 supervision, and 

partial salaries of the personnel to operate the program. In Quarter 1, 2024, the first house began operating.

The program received nine referrals and completed three intakes, with two more scheduled for April. Referrals 

came from the 1st, 2nd, 8th, 12th and 18th Judicial Districts. In addition to taking clients, the program acquired a 

van to transport clients, initiated the process to receive BHA licensing, hired a clinical director, and obtained

commercial space for clinical operations. It is notable that this program was funded and began operating in the 

same quarter.

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Gateway to Success – 

Pueblo 

In December 2022, the Fines Committee approved $275,000 for one year of funding for Gateway to Success to 

provide a Forensic Day Reporting (FDR) program in Pueblo. The original MOU between the Fines Committee 

and Gateway to Success was set to expire on December 4, 2023; however, a no-cost extension was granted to 

Gateway extending the MOU and service provision through the end of February 2024. The Fines Committee 

awarded renewal funding in the amount of $235,000 through February 2025. The goals for the FDR program 

are to support formerly-incarcerated individuals who are involved in the competency system, to provide a 

center at which services can be delivered to out-of-custody competency individuals, and to reduce the number 

of defendants with behavioral health disorders incarcerated in the Pueblo County Jail. The award provides 

partial funding for full-time employees including a Restoration/Day Reporting Administrator, Lead Case 

Manager, Case Manager, Peer Support Specialist, Coach, Receptionist, Prescriber, and LPC/CAS. The funding 

also covers transportation, participant manuals, medications, food/beverages, medication compliance 

incentives, and prosocial activities. The program began fully operating toward the end of Quarter 1, 2023 and 

has received fifteen total referrals. As of the end of Quarter 1, 2024, the program has seven active clients. 

Throughout the funding term, the FDR program intends to serve 70 clients who have transitioned from the 

Pueblo County Jail and have been found to have a moderate to severe substance use disorder and/or cooccurring mental illness. 

Homeward Alliance Funding, in the amount of $217,800 was approved for this program in February 2024, with formal launch in 

March 2024. The goal of this program is to provide housing navigation and case management services to 

individuals who are competency-involved in Larimer County. The program partners with the Larimer County 

Competency Docket and SummitStone Health Partners to receive referrals. Homeward Alliance connects

clients with resources provided by partners of the State Division of Housing and completes intakes for clients to 

enter that system. Funded staff include a housing specialist (1 FTE) and a program manager (0.5 FTE). Direct 

client expenses are also provided, which include moving facilitation, tenant rights education, life skills 

education, and landlord/tenant communication and mediation. In Quarter 1, 2024, Homeward Alliance 

received two new referrals from the Larimer Competency Docket and completed intakes on both clients. This 

program partially fills the housing gap in a jurisdiction already replete with Fines- Committee supported 

competency resources.

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Integrated Insight 

Therapy IMPACT 

IMPACT (Intensive Monitored Preventative and Acute Competency Treatment) was operated by Integrated 

Insight Therapy, a behavioral health treatment provider serving the 7th, 21st, and 22nd Judicial Districts. The 

Fines Committee allocated $1,178,000 in total to the program. IMPACT housed clients in two residential 

houses, providing treatment and wraparound care. The program operated from February 2022 until January 

2024 and served 22 clients. 

Larimer County 

Competency Docket 

and the Larimer 

County Public 

Defender’s Office 

The Larimer County Competency Docket is operated by the Larimer County Community Justice Alternatives 

Department. Funding ($533,242) was approved for this program in December 2021, with formal launch of 

funded program elements in January 2022. The original MOU between the Fines Committee and the Larimer 

County Competency Docket was set to expire in February of 2024; however, a no-cost extension was granted 

allowing the provision of services to continue through the end of September 2024. The goal of this program is 

to divert individuals involved in the competency process from custody while coordinating necessary care in the 

community. The Fines Committee funds a Competency Services Case Manager and a Competency Services 

Team Lead. In January 2023, funding in the amount of $262,000 was approved for the Larimer County Public 

Defender’s Office to support the Larimer County Competency Docket through January 2025. As a result of the 

approved funding for the Public Defender’s Office, the Fines Committee also supports one dedicated Public 

Defender to staff the docket. Throughout Quarter 4, 2023, the team collaborated with the Larimer County 

Court to bring in all county court cases where competency has been raised (individuals with misdemeanor 

charges) into the Competency Docket that traditionally only handled felony cases. By the end of Quarter 1 of 

2024, there were 112 total active participants in the Competency Docket. There were 55 terminations in 

Quarter 1; of those, 23 were found competent to proceed at the initial evaluation, 19 were found incompetent 

to proceed, and were then restored, 11 were dismissed or their case(s) timed out, and 2 passed away. In 

Quarter 1 of 2024, a total of 51 cases were dismissed; 18 were felonies and 33 were misdemeanors.

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Mesa County Pretrial 

Community 

Alternative Placement 

(Pre-CAP) 

The Pretrial Community Alternative Placement (Pre-CAP) program operated by the Mesa County Community 

Justice Services Department (CJS) was funded to divert individuals, deemed likely to be found incompetent to 

proceed, from confinement to supportive community-based treatment. Fines Committee funding, in the 

amount of $27,900, provided inpatient treatment for clients diverted from confinement. This program 

augmented the capacity of an existing county pretrial mental health program, specifically to serve competencyinvolved individuals. Mesa County CJS declined to request renewal funding, so it was only funded for one year 

of service. Inpatient treatment was provided for three clients referred for out-of-custody competency 

restoration. All three clients successfully transitioned from inpatient treatment; two were then ultimately 

unsuccessfully discharged from Pre-CAP, and the other individual successfully completed Pre-CAP and 

transitioned to the community. Mesa County was selected as a National Association of Counties (NACo) Justice 

Initiative site in 2023, and as NACo works with Mesa County to identify needs and gaps, there may be an 

interest in future funding to serve competency-involved individuals.

Mesa County Sheriff’s 

Office – Long-acting 

Injectables Program 

In May 2023, the Fines Committee approved $360,000 for one year of funding to the Mesa County Sheriff’s 

Office (MCSO) to provide clients with long-acting injectable medication. In March 2024, the Fines Committee 

signed a no-cost extension agreement with MCSO to allow for continued operations through May of 2025. The 

medication treats clients who return to jail from the state mental health hospital, or who upon initial charge 

and booking, will likely end up in the competency system without the medication. Over the course of a year, 

NaphCare, MCSO’s medical contractor, expects to provide medication to up to ten individuals per month. Since 

the program began operating in the 3rd Quarter of 2023, eleven long-acting injectables have been administered 

to ten individuals in the Mesa County Detention Facility.

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Mile High Behavioral 

Healthcare 

Funding ($137,494) was approved for the Mile High Behavioral Healthcare (MHBHC) program in December 

2021, with formal launch taking place in Quarter 2 of 2022. The MOU between the Fines Committee and 

MHBHC expired in January of 2023; however, given the entire awarded funding had not been spent, a no-cost 

extension was approved for funding to be spent through September 30, 2023. In October 2023, the Fines 

Committee agreed to renew funding to the program through September 30, 2024, with additional funding of 

$149,251. The goal of this program is to help clients acquire treatment and wraparound services out of 

custody. Its target population includes pre-release incarcerated clients with mental health and substance use 

disorders. The Fines Committee funds two clinical case managers, and Signal Behavioral Healthcare funds two 

additional case managers. As of the end of Quarter 1, 2024, one of the two positions funded by the Fines 

Committee continues to be vacant, despite MHBHC’s continued attempts to keep both positions filled. In 

Quarter 1, 2024, the program received 25 referrals and completed 24 intakes. Thirty-one individuals 

terminated the program this quarter; twenty-nine of which were successful, while two were unsuccessful. The 

reported capacity of the program is 80, when all four positions are filled.

Monarch Competency 

Housing 

Funding ($953,074) was approved for Monarch Competency Housing in April 2023, with formal launch taking 

place in June of 2023. The goal of this program is to provide supportive monitored sober housing. Its target 

population includes clients ordered to have competency evaluations or outpatient restoration services. The 

Fines Committee funds two case managers, two peer support specialists, a director of operations, an executive 

director, as well as all costs directly related to clients including transportation, case management, groceries, 

clothes, toiletries, and housing supplies. In Quarter 1, 2024, the program received 33 referrals, completed 

eleven intakes, and had eleven terminations, five of which were successful. As of the end of Quarter 1, 2024, 

the twelve active clients are progressing in connecting with psychiatric services, restoration, recovery support 

groups, therapy, employment, and independently using public transportation. An additional six clients are 

pending an intake upon release from the jail. The program is expected to provide 24 beds, 12 female and 12 

male, to serve clients referred by the Forensic Support Team and Bridges.

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NAMI Colorado Funding, in the amount of $91,030, was approved for this program in February 2024, with formal launch in that 

same month. The goal of this program is to provide evidence-based peer programming for patients and staff of 

the State Mental Health Hospitals in Pueblo and Fort Logan. Specifically, the training consists of peer-to-peer 

experiential learning for people with serious mental illness, a recovery peer-based support group program, a 

training module designed to educate staff on attitudes and assumptions about people with mental health 

conditions, and with an overall focus on underserved populations. Funded staff include partial salaries of the 

program director (0.2 FTE), assistant program director (0.5 FTE), executive director (0.1 FTE), operations 

director (0.2 FTE), special projects director (0.2 FTE), and a community outreach coordinator (0.3 FTE). Funding 

also supports mileage for facilitators and peer specialists, travel expenses for NAMI, and printing of class, 

session, workshop, and group materials. In Quarter 1, 2024, NAMI Colorado engaged in outreach activities with 

leadership of the State Mental Health Hospitals and are planning additional activities based on that outreach.

One training session, In Our Own Voice, was held during the quarter at Fort Logan, involving 31 patients, 7 staff, 

and 5 nursing students. Upcoming training modalities being scheduled include peer-to-peer, NAMI 

Connections, In Our Own Voice, NAMI Train the Trainer, and Hearts and Minds. 

Pulse Line 

Collaborative Training 

In October 2023, the Fines Committee approved $1,058,270 for two years of funding to Pulse Line 

Collaborative Training, LLC. Funding provides for training to be administered to law enforcement, first 

responders, clients, and family members of clients and potential clients, to help reduce unwarranted use of 

force incidents. Many individuals who ultimately become involved with the competency system acquire serious 

criminal charges stemming from unnecessary altercations with law enforcement or first responders, owing 

mainly to symptoms of mental health disorder, rather than intentional criminal behavior. Funding provides for 

a director of development and training (1 FTE), a mental health lead and program coordinator (1 FTE), and 

administrative support (0.75 FTE), as well as operational expenses. In Quarter 1, 2024, the program onboarded 

11 contract trainers and completed the train-the-trainer curriculum with each. Additionally, the program 

completed 10 training sessions, each 8 hours in duration, with first responders and self-advocates/caregivers. 

Although it appears to be a slow start for this program which agreed to hold 462 sessions over its two-year 

funding period, the program is gaining momentum towards its ultimate goal. As part of this program’s 

evaluation plan, it has agreed to survey training participants. The survey shows highly positive response rates 

to questions asking about the value of the skills and knowledge in their jobs or daily lives. 

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SAFER Opportunities In March 2023, the Fines Committee approved $2,007,500 for SAFER in Arapahoe County, within the 18th

Judicial District. This program provides housing and supportive services to individuals transitioning from 

custody to support out-of-custody competency restoration, with a goal of increasing the number of individuals 

released from custody who otherwise would be released homeless. Per the MOU, SAFER promises to provide 

9,125 bed days, and as of the end of Quarter 1, 2024, a total of 3,725 bed days have been provided. In Quarter 

1, 2024, the program received 28 referrals and completed 5 intakes. One client voluntarily left the program 

this quarter. The capacity of the program is 25.

San Luis Valley 

Recovery Housing 

In May 2023, the Fines Committee approved $313,762 for two years of funding to San Luis Valley Recovery 

Housing, which is used to provide supportive, sober-living housing to clients released from custody for 

competency evaluation or restoration. The program can serve up to five clients at a time, referred from the 

12th Judicial District. Although the program is still renovating the facility it purchased for this program, it has 

begun taking referrals and placing clients at other facilities. The renovation has been plagued with multiple 

delays. SLV Recovery Housing continues the process toward becoming CARR (Colorado Association of Recovery 

Residences)-certified. Further, the program has collaborated with Bridges and with Navigators, such that the 

referral process is ready to implement once the facility is operational.

Second Chance Center 

in the City 

In July 2023, the Fines Committee approved $488,125 for one year of funding to Second Chance Center in the 

City (SCCIC) to provide onsite case management, peer mentoring, employment services, and housing navigation 

to at least 50 unique individuals in or at-risk of being in the competency system. SCCIC assesses each client’s 

needs, specifically related to mental health, substance use, intellectual and developmental disabilities, and 

traumatic brain injury for appropriate treatment. SCCIC also connects clients to ReShape Minds Care Managers 

for transportation and appointment-appearance support. Fines Committee funding covers a care manager, a 

behavioral health navigator, and partial salaries for the director (0.5 FTE) and an assistant director (0.5 FTE). 

Costs directly related to clients’ basic needs, assistance with leasing office space, and funding for ReShape 

Minds to provide community navigation directly to clients are also covered. In Quarter 5, 2023, SCCIC began 

receiving referrals and conducting intakes. Since that time SCCIC has received 47 referrals and has successfully 

enrolled 39 of those referred. As of the end of Quarter 1, 2024, eight clients have been terminated: five due to 

an inability to contact the individual, one due to refusal to engage in services, one left the state, and one 

individual was found incompetent to proceed.

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Solange Assisted 

Living 

Funding, in the amount of $600,000, was approved for this program in January 2024, with formal launch in that 

same month. The goal of this program is to divert individuals on whom competency is raised, from 

confinement, by providing dedicated program housing with wraparound services and partnering for treatment 

services. The Fines Committee funded 20 beds in assisted living facilities, a van to transport clients, furniture, 

entertainment equipment, and supplies. In Quarter 1, 2024, Solange received fourteen new referrals from 

Embark Recovery Residences, Peak View, Rocky Mountain Human Services, CDHS, and the Pueblo County Jail. 

As of the end of Quarter 1, 2024, there were nine active clients in the program (five males, four females). 

Solange had agreed to provide five beds in Mesa County; however, that became impracticable shortly after the 

MOU was signed. Solange will continue to receive referrals from Mesa County, but it is unable to operate a 

facility there at this time.

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Page 59

State Court 

Administrator’s Office 

Competency Programs 

Analyst 

In August 2023, the Fines Committee approved $222,664 for two years of funding to the Office of the State 

Court Administrator (SCAO) for a competency programs analyst. The analyst supports judicial districts 

operating special programs in the competency system. Training, awareness of resources, data collection, and 

evaluation support is also provided by the analyst. SCAO filled the position in December 2023. SCAO is focused 

on several key initiatives: 1) data-driven advocacy, 2) National Center for State Courts (NCSC) grant proposals, 

3) Judicial Department JBC analyst request, 4) training, awareness, and support, and 5) general administrative 

assistance. The competency programs analyst has made significant progress in establishing and advancing 

competency dockets across Colorado. 

1. Needs Assessment and Program Development: Conducted meetings with all judicial districts to 

understand existing and upcoming dockets; Established a data management system (DIMS) launching in 

May 2024; Finalized roles and responsibilities for court coordinators (documentation: finalized 

document).

2. Data Collection and Analysis: Leveraged data to inform stakeholders through presentations and 

discussions, leading to docket and process improvements.

3. Training and Resource Development: Partnered with the OCFMH Judicial Liaison for ongoing training; 

Created and maintained a communication hub for competency docket teams.

4. Collaboration and Advocacy: Worked towards funding through partnerships with the legislature and Joint 

Budget Committee; Collaborated with Bridges of Colorado and Office of State Public Defender on HB-24-

1355; Advocated for judicial district needs and funding opportunities.

5. Federal Grant Applications: Bureau of Justice Assistance-Statewide Competency Court Docket Evaluation 

and Creation of Key Principles, Best Practices, Implementation Guide, Competency Diversion Analyst; 

Justice Assistance Grant-Statewide Competency Court Docket Evaluation and Creation of Key Principles, 

Best Practices, Implementation Guide.

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Page 60

SummitStone Health 

Partners Competency 

Hub 

In October 2022, the Fines Committee approved $3,029,283 for three years of funding to SummitStone Health 

Partners (SummitStone) in Larimer County within the 8th Judicial District. This program consists of two 

elements: The first is to provide psychiatric care, including prescriptions for medications, to clients in custody 

on whom competency has been raised with the goal of increasing the quantity of clients who may be released 

from custody during the competency evaluation and restoration process. The second element of this program 

is the establishment of a competency services hub at which clinical services, case management, and peer 

support are provided to out-of-custody clients. The hub enables clients to receive a range of services from one 

location, including competency restoration education, medication management, and other collaboration with 

system providers. In Quarter 1, 2024, the Medical Services Team served 66 unique individuals, while the 

Competency Supportive Services team served 86 unique clients. The reported capacity of the program is 80 for 

in-custody and outpatient services.

United Way of Weld 

County Rapid 

Rehousing 

Opportunity 

In August 2023, the Fines Committee approved $1,421,440 for two years of funding to United Way of Weld 

County Rapid Rehousing Opportunity (UWWC) to transition fifty competency-involved individuals from the 

Weld County Jail to the community by providing housing, case management, assistance with benefit 

acquisition, and wraparound services. Funding covers two case manager FTEs, bridge housing, cold weather 

shelter space, Rapid Rehousing for 50 participants, and maintaining and supporting the operations of the 

Housing Navigation Center services. UWWC began to receive referrals in Quarter 4, 2023, and by the end of 

Quarter 1, 2024, UWWC screened 13 referrals and completed 11 intakes since the program began. Four 

individuals have terminated, all unsuccessfully.

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University of Denver, 

Denver FIRST, Brain 

Injuries Screening 

Program 

In September 2022, the Fines Committee approved $948,729 for two years of funding to Denver FIRST, a 

regional hub for forensic mental health expertise within the Graduate School of Professional Psychology at the 

University of Denver. In January 2024, a no-cost extension was granted to continue the program through 

September 30, 2025. This program focuses on competency clients suspected of having brain injuries and 

provides cognitive screenings, full neuropsychological evaluations, and referral for treatment by professional 

students to clients referred by the Forensic Support Team. Its target population includes incarcerated and outof-custody clients with a history of and/or symptoms of potential brain injury. The Fines Committee funds 

student and professional staff time to complete cognitive screenings and neuropsychological evaluations. The 

program became operational and began receiving referrals in Quarter 2 of 2023. This quarter, the program 

received 15 referrals and completed 6 intakes. Of the 21 individuals who have terminated the program, 7 were 

restored to competency, 7 individuals had their case(s) dismissed or closed, and 4 were ordered outpatient 

restoration. Of those assessed, 91% have been positive for a brain injury, and 100% have presented with 

cognitive and functional-related deficits. The program continues to see severe comorbid mental health and 

medical issues complicating individuals’ presentation. The reported capacity of the program is 20.

Valor Program at 

Embrave 

In March 2024, the Fines Committee approved $8,902,175 to Embrave for acquisition and renovation of a 

former hotel out of which the program will operate, serving 72 clients at a time. Funding also provides for nine 

months of program operation after start up. The sale of the building closed in April, and it is expected to be 

ready for operation by June. The program has hired staff and has held several stakeholder coordination 

meetings so that the referral pipeline is established once the program opens. The facility is based in El Paso 

County, but leadership has been making connections with stakeholders who will refer clients to it statewide. 

Valor is the largest program funded to date by both dollar amount and clients anticipated to be served. 

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