Oklahoma’s Department of Mental Health and Substance Abuse Services (ODMHSAS) is at risk of incurring significant sanctions, potentially amounting to $3.5 million, due to its noncompliance with a federal court consent decree established on March 10. This decree addresses the treatment of individuals deemed mentally incompetent for adjudication, following a comprehensive report from three monitoring consultants.
The consent decree was finalized in a Tulsa federal court and has drawn attention for its critical provisions regarding competency restoration therapy. According to the consultants, ODMHSAS has failed to demonstrate the necessary ‘Best Efforts’ across multiple areas outlined in the agreement, which they categorize as a ‘Material Violation.’ In a report delivered last Friday, they noted that the state agency submitted a compliance plan on August 12, which arrived more than two months late, and was fraught with inaccuracies and inconsistencies.
The consultants acknowledged some progress since retired Rear Admiral Greg Slavonic took over as interim commissioner in June, noting increased attention and effort. However, they stressed, “the Decree requires more” than just good intentions if compliance is to be achieved.
Key requirements of the consent decree stipulate that competency restoration therapy must commence within 60 days following a court order for a defendant. Beginning in July, this timeline will be further reduced to just 21 days. ODMHSAS faces potential penalties of up to $500 per day for each individual whose treatment begins beyond the 60-day window, with fines capped at $3.5 million in the first year.
Paul DeMuro, the lead attorney representing plaintiffs in the class-action lawsuit Briggs v. Friessen that led to this decree, described the findings of the report as “very damning” and “very alarming.” He emphasized that despite being six months past the decree’s initiation, the department is still unable to provide accurate data on how many individuals are waiting for competency restoration services.
The issue of conflicting data on wait times has been persistent. The lawsuit uncovered that many mentally incompetent defendants were detained for extended periods—some for months or even years—before receiving treatment at the Oklahoma Forensic Center in Vinita. During this time, the only form of mental health care they received often consisted of medications, which they could opt to refuse.
An agency spokeswoman stated, “ODMHSAS continues to work closely with the court-appointed consultants. We value their guidance to complete a Competency Restoration Plan that will comply with the terms of the consent decree. We appreciate the consultant’s recognition of our progress.”
While the consultants mentioned signs of reduced wait times, they struggled to validate these improvements due to inconsistent data from ODMHSAS. For example, the agency reported a waitlist reduction to 105 individuals, while consultants were informed on the same day that the count was 146. Independently analyzing data supplied by ODMHSAS, the consultants determined that there were actually 187 individuals awaiting treatment as of August 8. Moreover, while the agency reported an average wait of 60 days in county jails for treatment, the consultants were informed it was actually 156 days during a conference call held the same day.
Regarding the data discrepancies, the consultants expressed concerns. “Do we know what the actual number of people on the waitlist is and what their average length of stay is? The short answer is that… we do not.”
The financial instability of ODMHSAS has compounded these challenges, leaving the agency in a confusing financial position. Earlier this year, Governor Kevin Stitt appointed Slavonic and attorney John Settle to help untangle the department’s finances. In light of this turmoil, ODMHSAS announced the cancellation or amendment of around 300 vendor contracts earlier this month, alarming many providers and patients.
The consultants’ recent report sheds light on the reasons behind these contract changes and the agency’s financial disarray, attributing it to staffing shortages. The Oklahoma Forensic Center is particularly under-resourced; with 268 beds and an additional 84 set to be operational soon, the facility currently employs only three psychiatrists and no psychologists. To meet the needs of its patient population, the center requires at least eight more psychiatrists and three for the new wing, as current lengths of stay for competency restoration patients far exceed the recommended 90 to 120 days, averaging nearly a year.
“While we offer no excuses for ODMHSAS, we also believe that the Department’s administrative forensic service continues to operate with a shoestring staff and limited funding,” the report concluded. “Important changes have occurred, but the Department needs more resources to meet its mandates.”
