The Jail-Based Competency Restoration Program (JBCR) is one of several services offered through Behavioral Consultants, Inc., a private company committed to providing expert, timely and ethically-sound clinical and forensic services throughout the state of Wisconsin.   The program is available through a contract with the Department of Health Services (DHS). The JBCR is staffed with a Clinical Director, an Assistant to the Director, a Senior Behavioral Specialist, Behavioral Specialists, Regional Jail Specialists, and a Program Administrative Assistant.  JBCR now serves over half of Wisconsin counties.

 

Mission
The Jail-Based Competency Restoration Program provides clinically appropriate, individualized services to participants with the aim of moving them toward competency. With this goal in mind, JBCR coordinates and collaborates with relevant mental health staff to identify and remove barriers to participants’ psychiatric care, collects objective behavioral observations to assist treatment providers and evaluators, and navigates and communicates with the various systems involved in each case.

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Overview
The Jail-Based Competency Restoration Program (JBCR) began in 2016 in response to the number of individuals committed to the DHS under WSS 971.14(5), who were detained in a secure setting while waiting for transfer to the state mental health institute for treatment to competency. Working with existing mental health services in the jail, the program is designed to reduce the overall length of defendants’ commitment, by either reaching competency prior to transfer or reducing length of hospitalization after transfer.

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Making Referrals
Once a defendant is committed to DHS, his/her name is slated for admission to a mental health institute. If a defendant is detained in a secure facility that has contracted with JBCR, the DHS Admissions Team or Court Liaisons makes a referral to the JBCR, and services are automatically initiated. Upon receipt of court order, the JBCR Regional Jail Specialist conducts an Initial Assessment to determine the appropriate level of service delivery.

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Typical Participant

All defendants committed to DHS and detained in a participating facility awaiting transfer to the state mental health institute for treatment to competency will receive JBCR services, regardless of clinical presentation. Favorable outcomes in JBCR have been associated with the following factors: ability and willingness to participate in remediation (if indicated), voluntary engagement with the jail prescriber (if indicated), and behavioral stability.

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Service Delivery
Following Initial Assessment, the Regional Jail Specialist, in collaboration with the Clinical Director, assigns the participant to one or more of three levels of service delivery: Regional Jail Specialist Monitoring, Clinical Coordination, or Behavioral Specialist Services.

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• Regional Jail Specialist Monitoring: Occurs for all participants, under all circumstances and consists of weekly contacts between the JBCR Regional Jail Specialist and facility mental health staff to exchange relevant observations and/or information regarding participants’ overall functioning, safety concerns, medication adherence, etc.

 

• Clinical Coordination: Occurs for symptomatic defendants who, in the absence of effectual psychiatric treatment, are unlikely to make meaningful strides toward competency with Behavioral Specialist Services. The clinical coordinator meets bi-weekly with the participant to observe and document clinical functioning and identify and address barriers to psychiatric treatment. Participation in clinical coordination assumes the participant can maintain a level of behavioral stability and does not pose imminent safety risks for him/herself, jail staff, and/or JBCR staff or that adequate external controls are in place to ensure safety.

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• Behavioral Specialist Services: Occurs when the participant is meeting regularly, up to twice a week, with a behavioral specialist for the purpose of psycho-education relevant to the court system and continued relative psychiatric stability. The Behavioral Specialist and Regional Jail Specialist remain in close contact throughout the participant’s involvement in JBCR.

Service delivery is reassessed on an ongoing basis and may change throughout the participant’s time in JBCR.

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Re-Evaluations
An independent examiner will evaluate the participant should the statutory review date arrive while the participant is enrolled in JBCR. Program staff provide the examiner a written summary of the participant’s engagement and responsiveness to assist the evaluation process.

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Frequently Asked Questions (FAQ)

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Will participation in this program affect the defendant’s position on the admissions list?
No.  Participants in the JBCR will not be handled differently than other defendants awaiting transfer. They will continue to move up on the admissions list as bed space becomes available.
 
Who pays for this service?
DHS covers all cost related to competency restoration services.

Will the defendant be re-evaluated according to the statutory timetable?
Participants in JBCR will be evaluated according to statutory requirements.  An independent examiner, typically through the Wisconsin Forensic Unit, will be assigned to conduct the evaluation.

What happens if the participant is found competent before transfer to the Mental Health Institute?
If a participant is opined competent before transfer to one of the state mental health institutes, a review hearing will be requested within 14 days of the court’s notification of this change in status.  

What happens if a participant’s status changes?
The Regional Jail Specialist communicates on a regular basis with jail staff to assess mental stability, medication compliance, and institution adjustment. DHS is notified when there is indication a participant has exhibited a marked change in his/her mental health status or clinical acuity which may trigger a request for an early re-evaluation or, conversely, more immediate transfer to a state mental health institute. An appropriate response to this change will be determined and implemented in collaboration with the appropriate agency.  If indicated, JBCR also provides an update of this change to court staff.

When will services close?
JBCR provides services until the participant is found competent, found not competent and not likely to regain, or is transferred to a state mental health institute.
 

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For more information, contact the Program Clinical Director, Dr. Christina Engen, or other JBCR staff at:
Phone: 414-271-5577

Fax: 414-271-6667

E-mail: christina.engen@bciwi.com