Nevada legislators have approved more than $27 million in coronavirus relief funds toward efforts to improve care for criminal defendants awaiting trial who need mental health treatment, as the state faces continued scrutiny over delays in providing the care.

The funding, approved Wednesday, seeks to increase the number of patients that the state can treat by hiring contractors and renovating a wing of a Las Vegas mental health facility. The funding will also go toward a two-year program that would help patients in Clark and Washoe counties by providing social skills training and various types of therapy. 

The money builds on an emergency $5.7 million approval from Gov. Joe Lombardo last month to reassign patients receiving inpatient care at the Las Vegas mental health facility to nursing facilities, freeing up space to provide what is known as forensic care for defendants.

The influx of funding comes nearly four months after the Nevada Supreme Court upheld $500 daily fines against the Division of Public and Behavioral Health (DPBH) for each day that a mentally incompetent defendant’s care is delayed. The department is supposed to transfer inmates for treatment within seven days of receiving a court order. 

As of mid-November, the average waiting time this year was 132 days, a three-day increase from last year, and there were more than 140 defendants awaiting treatment, according to a DPBH report. DPBH had also paid $101,000 in fines as of mid-November.

State and county officials testified Wednesday that the efforts were necessary to alleviate a long-running problem. Members of the Interim Finance Committee — a group of lawmakers that makes state spending decisions while the Legislature is out of session — questioned officials on how they plan to continue certain programs after funding runs out and how they plan to fill vacant positions, but unanimously approved the funding.

DPBH had also proposed allocating roughly $8 million toward hiring 83 full-time employees for forensic treatment. But recently released guidelines from the U.S. Treasury prohibit the state from using American Rescue Plan (ARP) funds past 2024 for personnel costs not related to ARP compliance. This does not apply to contractors, so DPBH plans to determine whether those 83 positions can be converted into contract positions.

“This is the opportunity for the current Administration and Legislature to meaningfully address this issue and move Nevada out of the struggle we have been in for so many years. These initiatives help the state move away from temporary solutions and build a system that is sustainable,” DPBH’s November report said.

Wednesday’s funding approval includes $14.9 million toward a program to provide care for 60 defendants at a time in Clark County and 30 patients at a time in Washoe County. The program will not provide competency restoration — which is bringing competency back to criminal defendants who were deemed unfit to stand trial — but will instead focus on social skills training, guidance on mental illness and medications and art and recreational therapy.

The program follows a similar framework as other Jail-Based Mental Health Programs (JBP), which have been found to decrease recidivism rates and time spent in prisons — though other states, including Florida, have programs with more staffing and a broader scope than Nevada’s proposal.

“This program is complementary to our inpatient restoration treatment services and will help the community to manage the demand for inpatient forensic services,” DPBH Administrator Cody Phinney said Wednesday.

State public health officials originally asked legislators to approve the program in October. But IFC members voted to table the proposal until December because the proposal lacked specific details. According to the plan provided to legislators Wednesday, DPBH will develop a process for screening defendants seeking to enter the program, as well as provide midyear and end-of-year reports and conduct in-person site visits.

Sen. Dina Neal (D-North Las Vegas) voted in favor of the proposal but remained critical of the information provided.

“The information that I didn't know in October, I still don't really have clarity on right now,” Neal said. “The acuity that you’re dealing with, the type of individual that you’re managing and the level of humans that you need in order to run this program within the jail.”

Legislators also approved roughly $8 million toward renovations and operational costs for Building 3A of a Las Vegas facility on West Charleston Boulevard operated by Southern Nevada Adult Mental Health Services. The renovations, which include interior repairs, windows and roofing, will enable the state to increase its forensic bed capacity.

The remaining funding approved Wednesday — $4.9 million — will go toward hiring contractors to provide inpatient and outpatient mental health care. DPBH also has plans to construct an additional psychiatric facility and pursue more funding from the Legislature to help forensic patients.

However, the funding does not guarantee results. In October, legislators — acting on the request of DPBH — terminated a $55 million project that would have added 45 psychiatric beds and 115 staff members at the Las Vegas Detention Center. The project had faced “delays with construction and design,” according to meeting documents from October.

Assembly Speaker Steve Yeager (D-Las Vegas) said in October that the project’s cancellation was a “gut punch” because of the urgent demand for mental health care care for prisoners.