rough the certification process for forensic analysis so it's it's just it's an educational certificate and do they have to do it within a specific period of time like opiates you didn't find who survives the work and so within five years don't do it you don't get it I don't think that's part of it it's it's it's an external certification it's not an OPR certification OPR so this is over about that yeah it is exactly get you get your license through OPR and you have your license through the medical practice board yeah and then you can go ahead and study other things that allow for you to practice your profession so as a forensic psychologist or a psychiatrist yeah that would you know the license itself is done by either the medical board or OPR but the certification in forensic psychology that's something that would be there are trade groups I'd imagine that there was the American you know association of psychologists and such that we could ask the next witness yeah mission department what no thank you Ben I didn't see the representative I was just wondering maybe if if Karen could speak to the competency evaluation itself and whether that is something that's is it administered with a tool or is there some sort of objectivity to it as we think about what level of clinician or training is required I'm curious just how standardized the process is and then we have a question for myself to go oh sorry yeah no go ahead all right um so it depends right um there is no like set test um there there are certain things they are looking at um but I think one of the things to remember is you can be incompetent for lots of reasons right it could be a mental illness it could be a developmental disability it could be the tbi it could be substance use um so it really depends on what the person presents with one of the reasons why getting records in advance is so important is because the psychiatrist has a sense of any past history and so may have a sense of where their where their questions need to be you know currently if someone has an intellectual disability we refer that to a psychologist because they can do some more specialized testing um but there's no kind of set every every evaluation looks the same it really depends on the person's clinical presentation did you okay did you have a question for for somebody else it's a general question um OPR pays attention to scope of practice so that when a clinician does apply for a license the medical board as well you have to state your scope of practice and I was wondering if forensic examinations might be part of the scope of practice in this context so that's the question that I'm curious about okay so why don't we go with Karen Barber does Emily pause here or just Karen from DMH just me just okay fine um Karen go ahead uh good afternoon for the record Karen Barber general counsel of the department of mental health we did submit some written testimony I don't know if um you had a chance to I'm sure we do so the department doesn't um take a position on whether or not um you should expand um what I can do maybe is answer your questions that may be more helpful and talk you through where we're at one of the things I will say um because there's been a lot of questions about their qualifications so DMH sets qualifications for people we contract with um and so I was just pulling up um our last RFP so we require that someone hold a current uh license in the state of Vermont um we require that our psychiatrists are board certified and then we also require some level of additional forensic training um which could be um a forensic psychiatry review course offered by the American Academy of Psychiatry and the law I can't tell them feedback or someone's asking any questions just feedback um or that they write a sample competency and sanity eval that we review so we um we do set um kind of quality parameters um the same with the psychologist we use that does disability evaluations um I don't have his RFP up in front of me but again we do require some level of specialized training just to make sure that um that people that the people we're hiring are licensed in the state of Vermont and do have a specialized training and are able to do these evaluations the other thing I can say that was talked about in our um in our memo is that um we do currently have 16 evaluators um 15 psychiatrists and then we have the one psychologist that we have um that we had had before the statutory change we have not enlisted anymore evaluators um as I had kind of mentioned in the past for us it wasn't so much the number of evaluators it was the process that was taking a really long time and was administratively burdensome we did just this week roll out a new process that we hope to really streamline our ability to do evaluations and we're hoping we can do going forward under the new process we do um when we submitted this memo yesterday it was numbers from Friday and we had 88 on the wait list right now we have 75 I just checked so we are working we've um we've scheduled 17 in the last uh week so we are working um to to move through the wait list as soon as possible again the problem is not necessarily that we don't have enough evaluators it's actually trying to get them scheduled at this point um there are a lot of really great changes that um were made in S 91 we don't fully know the impact of those yet but we are working on tracking that data much more closely we do still have about 25 sanity evaluations that we need to get through so we are haven't yet seen the benefits of that um but we have um based on the new changes the Novotel was able to retain many more psychiatrists than they were before and just to give you an example pre-covid we had five evaluators uh we now have as I said 16 so uh we are rolling out the new process um it is going to um hopefully be less administratively burdensome on the department and allow us to more quickly schedule these evaluations I think one of the things to remember right is this is just a very small part of what the department does um and this is scheduling these evaluations is a huge administrative undertaking um for one of the paralegals in the legal department who has many other job responsibilities so she is working as quickly as possible as she can we're working on getting her some support and again streamlining that process um but right now we don't necessarily need more evaluators what we need is to kind of figure out a process um so that we can be referring them more quickly one of the things we've asked of the court is to make sure the documentation right off the bat so that's not a delay one of the things we've asked uh defense counsel is to get back to us more quickly about whether or not a date will work in the past we're just kind of waiting until we heard back uh we've now set kind of a 48 hour deadline and if they don't accept it within that time then we're going to move on and assign that time to the next person so we're really thinking about how we can work some more things I hope to be able to come back in a couple months and have more of an update but it's too early right now to see what actually um how the new process is going to roll out but we do anticipate it having a significant impact on the wait list there's a different testimony than we've heard this winter not from me but yes I know the defender general did feel strongly that psychologists made sense and and I and we respect that right um from our case we've always felt that it was causing some of the delays and you very we do think a lot of the changes in s91 are the changes we asked for such as the orders um separating competency and sanity making sure we could get the records issuing the bench warrants if someone's don't show those are all the things that we really felt like we're going to have an impact and we do anticipate that they are going to have an impact we're just starting to kind of slowly see that um so I'm always curious about places where bias or some discrepancy can can creep into the process so my question and maybe you can help me if I'm not understanding this clearly if they come through your office is that because there was it's a it's a public um payment for this this expertise as opposed to if they get their they hire their own private person to make the evaluation is that sometimes because the the legal team can afford um to hire a different expert and do you monitor any trends in the people that you hire if some tend to find more competency or incompetency do you sort of track demographics of what they find and if there's any age gender or race um discrepancy and who's deemed competent or incompetent I'm just trying to better understand where where someone could use a new category of evaluator to if they have money or resources be able to hire somebody as opposed to what your office does which is it is a public process are you hired by the court therefore you're paid by the court and there's not money exchanging hands from the person who's hiring an attorney so um so the court doesn't pay or hire anyone it's all dmh right they'll make a referral to the department of mental health and we arrange for it um so there's a couple different ways right you can get an evaluation the court can order dmh neutral evaluation um yes or either party can go out and get their own and they're free to hire who they want I think what you heard was a lot of testimony from the defender general that they tend to hire a psychologist it's just like in any other case right you're allowed to get your own expert um if you're the defender general then the defender general pays for it um the state um you know the state's attorneys have a budget so certainly I guess yes if you're also um if you have private counsel then you're kind of privately hiring them but other than that it would be the defender general's office the state's attorney's office who are doing it we don't um dive real deep into the data as to who's found incompetent and who's not again you know these are not necessarily folks in dmh custody they may not even have a mental illness this is a very small part of what we do we do look kind of trend-wise um I think about maybe 50 percent of those ordered are found incompetent I'd have to double check um but we kind of look at it that way um we are trying to think about what data may be more helpful to collect but again we don't we're not a part of these cases um so we don't necessarily know what happens right once they're found confident we are done with that if they are found incompetent they may ask um to see if they qualify for dmh services but they may not right because again you can be incompetent for many reasons so we don't necessarily know the outcome of these cases and we're not a party um hi I'm not a standing member of this committee and a bit of an interloper today but I do have a question um around scheduling it's really important and I'm wondering if you can speak a little bit to what the administrative burdens are around scheduling other than it sounds like the friction of time and distance are problematic but I'd love to hear a little bit more about that sure um so what was happening um was that we we'd get a request um sometimes the court would send the relevant information we needed in terms of like the the charging documents in the affidavit sometimes they wouldn't and then we work to go to our contractors and say we have these evaluations they give us dates and times that work for them and then what we were doing is then going to the defense council and saying hey would this date and time work for you and then they contact their client and it could be a couple days it could be a couple weeks until we hear something um and then we would try to schedule it assuming those dates still worked for everyone um and then if we didn't have the records um the evaluator maybe couldn't finish the evaluation because they needed the records we get a lot of no shows if the person doesn't show then that's all this time wasted no one else can be fit into that spot and the wait list is moving so um the new process is that we're not going to go back and forth about dates and times it's too administratively burdensome it means we can only refer you know a limited number a week versus just sending out a mass um so what we're going to do is we're going to get a date and time from the evaluator we're going to give that date and time to the defense council if that works great if it doesn't the following week and hope that works um but we need to much more quickly move through because we have you know one paralegal who has got money more things than just this she needs to do that was spending all of her time on emails trying to coordinate people's schedules um and it just wasn't working it was really causing um those delays the other thing is you know we're counting on the defense council to try to contact their client a lot of times they can't find their client so we're not we don't know if they're going to show or not um and then if they don't show there was no consequence for them not showing right it just would mean our evaluators didn't want these cases because they were losing that money and it meant that that time was wasted because evaluators set aside huge chunks of of the time of the day to do these um that no one else could use at that point because it was too late so we're also going to ask a week in advance that people confirm that they can still do that date and time and if they don't we're going to assign it to someone else so ideally we're not losing so much um so again we're asking people to be a little bit more involved and help us out a little more so that hopefully we can more streamline the process thank you so um yes Karen the the problem is being solved through the legislation act 28 was to place the competency hearing prior to the any assessment of insanity the that's one problem is being solved to carry to go forward and I think the courts are very thankful that's happened and then uh if someone is declared incompetent to stay in trial as a result of the evaluation what happens it depends which is a very low lawyer answer um we love those black and white answers so clear answers sorry go ahead and so the biggest thing is it depends why they were found incompetent um so it was at a mental illness and so do they if so then they may have they'll reach out to the department of mental health and we'll think about is an order of non-hospitalization appropriate is an order of hospitalization appropriate if they had an intellectual disability is an act 248 order appropriate um it was if it's substance use or dementia and we don't really have involuntary programs for those um so it really depends on the needs of the person one of the things we were also asked to look at um in s91 was the potential for competency restoration that could you know potentially change how things go right now how things go in the future but right now um Vermont does not have any sort of restoration uh mandate and so no one is actively restored to competency that doesn't exist they may get there as a benefit of treatment or just engaging but there's no um we're not trying to restore them to competency even if they were to come in to say the dmh system or the dale system and then one further clarification which we probably hear from um dale that an individual with an intellectual or developmental disability would be evaluated by someone who understands uh those areas yes so that that would still be dmh right so dmh is still the one that hires the forensic psychologist so dale doesn't have anything to do with competency evaluations they may end up receiving custody through act or 248 at the end of the process but they are not involved in the initial process at all it's solely dmh that holds those contracts but yes if there is a suspicion of an intellectual disability then we use our forensically trained psychologist to do the evaluation um if we know right away that may be an issue then dr donnelly is assigned right away um if we're unclear then we would um we would first assign a psychiatrist and if the psychiatrist says hey actually I think that what I'm seeing might be an intellectual disability then we would ask dr donnelly to do the evaluation um so they are getting specialized evaluations but again that's all through dmh thank you for clarity um what I'm a little confused by the dale role they don't come into it until after the psychiatrist or psychologist would find that the person has an intellectual disability correct so they're not even that's how somebody gets to act 248 right after there's been a competency determination is there any uh victim involvement in the competency evaluation process or the act I meant in the process they know do they have any um I do not apologies I do not know much about the act 248 process so I am not sure um so I can say on the dmh side no like if someone was getting an order of nonhospitalization there wouldn't necessarily be any victim involvement right because it's a clinical determination about whether or not someone needs their services I don't know how that works on the dale side it could very well be different okay thank you yes um this might be a question for those who heard this testimony but first karen in addition to being legal counsel are you a licensed mental health professional in any capacity me personally yes no okay I didn't ask that is it tack on you but I'm looking around them who were not hearing from our mental health professionals about what this is our first hearing okay that's going to take four meetings okay to get through and so I guess that's why right now we're having that yeah mental health and then explaining what our charge is okay I expected our next meeting we'll hear hopefully from mental health professionals right as well as I mean my only comment in this context is hearing from dmh that they feel like the problem was not a personnel related problem it's a court issue the court the courts were finding a confusion about having uh and I can't speak for the court but certainly the confusion around having competency hearing and sanity hearings going on concurrently and trying to put it into a stepwise progression yeah so you're competent or incompetent to stand trial and then if you do stand trial did you have sanity at the time of that you committed the crime right so the so what we're doing now is understanding that there was a backlog what whatever the cause of the backlog for the competency hearing we're hearing from Karen that some of this is being resolved for whatever reason that's good to hear but for until next year we have a forensic psychologist as well as psychiatrist performing a competency hearing so there's there's a lot going on and things are being pulled apart and solved at the same time that we're still trying to solve the problem right so I would just in the future meetings want to make sure that we're not letting a quality question be answered by a logistical question that changing the timing is different than having different types of professional who can make this determination right but when you have a backlog then you also want to consider numbers of professionals who are available to do that analysis so it's a catch 22 you do one or you do both and so now we're actually doing both so see how it goes and and Ben remind me it's a preponderance of the evidence that must be demonstrated uh for to demonstrate incompetency or competency your committee was the jurisdictional committee came from judiciary okay to our committee so we were collaborative did you hear opposition to this change not opposition to psychologists okay so psychiatrists didn't come in and say they don't have x y or z no i think it's i think at the time we recognized you know going back to the testimony this morning about psycholot you know psycho mental health care and the institutions it's there's a shortage of professionals and that's part thank you i was just wanted to add that there was going to be an all day conference coming up about mental health in the courts and that might be something that would be really and you're all excited yeah might be forget what the day we have judge zoney coming up so shortly but first if there are any other questions for Karen but we will hear from the medical society at the very least well it represents psychologists psychologists it's not the medical society no it's gotta be a and psychiatric social workers yes i'm not sure um our next witness is defender general matt valerio thank you matt good afternoon why don't we just get this on you are on september 14th i'm uh i'm uh yes and thank you for having me i am matt valerio i'm the defender general this uh suggestion of having uh psychologists due forensic competency evaluations was my suggestion this arose out of initially a shortage of individuals were available in the state of vermont who were by statute recognized as competent to do these evaluations vermont was one of only two states in the nation that didn't allow um or recognized by statute uh doctoral level psychologists from performing uh of forensic competency evaluations the other was rhod island and we had a shortage and a backlog and i'm glad to hear that apparently department of mental health has more people who are available to do the evaluations and that the backlog has trimmed significantly from uh six months ago when we were having this discussion in the legislature um there is uh there were a number of questions and comments that i heard during the prior 50 minutes or so of discussion that i was hoping i could clarify um one of the things that i did want to clarify is that competency is an issue also in juvenile cases that is in juvenile court and and hence the family doctoral level psychologists have always been approved for use in competency evaluations in in those cases but it had recognized in criminal cases what the defense defense council because it's you know we don't do we do almost every case in criminal court but not every case in criminal court uses forensic psychologists oftentimes to attack the positions of the psychiatrists who come up with their evaluations if we don't feel that they are appropriate and that might arise out of that probably rises out of the court ordered evaluation and the court has to make a determination based on what they hear in evidence of whether or not the person is competent or not so there is it's a full-blown evidentiary hearing on whether somebody understands the proceedings that they're taking part of whether they can adequately participate with their council in defending themselves in these cases and and as uh Karen paper indicated that can arise out of a bunch of different areas whether it's a major mental illness traumatic brain injury development of disability or the like ultimately the qualification to do competency evaluations whether an individual is qualified to do that really rests with the court but because there has been a presumption that psychiatrists um are are statutory um authorized to do it um where there is a a balance to be made oftentimes the psychiatrists would would get the nod um one way or the other um when the court is trying to make a decision that would be that whole situation is contrary to really what the nation does except for Rhode Island um so we believe that for a bunch of different reasons that and and again I I I wouldn't have made the suggestion if I didn't think it was going to be beneficial that doctor level psychologists um appropriately should be used to deal with these cases now the other the other side of this is it's not just about the initial evaluation that perhaps the departmental health through the contractor is is doing regarding these evaluations but it's the availability of individuals to all of the members of the criminal justice system whether it's the prosecution or the defense um test those evaluations um it's not a monopoly that um departmental health has on doing these evaluations and they really don't have or shouldn't have a um horse in the race of um whether somebody's competent or not but it's the availability of of competent people to um test the evidence that's out there whether it comes from the department of mental health or anywhere else um and so the more people we have available to do it um and competent people and I suggest that doctoral level psychologists is one of the areas uh there is probably you know that's where I would like to see it go I I don't there are some states that allow um you know master's level clinicians and and other types of licensure to do these evaluations and I don't suggest that we go there I I think a doctoral level um of a evaluator psychologist clinical psychologist or PhD level psychologist is uh is probably that that's about as hard as far in the um kind of the credentials as I would want to go I wouldn't want to go any lower than that that's gonna be helpful ultimately it is way too soon right now to make any evaluation about whether or not this is um assisting the system um that's always one of the kind of the frustrating things is a lot gets passed throws into effect on July 1st and then on August 8th we have a a hearing to to see how it's going and basically um nobody's had a chance to take a breath as to what what this is all going to mean and be implemented so as far as we're concerned we we've been supportive of it and we're interested to see how it pans out we've actually been using as I said doctoral level psychologists to test the psychiatrists for decades use the term test the competence of the psychiatrist you know it it's interesting because they psychiatrists and psychologists do very different things when they evaluate a an individual's confidence to stand trial psychologists are trained in administration of a number of different instruments that have been tests and the like that have been validated that's part of what they do the psychiatrists don't administer those tests they have sort of clinical evaluations and talk to the people about the legal elements that are part of it so oftentimes when you are if you're a defense council or if you are a prosecutor and you like the result of the mental health uh um independent mental health evaluation you'll hire a phd or doctor level psychologists to pick apart the clinical evaluation of whatever happened with the department of mental health and the um doctor level psychologists are very effective at doing that because they have more tools at their disposal to make that determination that's kind of in the weeds for for you folks as legislators but um that that's the facts as as the how these cases prove when they're contesting how they perceive um i don't know how i i did receive the uh um departments proposed memo on scheduling and the like uh yesterday afternoon um i will be interested to see how that works out well i hope there's some respond to this but what i'm what i'm hearing is that there might be a different reason to allow psychologists to to engage in these in these competency exams besides the backlog that they might actually be more qualified in certain instances to do the evaluation and i would rather have that conversation than one about scheduling if that makes sense and so i guess my question in that is uh if if the defender general's office has availed themselves of of a clinical psychologist now that it's allowed in this pre sunset period because it was the better evaluator versus like do you see a case coming up where you'd rather have a clinical psychologist and you feel like that would be a better decision not like whoever's available first kind of thing we've actually been doing that for decades well you said for decades but how but you've been doing it as an understudy to the person who has to write off on the evaluation is that right not really a study we have done it as part of litigation to attack the um the opinion of the psychiatrist um who uh did an evaluation that we don't feel is appropriate so this goes back to my like original question for Ben which is the importance of who gets to do this so you're saying that right now in Vermont a psychiatrist is the only one though that can go into court with that initial determination of competency but you could you can attack their report with a clinical psychologist yes the the only thing right now that is the independent evaluation that is ordered by the court through the department of mental health prior to the passage of the legislation that you just passed was a psychiatrist passage of the legislation um qualified uh doctoral psychologists and they may be clinical psychologists they may be phd level psychologists um there's you know there's the psyd's there's the phd level psychologists both of them would be qualified to do these evaluations in the first instance and would and what we are hoping is to attract more of those people to the state because we've had a turnover and a large number of retirements in this community over the last couple of years i know i think i'm more confused about the problem we're trying to solve but problem we're trying to solve yeah is was the backlog but also whether or not because of the backlog which may or may not no longer exist would it be who should be doing these evaluations and so we put a sunset on the psychologist to get this information and take testimony well it's the backlog to be clear i think the backlog still exists it's just not as enormous as it was a year ago or six months ago um and it's really we're about 80 of them backlogged up and people were 80 instead of 160 right and people were spending time in jail because they had to wait for the competency evaluation but okay but the only person who can do the initial competency evaluation has to be through dmh it's a quarter yes it's a quarter it has to be quarter it has to be close so okay so that's what that's why if dmh is saying we're neutral but we're still only using they said they were neutral to the psychiatric social worker and others right oh so they're not neutral i think they were in favor we can check with karen but i thought their testimony was in the letter indicates their favor of the psychologist oh i thought she came on it said they're neutral about us well the question is do we extend i read the letter as being in favor of the current statute and lifting the sunset if i could put that back on so they're here the treatment the department departments dmh and dale do not have a position as to whether to expand evaluators beyond forensically trained psychiatrists and psychologists so they're so beyond what but let karen speak to them make it that was basically what i was was going to say um you know we don't really i think um matt said it really well we don't have a dog in the fight right like it doesn't we our job right is we get an event we get by statute we have been told that this is what we need to do we hire evaluators we do the competency evals we do not have you know our role is to assure that people who need mental health treatment get it as to whether or not someone's found competent and who's appropriate to find them competent you know we really feel like we're a neutral in this and so we're not taking a position on it well it is except what i think i heard was that you're still almost exclusively using psychiatrists so do you feel like there's situations where a psychologist would be a better person to evaluate competency that they're not getting a psychologist they're getting a secretary we and when in cases of intellectual disabilities we do use psychologists okay but you weren't before this law no we were yep no that it was allowed i think what changed now is that psychologists can also do people who have primary mental illness we are continuing to use psychiatrists for that but we use psychologists when intellectual disabilities are when aren't indicated so it can seem like it's going to be a major change any comments further i'm sorry senators say that again any further comments from you on this issue yeah i i was around obviously for pretty much every part of this and and i know that there are obviously members of this committee that weren't part of that testimony and um you know the horse was beat pretty dead about the this this issue of uh the doctoral level of a psychologist i didn't think that there was any real i didn't think there was any opposition that i didn't hear even opposition from i didn't hear opposition from the psychiatrist who testified um were anybody else the the question as i understand it is whether it should be expanded to people beyond doctoral level psychologists um and i would not be in favor of that but i i would play out again we've had a month so far so it's a little early to make an evaluation i'd also want to comment on i had on my list here uh but i do know that our what psychiatrists in the in the past you know who who finds it who finds everybody competent he doesn't find everybody competent um we didn't break it down on a great Catholic background this question was brought up earlier but we definitely know who the ones who are more likely just as a matter of statistics to find somebody competent versus not so it's it's like you could be judge shopping yeah except for we don't assign any of them so um and the department of mental health and uh and and um the name comes up and we say oh that one is very very likely to find this person competent um you know then we have to be more uh we have to take a look at that closely and and see what we're going to do with it do you use Ramon or out of state psychologists when you're we have used both depending upon uh the appropriateness in any given case um i there's there's there are people we bring up from Harvard i'm a clean medical who are you know one of the guys behavioral pharmacologist exactly a phd level psychologist who talks about drug interactions and how they are mental illness and and that's somebody who's not he's not a Vermont guy but he's you know one of the world leaders in the in that area we bring him up there there are people from around who they're not just not just from Vermont um but the statutory presumption of psychiatrists is something that um really was only part of Vermont and Rhode Island law and we thought it beneficial that it if we could get in line with the rest of the country i have one more i'm sorry i maybe i've had too much caffeine um so Representative Emmons help me understand that the second part of the question is whether others would be included and so i guess my question for our defender general's office is do you see i mean the only reason i could think of including others is because there's not a lot of diversity in terms of who is a doctor a level psychologist or psychiatrist we struggle with that a lot in the mental health field writ large for people of color um you know i can probably think of other discrepancies too but it's a huge discrepancy among someone you might find that's a black mental health professional or otherwise so i just wonder in your perspective if you think there are cases where you would want expertise from somebody um who has a perspective that might close disparities beyond people who are licensed uh doctoral level psychologists or psychiatrists i haven't thought about that to be honest you know i would hope somebody who's a doctoral level psychologist or psychiatrist would have training do i recognize those issues i don't know that if you gotta had a master's level person in color looking at the issues that you would be any better or worse off i don't know the answer honestly haven't haven't thought about it that in that in that term well maybe let's not think out loud about it but if you could come back with an answer any empirical studies or we could ask the medical community you know that that to me is the question i want to answer for that second part is is there a gap because it's very hard to make it to your doctoral level of psychology or psychiatry if you come from a marginalized background i think one of the questions to ask is really maybe a little bit flipping that so is there sufficient diversity within our doctoral level psychologists and psychiatrists to account for providing adequate representation for these evaluations for people of color yeah i would like to know that yeah that's probably a better question for the for the doctors to be honest i um final question for me is a geographic disparities in terms of or is it just individual psychologists or psychiatrists to find out that you're not yet you know with with mental health now using the you know the video evaluations over computers um the the that issue is is less of an issue the issue that arises more is the availability of and and how people are kind of respond to the video as opposed to in person um but it's i don't think it's uh i don't think it's as geographic as it as it used to be i think it is more um facility with technology and just comfort level with using that many of our clients and this is going to be this is what i foresee by the way with the proposal that department of mental health has with these many of our clients are transient some are homeless they don't stay the same place over and over they are either they do or they don't have some level of mental illness they aren't always they are particularly reliable when it comes to their scheduling um and um or they're i think that i guess if everything was a perfect world the departments memo with these 48 hour deadlines and the like are you know that would be wonderful if that would work i just don't think that's the way our clients work and so um we're either going to have a lot of arrest warrants or we're going to have uh you know there's going to be some level of disruption with the clientele that we deal with anyway that are you know qualified to have uh competency evaluations um and uh and and getting them scheduled and that's part of the world we live in i think so uh while i um i guess we would aspire to be able to uh work with the department of mental health i don't have great hopes that our clientele are going to be amenable to that but we'll see because i got it yesterday afternoon so we'll see what happens i hope we'll be back to this and i'll put here for you later can't just ask another question for matt larry oh no it's actually for karen can i ask another question for karen if you're available hi thank you um i i'm just uh curious if there's any background questions or information that's gathered from the um the person to be evaluated in order for the department to understand whether or not you need to seek an evaluator that has some uh potentially you know specialized um skill or background um that would be relevant to assess so whether it's a person of color or an lgbtqia person or a look you were talking about person with a disability it is um it seems as though um that was considered for people with developmental intellectual disabilities or brain injury i'm just wondering if other characteristics are taken into consideration when assigning or requesting an evaluator um no so all we get right again we're not a party we're not at these hearings um all we get is a referral from the court which generally includes the charging documents and an affidavit that talks about what the crime is um we may know the person um which is made why we may know a psychologist is indicated or it may indicate they can ask for a psychologist they can indicate there's an intellectual disability um again i think the thing to remember too is you know i haven't this is a competency is a legal question right it's do you know how to talk to your attorney do you know i i don't know how much um they're not super in-depth evaluations right it's not like we're doing a mental health assessment where we're really trying to think about what programming does the person need it's it's very different it's can they are they confident to engage with their attorneys so we don't have a lot of background information we again we're not even in court when these are done we just get emails us we take it we um and we just assign it we don't pick we don't we don't tell people we're not picking certain psychiatrists based on who we think right we just we send it out and whoever can take it takes it the only difference is that if there's an intellectual disability we assign it to a psychologist but otherwise whoever gets it gets it i will just quickly respond i know that there are times when we do hear from um mainly defense bar that they have a concern with an evaluator if we do get that we we have our own medical director read the evaluation to see if she has any concerns and then we also a novital has a head psychiatrist who oversees um and so we do if someone raises a concern with us we do make sure to go back and and make sure we feel comfortable with the evaluation but we don't we don't assign special psychiatrists for certain so i'm presuming you um have interpreters available for people with different languages we do yep okay thanks question representative i couldn't put an answer okay um someone earlier mentioned in ovitel karen i think it might have been you i'm curious if dmh is using um in ovitel clinicians for evaluations remotely via telehealth and if you are um are you using in ovitel scheduling services too to schedule this no we schedule them have you considered using in ovitel scheduling because i know they offer that i'm just curious whether that might help with addressing some of the backlog um we haven't i we haven't we have not it i don't know the logistics of that again it's i think the most of the delay is just trying to make sure that we're working with the defense council to find a date um but could we we could we do that in the future i don't know thank you okay tim what is the representative of the state's attorneys hello mr chair and i think i'll be pretty brief because you've already had uh the experts going in front of me um and so yeah i think we're we're very hopeful that many of the changes to s 91 put into um place we'll we'll eventually um bear some results um for all the different parties and and you know the question about no victim notification as long as it's allowed by law our victim advocates inform victims as to every step of the of the process when there's a criminal justice involved um individual um and you know we do think that s 91 will be helpful and the competency evaluations going forward we are we were supportive of the bill as it passed um and we uh agree with the defender general's perspective that it's important to have as many qualified evaluators as possible for the state to um make sure that individuals are being evaluated as soon and as close in time to potential court hearings as possible um that said if there's going to be an extension of the sunset as to doctoral level psychologist or an expansion that this group considers um i had sent along a mostly technical recommendation to attorney nova growsky that you then also amend 13 vsa 48 16 e which is the presumptive allowance of relevant portions of what was previously just psychiatrist reports to include whatever the list may be so if it's doctoral level psychologist which it is now um or other individuals who are professionals uh in this area that 46 sorry 48 16 e in title 13 is amended to reflect whatever the list is um and next session we would we would recommend that 38 a 13 vsa 48 16 e include doctoral level psychiatrist if the sunset will be extended and i've i've sent that along um to um ben so he has it uh as well but really that's the extent of our comments we're meeting every couple of weeks with dmh and dale um to make sure that if we can be helpful on anything we will be and we're certainly interested in seeing if there's any progress that can be made in competency restoration going forward the state's attorneys have any recommendation regarding those other than doctoral level psychologists we leave that in your learned hands mr chair um okay any question hey that that was briefed him and thank you very much thank you all good to see you forward to seeing you coming south it's one of these days i look forward to that as well the the blue ben uh i understand the menu hasn't changed so i know exactly exactly well that's why it has but still the same old blue ben with a new owner and doing a great job um our next witness is the honorable judge don't they so good afternoon are you open today we are we're in a different location but we are certainly open for business today it's good to be here tom so he has a sign behind him saying open so i i too think i can be brief we the judiciary supported the expansion to include the doctoral level psychologist for the evaluations and i think what i've heard during the discussion this afternoon ties into the idea that well perhaps people started to look at this because of the backlog and because of the delays but the question really becomes even if you took that out is it the right direction to go in and if you look at 40 the other jurisdictions they go there i believe 48 of the other states were already there and they found that having a broader pool than just psychiatrists enabled the effective administration of justice and from contacts with my colleagues across the country when i've asked about the timelines i am sorry to report that the timelines between getting reports in vermont and getting reports and other jurisdictions don't match we take a lot longer when we had the backlogs and even in the normal course i suggest we took longer to get our reports and evaluations i believe for instance new hampshire requires that if someone's incarcerated the report has to be submitted within 45 days if they're not it's within 90 days there are jurisdictions that have actually much tighter requirements than that and by expanding the pool of qualified individuals you're adding a diversity to the evaluators that doesn't exist with just one discipline of psychiatrists and you're reporting the opportunity to have more reports done by more people thereby the time frame so we can get the cases into court sooner and and that loses part of the issue that we heard about from mr valerio also and that is you lose touch with people when they have extended periods of time we saw that during the pandemic so the more we can do to shorten those time frames i suggest that it will also mitigate the potential of defendants losing touch with their attorneys perhaps and it should help all of us move forward in the criminal justice system not just again to address a backlog but to keep the system moving with case flow as efficiently and expeditiously as we can and i as far as lowering i won't say lowering as far as expanding who can do the evaluations i was just looking at a document put out by the national center of state courts from a number of years ago and they mentioned that there are some that allow master level with licensure mental health professionals with forensic training i'm not prepared to weigh in on whether the vermont system should go any further than where it has right now but we do support the idea of the doctoral level psychologists continuing not just during this period but after the sunset question to the judge judge thank you very much thank you so judge johnny i do have a question i'm going to follow up on senator ron hen sales question and the question uh is any data that you keep is there any data that you or perhaps it's the department of mental health keep with regard to who is declared competent versus incompetent based on gender or gender identity race ethnicity is that is that pertinent data that you have and do you see that as an issue in the process of competency determinations we do not keep that data and it would be difficult to assess whether it's if you will an issue in the process right now because i don't have the data to compare it to and to understand see how things came out but we do not keep that type of data i would note that the judiciary does have a commission on diversity equity and inclusion justice cohen is working on a committee that is dealing with data i submitted a report last year to the legislature regarding certain types of identifying and demographic data uh relative to civil cases and i know that the dei commission is looking into different areas for data so i will mention this inquiry to justice cohen and see if it's something that they are looking at thank you very much that would be very helpful great thank you all so much thank you i'm wondering um i'm wondering who you would like to hear from besides someone from the american psychological i think it's the mon chapter mon chapter american psychological association i believe that would be appropriate and the monday society would probably have psychiatrists the the the testimony that we heard from the psychiatrist psychiatrist affiliated with the howard center would be useful okay and and and perhaps um to have a a psychologist a doctor level psychologist who's currently involved what about the other groups that were mentioned in the legislation so and then beyond that um i think opr might be practical and identifying master's level uh nurses who else is it psychiatric after nascit nurse practice thank you mental health providers psychiatric ms practice maybe a closer maybe hearing from the local mental health center you said that yeah yeah so so uh when we were taking up s91 i was contacted by a doctoral level licensed psychologist uh who i think we should probably reach out to as well uh he he could serve that role he is familiar with these issues his name i don't know it's possible you've heard from him as well thomas powell is yeah well he used to work for the correction so i know right yeah i think he may have reached out but you know we can certainly beggy can get in touch with him who else martin i have a question because now i'm very confused but before i say that before i ask the question i do sometimes wonder historically there's a little bit of bias toward or against psychologists and psychiatrists i just it has come up in our health and welfare committee before and it just i just want to throw that out there my question though now is it seems our what question are we asking now well the the legislation requires us to consider whether or not to lift the sunset on the psychologist okay and whether or not to add other professions to the list and that's where the other professions come in now whether we heard it from actually matt larry or that that he thinks psychiatrists enough and we heard i thought tim space and i think karen was neutral and so i don't remember what i don't think i think he said this this sunset has not been lifted yet no that would need to be in the legislation next year the sunset's july of 24 july of june 30th of 24 thank you so we can lift it or you can extend it for another year or or do away with it and be like the other 48 then the next question is do you then one thing that he was it was it um tim mentioned or was it matt someone mentioned about the time frame yeah some states have i think time frame which i've donated and i think that's probably something to consider as we consider recommendations because i people the testimony we heard everywhere probably in judiciary was that those weighing competency evaluations were in jail longer on detention than any other group other than those with charges that like murder that would take you know all the time to resolve are any folks who are required to go through the evaluation are any of them held with the state hospital or they all held you know i don't know can anybody answer that that's still on is that karen i can um so it depends um you can be ordered to have an evaluation or an out patient evaluation um if you're ordered to have an inpatient evaluation uh we have a psychiatrist that then assesses the person to determine whether or not they meet hospital level of care if they do meet hospital level of care um then they would um go to an inpatient unit wouldn't necessarily be bb ph could be any hospital um if they uh do not qualify for an inpatient but instead an outpatient evaluation they could be in doc or just in the community so karen would i know we're talking about a future possible forensic unit would any of these folks were waiting for a competency evaluation or have been deemed incompetent to be housed at the forensic unit so the way the legislation was written at the end of last year um it would um be only for people that have been found incompetent or insane so it wouldn't be um before that determination was made and then it would be only for people that were incompetent or insane does that make sense it does so right now if someone has been deemed to be incompetent stand trial are they housed at the state hospital or a doc in a correctional facility um so again it depends on their clinical needs um if they're incompetent they wouldn't remain in corrections um the the reason we propose the forensic facility right is because there's a gap between the folks that need hospital level of care and those that do not that still remain in need uh intensive services in a secure setting um so right now they could wait in a hospital again doesn't need to be vpch could be any hospital throughout our system if they need that level of treatment right it depends on their clinical need not whether or not they're incompetent um or they could be in the community or in some sort of residential setting if they on an act 248 order then dale provides services to them so there is a uh s 89 i forget the act number working group right now uh looking at the gap issue so there's another working group looking at who would go into a forensic clinic wasn't that 91 or was it 89 it's in yeah that yeah i'm i keep what's the act number a 27 thank you yeah i keep confusing 89 and 27 i thought i was a root number to come up here 91 and 89 heart but at any rate sort of that's that issue is whether or not developing those eight votes right would be that's a daily or if there's a number of questions that are being asked and steward shore is the expert in that area but i think that's not part of what we're going on we're not justice oversight it's not taking that special committee for that you were on that one too we're going to go i wrote down a meeting for a win for a win the second meeting i wrote it down for wednesday and i was online and all set to go on and they wouldn't let me join the team because i was so on it's easy to do all right okay we don't have meetings scheduled i think we have an idea of an agenda the next meeting but we also have other issues we have to take on but we don't have a meeting scheduled yet for september october november december so peggy will do a doodle poll everybody um and then for our guests we can send you the doodle poll but i think we'll at least do one more meeting on the on this question although it was i found it pretty helpful today what the practitioners had to say did you do the thing for what was it the letter yes and then we have the letter why don't you send it to the committee can we act on that today well it'd be helpful if we could talk about it briefly you don't have to share it on the screen yeah i'll share it on the chat that could be a lot easier let's try another one it was just a letter of recommendation absolutely there's a public maybe a situation so the question that so my committee members had was whether or not they should be voting on this letter of recommendation since they're the health care and human services participation and health and health care and human services 12000 senate specific to act 28 competency so we would not vote on this letter okay nothing again yet you can deal with it come january you got a heads up better than i cover with them oh yeah that's where you get paid the big bucks for that is what it i'll move that we have to be the senate senator please help we call it programs in the second line we call it program in the first paragraph so we just be consistent i think it that second it's the fourth one in the first paragraph the first word i think it should be programs in and it says programs in the second so i like the first one so i'm just wondering should we thanks the journalist should we um in that second paragraph ask them to i mean we heard from these two areas we don't know what the status is in the other areas should we be asking them to look at the status in the last sentence yeah i will cross the state i missed that okay okay thank you so i was like in that motion if nobody else thank you maybe there's martin all in favor say aye i opposed what's unanimous are we going to get a copy of that letter it's sounds good is there anything else we'll do the duty poll and thank you with us to contend the duty poll to all members including those else in welfare and even service to members thank you for including us thank you for including us by thank you oh by uh wasn't just a nice josh oh you did it so they're required they should put in for prudine yes we should put in for prudine in expensity well i think he does that which thank you for reminding me he got an email saying he puts us but i'm not sure thanks everybody good to see you all


I thought for a change of pace this week we'd take a look at the three classic WWF arcade games. There is a fourth WWF Royal Rumble that came out in 2000 and was ported to the Dreamcast, but for the life of me I cannot get the ROM to work, so I have to stick with these three. Sorry. The first being WWF Superstars, which came out in 1989, and yeah, as you can see this game actually has quite a bit going on with the gameplay despite how simple it looks. Yeah you punch and kick, but out of the grapple you can toss them, throw them into the ropes, or go into a headlock where you can do moves specific to your character, like Macho Man's Suplex, Hulk Hogan's Piledriver, or the Ultimate Warrior's Gorilla Press. So yeah, finishers are all here too. They're a bit tricky to pull off for some people, but most of them are pretty easy. What I really love about this game, however, is that you can fight outside the ring, you can pick up a freaking table and swing it at people. That is awesome. The best part of WWF Superstars, though, is the roster of wrestlers. This is just quintessential golden era WWF wrestling right here. With Hulk Hogan, Ultimate Warrior, Macho Man, Honky Tonk Man, Hacksaw Jim Duggan, and the Big Boss Man. You form a tag team with two of these guys, so yes of course this game is multiplayer, and you fight for the right to face the tag team champions, the Million Dollar Man Ted DeBiase and Andre the Giant. Sadly they're not playable characters, but you can monkey around with the rom and unlock them. However, do so at your own peril because it makes the game super glitchy. But yeah, WWF Superstars is a great time and a cool throwback to the golden age of wrestling. A few years later came WWF WrestleFest, and naturally the graphics, art style, and sound have all taken a massive leap forward. Ehh, except for these headshots here. Who thought it was a good idea to make Hulk Hogan look like he was sniffing glue? I know the guy was high strung, but jeez. Anyway, this game was developed by Technos Japan, the same people that made WWF Superstars, so the gameplay feels very similar. WrestleFest supports up to four players and vastly increases the variety of moves each guy can do, and even includes double team moves when you play as a tag team. Your partner on the apron can even power up and come into the ring a house of fire, just like the old days. That's fantastic. There's also the Royal Rumble mode, where you can have six wrestlers in the ring at once. If a guy is pinned, submits, or is thrown out of the ring, he's eliminated and somebody new comes down to take their place. I love the goofy picture in picture in the corner here. Mr. Perfect is making a duck face, I guess? What's wrong with him? WrestleFest has ten wrestlers to choose from, bringing back Hogan, Warrior, Boss Man, and D.B. Ossie, but sadly leaving out Macho Man, and my extreme bias for him means that I have to like the superstars roster better. Sorry, just how it is. There's also Sergeant Slaughter, Mr. Perfect, Jake the Snake, Roberts, and Demolition, and this time the tag team to beat to become champs are the Legion of Doom. So yeah, despite the regretful lack of Macho Man, Randy Savage, WrestleFest improves on superstars in pretty much every way. Seriously, this game is old time beat em up pro wrestling action at its best, and it's especially fun with a couple friends. Last week, we come to WrestleMania, the arcade game, and yeah, immediately you can tell this game is much, much different than the previous two games. But thankfully not in a bad way. The home console ports on Super Nintendo and Genesis may be kind of limited and get stale after a while. But the original arcade game is very lively, with a ton of energy, not to mention two extra playable characters in Yokozuna and Bam Bam Bigelow. The main selling points here are the digitized graphics, which are really impressive looking, but this game has a strange cartoony quality to it that might turn some people off. It's still really impressive looking nonetheless.  Sure, okay. There's also weird stuff like Doink the Clown pulling out a mallet out of nowhere, Bam Bam hitting you with fists and Gulf and Flame. That's really what the action is predicated on here. There's less of an emphasis on grappling and doing wrestling moves and all that.  WrestleMania the arcade game came out in 1995, and the one thing this game definitely does well is capture how goofy wrestling was at the time during that whole next generation era. This game feels detached from the previous two games, and rightfully so, because wrestling at the time felt detached from anything else before it, and thankfully after it.  So there you have it. Each of these games all have their strengths. WrestleFest is four player compatible with a ton of moves and finishers. WrestleMania the arcade game perfectly sums up the mid 90s WWF and provides a surreal cartoony experience, and Superstars has, uh, well, it has Macho Man, okay? It doesn't need anything else. Alright, so that's it for now. Thanks for watching, and have a great rest of your day.