Pretrial Forensic Coordination in a State Hospital: Oversight of Persons Adjudicated Incompetent to Stand Trial

State hospitals are experiencing significant increases in pretrial forensic admissions, resulting in forensic waitlists and a "battle for beds," necessitating daily census management procedures. This column describes strategies designed and implemented at a state hospital in Virginia to address the bed crisis, with a focus on identifying and reducing barriers that affect the flow of admissions and discharges for persons ordered for competency restoration. Essential to this process is the forensic coordinator, who provides oversight across internal processes within the state hospital and engages in "boundary spanning," which strengthens collaboration with courts, jails, and local providers to address the competency crisis.