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Hospitals ask judge to reinstate lawsuit against Oregon for forced boarding

Large systems say federal judge erred in earlier dismissal of suit over patients civilly committed while experiencing mental illness
Oregon State Hospital in Salem. | OREGON HEALTH AUTHORITY
June 27, 2023

Four of Oregon’s largest hospital systems are asking a federal judge to reconsider their suit against the state for failing to treat people who are civilly committed while experiencing mental illness.

In a motion filed Monday, the hospitals told U.S. District Judge Michael Mosman he’d made a clear error of law in dismissing their earlier lawsuit and asked him to consider a new, revised filing.

If successful, the new motion could bring a new focus to long-running civil rights litigation over the state’s lack of treatment beds. Advocates have sued the state for causing people charged with crimes but who are considered mentally unable to assist in their case to languish in jail without treatment because of lack of beds at the Oregon State Hospital. Mosman has responded to the bottleneck by setting deadlines for the state to release patients from the Oregon State Hospital.

The four hospital systems, meanwhile, say civilly committed patients are being boarded without adequate psychiatric treatment in their facilities as well. At times, hundreds of beds around the state have been devoted to boarding patients who no longer need hospital care or generate revenue, due to a lack of facilities that can accept them for further care— causing hospitals to increasingly go to court. The hospitals also asked the Legislature to reimburse them for boarding, but the bill went nowhere.

With their recent filing, Legacy Health, PeaceHealth, St. Charles Health System and Providence Health & Services want to up the pressure on the Oregon Health Authority to build additional treatment facilities, echoing litigation in New Hampshire and the state of Washington.

“Rather than addressing these problems by increasing long-term treatment capacity and options throughout Oregon, OHA has effectively outsourced its responsibilities to civilly committed patients by leaving patients indefinitely in community hospitals’ emergency rooms and acute behavioral care units,” the systems argued in a revised complaint attached to their motion.

In their motion, they say the judge improperly failed to give them a chance to address Mosman’s argument in dismissing the case: that the hospitals had applied to be certified to provide acute care for such people. Even if they hadn’t applied for certification, they’d face the same burden, they argued.

The four health systems “collectively provided almost 60% of the psychiatric inpatient patient beds in Oregon. If (the systems) were no longer certified to provide acute care services to civilly committed patients, there would be a massive shortage of beds and civilly committed patients would instead languish in … emergency rooms and inpatient beds.” 

Also, if the hospitals “discharged civilly committed patients with nowhere to go, as (the health authority) has suggested, (the hospitals) would violate federal and state laws and ethical rules that may subject them to fines and jeopardize their licensure.”

​​You can reach Nick Budnick at [email protected] or at @NickBudnick on Twitter.


Submitted by Mary Murphy on Tue, 06/27/2023 - 13:38 Permalink

A failure so deep as to reframe the falling-through-the-cracks-in-the-system metaphor. The cracks, it seems, are the system.

“No amount of well-intentioned money we throw at programs will stem the tides of death and harm and exposure and abuse for patients with brain disease when bad policies and bad laws are at the core of what’s filling our streets with sick people. You cannot put even a good-plated bandaid on a gaping wound and expect blood to stop seeping through it. The current brutal mental health system was designed to fail patients and families and it’s succeeding brilliantly.

Until we aren’t stepping over sick people in the street, until there are no more wailing Mothers, until there are no more mentally ill rotting in solitary, until there are no more ragged, filthy, limping beggars at the stoplights, I’m not keeping my mouth shut, and I’m not backing down from criticism.

There are spaces in the world of advocacy where desperate stories and terrible consequences are sugar coated with words like ‘choice’ and ‘civil rights.’ It’s easier to battle stigma, to leave irrational patients to irrational choice, to focus on low hanging fruit and quick wins. Its easier to insulate ourselves than it is to confront misery. It’s easier to jail a problem than to heal a life of suffering. It’s easier to ban and shoot and blame and marginalize and step over the sick than it is to walk beside them.”