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Judge rules that hospitals can’t sue the state over civilly committed patients

Oregon hospital systems can’t complain about costly and difficult patients while advocating for their civil rights, a federal ruling says
Oregon State Hospital in Salem. | OREGON HEALTH AUTHORITY
May 30, 2023

A federal judge has thrown out a lawsuit from four of Oregon’s largest hospital systems alleging state health officials are improperly warehousing civilly committed patients in private hospitals.

U.S. Judge Michael Mosman on Tuesday dismissed arguments from the health systems that the Oregon State Hospital’s admissions crunch is saddling them with patients they can’t properly care for while violating their civil rights. Mosman wrote in his order that the “Health Systems do not have standing to bring claims on behalf of their civilly committed patients.”

“Health Systems claim in their briefing that they would like to treat more civilly committed patients,” wrote Mosman. “They also say they have a close relationship with these patients because their staff treat these patients. Yet Health Systems also complain about how much civilly committed patients are costing them and about the harms they inflict on their staff members. These arguments are not aligned.”

The order comes at a time when hospitals complain that they are bearing costs caused by lack of beds elsewhere in the state’s health care system. Hospitals around the state have been boarding hundreds of patients without reimbursement. Most are not civilly committed; others can’t be discharged because facilities offering lower levels of care, such as skilled nursing facilities, won’t accept them. 

The four health systems responded to the ruling with a joint statement that they “are disappointed by this decision.” 

“The hospitals filed their case to advocate for the right of people with mental illness to receive treatment in the most appropriate setting and to hold the state accountable for its legal responsibilities to those individuals,” reads the statement. “Today’s decision does nothing to address these issues and fundamentally misunderstands the dynamics of Oregon’s mental health system.”

The statement also said the health systems plan to “seek further review” of the decision. 

While the order represents a setback for Legacy Health, PeaceHealth, St. Charles Health System and Providence Health & Services, Mosman also granted the health systems “amici” status in ongoing litigation over state hospital admissions. The status means the health systems aren’t directly involved in litigation but are allowed to offer the court relevant information. Mosman earlier granted the same status to two separate groups of local prosecutors and judges. 

Mosman’s order is in response to a lawsuit filed by Legacy Health, Providence Health & Services and PeaceHealth in federal court in September. The lawsuit, later joined by St. Charles, challenged a sweeping order Mosman issued earlier that prioritized state hospital admissions for patients who need treatment in order to face criminal charges. 

The health systems argued the order violated the civil rights of patients committed to state care through a civil court process. The order, the health system argued, kept civilly committed patients in acute care hospitals instead of the state psychiatric facility where they would receive better care. They further argued they hadn’t been consulted by the court and were being encumbered with costly and difficult patients who require long stays.

In his new order, Mosman wrote that Disability Rights Oregon would be a better organization to advocate for civilly committed patients. The organization is a federally designated advocate for people with mental illness that’s driven litigation over state hospital admissions. 

During a hearing last month, Carla Scott, a state attorney representing the Oregon Health Authority, argued the health systems’ lawsuit should be thrown out because they had voluntarily agreed to take the patients. Mosman agreed, writing that the health systems’ “voluntary participation in the very conduct that causes their alleged injury” undermined their case. 

Additionally, Mosman faulted the health systems for not seeking to intervene earlier in ongoing litigation over state hospital admissions. Mosman pointed out that Disability Rights Oregon and the health authority reached a settlement last year to begin bringing the state hospital in compliance with an earlier order to prevent mentally ill defendants from being kept in jails.  

The health systems “admit that many of the alleged harms - including OHA’s policy of limiting OSH admissions to effectively exclude most civilly committed patients - have been ongoing for years,” wrote Mosman. “This suit has also been progressing quite publicly during that time, yet (the health systems) failed to intervene until just last fall. There is no good excuse for this delay.”

You can reach Jake Thomas at [email protected] or via Twitter @jakethomas2009.