Skip to main content

Marion County sues Oregon State Hospital over treatment

Seeking home turf after a federal court ruling, Marion County wants a local court to find that the state is not fulfilling its duties to patients and the public
Oregon State Hospital in Salem. | OREGON HEALTH AUTHORITY
September 12, 2023

This article has been clarified and updated with additional reporting. 

Six days after taking a partial loss in federal court over Oregon State Hospital discharges, Marion County is suing in state court, accusing the Oregon Health Authority of failing to properly treat and evaluate people who are facing trial while experiencing mental illness.

The suit is the latest development in a months-long struggle between lawyers over management of the state’s premier psychiatric facility. At issue: what the state does to restore people to competency so they can stand trial.

One group of lawyers has been trying to keep the matter in federal court; there, U.S. District Judge Michael Mosman has ruled that state hospital discharges of people with pending criminal charges must occur within a certain amount of time, thus opening up beds so other patients are not languishing in jail without treatment.

Marion County, home to the psychiatric facility, has been an important figure in the legal wranglings as it's received contrary rulings from local judges in state court to keep patients from being released from the state hospital. The county sheriff has been following the state rulings, despite the federal one.

The county's new suit, which was filed in Marion County Circuit Court, seeks to force the Oregon Health Authority and its psychiatric facility, the Oregon State Hospital, to invest in more treatment beds and staff to properly evaluate people considered unable to assist in their own criminal defense, according to an announcement issued by the county late Tuesday. The lawsuit charges that the health authority has failed to meet its legal obligations to provide services for people committed to the state hospital, and, as a result, is burdening Marion County with tasks it’s ill-equipped for. 

“Oregon's behavioral health systems are in a state of crisis,” reads the lawsuit, filed Tuesday by Marion County Counsel Jane Vetto. “In recent years, the state has experienced an unprecedented surge in the number of individuals in desperate need of mental health treatment, yet despite receiving almost one third of the most recent biennial state budget, the Oregon Health Authority ("OHA") has failed to answer their call.”

The lack of treatment options has resulted in many people with severe mental health challenges becoming involved in the criminal justice system, according to the lawsuit. While in the criminal justice system, courts have deemed these individuals as being unable to "aid and assist" in their own defense and mandated them to the state hospital to receive treatment in order to face prosecution. 

“Despite having a statutory responsibility to provide care for these individuals, OHA is now failing them a second time by providing inadequate restorative services, leading to a severe backup at the Oregon State Hospital ("OSH") doors and several widespread systemic impacts,” reads the lawsuit. 

Last September, despite blowback from prosecutors and some advocates, Mosman addressed the bed shortage at the state hospital by placing a strict limit on how long patients could be housed at the facility. Critics said it did not do enough to protect communities, leading to subsequent revision of the order.

The shortage of beds at the state hospital has strained Marion County’s community mental health programs, requiring them to take people who need hospital-level care because of the shortage of beds at the state-run psychiatric facility, according to the lawsuit. 

Marion County’s community mental health programs don’t have the legal ability to compel people in its care to take medications, reads the lawsuit. It also doesn’t have a secure facility for individuals charged with violent crimes, some of whom “disappear into the community,” the lawsuit states. Additionally, the lawsuit states that staffing shortages have meant Marion County has been unable to provide services to people who require higher levels of care. 

The lawsuit faults the health authority for offering salaries for state hospital nurses and other positions that “were significantly below market rates.” In December 2022, outgoing health authority Director Patrick Allen told a legislative panel that the agency needed “more of everything,” including more beds at the state hospital. 

However, the lawsuit states that the health authority did not seek funding for additional state hospital beds or staffing during the 2023 legislative session. One bill introduced last session sought to increase patient capacity at the state hospital but died in committee.

“It is clear that OHA and OSH have no intention of taking immediate action to address what they themselves have identified as the core barriers to being able to provide the services required by Oregonians across the state,” reads the lawsuit. “Instead, they are content with simply using the federal court's order to solve problems in the short term without any sort of significant effort to meet their long-term obligations.”

Mosman's landmark September order has been a running source of tension in Marion County and elsewhere in the state. Earlier this year, as The Lund Report first reported, the Marion County Sheriff’s office stopped transporting newly discharged patients where they were supposed to go, despite the federal order requiring their discharge.

Driving the transport breakdown were conflicting orders from Marion County Circuit Court judges ordering patients to not be discharged from the state hospital. One of them, Audrey Broyles, even sent a letter threatening Oregon State Hospital Superintendent Dolores Matteucci with contempt of court if she tried to discharge a particular patient again.

In late July 2023, an outside expert reported that it was Marion County’s attorney who’d ordered the sheriff’s office to not transport some patients from the state hospital, effectively blocking their discharge.

Last month, the group Disability Rights Oregon filed a motion accusing municipal officials, prosecutors and circuit court judges in Marion County of “obstructing” the state hospital discharges in order to “thwart” Mosman’s order. The motion asked Mosman to compel the state judges to follow his earlier direction.

In a Sept. 6 court hearing, Mosman said he was granting in part the motion regarding judges; he followed up with a written order Monday. He stopped short of ordering the Marion County sheriff to transport patients — thus siding with Marion County's argument. But he did declare any conflicting state rulings void, thus rejecting the county's argument that less intrusive actions were available to him.

“It's very significant,” Disability Rights Oregon’s spokesperson, Melissa Roy-Hart, told The Lund Report on Sept. 8. “Because, as of today, Marion County is finally transporting people back to their home county.”

Mosman's ruling appeared to tee up the issue for the Oregon Legislature to settle next year.

“The order expires in December, so the Legislature has an opportunity to permanently fix this issue during the short session,” Roy-Hart said  “Otherwise, DRO is concerned that things will go right back to where they were before Mosman's Order.”

Jail wait times for people awaiting admissions to the Oregon State Hospital had plummeted in the wake of Mosman’s order.

On Tuesday, Marion County announced its new filing accusing the state of failing to provide resources to adequately treat those who needed to be restored to competency to assist in their own defense. It arguably gave the Legislature another legal issue to consider.

According to the county’s statement, “sicker and more violent people are being pushed out into the community where their behavioral health restoration needs simply cannot be met.”

This article has been clarified to reflect a fuller description of how Mosman ruled in relation to Marion County's arguments. It also includes description of the Marion County suit that had not been made public at the time of initial publication.

Jake Thomas contributed reporting for this article.

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