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Oregon hospital systems file new appeal to pressure state on psychiatric care

New filing contends a federal judge in Portland wrongly dismissed an earlier case related to the Oregon State Hospital
Oregon State Hospital in Salem. | OREGON HEALTH AUTHORITY
December 7, 2023

Four Oregon hospital systems are seeking to revive their lawsuit alleging they’re being burdened with psychiatric patients because of the state’s inadequate mental health system. 

The hospital systems — Legacy Health, Providence Health & Services, PeaceHealth and St. Charles Health System — on Monday filed an appeal in Ninth Circuit Court of Appeals seeking to overturn U.S. District Michael Mosman’s dismissal of their earlier lawsuit. The appeal is the latest in recent legal wrangling over how the Oregon State Hospital and the state’s scarce mental health resources are allocated. 

The hospital systems, which provide nearly 60% of the state’s psychiatric inpatient beds, first brought the lawsuit against the Oregon Health Authority in September of last year arguing that the agency had violated the civil rights of mental health patients by failing to provide them adequate mental health treatment options. As a result, the hospital systems are providing long-term care to civilly committed mental health patients for whom they’re ill-equipped to care, the lawsuit alleged.

“Consequently, when OHA abandons civilly committed patients in community hospitals, patients do not receive the long-term treatment they need—and emergency and acute care resources are made unavailable to other psychiatric patients who desperately need them,” reads the appeal. 

According to a statement from the hospital systems, civilly committed patients are being kept too long in inappropriate settings. The acute care inpatient model is designed to care for patients from seven to 10 days on average. However hospital systems are caring for these patients staying there longer than 120 days. 

 One civilly committed patient has stayed at the Unity Center for Behavioral Health, a short-term crisis stabilization center in Portland, for 224 days, according to the statement. Half of its civilly committed patients have been there for more than 30 days, according to the statement. 

Earlier this year, Mosman dismissed the hospitals’ lawsuit. Mosman concluded that the hospitals’ arguments that they were advocating for the rights of patients while complaining about the difficulty in caring for them “are not aligned.” Mosman also ruled that the hospitals could withdraw from Oregon’s civil commitment system.

The appeal argues that Mosman erred in his reasoning and that the health authority has a legal obligation to provide care for civilly committed patients. It further argues that hospitals are only approved to provide short-term treatment to civilly committed patients. 

 “Hospitals also cannot legally or ethically discharge an individual who has been found to be an imminent danger to themself or others or unable to take care of their basic needs, until their condition improves and there is an appropriate discharge plan,” reads the appeal.