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Oregon State Hospital treatment limits to remain in place

A judge upholds a ruling that limits the length of psychiatric treatment for patients awaiting criminal prosecution.
Oregon State Hospital in Salem. | OREGON HEALTH AUTHORITY
January 10, 2023

This article has been updated with comment from the health systems involved.

A court order limiting the treatment length of Oregon State Hospital patients who are waiting to be criminally prosecuted will remain in place after a judge denied a move by private hospitals to modify or throw it out.

Federal Judge Michael Mosman on Monday upheld his September order that required the state psychiatric hospital to treat patients on an exacting timeline so they could participate in their defense against charges. The ruling is the latest in decades-old litigation over the care of such patients.

Legacy Health System, PeaceHealth and Providence Health & Services had pushed back against that ruling, arguing in a Sept. 28 filing that community hospitals hadn’t been consulted. The hospitals argued that the order violated patients’ rights by prioritizing state hospital admissions of those that had been accused of crimes. They further argued that patients committed to state care through a civil court process would languish in acute care hospitals instead of the state hospital where they would get better care. 

The hospitals — who were joined by prosecutors from Washington, Clackamas and Marion counties — offered alternatives to Mosman’s earlier order that included increasing capacity or modifying the timeline. 

“The September 1 Order must be given time to work and for its effects to materialize. If all goes to plan, it will enable the state to achieve compliance with the Constitution next year, for the first time in nearly half a decade,” wrote Mosman in his ruling.

Mosman, also noted that state health officials had publicly stated they “had no solution” and were “out of ideas” on how to fix the psychiatric hospital logjam that has risen to crisis level in recent years. The Oregon Health Authority has sought to recruit more staff, increase community behavioral health settings and open more units with $1.3 billion allocated by the Legislature, wrote Mosman. 

“To date, none of these have solved the crisis,” he said.

Last September, Legacy Health, Providence Health & Services and PeaceHealth filed a lawsuit against the health authority in U.S. District Court in Eugene arguing that they’ve been unduly burdened with civilly committed mental health patients due to the state hospital’s overcrowding. St. Charles Health System later joined the lawsuit. In November, Mosman consolidated the suit with the larger state hospital litigation.

The four hospital systems responded to the order issued Monday with a joint statement stressing their commitment to “a compassionate approach to behavioral and mental health treatment.”

“Judge Mosman’s order recognizes that the state has long fallen well short in providing necessary care to those in both the criminal justice and behavioral health systems,” reads the statement. “We are disappointed that the order continues the denial of appropriate care to vulnerable patients who can best be treated at the Oregon State Hospital.”

The statement said that the order “means that many patients whose freedoms are taken away through civil commitment will be unable to access meaningful treatment in the most appropriate setting.”

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