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Prusak floats legislation to overhaul Oregon State Hospital board

Draft bill circulated by outgoing Rep. Rachel Prusak seeks to stabilize the board’s spotty membership and better oversee the state's psychiatric hospital.
Oregon State Hospital in Salem. | OREGON HEALTH AUTHORITY
December 13, 2022

State Rep. Rachel Prusak, D-Tualatin/West Linn, is finishing up her time in the Legislature, but she’ll be watching the legislation she leaves behind, including a draft bill intended to give workers and families of patients at Oregon State Hospital more of a say in the operations of the psychiatric facility. 

Prusak announced in February that she would not run for reelection. But she remains engaged, and told The Lund Report that she worked on a legislative concept to rework the composition of the Oregon State Hospital Advisory Board. The board is a low-profile group that has struggled to retain members as it has clashed with hospital leaders. A draft of a board report obtained by The Lund Report shows its members distrust hospital management and are seeking a more active oversight role. 

Prusak sits on the board with Sen. Kate Lieber. The 16-member panel was created by the Legislature in 2009 to evaluate if patients are safe and being cared for at the hospital and to recommend improvements. But it’s been plagued by vacancies.

“The hospital has not had an active board for a long time,” said Prusak, who was appointed to the board in 2021. “We need people to give a voice to patients and people who work at the hospital.” 

She said lawmakers are interested in introducing her draft bill and she is confident it will be pursued.

Amber Shoebridge, hospital spokesperson, told The Lund Report in an email that the Oregon Health Authority was not aware of the draft bill, but the agency’s government relations team “is always available to work with elected officials on any proposed legislation that benefits the people of Oregon.”

Prusak is stepping down from the Legislature when her term ends next month, but began drafting the bill earlier this year. The board, mostly appointed by the governor, includes designated positions for health care providers, members of the public who live near the main hospital’s Salem campus, in addition to mental health advocates and consumers of services. A family member of a consumer of mental health services has a seat as well. 

Also included are non-voting positions for three representatives of the hospital’s unionized staff, in addition to two legislators picked by the House speaker and Senate president respectively. 

Prusak said the board has an important role in advocating for staff and patients at the hospital, which has come under repeated scrutiny for treatment of patients and staff. Regulators fined the hospital $54,180 in September for failing to investigate worker injuries tied to violence. Disability Rights Oregon last year issued a report finding staff was overworked and patients were not receiving proper care. 

The Centers for Medicare and Medicaid Services earlier this year found a range of problems at the hospital's Junction City campus including patients assaulting each other and faulty record-keeping. The problems were so severe, federal authorities threatened to block the campus from participating in Medicare.

The Oregon Health Authority on Friday announced that the state hospital was now in “substantial compliance” with federal requirements. 

Despite the challenges facing the hospital, the board currently has seven vacancies.

“We have about four or five consistent members who attend the board meetings, but we have a lot of vacant spots on the board right now, too, and we are consistently trying to increase those numbers,” Joshua Ferreira, a board member representing health care providers, said at the board’s September 15 meeting. 

Ferreira said a more consistent and “well-rounded group” was needed to fulfill the board’s mission.  

The draft legislation would change the designated voting positions on the board for mental health advocates from three to two. It would also reduce the three voting positions for health care professionals to two. 

The legislation would boost the number of positions for family members of a consumer of mental health services from one to two. It would also increase from two to three the number of consumers of mental health services. The Salem residency requirement for the two positions representing the general public would be dropped. 

Prusak said the legislation would cut down on vacancies and bring better balance to the board. The two positions for Salem residents who live near the hospital are currently vacant and Prusak said they’ve been hard to fill. She said it makes sense to drop the residency requirements since the hospital serves the entire state and meetings can be held remotely. 

Javonnie Shearn, the board’s chair, told The Lund Report in an email that the board had input on the legislation and supports it. 

Prusak said some staff members are worried their jobs would be affected by serving on the board. Two of three board positions for hospital staff are currently vacant. Kim Thoma, who represents the hospital’s direct care staff, declined to comment on the legislation.

The board last year raised concerns to officials about reports of racism and transphobia at the hospital and said it was left out of a decision to call in the National Guard in response to a dire staffing shortage. 

A rough draft of the board’s annual report to the Legislature dated Nov. 18 complained of a “lack of clarity of the purpose of the Board, especially given the challenges currently facing OSH” and a “lack of transparency from OSH leadership in a timely fashion.” 

The draft report recommends putting a member of the board on a review panel that hears serious grievances filed by staff or patients. It also calls for medical associations to be represented on the board while requiring the Oregon Health Authority to staff it with a manager, policy analyst and administrative assistant. Additionally, it suggested allowing hospital worker unions to select representatives to serve on the board, while offering “flex” time for serving on the panel.

“Oregon Health Authority and Oregon State Hospital value and respect the insight and feedback from members of Oregon State Hospital Advisory Board and look forward to seeing their final report to the governor,” Shoebridge said in response to the draft report.

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