McMinnville Republican Sen. Brian Boquist wants Oregon to cut the red tape and allow for the construction of for-profit, private hospitals dedicated to veterans’ psychiatric services, but he faces opposition from an unlikely quarter -- leading mental health advocates.
Senate Bill 1054 would allow new hospitals to come into the state to address an acute crisis facing returning military veterans while avoiding the Oregon Health Authority’s rigorous certificate of need process.
For Boquist, there’s no question of the need for better mental healthcare, especially for those returning from the Middle East -- he served in the Iraq War and saw men under his command take their own lives. His stepson, a U.S. Navy member, also committed suicide.
“OHA says there is no need at all. F’n bullshit,” Boquist complained. “So therefore, OHA will approve no certificate for anyone.”
Greg Walker of the Green Beret Foundation, the military liaison to Cedar Hills Hospital in Portland, said Cedar Hills is the only existing, stand-alone psychiatric hospital in the Northwest with a dedicated program for veterans, serving 25 to 35 at a time. He says it’s ready to set up an additional unit, but the state has stood in the way.
SB 1054 passed the Senate Veterans Committee, but it’s currently bottled up in the Senate Rules Committee. Republicans are agitating to force a vote to the floor, but so far Democrats, with the backing of SEIU and Portland’s major hospital systems, aren’t budging.
Both Disability Rights Oregon and the National Alliance of Mental Illness say the approach outlined in SB 1054 will lead to the construction and prioritization of expensive hospital beds, at the expense of a community mental health system that keeps people out of crisis.
And like a trojan horse, the push will affect much more than veterans, spilling over into the civilian population and disrupting the mental health system, these opponents argue.
Bob Joondeph of Disability Rights Oregon, a publicly funded watchdog, said SB 1054 appeared to be an end-run around Universal Health System’s failed application to build a $35 million, 100-bed, for-profit psychiatric hospital in Wilsonville in February.
“It’s a for-profit corporation that wants to build a hospital and they’ve changed their proposal several times,” said Joondeph, who accused Universal Health and its subsidiary, NEWCO, of using veterans as political pawns. “They’re trying to use a politically popular group to do what they want.”
If the project doesn’t have adequate safeguards, it could hurt existing psychiatric facilities at Portland-area hospitals and stick them with the lion’s share of patients on public assistance, while diverting the patients with richer private insurance to the new hospital.
“While OHA believes that NEWCO has met its burden of showing that this project is financially feasible and profitable, that profit will come at a cost to existing community hospitals providing psychiatric care, and will not provide a reasonable alternative to the patient population that most needs inpatient psychiatric care,” wrote Dana Selover, a health authority official, as she rejected the Wilsonville application.
NAMI-Oregon executive director Chris Bouneff, however, said he recognizes the acute crisis facing Oregon’s veterans and would support SB 1054 if it were amended to allow an exception to the certificate of need process only for veterans’ services. “There’s a shortage of veterans’ services throughout the state,” Bouneff said. “If we’re going to make an exception, it should be all veterans, all the time.”
The bill has been amended from its original form to focus more squarely on veterans, but it still allows new veteran-oriented hospitals to shift away from veterans after eight years and to begin providing institutionalized care to the general public, which Bouneff wants to avoid.
Bouneff said the state does have a need for acute, in-patient psychiatric beds -- but these are needed primarily in rural areas. Mercy Medical Center in Roseburg no longer has a psychiatric ward and residents of a huge geographic area of Eastern Oregon are also without such services.
In the Portland area, leading hospital systems have opened the Unity Hospital on the site of the old Portland State Hospital.
A large inpatient facility is the most expensive method of delivering mental healthcare, and advocates say it inevitably would drive up the cost of health insurance for employers and individuals as well as taxpayers.
Like the Oregon State Hospital in Junction City, federal Medicaid funds could not be used for the proposed Wilsonville hospital. Just three years into its operation, Gov. Kate Brown has already proposed closing the Junction City hospital, which has become a drain on state coffers and must be funded entirely through the general fund, with no assistance from the federal government, unlike other mental health programs.
Both Disability Rights Oregon and NAMI criticized the construction of the state mental hospital in Junction City, and supported the late Sen. Alan Bates’ alternative proposal to build a network of 16-bed inpatient facilities throughout Oregon, to complement increased funding for community mental health and crisis intervention.
However, Joondeph said the Junction City hospital will likely stay open for the foreseeable future for the same reason it was constructed in the first place -- it’s a great source of jobs for Lane County and the state doesn’t yet have much else to fall back on.
Reach Chris Gray at [email protected].
