State hospital must produce data on court-ordered admissions, says outside expert report


As part of a short-term plan agreed to by the state, Disability Rights Oregon and Metropolitan Public Defender following a settlement in December, the state hospital will also have to revise its admission and discharge process. of patients to allow more bed space.

(Amanda Loman/Salem Reporter)

By spring, Oregon State Hospital will have to produce data showing progress in admitting people with mental illness on time for court-ordered treatment, according to a report by an outside expert brought in by the state to solve the hospital’s capacity problems.

The hospital will have to stop prioritizing admissions of “helping and assisting” patients – people with criminal charges who have been unable to help and assist in their own defense due to mental illness or of a disability – compared to patients convicted, except for insanity. It should also avoid keeping patients in hospital longer than necessary or legal.

The Jan. 30 report is one of two to be released by Dr. Debra Pinals, clinical professor of psychology and director of the University of Michigan’s law, psychiatry, and ethics program.

The state contracted with Pinals as part of a temporary settlement that the state, the Oregon disability rights group and the Metropolitan Public Defender agreed to Dec. 10 after a legal battle over 19 years on delayed admissions.

Pinals is tasked with coming up with a short- and long-term plan to resolve the staff crisis at the public hospital so they can comply with judges’ orders to admit patients. Court documents showed that several people who would otherwise have had to be treated at the state hospital were instead waiting in county jails. Hospital administrators argued in court that it did not have the resources to accommodate all the people the judges were ordering to admit.

The state hospital is caring for about 500 Oregonians with mental illnesses and disabilities who have been court-ordered to receive treatment. People unable to understand the criminal charges against them or help in their own defense are supposed to receive treatment in hospital, which allows them to participate in the criminal justice system and understand their legal rights and responsibilities.

All parties involved in the settlement have agreed to several short-term actions based on Pinals’ recommendations, including speeding up discharge processes for patients who do not need hospital care, coordinating admission lists between patients convicted except for insanity and aiding and helping patients shorten overall jail sentences for both, and using the data to monitor hospital compliance with court orders.

Its recommendations for a long-term plan are expected by April 29. Disability Rights Oregon and OHA will then meet and decide whether or not to settle. If they don’t reach a settlement, they will return to court to see if the state should be ordered to follow the recommendations.

By Thursday, the Oregon Health Authority must submit a progress report to Pinals outlining what the hospital is doing to prevent or reduce the number of hospital admissions of patients “who can be clinically served in a level less medically intensive care”, as well as the ways in which he has funded other community resources for people who are being restored to where they are fit to stand trial.

“Long-term compliance with court orders and the Constitution will require bold action by the state hospital and policymakers,” KC Lewis, general counsel at Disability Rights Oregon, wrote in a statement. “Let’s be clear, at the moment we are still going in the wrong direction: the number of monthly referrals to the public hospital has more than doubled in the last decade and continues to increase every month. The only real path to compliance is for the state to invest in community resources for people with mental illness and divert more people with mental illness from the criminal justice system.

The public hospital was unable to comment at the time of publication.

State judges have found the hospital and the Oregon Health Authority, its parent agency, in contempt six times in the past three years for failing to comply with their orders.

The contempt findings indicate that the state hospital failed to follow orders from Jackson and Washington county judges to admit people to Salem Hospital.

Seven contempt proceedings initiated in the past four months remain open, including six in Marion County. Judges use contempt proceedings to enforce court orders that have not been complied with. Contempt isn’t considered a crime under Oregon law, but can result in fines and jail time for those who don’t comply with judges’ orders.

By March 1, the parties will develop a data dashboard showing progress in complying with judges’ orders to admit patients. The data should be distributed “between entities” by April 1, according to the report. The OHA will consider whether additional personnel are needed to create the dashboard and, if so, seek funding from the state legislature.

To ensure that patients convicted except for insanity and help and assist patients waiting around the same time to be admitted from prison, the state hospital will have to prioritize the admission of those convicted , except for insanity, at its Salem campus. The hospital has previously said it must prioritize patients on mental health treatment prescriptions to help them help and assist in their own defense. A 2002 federal order required the hospital to admit help and assist patients within seven days.

The hospital will then need to assess whether patients should be moved to its Junction City campus to free up beds in Salem. In November, a new 24-bed unit opened on the Junction City campus, and another 24 beds are expected to open early this year.

According to the report, some state courts and community mental health programs are not following state laws requiring that aid and assistance to patients who no longer need hospital care be referred.

The state hospital and OHA are to review inpatient discharge processes and, by March 3, present the review to the Multi-Function Resource and Vacancy System Improvement Team. occupation OSH, a recent effort to get out patients who no longer need the hospital. level care. The review will also be presented to Pinals and parties involved in the settlement with the goal of implementing a new protocol by March 14, according to the report.

The report says the OHA has proposed legislation that would allow counties to be billed for patients who no longer need hospital care.

The state hospital is trying to work with counties housing patients on the “ready to place list,” meaning they are ready to return to their communities, according to the report.

“Everyone on the ‘Ready to Place’ list is occupying a bed at the state hospital that could be immediately released for someone who really needs hospital care but is instead in jail,” Lewis said.

The state Department of Justice will assess cases filed statewide on behalf of the state hospital if it believes state courts or community mental health programs are not following the law.

“This report is a good first step, but there’s a long way to go before these issues are resolved,” Lewis said. “It will take the commitment and creativity of all parties involved, as well as the support of policy makers to solve this problem.”


State hospital gets outside help admitting mentally ill people on judges’ orders

State hospital embroiled in contempt proceedings for failing to admit sentenced mental patients for treatment

Contact journalist Ardeshir Tabrizian: [email protected] or 503-929-3053.

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