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Hospitals appeal judge’s ruling that dismissed their case against Oregon 


Hospitals appeal judge’s ruling that dismissed their case against Oregon 

Dec 07, 2023 | 4:59 pm ET
By Ben Botkin
Hospitals appeal judge’s ruling that dismissed their case against Oregon 
The Oregon Health Authority oversees the Oregon State Hospital in Salem. Hospital systems want civilly committed patients to go to the state hospital or other long-term care facilities for care. (Oregon Health Authority)

Four of Oregon’s largest hospital systems announced on Thursday they have appealed a federal court ruling that dismissed their lawsuit alleging the state violates the civil rights of Oregonians with mental illnesses by giving them inadequate care. 

The four hospital systems – Legacy Health, Providence Health & Services, PeaceHealth and St. Charles Health System – filed their appeal of Judge Michael Mosman’s ruling on Monday in U.S. District Court in Portland.

The case could determine the outcome for hundreds of people every year who need intensive mental health care in a residential hospital like the state psychiatric hospital in Salem. There’s little room for them there because the hospital is largely tied up treating people accused of crimes who need mental health treatment to face charges. . 

The original lawsuit, filed in September 2022, alleged the Oregon Health Authority has failed to meet its legal obligation to provide adequate mental health treatment for people who are civilly committed by judges and instead warehouses them in traditional acute care hospitals that are not equipped to provide intensive and long-term behavioral health care. 

In May, Mosman dismissed the suit, saying the hospitals lacked the standing to bring claims forward on behalf of civilly committed patients.

The hospital officials said this week in their statement that they were disappointed in the dismissal because the case was filed “to advocate for the right of people with mental illness to receive treatment in the most appropriate setting and to hold the state accountable for its legal responsibilities to those individuals.”

A spokesperson for the Oregon Health Authority, which oversees the Salem psychiatric facility, declined to comment because the matter involves pending litigation.

The hospital officials said the Oregon Health Authority is violating the constitutional rights of civilly committed individuals because they don’t receive appropriate care to recover while in traditional hospital settings. Patients stay in hospitals for weeks or months without a treatment plan for long-term mental health needs. In appropriate mental health treatment facilities like Oregon State Hospital, patients would get the care they need, the hospital systems said.

At Portland’s Unity Center for Behavioral Health, one civilly committed patient stayed for 224 days, and half of the others have been there for more than 30 days. The hospital, which is run by Legacy with backing from Kaiser Permanente, Adventist Health and Oregon Health & Science University, is the state’s only mental health hospital besides the one in Salem but it’s focused on emergency and short-term care. 

The other hospital systems have civilly committed patients who stay longer than 120 days, even though they are designed to care for patients an average of seven to 10 days.

“Acute care hospitals are simply not designed to provide long-term care,” said Melissa Eckstein, president of Unity Center for Behavioral Health. “These patients should be in specialized long-term care facilities, such as secure residential treatment facilities or the Oregon State Hospital, where they receive levels of care designed for step-down and long-term treatment care needs.”

Oregon has too few options for people who need residential mental health care, and the state hospital is perpetually full as it struggles to treat patients who are facing criminal charges. A court order mandated deadlines for so-called aid-and-assist patients to enter and leave the facility. Civilly committed patients need similar care to ensure they don’t harm themselves or others.

Under state law, people can be civilly committed for involuntary treatment when they pose a danger for up to 180 days. Each year, more than 500 people with severe mental illnesses are civilly committed to the Oregon Health Authority.

UPDATED at 2:25 p.m. on Thursday, Dec. 7, 2023 with a response from the Oregon Health Authority.