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Oregon hospitals try to revive mental health lawsuit, say state violated patients’ rights

Four of Oregon’s largest hospital systems are trying to revive a lawsuit that accuses the state of failing to provide its residents with adequate mental health care.

The hospital groups — Legacy Health, Providence Healthy & Services, PeaceHealth and St. Charles Health System — sued Oregon Health Authority and the Oregon State Hospital last September, alleging that the two entities had failed to make room for patients admitted through civil commitments, who aren’t accused of a crime but found to be a danger to themselves or others but not charged with a crime.

The health systems say their medical hospitals are forced as a result to provide mental health treatment they’re not equipped to give.

In May, U.S. District Judge Michael W. Mosman dismissed the lawsuit after the state hospital agreed to expand its criteria for admitting civilly committed patients. Shortly thereafter, the hospitals tried to get Mosman to reconsider the suit, but he denied their request.

In an appeal filed Monday, the hospitals said that Oregon Health Authority has “failed to fulfill” its responsibility to patients with mental illness.

“Rather than ensure and provide timely access to appropriate treatment, OHA has adopted a practice of abandoning civilly committed patients in community hospitals,” attorneys for the hospitals wrote in the appeal, “even though many patients have no medical need to be there.”

Larry Bingham, an Oregon Health Authority spokesperson, declined to comment on pending litigation.

The state psychiatric hospital’s failure to admit those patients harms both the patients and the medical hospitals where they end up instead, the appeal said. They said community hospitals are not designed or equipped to provide long-term mental health treatment, meaning patients don’t get the help they need and divert resources from other patients.

Melissa Eckstein, president of the Legacy-owned Unity Center for Behavioral Health, said that patients should instead be in specialized long-term care facilities, such as secure residential treatment facilities or the Oregon State Hospital.

Though filed separately, the case overlaps with another ongoing lawsuit filed by watchdog group Disability Rights Oregon.

A court order stemming from the advocacy group’s suit requires the state hospital to admit aid-and-assist patients, or those charged with a crime but found unable to defend themselves, within seven days. The state hospital has struggled to meet that deadline for years, and many patients languished in jail for months while awaiting mental health treatment.

Last year, Mosman, the federal judge, imposed strict time limits on how long those patients could remain in the state hospital in order to quickly clear the way for new ones.

That decision faced mounting opposition over the next few months. Several district attorneys, counties and judges filed to join the case, saying the expedited timelines for releasing patients could put their communities in danger, as patients might be released before their treatment was complete.

Disability Rights Oregon attorney Tom Stenson said the community hospitals’ lawsuit reveals something of a conflict: While the hospitals say they’re acting on behalf of patients, they’re also pushing to get them out of their emergency departments.

But because there aren’t enough residential treatment facilities to meet the state’s needs, Stenson said, there’s currently no viable alternative to hospital care. Until that’s fixed, he said, some patients aren’t getting the treatment they need.

“The fundamental problem is that we have a system that’s inadequate to serve the needs of people with disabilities,” he said. “Not enough housing, not enough community mental health support. Not enough overall resources.”

A judge in Pierce County, Washington, recently ruled against that state in a similar case, ordering its Department of Social and Health Services to immediately evaluate patients with behavioral health conditions.

Prosecutors from 22 counties in Washington had sued the agency over its failure to evaluate and treat criminal defendants whose charges were dropped because they were mentally unable to understand the charges against them.

—Jayati Ramakrishnan;

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