SALEM, Ore. – Oregon State Hospital’s operations remain the focus of a federal case over timely admissions to ensure people are treated before they are prosecuted.
The long-running case was heard again Monday in U.S. District Court in Portland, with a judge hearing lawyers from Oregon hospitals, district attorneys and disability rights about a court order that required Oregon State Hospital to keep patients facing criminal charges within a prescribed period of time so that they can assist in their defense. These patients are referred to as “Aid and Assist” cases.
Prosecutors are unhappy with the order, as are hospitals treating people with psychiatric illnesses. Both sides brought their cases before US District Judge Michael Mosman on Monday, who signed the order on September 1.
It allows up to 90 days of treatment for people charged with misdemeanors, six months for nonviolent crimes, and one year for violent crimes. After that, the state psychiatric hospital has to release the patients into the care of their districts.
Mosman indicated that he would clarify his appointment to reflect some of their concerns.
Districts, prosecutors and hospitals have all raised concerns about the order’s potential impact on public safety and mental health treatment for those involved in the criminal justice system.
They want Mosman to reconsider the order. At the same time, they recognized that Oregon needs solutions to the simmering problem of suspects serving months or more in prison.
Billy Williams, a former U.S. Attorney and attorney representing Oregon District Attorneys in Clackamas, Marion and Washington counties, called for “practical solutions” for Oregon to “fix a broken system.”
“What an opportune time for the state of Oregon to actually do something to solve the problem,” Williams said, noting that the state has a new governor and will have new leadership at the Oregon Health Authority that will psychiatric hospital supervised. The agency’s director and its head of behavioral health dismount.
“Where all these countries can still be seen, but the reality is how I see that, we can argue for years what the problems are — we can do that — but we can also find solutions,” Williams said.
He added: “I’m not interested in finger pointing; these efforts are meaningless to me.”
At the heart of the lawsuit is a 20-year-old lawsuit. focused on the plight of people facing criminal charges and in jail for not receiving prompt treatment. A court order in that case ordered the hospital to admit them within seven days after a judge determined they needed psychiatric treatment to help their defense.
The number of people waiting in prison to go to Oregon State Hospital after a court order has been staggering. There are currently about 90 people, according to disability rights attorneys Oregon and Metropolitan Public Defender.
Disability Rights Oregon, then called the Oregon Advocacy Center, filed the original lawsuit with Metropolitan Public Defender, a not-for-profit law firm that contracts with Oregon to provide public defense services. They returned to court in 2019 after the state failed to consistently comply with the order.
In December 2021, the court appointed an external neutral expert to make recommendations to address the hospital’s capacity issues. Subsequent recommendations included new schedules for treating patients.
The external expert Dr. Debra Pinals, director of the Law, Psychiatry and Ethics program at the University of Michigan, recommended – among other reforms – tighter timeframes for restoring people to competence.
Groups join the case
In response to the Sept. 1 order, various groups intervened – or joined the case, including hospitals and prosecutors who feared people facing criminal charges would fall through the cracks if they didn’t receive proper treatment and were in Districts would return that lack resources to care for them.
Thomas Carr, Washington County’s lead attorney, said the county is concerned the order does not provide discretion to hold people past the deadline if they still need hospital treatment.
While most people are treated in 180 days, he said, “there are still people who need treatment after that” who are discharged too soon. Carr said he was concerned that dangerous suspects could be released and pose a threat to the community.
Portland-area hospitals also want the order changed.
Eric Neiman, an attorney for Legacy Health, PeaceHealth and Providence Health & Services, said it doesn’t address the needs of the state’s population of civic-minded people who need treatment in a secure, residential treatment facility so they don’t harm themselves or others. Neiman said the focus on help and support cases limits opportunities for volunteers to get the care they need at the state hospital. Many civic workers who don’t make it to Oregon State Hospital end up in other hospitals, sometimes for long distances. Hospital officials say this is taxing their systems.
In recent months, hospitals have taken the unusual step of suing the Oregon Department of Health when the agency refuses to send patients to the state hospital in civil cases a report in The Lund Report.
About 500 people volunteer in Oregon civil rights each year, Neiman said.
Neiman said hospital officials felt their interests were never presented to the court, calling it a “remarkable omission.”
Emily Cooper, an Oregon disability rights attorney, said it’s wrong to say the plaintiffs are trying to help the aid and relief community at the expense of civic-engaged patients.
The Advocacy Watchdog “has a reputation for representing the issues of all people with disabilities in Oregon,” Cooper told the court.
Cooper noted that the settlement agreement — and the September 1 order — came about after the parties agreed to work with Pinals if waitlists didn’t decrease.
“We didn’t see the needle shift,” Cooper said.
After the hearing, Cooper told the Oregon Capital Chronicle that while the issue is far from resolved, the fact that the judge is including the expert-recommended compliance plans in the order — and the state is not opposed to it — is a big problem step forward.
“This is significantly different than three years ago,” Cooper said.
Mosman said he would work on refining his order, such as making it clear that someone who is able to attend his criminal trial and returns to prison can return to hospital for treatment if he needs further treatment. He thanked the parties for their willingness to speak openly on this issue.
“I know it’s difficult for lawyers to look a judge in the face and say you’re wrong,” Mosman said.
The long-running case, which brought defendants and Oregon State Hospital back to court, first appeared in the Oregon Capital Chronicle.