Three Oregon Hospital Systems Sue State Over Failure to Accommodate Civilly Committed Patients

The lawsuit aims to end the warehousing of psychiatric patients in acute-care hospitals.

Three Oregon hospital systems today sued Oregon Health Authority director Pat Allen in U.S. District Court in Eugene, alleging that OHA is failing to meet its legal obligation to serve Oregonians who have been civilly committed.

Legacy Health, Providence Health & Services, and PeaceHealth jointly brought the lawsuit in federal court after PeaceHealth successfully argued earlier this year in state court that OHA could not just leave patients who had been judged a danger to themselves or to others to languish in community-based hospitals.

“Rather than ensure and provide timely access to meaningful treatment, OHA is abandoning civilly committed patients and leaving them for extended periods of time in acute care community hospitals,” the lawsuit says.

As WW reported previously, PeaceHealth sued to force OHA to take responsibility for such patients and place them either at the Oregon State Hospital or find an appropriate outpatient placement in a secure facility. Under Oregon law, civilly committed patients may be held up to 180 days to stabilize them and provide necessary treatment.

Related: A Novel Court Case Reveals Yet Another Crisis in Oregon’s Mental Health System.

About 550 Oregonians are civilly committed each year. In today’s lawsuit, the three hospital systems say that OHA’s failure to accommodate civilly committed patients is leaving “hundreds” or most in limbo, locked in highly confined spaces in acute-care hospitals where they are prevented from going outside, exercising, wearing their own clothes, or getting the care they need. They are deprived of their civil rights, the lawsuit says, and their conditions may worsen as a result of being held in an inappropriate setting.

Acute-care hospitals, such as PeaceHealth’s facilities in Eugene and Cottage Grove or Providence Portland, say they are not equipped or staffed to care for such patients, and having to allocate scarce psychiatric beds to civilly committed patients diverts resources from other patients who may need care.

The hospitals say they are not being fairly compensated for their efforts, nor are the patients being served.

“Because their rights are not being protected by the state, some patients who have severe mental illness and may be violent have been forced to stay for as long as a year at community hospitals,” Alicia Beymer, the chief administrative officer for two of PeaceHealth’s Oregon hospitals. “This is unsafe for patients, those charged with their care, and our communities.”

PeaceHealth pressed that point in the case of an individual patient earlier this year, a Lane County man who was civilly committed. The Oregon State Hospital was full and there were no available community placements, so the man ended up warehoused at PeaceHealth hospital for more than 100 days.

A Lane County judge found that violated state law, a ruling the Oregon Court of Appeals later upheld. Providence then brought similar suits for other patients, leading to the joint lawsuit today.

At the heart of the matter: overcrowding at the Oregon State Hospital, which, between its main location in Salem and a satellite facility in Junction City, can serve about 700 patients. The state hospital is designed for three types of patients: those found guilty of criminal charges except for insanity; those whose mental illness renders them unable to assist in defending themselves against criminal charges; and those who have been civilly committed.

In recent years, the number of patients in the state hospital who’ve been found guilty except for insanity or are unable to aid and assist in their own defense have crowded out those who’ve been civilly committed. Meanwhile, the number of secure psychiatric beds in the community is woefully inadequate. Compounding the complexity: a 2002 case, Oregon Advocacy Center (now known as Disability Rights Oregon) v. Mink.

Related: A Federal Judge Has Ordered the Release of More Than 100 Patients From the State’s Locked Psychiatric Hospital

The court ruled in that case that “aid and assist” patients awaiting a bed at the Oregon State Hospital could not be held in jail for more than seven days. As state officials have sought to comply with that order, while also serving those patients who’ve been found guilty except for insanity, civilly committed patients have been left out in the cold, the lawsuit says, going from about one-third of OSH patients five years ago to fewer than 5% today.

Last year, in a case brought by guilty-except-for-insanity patients, U.S. District Judge Marco Hernandez told the state t could not favor one group of patients over another, the lawsuit notes.

“If OSH cannot admit GEI patients while admitting aid-and-assist patients within the court-ordered time frame, it’s because OSH lacks the space and the funding to do so—not because the Mink order compels it to prioritize one group over another,” Hernandez wrote. “When satisfying constitutional guarantees, defendants cannot rob Peter to pay Paul.”

The plaintiffs are seeking injunctive relief—i.e., they want the court to order the state to change its practices, rather than financial compensation.

Kristina Edmunson, a spokeswoman for the Oregon Department of Justice, which represents OHA in court, says her agency is reviewing the complaint.