PORTLAND, Ore. — Three of Oregon's largest hospital systems are suing the state over its alleged lack of adequate mental health care, which they say has forced the hospital systems to house patients in need of long-term mental health treatment for months.
Providence Health & Services, Legacy Health and PeaceHealth say in the lawsuit the Oregon Health Authority has forced them to provide care they're not equipped to give for patients who should be civilly committed to psychiatric institutions such as the Oregon State Hospital.
The state psychiatric hospital's ongoing capacity crisis, along with a recent court ruling that strictly limits who can be admitted, has left community hospitals with nowhere to send patients in need of mental health treatment. Hospital representatives say they have been forced to treat those patients long-term.
"The necessary components for safe and effective treatment provided at long-term care facilities — such as security, private rooms, kitchens and physical exercise — are not feasible at hospitals that are also responsible for meeting the short-term acute care needs of their communities," a joint statement for the facilities read. "As a result, patients left in these environments by OHA do not receive needed care and, in many cases, decompensate back to unstable conditions."
State hospital spokesperson Amber Shoebridge didn't specifically comment on the lawsuit.
"Oregon Health Authority and Oregon State Hospital remain focused on the care of the hospital's patients and supporting them on their road to recovery as they search for a new path forward," Shoebridge told KGW.
OHA did not comment on the lawsuit itself.
The hospital systems want the health authority to start admitting civilly committed patients again at the Oregon State Hospital, although a federal court order issued last month says they cannot.
Trying to stem a capacity crisis at the hospital, a judge ruled in August that the hospital must only admit patients accused of a crime but found unable to aid in their own defense, or those found guilty except for insanity.
Melissa Eckstein, president of the Unity Center for Behavioral Health, which is part of Legacy Health, said there is 'tremendous backup' for mental health services as a result of the state's policies, which includes emergency room waits and difficult securing outpatient services for patients.
"Our community hospitals, which provide acute inpatient treatment for behavioral health, are meant to stabilize individuals and then move them to the next layer of care that they need," she said. "When we can’t do that, those beds are not accessible for people who are in acute crisis."
"Civilly committed" patients are those who have been deemed a danger to themselves or others, and whom a judge has ordered for involuntary treatment at the state hospital.
Those patients are often initially committed to an acute care hospital for short-term medical treatment only. A civil commitment can last up to six months.
The Oregon State Hospital stopped admitting most civil commitment patients in 2019,even though about 500 people are committed in the state each year.
As a result, the number of civil commitment patients at the state hospital dropped from hundreds of people per month to about a dozen, according to recent OSH reporting.
Following federal court rulings, OHA has prioritized mental health patients who are facing criminal charges or are considered guilty except for insanity.
The hospital systems say this practice violates the civil rights of civil commitment patients, leaving hundreds of people in community hospitals that aren’t designed for long-term care.
"We want to end the cycle of people not being able to get the care they need in the moment they need it, and to advocate for having a full continuum of care regardless of where people are in their crisis," Eckstein said.
The lawsuit claims the state has known for years about OHA’s failure to provide “appropriate and legally required treatment to civilly committed individuals” – referencing a 2017 study that found limited acute care beds and emergency room backups.
The hospitals want a federal judge to rule that OHA’s practices towards civil commitment patients are unconstitutional and for the state to assume care of long-term civil commitment patients.
