Some defendants unable to assist in their defense will no longer go to Oregon State Hospital

A Portland federal judge ruled Monday to change his September order to limit some Oregon State Hospital patient stay times.

The decision follows months of conversations with county officials, behavioral health system representatives and patient advocates.

The amended order by U.S. District Court Judge Michael Mosman is effective within 30 days. It will allow more time to plan for patient release from the hospital as well as change the type of patients who are sent to the hospital.

Counties will have a minimum of 60 days to coordinate community treatment options for patients who are released from the hospital but still unable to aid their lawyer in their defense. Judges also will have more time to schedule post-release hearings.

Hospital clinicians may have extra time to provide care to patients, too. And defense lawyers can petition for patients charged with violent felonies to stay at the hospital longer.

Right now, individuals with misdemeanor and felony charges who are unable to aid their lawyer in their defense are put on a waiting list for a state hospital bed. With the amended order, individuals charged with non-person-centered misdemeanor charges will no longer go to the state hospital.

County court judges can choose to dismiss the individual’s charges, have them stay in their counties for community restoration or send them to a residential treatment facility to receive care.

“That's really what's so remarkable about this proposed order, is it shows a true consensus of system partners about what patients should go to the state hospital, how long they should be there, and what should the discharge process look like,” Emily Cooper, legal director of Disability Rights Oregon, an advocacy organization, said before the ruling was issued.

Mosman's September order required the hospital to release aid and assist patients with misdemeanor charges within 90 days of admitting, those with felony charges within six months, and those with “violent felony” or “person-centered” charges within a year. Patients were to be discharged to counties with 30 days' notice to create a plan for care after their release.

Disability Rights Oregon asked Mosman for the order due to concerns that defendants were spending too long waiting in county jails for state hospital beds.

County administrators, however, said the order created an array of problems for county behavioral health systems, which were not able to coordinate care for the influx of defendants with behavioral health conditions.

Marion County District Attorney Paige Clarkson has said trying to care for defendants within the county poses public safety concerns. Clarkson was not available for comment Monday.

Looking for a compromise

During a June 30 hearing, Clarkson told Mosman the county’s rights were incriminated by the enforcement of the 2002 Mink order.

OAC v. Mink ruled that defendants unable to aid their lawyers in their defense cannot spend more than seven days in jail while waiting for treatment.

Mosman denied Marion County’s request, saying it was untimely given the 20-year precedent of the Mink order.

“What the county said in open court was pretty concerning about really just seeing our clients as undesirable and not wanting to assume responsibility for their care and wanting them to stay at the state hospital,” Cooper said. “And that's not a moral justification for keeping someone at the state psychiatric hospital.”

For months, Disability Rights Oregon, Oregon Health Authority and county behavioral health representatives sought a compromise for amending the September order.

Disability Rights Oregon wants to prioritize patient rights, Cooper said. Any compromise must help patients.

“It has to help them get to the hospital faster, get the services they need when they're there, and get the care coordination so they can go home and stay there,” Cooper said.

Some county behavioral health systems, such as Marion County, have struggled to adapt to the influx of defendants needing community behavioral health care.

The Oregon Health Authority wants to ensure the state hospital is able to gain compliance with the Mink order. By discharging patients more quickly, they have been able to admit more defendants waiting for hospital beds.

In September 2022 there were 409 aid and assist patients at Oregon State Hospital. As of July 2023, 390 of these initial patients have been discharged back to the communities in which they were charged.

“State and local partners have worked together to reach a significant compromise that limits new admissions and addresses public safety concerns,” David Baden, interim director of Oregon Health Authority, said. “There is more work to be done and the state cannot do it alone. Thank you to our community partners who participated in the extensive mediation.”

Sydney Wyatt covers healthcare inequities in the Mid-Willamette Valley for the Statesman Journal. Send comments, questions, and tips to her at SWyatt@gannett.com, (503) 399-6613, or on Twitter @sydney_elise44

The Statesman Journal’s coverage of healthcare inequities is funded in part by the M.J. Murdock Charitable Trust, which seeks to strengthen the cultural, social, educational, and spiritual base of the Pacific Northwest through capacity-building investments in the nonprofit sector.  

This article originally appeared on Salem Statesman Journal: Judge limits who goes to Oregon State Hospital and for how long