Governor rejects Oregon State Hospital oversight

From the Salem Statesman Journal, April 9, 2010

Anna Richter Taylor is wrong – mental health services are NOT a priority for Governor Ted Kulongoski. Under his watch and with his approval, state legislators mis-directed the future of funding for desperately needed outpatient services to unneeded and unwanted hospitals. This misdirection satisfies public employee unions and is promoted by the state as a jobs program. Further, it misinforms by indicating the problems at the Oregon State Hospital can be resolved with bricks and mortar. This is utterly false.

Our impression is it’s the state and it’s employees recalcitrance which causes “prolonged monitoring, expensive legal bills and sluggish reforms.”

Gov. Ted Kulongoski doesn’t intend to heed calls from mental-health advocacy groups, all urging him to enter into a court-enforceable agreement with the U.S. Department of Justice for terms of better patient care at the Oregon State Hospital.

Ted Kulongoski

Ted Kulongoski

Advocates say federal court oversight of the state hospital is necessary to hasten reforms and stop a pattern of patient abuse and neglect at the 127-year-old mental institution in Salem.

Though Kulongoski “agrees with advocates that the hospital has been neglected for too long,” he won’t enter into any agreement with the U.S. DOJ that would result in federal court oversight of the state hospital, Anna Richter Taylor, the governor’s spokeswoman, said Monday.

“The bottom line is the court-enforced agreement adds another layer and hurdle to our efforts to improve patient care at the state hospital,” she said.

Once a state enters into a court-enforceable agreement with the U.S. DOJ, a court-approved monitor keeps tabs on mandated improvements. The process can lead to prolonged monitoring, expensive legal bills and sluggish reforms, Richter Taylor said.

“In looking at other states, like Georgia and Hawaii that have had federal court oversight of their hospitals, their outcomes have actually been slower, not faster, and they’ve been very, very costly because of litigation,” she said.

Mental-health advocates reacted strongly Monday to the governor’s rebuff of their request for federal court oversight of the state hospital and the reasons against it cited by Richter Taylor.

Leaders of Disability Rights Oregon, NAMI Oregon and Mental Health America of Oregon said in a joint statement: “We are disappointed that the governor does not see the need for a new direction. If there is a bottom line to the tragedies at OSH, it is that the change is not coming fast enough.

“The costs of litigation occur only if Oregon fails to obey a court agreement. Georgia and Hawaii didn’t do that but instead chose to fight all the way …We say: make the agreement and stick to it.”

The three advocacy groups went public with their request to Kulongoski in the wake of Friday’s release of a critical report examining the death of a state hospital patient.

Capping a five-month investigation, the state Office of Investigations and Training concluded that the hospital failed to provide Moises Perez, a longtime OSH patient, with adequate medical care.

Perez, 42, was found dead in his hospital bed Oct. 17.

Investigators ruled the evidence was inconclusive about whether Perez was neglected the day of his death. But it found the hospital negligent in failing to provide him with proper care for chronic medical problems that led to his death.

Advocates described the case as all-too-familiar.

“Unfortunately, what happened to him is not outside the ordinary in the hospital in terms of the level of attention and care that people receive,” said Bob Joondeph, executive director of Disability Rights Oregon.

A court-enforceable agreement voluntarily entered into by the state, or a lawsuit brought against Oregon by the U.S. DOJ, are the only ways to hold state officials accountable for real reforms, advocates said.

“At present time, there is no penalty, there is no enforcement mechanism, to make sure goals are met,” Joondeph said.

Chris Bouneff, executive director of NAMI Oregon, a chapter of the National Alliance on Mental Illness, said: “The truth of the matter is, they don’t want to be forced into actually making changes. I think our only hope now is that the Department of Justice files suit and forces them to do it.”

Richter Taylor said Kulongoski supports changes announced Friday by leaders of the state Department of Human Services, including the forced resignation of hospital superintendent Roy Orr. Orr was ousted by Human Services Director Bruce Goldberg and Addictions and Mental Health Division chief Richard Harris.

“The governor does support Dr. Goldberg’s decision to change the superintendent and for additional staff (at OSH), such as hiring a compliance officer and bringing in an objective consulting team to help address the cultural issues within the state hospital,” she said.

Kulongoski “has been and continues to be committed to working closely with the U.S. Department of Justice to address the quality of patient care,” Richter Taylor said.

The U.S. DOJ has been investigating patient care and hospital conditions since mid-2006.

Bouneff blasted Kulongoski for not doing enough to reform the state hospital.

“This governor has had eight years to change this institution,” he said. “Clearly, this is not a priority for him, and the patients in this institution are not a priority for him.”

Richter Taylor defended Kulongoski’s OSH track record.

“I don’t think there’s a question about the governor’s commitment,” she said.

During Kulongoski’s tenure, the state hospital has added hundreds of new employees, and the state now is moving forward with a $458 million plan to build two new psychiatric hospitals to replace the existing facility, which was deemed obsolete and unsafe by state-hired consultants in 2005.

“If you look at his record, it was under his administration that changes really started to be made at the state hospital,” Richter Taylor said. “Today’s hospital is not the same one it was a few years ago. Recognizing that there are still many, many improvements that need to be made, tomorrow’s hospital will be even better.”

READ – Advocates want oversight at Oregon State Hospital, Oregonian, April 6, 2010
READ – Advocates call for increased federal oversight at Oregon State Hospital, Oregonian, April 6, 2010