Dismantling of the Oregon State Hospital’s historic J building began April 6. A federal report about conditions at the hospital prompted major changes, including plans to build a new facility.
Federal investigators plan to return to the Oregon State Hospital next month for a fresh review of patient care and conditions.
Eighteen months ago, the U.S. Justice Department’s sharp critique of Oregon’s main mental hospital shocked state officials and spurred reform-minded changes.
A team will examine patient care and conditions as state and federal lawyers work on an agreement for reforms
Federal investigators plan to return to the Oregon State Hospital next month for a fresh review of patient care and conditions.
Eighteen months ago, the U.S. Justice Department’s sharp critique of Oregon’s main mental hospital shocked state officials and spurred reform-minded changes.
A team from the federal DOJ is scheduled to arrive at the Salem psychiatric hospital July 27 for a weeklong evaluation, hospital superintendent Roy Orr said this week in an e-mail to staffers.
“Because of all the changes and improvements we have made since the last review, this will be a welcome opportunity to showcase the good work all of you do,” Orr wrote.
As the hospital gets ready for another review, state and federal lawyers are trying to hammer out an agreement for ongoing hospital reforms.
At stake is a potential agreement between the two sides, known as a Memorandum of Understanding, that would spell out required improvements during the next two to four years.
Oregon’s latest counter-proposal, outlined in a May 15 letter to the federal agency, shows that the two sides still differ on key issues, including how fast reforms should occur and whether an independent monitor should be hired — at state expense — to track hospital compliance with the agreement.
The Statesman Journal obtained the 11-page letter this week.
Here’s a look at sticking points that remain in the negotiations:
Reform schedules
The federal DOJ proposes a two-year timeframe for additional hospital improvements.
The state wants four years to achieve the results.
Writing to the federal agency, Micky Logan, Oregon’s Senior Assistant Attorney General, said four years is necessary because of planned construction of two new hospitals designed to replace the existing facility, which has been deemed obsolete and unsafe by state-hired consultants.
“Given that the construction of new OSH facilities will not be completed in two years, it is not realistic for OSH improvements to be completed in two years,” Logan wrote. “Oregon intends to continue to improve OSH and hopes to have one of the best psychiatric hospitals in the nation by 2013.”
A new 620-bed hospital in central Salem is scheduled to fully open in 2011. A 360-bed hospital in Junction City is scheduled to open in 2013.
Budgeted costs for the two new facilities total $458 million.
Potentially, the state might not need four years to accomplish improvements mandated by the Memorandum of Understanding, Logan wrote.
“If Oregon feels OSH has satisfied the MOU before the four years is up, Oregon will ask the USDOJ to come back for a final tour,” she wrote.
Monitoring
The federal DOJ wants Oregon to pay for an independent monitor to determine whether the state “is in substantial compliance” with the Memorandum of Understanding.
The state doesn’t want to foot the bill.
“While Oregon recognizes that your office must obtain information regarding Oregon’s efforts at voluntary correction, Oregon is unwilling to pay the costs of your office’s monitoring efforts,” Logan wrote.
Instead of an independent hospital monitor, the state proposes to provide the federal agency with regular status reports and other documents.
Logan’s letter lists reports and data the state would deliver to the federal DOJ. Among them:
-Records to verify the hospital has taken actions described in the status reports.
-Notification within 24 hours of any patient death or severe injury.
-Final reports of investigations into allegations of patient abuse or mistreatment by the state Office of Investigations and Training.
-Written answers within 30 days to all questions posed by the federal DOJ concerning Oregon’s compliance with the Memorandum of Understanding.
Federal court involvement
The federal DOJ favors this approach: should the independent monitor determine after two years that Oregon hasn’t complied with terms of the Memorandum of Understanding, it wants the document automatically entered into federal court as a consent decree.
Under this scenario, the federal court would monitor the state hospital and hold it accountable for reforms.
Oregon officials strongly oppose legal action that could lead to prolonged and costly federal court oversight of the hospital.
“As you know, throughout this case, Oregon has been clear that it would never agree to the filing of a complaint or a consent decree,” Logan wrote in her recent letter.
If a Memorandum of Understanding is struck, Oregon officials favor using mediation to resolve any disputes arising between the state and the federal agency concerning state compliance with the agreement.
State lawyer cites progress
Logan’s letter outlines numerous steps the state has taken to improve patient care and conditions at the psychiatric facility.
For instance, she noted that 312 new hospital employees were hired last year; four remodeled cottages were converted into transitional cottages for patients preparing to leave the hospital; staff use of seclusion and restraints on patients has declined; and new treatment malls provide patients with better treatment.
“Given that both sides recognize that Oregon has made significant progress in addressing concerns identified by the USDOJ, we believe that further progress will not be facilitated by the counter offer from DOJ,” Logan wrote. “With that in mind, Oregon urges the USDOJ to accept Oregon’s counter-proposal.”
READ – Oregon’s Letter to the Federal Department of Justice, June 2009