Lawsuit looms at state hospital

From the Salem Statesman Journal, March 21 2009

Oregon may be forced to hire hundreds amid budget crisis

Despite dramatic improvements in patient care during the past year, Oregon State Hospital still faces a potential federal lawsuit that could place it under court control, hospital superintendent Roy Orr told legislators Thursday.

“The threat of a federal lawsuit continues to hang over the organization,” Orr said during testimony before the Legislature’s Ways and Means subcommittee on human services.

Oregon State Hospital

Oregon State Hospital

Orr also told legislative budget-writers that a massive infusion of workers is necessary to rectify chronic understaffing at the 126-year-old psychiatric facility and keep hospital reforms on track.

Hospital administrators are seeking to add 958 new positions — more than half during the 2009-11 budget period, which starts July 1, and the remainder during the 2011-13 biennium.

The proposed staffing package calls for adding 540 positions in 2009-11 and carries a price tag of about $40 million.

Long-range plans call for adding a further 418 positions in 2011-13.

Total costs for adding nearly 1,000 new employees during the four-year period are pegged at nearly $125 million.

Orr and other hospital administrators said the extra staffing is required to make up for habitual short staffing, prune dangerous and costly overtime shifts by current employees, and provide the kind of patient treatment demanded by federal regulators.

“It’s not only long overdue, it’s the right thing to do,” Orr said.

Legislators asked Orr to report back with more information about hospital staffing and how it compares with similar psychiatric facilities in other states.

The hospital has hired nearly 300 employees in the past year, boosting its work force to more than 1,300.

Ultimately, legislators must decide how much general fund money to allocate for additional hospital staffing in the next two-year budget. They face a tough decision because the hospital remains under federal scrutiny, while a $3 billion state budget shortfall looms for 2009-11 — raising fears about potential cutbacks in many state programs and services.

In January 2008, the U.S. Department of Justice Civil Rights Division issued a blistering report that cited numerous flaws in patient care and conditions at Oregon’s main mental hospital.

Among the defects listed in the 48-page report: poor supervision of patients, high rates of patient-on-patient assaults, excessive use of seclusion and restraints, severe understaffing, medical errors and subpar psychiatric treatment.

The federal report shocked top state officials and legislators, prompting a flurry of reform-minded changes.

Orr, who became superintendent in February 2008, cited progress in all of the areas targeted by federal investigators.

Even so, he said, the threat of a federal lawsuit remains a daunting reality. That’s reportedly because federal Justice Department lawyers want Oregon to enter into a consent decree, which would spell out court-approved marching orders for additional hospital improvements.

Oregon lawyers and mental health officials don’t want the state-run psychiatric facility subject to federal court monitoring and enforcement action, which would crimp state authority over the institution and could prove enormously costly.

More than a year after the federal report put a spotlight on chronic state hospital problems, federal and state lawyers still have not resolved the key sticking point.

Meanwhile, the state is moving forward with plans to build a new $280 million replacement facility on the grounds of the decayed and obsolete hospital complex in central Salem. The new 620-bed facility is projected to open in 2010 and become fully operational in 2011.

EXTRA – Roy Orr’s presentation to the Ways and Means subcommittee on human services, 3 20 2009

EXTRA – Civil rights violations found at Oregon State Hospital, January 16 2008

EXTRA – Read the full DOJ report on the Oregon State Hospital.