Oregon State Hospital chief addresses federal team

Oregon State Hospital Superintendent Roy Orr outlines steps the hospital has taken to improve patient care and conditions during his opening remarks to a team sent to Salem by the U.S. Department of Justice.

Oregon State Hospital Superintendent Roy Orr outlines steps the hospital has taken to improve patient care and conditions during his opening remarks to a team sent to Salem by the U.S. Department of Justice.

From the Salem Statesman Journal, July 27 2009

Review under way by DOJ concerning care, conditions

Federal investigators arrived Monday at the Oregon State Hospital, launching a fresh, week-long review of patient care and conditions at the much-criticized psychiatric facility in Salem.

The visit by U.S. Department of Justice officials to the 126-year-old hospital started shortly after 9 a.m.

Nearly a dozen members of the federal team took designated seats at a large table in the Brooks Conference Room — named for retired state hospital superintendent Dean Brooks.

The federal guests included a handful of U.S. DOJ attorneys and an equal number of mental-health experts employed by the agency.

Seated on the opposite side of the table were Oregon team members, including state hospital administrators, clinicians, nursing leaders, outside mental-health consultants and lawyers with the Oregon Department of Justice.

Facing the feds, hospital Superintendent Roy Orr gave a 30-minute summary of steps taken to improve patient treatment, safety and living conditions.

After Orr’s opening remarks, the Statesman Journal was asked to leave the meeting. As dictated by the U.S. DOJ, the rest of the week-long review has been deemed off-limits to press coverage.

“It’s an ongoing investigation, and our investigations are never really done in the public light, simply because of the nature of law enforcement,” Justice Department spokesman Alejandro Miyar said Monday. “The other rationale is that there are privacy implications concerning the patients. So that really just doubles down the aspects.

“When the matter has been resolved, we communicate as much as we can in terms of giving all the information that is fit for public consumption. That’s been the practice of the department through different administrations for many, many years.”

The initial U.S. DOJ visit to the Oregon State Hospital occurred in November 2006. More than a year later, in January 2008, the agency issued a damning report that criticized nearly every facet of the institution.

The 48-page report put Oregon officials on notice that the feds could sue the state over alleged massive violations of patients civil rights linked to subpar treatment and unsafe conditions.

Oregon officials launched efforts to fix the hospital’s flaws even before the blistering federal report was made public.

In August 2007, the hospital adopted a Continuous Improvement Plan, a thick document that became the framework for ongoing hospital improvements.

As it stands, about 35 percent of the 216 tasks outlined in the multi-year improvement plan have been accomplished, according to Orr’s report. By December, the hospital predicts that 69 percent of the improvements will be completed.

Orr rattled off various signs of hospital progress, including steep reductions in staff use of seclusion and restraints to control unruly patients, creation of new treatment malls designed to expand patient therapy and activities, and opening of six remodeled cottages as transitional homes for 36 patients nearing their discharge dates.

Decades of legislative neglect spawned abysmal conditions at the state hospital. However, Orr told the federal team that state lawmakers have made the hospital a top priority in recent years. He said state spending gradually is bolstering the hospital’s chronically thin staffing levels and will pay for building two new state-of-the-art psychiatric facilities.

Among the funding highlights mentioned by Orr:

    – Lawmakers have greenlighted spending $458 million to build two new hospitals to replace the existing facility. A 620-bed hospital in central Salem is scheduled to partially open in late-2010 and become fully operational in 2011. A 360-bed hospital is scheduled to open in Junction City, about an hour’s drive south of Salem, in 2013.

    – Since the federal agents’ initial visit in November 2006, the hospital has hired 293 new employees. Plans call for adding 540 more employees in the 2009-11 budget period, which started July 1.

    – The hospital’s $324 million budget for 2009-11 amounts to a 31 percent increase over the $248 million budget for 2007-09.

As hospital officials began showcasing reforms to federal investigators Monday, two mental-health advocates contacted by the Statesman Journal expressed doubts about the hospital’s touted improvements.

“Patients and family members and staff people aren’t saying that there’s anything different,” said Jason Renaud of the Mental Health Association of Portland. “There’s not a whole lot that I can see as an outside but close observer of the hospital that would show me that there’s been any changes.”

Beckie Child, president of Mental Health America of Oregon, said the hospital deserves credit for curbing the use of patient seclusion and restraints. However, she’s skeptical about whether marked progress has been made in many other areas.

“I talk to a number of state hospital employees who feel that the changes being made are smoke and mirrors,” Child said.

EXTRA – Superintendent Message: Update on USDOJ Return Visit to OSH, July 2 2009 (PDF)
EXTRA – the Oregon State Hospital staff newsletter, July 2009 (PDF)
EXTRA – The Oregon State Hospital’s continuous improvement plan, July 17 2007
EXTRA – Tarrytown Tattler, July 1943 – a Oregon State Hospital patient-written newsletter (7 MB PDF)