Portland Tribune – October 24, 2012

Yovane Muro is still in sights of police, immigration officials

When murder charges against Yovane Muro were dropped earlier this year, he technically gained his freedom.

READ – After several years in state hospital, suspect arraigned again in 2004 killing, January 2010
READ – Man accused of 2004 Forest Grove slaying ruled mentally incompetent and won’t stand trial, May 2012
READ – Legal loophole may free mentally ill man accused of murder, May 2012
READ – The $1 million murder suspect, October 2012

But Muro, who suffers from catatonic schizophrenia, is still a wanted man.

Forest Grove Police still hope to arrest Muro and county prosecutors still hope to take him to court (again) for the 2004 murder of Gilberto Vasquez Ramos in Forest Grove’s Lincoln Park. Immigration and Customs Enforcement officials, for their part, want to review his immigration status.

But none of that can happen until Muro’s mental illness abates. And given that efforts to help him regain his mental health have been fruitless for the past eight years, few expect that to change.

Muro, whose whereabouts are unknown to police, has stumbled through an expensive legal loophole and may never come out of it.

Costs continue to mount

As required by state law, Muro’s case was dropped in 2008 after he was deemed unable to aid in his own defense.

On his discharge from the state mental hospital in January 2010, he was re-arrested.

But in May, after three years of court-ordered treatment, he was again ruled unfit for trial and released.

Police suspect Muro returned to psychiatric care, but because of federal health privacy laws, law enforcement officials don’t know exactly where Muro is, and there is no guarantee they will be told if he is released into the general population. Repeated attempts by the News-Times to locate Muro or his family also led nowhere.

Muro’s case is as expensive as it is vexing for the agencies involved in investigating the brutal 2004 murder of Vasquez Ramos. Already, the state has spent in excess of $1 million treating and jailing Muro in an effort to bring him to trial.

With law enforcement stalled, Muro’s case has racked up a serious bill.

It’s difficult to say exactly how much Oregon has spent trying to take Muro to trial. But based on court records, the News-Times was able to come up with a rough estimate of the costs involved, which total $1.12 million. Here’s a conservative breakdown:

• Muro’s care at the Oregon State Hospital cost about $1,013,678.
• For the time he spent in the Washington County jail, the bill nears $64,164.
• Transportation back and forth from the jail and the state hospital cost about $8,100.
• Also, Muro was hospitalized two different times at Providence St. Vincent Medical Center in Portland, which rang up an estimated $34,815.

The actual costs are likely even higher

Based on court records, Muro was admitted to inpatient care under an aid and assist order a total of four times, for periods lasting from four months to a year and a half from September 2004 to July 2008. An aid and assist order demands that a person be admitted to the hospital and given treatment to try to restore their mental capacity to the point that they can help in their own defense in court.

Muro was also civilly committed from July 2008 until January 2010, meaning he was admitted to the hospital by court order.

However, there isn’t a similar report that lays out the exact dates of Muro’s time in the state hospital past June 24, 2008. But based on Washington County Jail records and court documents it’s possible to determine where Muro probably was. Muro stayed at the hospital for eight different periods, all of which added to the cost of his case. In 2004, care like Muro would have probably received cost $9,425 per month, but by 2012, the monthly cost of care shot up to $20,636.

Although the cost to house an inmate at the Washington County Jail is much lower than mental health treatment at the state hospital, Muro has spent significant time in jail, racking up significant costs.

Since May 2004, Muro spent nine stints in jail, ranging from five months to just three days.

Washington County Sheriff spokesman Sgt. Bob Ray said the cost per day at the Washington County jail ranged from $69 to $103 during Muro’s stays.

The Sheriff’s Office was responsible for transporting Muro from the state hospital to jail numerous times. Including the cost of gas, wear on the vehicle and the officer’s wages for the hour-long drive, each trip cost $450.

Muro was transported to Salem on the county’s dime an estimated 18 times, adding $8,100 to the total cost of his case.

Court records also show that on two different occasions Muro stopped eating and drinking while he was in jail, requiring a stay at Providence St. Vincent in Portland for dehydration and malnutrition. Records show that Muro was at St. Vincent for two days in May 2010, and then two days the following August. The Washington County Jail paid the bill, which cost about $24,600.

The most expensive part of Muro’s care was due to the extensive treatment he received at the Oregon State Hospital for his struggles with schizophrenia.

While patient confidentiality keeps Muro’s hospital records under lock and key, the proliferation of court records relating to his case give a glimpse of what kind of care he must have received at the Oregon State Hospital.

Mental illness complicates court

Dr. Christopher Lockey, director of the Oregon State Hospital’s Forensic Evaluation program, said each patient admitted under an aid and assist order has his or her own individual treatment plan. He said treatments include everything from sessions that teach patients how to deal with their mental illness to substance abuse and addiction counseling. There are also sessions that help a patient understand what their case means and how the court will proceed.

He said most patients admitted for aid and assist treatment stay from two to three months, but can stay longer if a court orders that a patient might be restored to health if given more treatment time. Hospital evaluators are required by law to do routine assessments to check a patient’s progress toward regaining their ability to face a courtroom.

Lockey also said there are cases like Muro’s where a patient is readmitted multiple times.

“There are some situations where the hospital discharges someone, but they stop treatment,” he said. “Then they just get sick again.”

Muro’s mental illness was first diagnosed as schizophrenia in one of the earliest psychological evaluations done on him following his arrest in 2004.

Muro’s case highlights the personal struggle caused by schizophrenia.

Dr. Jonathan Betlinski, assistant director of Oregon Health and Science University’s division of public psychiatry, said it’s hard to know when someone may be suffering from schizophrenia.

“The initial signs can be pretty vague,” he said. “It’s a problem with the way a person’s brain develops, but we don’t see the results of that until later in life.”

Betlinski said the disorder affects a person’s senses, and they have hallucinations, hear things that don’t exist, or believe things that aren’t true. People with severe schizophrenia have a hard time organizing or forming thoughts and struggle to bond with other people.

“You can lose your ability to navigate the world,” he said. “A part that is heartbreaking is that it can really rob someone of their ability to have relationships with other people.”

But, Betlinski said that it is rare for someone with schizophrenia to commit a violent crime.

Betlinski said about 1 percent of people over 18 has a form of schizophrenia. In most cases, other people may not even be able to tell. But, Betlinski said that for those like Muro, who have a severe case, the illness can be very debilitating.

Disease is a ‘torturous thing’

Mary Claire Buckley, executive director of the Oregon Psychiatric Security Review Board (PSRB), said that schizophrenia is one of the hardest illnesses to understand.

“Clearly schizophrenia is one of the most challenging and heart wrenching diseases,” she said. “I can’t think of a more torturous thing than hearing voices.”

The Oregon Psychiatric Security Review Board is responsible for people who are found guilty except for insanity. The board decides how long a person will receive treatment at the Oregon State Hospital or if they will serve out their sentence in another manner, like at a group home. The board also helps support people who are ready to live in society again when released from the hospital.

But the question still remains as to what happens to those who need treatment, but haven’t been found guilty of the charges brought against them, and therefore are out of the PSRB’s jurisdiction.

Donn Spinosa, who has also been charged with murder and suffers from schizophrenia, has been caught between the Washington County judicial system and the Oregon State Hospital. Spinosa’s case is similar to Muro’s. He also has never been fit to stand trial.

According to a report by Disability Rights Oregon, Spinosa was charged with fatally stabbing his wife in 1997. After three years of treatment at the state hospital, but not enough treatment to restore him to stand trial, the state dropped his case in 2000. Spinosa was civilly committed, and remained at the Oregon State Hospital for the next ten years.

When Spinosa’s term at the hospital ended, he was rearrested and charged with murder in 2010. Spinosa was then again transferred between the jail and the state hospital, depending on his mental state, before he was finally sent to the state hospital indefinitely.

Spinosa’s treatment since he was charged with murder prompted an investigation by Disability Rights Oregon.

A complaint has also been filed against the Oregon State Bar for the indefinite order that put Spinosa in the hospital, citing that the order has no legal authority.

In the report, Disability Rights Oregon proposed legislation that if taken seriously could potentially be a solution for Muro as well. The proposed change to law would require an evaluation of a person arrested after they were deemed, like Muro, unable to assist in their own defense. Then the court could permit “ongoing assessment of a person’s ability to aid and assist.”

The key to any solution, according to the Disability Rights Oregon report is for the legislature to tackle the issue with a “well thought out plan for addressing both safety and civil rights issues.”

But until then, Muro and all those involved in his case will be waiting.

“You see so many tragedies of people with mental illness that get to this point,” Buckley said. “This man is a tortured soul too. It’s not something he chose.”