U.S. federal Judge Michael Mosman has denied requests to change his ruling ordering strict deadlines on how long the state of Oregon can keep patients at the Oregon State Hospital while receiving treatment to restore their ability to defend themselves against criminals charges.
Mosman said in his ruling released Monday that “the solution to the state-wide humanitarian crisis” of defendants spending lengthy periods in jail awaiting transfer to the state hospital needs more time to be implemented.
In September, Mosman ordered the state to release “aid and assist” patients with misdemeanor charges from the hospital within 90 days, felony charges within six months, and “violent felony” or “person-centered” charges within a year. Releasing patients quicker would allow defendants waiting in jail to be admitted sooner.
“If all goes to plan, it will enable the state to achieve compliance with the Constitution next year, for the first time in nearly half a decade,” the judge said in his order.
Oregon State Hospital spokeswoman Amber Shoebridge said since the September ruling through Jan. 1, the state hospital has released 352 aid and assist patients — individuals determined unable to aid in their own defense because of a behavioral health condition.
Patients are discharged to the county from which they were referred to the hospital. Oregon State Hospital gives counties 30 days’ notice to create a plan for care post-release, Shoebridge said.
An example of working through the Mosman order
Presiding Marion Circuit Court Judge Audrey Broyles said during a Tuesday hearing to discuss placement for a defendant released under the Mosman order that she was frustrated.
The defendant was charged with multiple assaults, assault on a public safety officer, robbery, and resisting arrest. She had been at the state hospital for more than a year receiving care intended to restore her ability to aid her lawyer in her defense, said her lawyer, Laura Johnson.
Johnson’s client exceeded the time limitations at the hospital under the Mosman order and was recently discharged.
The lawyer said she did not believe her client would be able to engage in community restoration because of the severity of her behavioral health symptoms. Johnson said she plans to file a motion to dismiss all the charges. Meanwhile, the defendant will be held in the Marion County Jail until the case is resolved.
Broyles said during the hearing that dismissing the case would be a “disservice to everyone,” as the defendant might end up putting herself or others in danger again.
“This is a situation where we don’t have anything to offer,” Broyles said.
Continued capacity challenges
Mosman’s order was issued after the state hospital failed to meet August admittance wait time benchmarks set by Dr. Debra Pinals, a neutral expert chosen by the Oregon Health Authority, Metropolitan Public Defender and Disability Rights Oregon to create a plan to address capacity challenges.
The August benchmark required the hospital to admit aid and assist patients on average within 22 days of receiving an aid and assist order while in jail. The hospital’s average wait time then, however, was nearly twice that.
At the end of last month, the average wait time was 39.2 days, according to Oregon Health Authority data. There are currently 114 individuals across the state awaiting beds at the state hospital, 91 of which are on aid and assist orders.
Disability Rights Oregon, a statewide disability advocacy group, and Metropolitan Public Defender requested Mosman’s strict deadlines, saying they believed the hospital would be able to comply.
Hospital system representatives of Providence Health, Legacy Health, and PeaceHealth and several county attorneys asked the judge to reconsider, arguing among other things that his order unlawfully prioritized aid and assist patients over civil commitment patients.
Since 2012, 15.5% of aid and assist patients stayed at the state hospitals in Salem and Junction City for longer than six months.
But some patients unable to assist after two years were classified as “never able.” Mosman’s order limits these lengthy stay times.
Never able patients typically face three options: Their charges may be dropped; they may be recommitted as a “civil commit,” which is rare due to capacity constraints and very strict requirements, or they may be committed to a behavioral health facility because they pose a danger to the public.
The state hospital has been facing capacity challenges for 20 years with defendants spending lengthy periods in jail despite orders to transfer them to the Oregon State Hospital.
A 2002 court order, OAC v. Mink, aimed to end “the practice of keeping defendants in jail for months awaiting mental health care.”
In June 2019, the federal court ordered Oregon State Hospital to comply with a federal seven-day admission requirement within 90 days. The deadline was initially met, but the COVID-19 pandemic brought new challenges, and the state requested a “pass” on complying with the Mink order.
Since the court approved this pass in 2020, Oregon State Hospital has consistently struggled to meet wait time requirements.
The Statesman Journal’s coverage of healthcare inequities is funded in part by theM.J. Murdock Charitable Trust, which seeks to strengthen the cultural, social, educational, and spiritual base of the Pacific Northwest through capacity-building investments in the nonprofit sector.