Feds Slam State Hospital Safety

Jan 17, 04:53 PM

Jan. 17--SALEM -- Care and conditions at the Oregon State Hospital threaten mental patients' safety and their constitutional rights, the U.S. Justice Department said in a report released Wednesday.

The Justice Department report follows federal investigators' November 2006 visit to state hospital wards in Salem and Portland. It documents patient-to-patient assault, multiple suicide attempts by patients who were supposed to be on one-on-one monitoring, improper use of seclusion and restraints to control violent patients, and dangerous medication practices.

Other problems highlighted in the 48-page report include inadequate staffing and disease control procedures.

The Justice Department warned state officials that the U.S. attorney general may sue Oregon to correct deficiencies. But it also says the feds would prefer to "resolve this matter by working cooperatively with the state."

In response, Wednesday, both the director of the Oregon Department of Human Services and the president of the state Senate characterized the findings as "damning."

"This is the worst report I have ever seen regarding any state program or services -- without a doubt," said Senate President Peter Courtney, D-Salem, who also announced that he would lead a legislative oversight committee to determine whether conditions at the Oregon State Hospital are safe for patients and staff to remain.

The committee will monitor the state's compliance with the Justice Department recommendations, Courtney said. He also said the Legislature may approve more money for the hospital in its February session.

"Whatever it takes, we will do," he said. "It's as simple as that."

The Oregon State Hospital treats adults with mental illnesses, including those who have committed crimes but have been found not guilty by reason of insanity. On any given day, about 741 patients are hospitalized in the state-run system.

In June 2006, the Justice Department's civil rights division notified state officials it was sending investigators to Oregon to review whether conditions, particularly at the Salem campus, violated patients' constitutional right to be safe from harm and to receive adequate care.

If the federal government now sues, Oregon could risk having the court take over operation of its mental health system. That happened in Hawaii, where the Justice Department filed a 1991 lawsuit alleging violations of patients' constitutional rights at Hawaii State Hospital.

Echoing other Oregon State Hospital reports, federal investigators noted the "state of severe deterioration and serious dilapidation" of the buildings at the 125-year-old Salem campus.

But unlike past reports, the Justice findings concentrate heavily on the quality of care inside the buildings.

The report describes mice in patients' rooms, norovirus and scabies outbreaks and the "failure of staff to clean up 'messes' in seclusion rooms."

The report also includes grisly examples of patients who were inadequately supervised or treated, including one woman under one-on-one supervision who was still able to wrap wires around her neck, swallow liquid cleaner and climb under her bed and wrap a sheet around her neck.

Investigators concluded: "It is incomprehensible how patients being supervised by staff members, whose only duty it is to monitor those patients, could be allowed to hurt themselves."

Dr. Bruce Goldberg, a physician and Human Services director, said the report outlines conditions and care that are "unacceptable for us as a state."

However, Goldberg also said the state has taken several steps to improve conditions at the hospital since November 2006, including hiring new staff, a chief medical officer and six additional psychiatrists.

The state is also moving forward on a new 620-bed hospital on the existing grounds in Salem, with another 360-bed hospital on state-owned property in Junction City in the southern Willamette Valley. The new Salem hospital is scheduled to be finished by 2011 and the one in Junction City by 2013.

"We've been working on these issues," Goldberg said. Still, he acknowledged that the Justice report is "damning and the burden is going to be on us."

Asked whether the Salem campus is safe, Goldberg answered: "I believe people are safer than they were when this report was written."

The Justice Department says it could file suit within 49 days of the report's release but Goldberg said he and his staff will consult with the feds immediately on what needs to be done -- and how soon -- to avoid court.

Gov. Ted Kulongoski said he will not tolerate any indication that patients in the hospital are unsafe, said the governor's spokeswoman, Anna Richter Taylor. "He remains committed to doing what we can today to improve the hospital while continuing to focus on the future to ensure Oregon's mental health system provides quality care."

Robert Joondeph, director of the Oregon Advocacy Center, said the report's findings are consistent with what he knows about the conditions at the hospital.

The center filed suit in late 2005 on behalf of patients. It was settled after legislators agreed to free more state money to hire additional staff and secure additional hospital space off campus.

The staff was hired, but the hospital's patient population remains over budget.

"It's embarrassing, and it's shameful that we are in this situation," Joondeph said. "We're talking about decades of neglect, and turning that around immediately is difficult."

Oregon leaders have been alarmed by the conditions at the state mental hospital for the past few years and the Legislature has approved money for staff and new buildings. But the Salem hospital's tarnished reputation dates back more than 30 years, when the movie "One Flew Over The Cuckoo's Nest" was filmed there.

Senate President Courtney said he read the Justice Department's report Tuesday night.

"I thought I was reading the movie script for 'Cuckoo's Nest 2,' " he said. "What happened here?"

Oregonian news researcher Lynne Palombo contributed to this report.

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