Mental Health Association of Portland

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Oregon State Bar to prosecute Washington County district attorney, defense attorney on ethics violations

Posted by admin2 on 27th September 2012

Published by The Oregonian, September 27, 2012

The Oregon State Bar will prosecute Washington County’s district attorney and a defense attorney on ethics violations stemming from their handling of a mentally ill man’s aggravated murder case.

Kateri Walsh, a state bar spokeswoman, said the decision came Saturday when the State Professional Responsibility Board reviewed the bar’s investigation into the allegations against District Attorney Bob Hermann and defense attorney Robert Axford.

Retired Judge Jim Hargreaves filed complaints regarding the two attorneys with the state bar in December. He also filed a complaint with the judicial fitness commission against Judge Thomas Kohl.

READ – Ethics complaints filed against Washington County district attorney, judge and defense attorney

Kohl signed an order for a “mental illness magistrate hold” in October, supposedly sending Donn Thomas Spinosa, 59, to the state hospital indefinitely.

Twice accused in his ex-wife’s 1997 killing in Aloha, Spinosa has never been found mentally fit to stand trial. Doctors have found Spinosa, diagnosed with schizophrenia, unable to care for himself and dangerous to others.

In his complaint to the state bar, Hargreaves said the law does not allow for the magistrate hold.

“Such an order is entirely without legal foundation in Oregon and stripped Mr. Spinosa of all his rights and protections,” Hargreaves wrote in the complaint.

Hargreaves’ complaint says Hermann, Axford and Kohl agreed to an “undeniably invalid order” to sidestep the law.

Hermann and Axford both told the state bar they believed the order was valid and did not intentionally violate the law.

READ – Washington County district attorney, defense attorney respond to complaints of ethics violations, misconduct

The state hospital asked Kohl to dismiss the order, which he did in May. Spinosa remains in the state hospital under a civil commitment, last renewed in June.

Disability Rights Oregon launched an investigation last year after reading about Spinosa’s case in The Oregonian. Bob Joondeph, the group’s executive director, said in December the organization wanted to know why a judge would skip the civil commitment process and impose an order that doesn’t exist within the law.

READ – The Incarceration of D.S. – An Investigative Report, by Disability Rights Oregon

At the end of that investigation in July, the advocacy group said in a report that Hermann, Axford and Kohl acted outside the law with the “mental illness magistrate hold.” The legislature makes law, the report said, and in Spinosa’s case, it was the attorneys and judge who “essentially created a new law that allows for a person with mental illness to be detained without the elements of due process.”

A three-person trial panel appointed by the Oregon Supreme Court will hear the bar’s case against Hermann and Axford, Walsh said.

READ – Jury finds man guilty of murdering Washington County judge’s daughter, March 26, 2009

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DRO recommends legislation after investigating what happened to Donn Spinosa

Posted by admin2 on 11th August 2012

From the Oregonian, July 23, 2012

Disability Rights Oregon on Friday concluded an investigation critical of the prosecution of a mentally ill Aloha man, twice charged in the 1997 slaying of his ex-wife.

READ – what happened to Donn Spinosa
READ – “The Incarceration of D.S. – An Investigative Report” from Disability Rights Oregon, July 2012

The investigation questioned how the schizophrenic man “came to be held in Washington County Jail for months without treatment and then was committed to the Oregon State Hospital without legal authority even though the legal means existed.”

The advocacy group investigated the case of Donn Thomas Spinosa, 58, who was first charged in the killing of Kathleen T. Relay in 1997. He was found unable to aid and assist in his own defense; his charges were dismissed and he was civilly committed to the Oregon State Hospital.

Spinosa’s charges were refiled in 2010 after Washington County District Attorney Bob Hermann learned that the state hospital planned to release him. A judge again found him unable to aid and assist last year and returned him to the hospital on an order that Disability Rights Oregon says was not legal.

Among other findings, the advocacy group says in its report that Hermann’s re-indictment of Spinosa was “inhumane and wasteful”; laws and resources assuring Spinosa’s appropriate treatment were not used; and the state hospital made decisions “without clear standards, accountability or understanding of the treatment options available in jail” that led to Spinosa returning to jail after 14 years in the hospital.

The report concludes that Spinosa’s “unnecessary transfers back and forth between the state hospital and jail left him without adequate mental health treatment for long periods of time, with little or no justification.”

Responding to the report, Hermann said in an email, “This advocacy group has a role in the system and certainly a right to express its opinions. … In addition, advocacy and safety for the victims impacted by this murder remain a priority.”

Last October, when Judge Thomas Kohl dismissed the aggravated murder case against Spinosa, he signed an order for a “mental illness magistrate hold,” supposedly sending Spinosa to the state hospital indefinitely.

The order elicited ethics complaints in December, filed by retired Lane County Judge Jim Hargreaves. In complaints to the state bar against Hermann and defense attorney Robert Axford, Hargreaves said the law does not allow for the magistrate hold. He also filed a complaint with the judicial fitness commission against Kohl.

The state hospital asked Kohl to dismiss the order, which he did in May. In June, Spinosa’s civil commitment was renewed.

Disability Rights Oregon launched an investigation last year after reading about Spinosa’s case in The Oregonian. Bob Joondeph, the group’s executive director, said in December the organization wanted to know why a judge would skip the civil commitment process and impose an order that doesn’t exist within the law.

The investigation report concludes that Hermann, Axford and Kohl acted outside the law with the “mental illness magistrate hold.” The legislature makes law, the report says, and in Spinosa’s case, it was the attorneys and judge who “essentially created a new law that allows for a person with mental illness to be detained without the elements of due process.”

The investigation report lists several recommendations to address the problems the group identified.

“Changes are in order to assure that citizens are not punished for having a severe mental illness,” Joondeph said in a statement.

Among those, the group recommends that patients who have been previously found unlikely to regain capacity to assist in their own defense should not be re-indicted without further evaluation to see if they have regained ability.

The also group recommends a change in the law to permit notification to authorities when a patient who could be re-charged with a crime is being released from the hospital. But the law should not violate the defendant’s right to keep personal health information protected, the report says.

The report, which refers to Spinosa as “D.S.,” says Hermann and jail staff violated his privacy rights by providing information regarding his mental health and behavior in the state hospital.

Hermann defended the way Spinosa’s case has been handled, saying in an email, “The aggravated murder of Kathleen Relay remains an open case. Donn Spinosa remains the only suspect. Law enforcement continues to perform its role by keeping a close eye on Mr. Spinosa’s situation and progress to ensure that the public remains safe as well as Mr. Spinosa himself. … To date the public and Mr. Spinosa have remained safe.”

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Cheryl Kidd joins defendant patients at Oregon State Hospital

Posted by admin2 on 12th June 2011

From the Eugene Register Guard, June 12, 2011

The woman accused in the death of police officer Chris Kilcullen is one of 105 “treat until fit” suspects at Oregon State Hospital

Cheryl Dawn Kidd

Cheryl Dawn Kidd

Cheryl Dawn Kidd is hardly rare in receiving court-ordered treatment at the Oregon State Hospital because she is too mentally ill to stand trial for an alleged crime.

Kidd’s case has drawn more public attention because she is accused of fatally shooting Eugene police officer Chris Kilcullen on May 22 during an attempted traffic stop.

But when Lane County Circuit Judge Mary Ann Bearden ordered Kidd transported to the mental hospital last week, the 56-year-old Springfield woman joined 104 other Oregon criminal defendants whose court cases can’t proceed because they lack the lucidity to assist in their defense against the charges.

Among them is another Lane County murder defendant, Miguel Angel Chavez. The 24-year-old Eugene man was placed in the Salem hospital in April after Lane County Circuit Judge Debra Vogt declared him unfit to proceed to trial for the killing of his landlord, Deborah Ann Stone, whose body was buried in the backyard of her Bethel home.

But the vast majority of “treat until fit” patients are not accused of violent crimes, according to state hospital spokeswoman Rebeka Gipson-King. In fact, only nine other such defendants are accused of serious violent crimes: four are accused of murder, three attempted murder, one first-degree rape and one first-degree kidnapping.

Criminal defendant patients receive additional services beyond the basic mental health treatment the hospital provides all its patients, she added.

“For example, the hospital provides classes covering the legal process, medication and stress management, all with the goal of helping them function in the courtroom and preparing them to be an active participant in their trials,” Gipson-King said.

Patients being treated so they can aid and assist in their criminal proceedings are housed in hospital units with secure peri­meters, she added.

Bearden ordered Kidd treated until she becomes well enough to stand trial or until she has been in custody for three years — the legal limit in Oregon for confining criminal defendants solely on the basis of incompetence to stand trial. Oregon adopted that limit after the U.S. Supreme Court ruled in a landmark 1972 case, Jackson vs. Indiana, that states may not indefinitely confine mentally unfit defendants.

When such defendants “time out” of the Oregon State Hospital, they are returned to the court that issued their treat-­until-fit order, Gipson-King said.

At that point, the state often moves to dismiss their criminal cases without prejudice, leaving the door open to refile charges later if the person becomes coherent enough to stand trial and the statute of limitations has not expired. There is no statute of limitations for murder, so defendants such as Kidd and Chavez could be held accountable years or even decades after their alleged crimes.

The state also typically seeks a civil commitment order from the court if the former defendant’s conduct and/or mental health evaluations suggest that he or she poses a danger to herself or others. Lane County District Attorney Alex Gardner last week called that solution “a huge hole in our criminal justice system,” calling civil commitment inadequate for someone representing “a mortal threat to the community.”

But Jim Hargreaves, a former 20-year Lane County Circuit judge who spent a year studying the Oregon State Hospital in 2008, said the current system generally works well at protecting the public. The same mental health professionals often advise judges in both criminal and civil proceedings, said Hargreaves, who was appointed by former Gov. Ted Kulongoski to recommend improvements at the hospital.

“I never came across a case where someone got out after three years still unfit to proceed and committed some serious vio­lent act,” he said, adding that the same was true for such defendants released after a subsequent civil commitment.

“If such a case exists in Ore­gon, it seems it is a well-kept secret,” he said. “The system, though pretty clunky, seems to sort people out pretty well.”

Patients who “time out” of their criminal case treatment orders and return as civilly committed patients have re-evaluation hearings every six months before a Marion County Circuit Court judge, Gipson-­King said.

If evidence shows they have improved to the point that they no longer pose a safety threat, they are released into the community. Infrequently, such patients also are released without a court hearing by state hospital doctors who determine that they no longer need confinement, she added.

When such persons no longer have criminal charges pending, however, state law requires no notice to the court in which they were once charged or to the victims of their alleged crime, Gipson-King said.

Hargreaves said his review convinced him that “treat until fit” and civil commitment orders fail to protect the rights of mentally ill criminal defendants who have not been accused of violent crimes.

“This group has not been found guilty of any crime,” he wrote in a recent guest editorial published by The Oregonian. “They have not been found to be a danger to anyone. They are simply in the hospital because they can’t understand what is happening to them. These people can be held in the hospital for up to three years.

“In a large number of cases, this detention time greatly exceeds any sentence they would receive if they were able to plead guilty and be sentenced. The rationale for this disparity continues to escape me.”

He said the Legislature should outlaw mandatory hospitalization of defendants charged with minor crimes.

Though Gipson-King could not provide numbers by the end of last week, she said only a few defendants remain too ill to stand trial after three years of treatment.

The median length of stay for treat-until-fit criminal defendant patients is less than three months, she said.

Hargreaves also sees a hole in the current system, however — Oregon’s failure to enact a process allowing involuntary medication of some unfit to proceed defendants who could become mentally competent to resolve their cases. Another U.S. Supreme Court decision almost eight years ago allowed for such forced medication in states with tightly prescribed guidelines. But Oregon has yet to adopt a law spelling out such rules and thus making that tool available, he said.

According to court documents filed by defense attorney Gordon Mallon, Kidd has a long history of mental illness, including schizophrenia. She had reportedly stopped taking her medication and was suffering from paranoid delusions at the time of the Kilcullen shooting — including the false belief that he and other police officers had fired at her car.

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Are Oregon State Hospital consultants worth it?

Posted by admin2 on 27th February 2011

From the Salem Statesman Journal, February 27, 2011

State officials refuse to answer questions about two mental-health consultants who have been paid $1 million to help the Oregon State Hospital respond to an ongoing U.S. Department of Justice investigation of the Salem psychiatric facility.

The taxpayer-subsidized tab for the consulting duo has nearly doubled since the Statesman Journal first reported on their pay in July 2009.

Despite this escalating expense, officials say the consultants work is off-limits to the public because it is part of the state’s response to the four-year federal investigation.

The hospital initially agreed to answer a set of written questions posed by the newspaper about the consultants work. Officials reversed course last week, opting not to respond.

In addition, officials canceled the newspaper’s prearranged Friday interview with OSH Superintendent Greg Roberts. The interview was set up to get the hospital leader’s take on the consulting work performed by Dr. Jeffrey Geller, a professor of psychiatry at the University of Massachusetts Medical School, and Kris McLoughlin, a mental-health consultant based in California.

Among the written questions submitted by the newspaper that were left unanswered:

  • Who do the two consultants report to at OSH?
  • Do they issue written reports, oral reports, or both?
  • How does their expertise benefit the hospital? What are some concrete examples?
  • In what specific ways have they assisted OSH in responding to the federal investigation?
  • How does their consulting role differ from the legal assistance provided to OSH by the state Attorney General’s Office?
  • How long will the two consultants continue to work at OSH?

On Friday, hospital spokeswoman Rebeka Gipson-King described the unwillingness to answer questions about the consultants as a mutual decision reached by the hospital and the state Attorney General’s Office.

“Everything that has to do with U.S. DOJ is going to go through the Attorney General’s Office,” she said.

Tony Green, a spokesman for Attorney General John Kroger, said the consultants work is confidential because the recommendations they make on how to improve patient care are connected to the federal investigation.

“The underlying issue is very much the subject of the investigation and potential legal action,” he said. “It’s not something that you can simply separate out and say there’s not a connection between that and the U.S. DOJ investigation. It’s a difficult situation because of the ongoing investigation. We’re doing our best to protect the state while addressing the concerns that are being raised.”

State officials enlisted help from Geller and McLoughlin in August 2006, shortly after the U.S. Department of Justice launched a civil-rights investigation into Oregon’s main mental hospital in June 2006.

Both consultants were highly regarded for their previous work in other states, which often focused on helping troubled psychiatric facilities deal with federal Justice Department investigations.

Terms of Oregon’s initial contracts with Geller and McLoughlin called for each to be paid $75,000, with the contracts to expire Dec. 31, 2006. However, the consultants have been kept on board through contract amendments.

The current veil of confidentiality on the consultants work is a departure from past practice at OSH.

In 2009, then-hospital Superintendent Roy Orr answered various questions that the newspaper posed to him about the work performed by Geller and McLoughlin.

Orr said the consultants typically visited the hospital each month, normally staying for several days and engaging in wide-ranging discussions with hospital officials and staffers.

“Every time they arrive, it’s like a one-week survey,” he said. “They start the week by asking, ‘What progress have you made on the major initiatives and the assignments we handed out last month?’ ”

Orr credited the consultants with playing key roles in helping the hospital launch reform-minded measures, such as sharply reducing the use of seclusion and restraints to control patients — one of many problems spotlighted by federal investigators.

Last week, Geller and McLoughlin separately declined Statesman Journal requests for interviews about their state hospital work, as they previously did in 2009.

In 2009, the newspaper reported that combined pay and expenses for Geller and McLoughlin totaled $517,859 from the start of their consulting work in September 2006 through July 3, 2009.

Since then, the state has paid out $498,384 to them in combined fees and travel expenses, raising the grand total to $1,016,243, according to pay and expense data obtained by the newspaper.

Geller and McLoughlin were the first in a series of outside consultants who have been brought in to help the hospital improve patient care and analyze operations during the prolonged federal investigation.

Among the former and current OSH advisers:

  • Former Lane County Circuit Judge James Hargreaves received $252,465 in state pay for the year he served as governor-appointed “special master” of the hospital. His 14-page report, issued in early 2009, rapped hospital management for poor planning, undefined goals and a lack of urgency.
  • Liberty Healthcare, a Pennsylvania-based consulting firm, was paid $175,000 to study the hospital last year. In September, the consultants concluded the hospital has “invested great energy and vigor in striving to improve, but the results to date have been disappointing.”
  • Kaufman Global, an Indiana-based consulting firm, is getting paid $2 million to spur culture change at the hospital and help it run more efficiently and effectively. The firm’s contract ends on June 30.


Above, Oregon State Senate President Peter Courtney criticizes Oregon State Hospital construction and opening delay in an interview with the editorial board of the Salem Statesman Journal in January 2011.

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Oregon State Hospital consulting firm no stranger to DHS

Posted by admin2 on 23rd January 2011

From the Salem Statesman Journal, January 22, 2011

Kaufman Global is not a household name in Oregon.

But the Indiana-based consulting firm is well known to leaders of the state Department of Human Services.

Since 2007, DHS has awarded Kaufman Global three contracts for consulting services, and the firm has played an influential role in reshaping the state’s biggest agency, which has a $13 billion two-year budget and employs more than 10,000 workers.

The contracts:

    -In 2007, the firm was paid $688,000 to assess the agency’s beleaguered financial department and identify cost-cutting efficiencies.
    -Last April, Kaufman Global was hired at a cost of $742,000 to provide “hands on coaching” for DHS managers.
    -Late last year, the firm landed a $2 million contract to craft a strategy for culture change at the Oregon State Hospital.

Taxpayers are leery about consulting contracts, especially now because of the state’s ailing economy and a projected $3.5 billion shortfall in the state’s 2011-13 budget period, which starts July 1.

However, DHS officials tout Kaufman Global as a consulting success story. They say the firm’s 2007 work for the agency paved the way for cost-saving initiatives that have reaped $100 million in savings.

Now, the state is banking on Kaufman Global to deliver results on a tough task — turning around the troubled state hospital.

READ – Kaufman Global’s contract with Oregon State Hospital to instruct their “Lean Daily Management System”

The firm has started working with hospital leaders and front-line employees to change the workplace culture at the 127-year-old mental institution.

Kaufman Global’s initial “cultural assessment” report, made public on Tuesday, concluded that OSH suffers from deeply entrenched problems, including poor communication, distrust and a lack of accountability.

The consultants pledged to help OSH become a first-class psychiatric facility by fixing the flaws.

“It’s now incumbent upon OSH leadership and stakeholders to help ensure these steps are taken to become the first class organization that it can be,” stated the report. “To that end, Kaufman Global pledges its intent not only to reveal those cultural issues that must be changed … but to roll up our sleeves and help implement those changes.”

Magnet for consultants

The Indiana firm is the latest in a succession of outside experts and consultants enlisted by the state to dissect the state hospital’s woes.

The Statesman Journal previously reported that former Lane County Circuit Judge James Hargreaves received $252,465 in state pay for the year he served as governor-appointed “special master” of the hospital.

His 14-page report, issued in early 2009, rapped hospital management for poor planning, undefined goals and a lack of urgency.

Another hard-hitting assessment of the hospital was issued last year by Liberty Healthcare, a Pennsylvania-based consulting firm that was paid $175,000 to study OSH. In that report, dated Sept. 30, consultants said the hospital has “invested great energy and vigor in striving to improve, but the results to date have been disappointing.

“It is paradoxical that the very efforts to improve the hospital have contributed to the current confusion because changes have been implemented on so many fronts and with such rapidity. The sheer volume of change at OSH would overwhelm any organization, but we believe that the essential problem has been the lack of adequate planning and coordination of these improvement efforts.”

Hospital Superintendent Greg Roberts said in a Friday interview that Kaufman Global’s ongoing work is designed to produce change, not just describe what’s wrong.

“We don’t need more and more assessments of the hospital,” he said. “We need to be focused on fixing the problem, and that is where Kaufman Global is coming from. What we need to do now is move on to take action steps to resolve the issues.”

Under its contract with the state, Kaufman Global’s work at the hospital will continue through June 30. Roberts emphasized that “their work is to help us find processes that will last beyond their contract.”
“Eager for change”

As spelled out in their initial report, the consultants plan to play an active role in prompting hospital change. Targeted areas for improvement include:

    -Strengthening accountability throughout OSH and ensuring that projects stay on schedule and on budget.

    -Providing coaching and mentoring to counter a lack of a shared organizational vision and strategy.
    -Revitalizing and realigning senior leadership.
    -Rebuilding trust and eliminating acts of retribution, real or perceived, through education, coaching and mentoring.
    -Eliminating separate agendas and creating “a blameless environment designed to foster continuous improvement.”

“The report doesn’t just tell us what is wrong; it tells us why and provides some valuable insight on how we can fix it,” Roberts said in a message to members of the hospital advisory board. “The good news coming out of this report is that we as a hospital are eager for change and dedicated to improving patient care.”

Roberts said hospital employees demonstrated their desire to embrace change through a “sometimes overwhelming response” to Kaufman Global’s requests for input. More than 1,500 staff and patients participated in the firm’s cultural assessment, filling out surveys and participating in interviews and other exercises.

“For the next step, we will use the tools we learn from Kaufman Global to develop and implement strategies for bringing about the changes we need to instill positive cultural norms at the hospital,” Roberts said in his message to the advisory board.

Previous work praised

Kaufman Global has a proven track record in Oregon, DHS officials said.

In 2007, the department hired the firm, to scrutinize the agency’s embattled financial department.

Jim Scherzinger, deputy director for finance in DHS, said the state turned to Kaufman Global in the wake of a financial debacle that occurred prior to his arrival at the agency.

“When I came in, DHS was taking a lot of criticism because of its finance system,” he said. “Probably the worst thing was that they told the Legislature that their budget was balanced.”

In reality, the agency had a budget shortfall of more than $170 million. Legislators were stunned to hear about the hole, and they had to hold a special session to plug it. Lawmakers told DHS leaders not to let it happen again.

Kaufman Global, hired through a competitive bidding process, came on the scene in 2007. The consultants introduced “lean tools” to DHS.

Initially devised by Toyota, lean tools and techniques are widely used in the private sector to streamline processes and cut waste.

“Ultimately, what they’re designed to do is not to make people work faster or harder but to eliminate waste in the process,” Scherzinger said.

A state Web site entirely devoted to the Transformation Initiative describes “lean” as the primary tool DHS uses to “do the right work, the right way.”

Agency director Bruce Goldberg, in a message posted on the Web site, says: “Today’s economic climate means more families, seniors and people with disabilities are turning to us than ever before. The Transformation Initiative gives us the tools we need to stretch the public dollar in order to deliver critical services that help people through tough times.”

DHS first applied lean tools and training taught by Kaufman Global to the DHS finance department. By December 2008, officials said, the new efficiencies had generated more than $8 million in savings for the agency, far surpassing the $688,000 cost of the first consulting contract.

Kaufman Global was hired again early last year to provide more coaching for DHS managers at a cost of $742,000.

“What they’re really good at is (providing) training on the lean tools and helping you develop ways of engaging your workers in improving processes,” Scherzinger said.

The 2007 consulting work done by Kaufman Global paved the way for a broader DHS “Transformation Initiative.”

Lean tools and techniques have been applied to dozens of projects — from an accelerated hiring program for nurses at the state hospital to a streamlined intake process for applicants seeking food stamps, medical and day care benefits.

As of Jan. 14, 35 lean process improvement projects had been completed, resulting in savings valued at $99.6 million, according to DHS calculations.

About 100 more projects, all based on the lean process, are in varying stages of completion, officials said.

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We must not fail in transformation of state hospital

Posted by admin2 on 20th April 2009

Opinion by Daniel Smith, published in the Salem Statesman Journal April 18 2009

Dr. Daniel Smith has spent 25 years working in community mental health, the past six as a forensic psychologist at Oregon State Hospital in Salem.

The governor’s special master, Judge James Hargreaves, reported that poor planning and a lack of urgency are at the heart of problems that continue to plague the Oregon State Hospital in Salem.

Hospital Superintendent Roy Orr points to significant progress in reaching accepted standards of care of the mentally ill.

Who is right in this glass half-full/half-empty debate? As a psychologist who evaluates mental-health consumers at the hospital, I don’t think either view is wrong. Yet each falls short of assessing the status of efforts to turn our state hospital into a modern mental-health treatment facility.

Efforts to recruit qualified staff, increase morale and modernize treatment have achieved some results. Administrators, nurses and physicians have been hired and old buildings are being refurbished, moved and razed in anticipation of a new facility in the aftermath of a scathing federal condemnation of hospital conditions.

These early steps tell me that if we fund clinically appropriate levels of direct-care staffing and services, Oregon can improve treatment of serious mental illness and give renewed hope to patients and their families. But that’s a big “if.”

One recent advance, the opening of cottages for residents preparing to return to their families, points up the need for good planning and preparation. Protocols were not complete when residents moved in, leading to problems. Other promising new transition programs have been rolled out before they were ready.

And even before the new central facility is complete, there are some warning signals.

Envisioning the best of all possible futures, the Oregon Department of Human Services set about to create a facility too small to meet the anticipated need with an eye toward compelling the state to revitalize and reinvent community mental-health programs throughout Oregon.

Then the economic crisis arrived. I know all about the downturn’s potential impact on services. I’m on the team negotiating a new state contract on behalf of 18,500 state workers represented by Service Employees International Union Local 503.

But coupled with a lack of public appreciation of the severe shortage of community mental-health care options, the budget crunch poses special threats for our new hospital, which could be understaffed and overcrowded from the day it opens.

We do not have to look far to see where that leads. Lack of community-based treatment has criminalized mental illness in Oregon. With few alternatives, localities treat the mentally ill through the criminal-justice system.

We have made some progress in de-stigmatizing mental illness and overcoming resistance to community group homes, but a lack of transitional housing continues to clog jails and send more individuals to the state hospital than we can properly treat.

These conditions contribute to a sense of frustration and futility in many residents and some respond violently, endangering themselves, their peers and the staff. And while reduced use of restraint and seclusion are notable reforms, they increase exposure of direct-care staffers to serious injury, accelerating a destructive cycle. Workers on paid medical leave exacerbate the staffing shortage, mandating overtime that increases cost of care and staff burnout.

READ – James Hargreaves’ report on the Oregon State Hospital

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Is the Oregon State Hospital report worth the cost?

Posted by admin2 on 13th April 2009

From the Salem Statesman Journal, April 12 2009

Judge’s comments don’t offer details – or anything new

A $250,000 report about the Oregon State Hospital may reveal more about state government than it does about the hospital.

Gov. Ted Kulongoski brought in retired Lane County Judge James Hargreaves as a special master more than a year ago to keep tabs on improvements at the hospital, which faced the threat of a federal civil-rights lawsuit. In February, Hargreaves submitted a 14-page report titled, “Governor’s Special Master Oregon State Hospital Excellence Final Report.”

Now taxpayers are left wondering: Was this a good investment — at more than $15,000 a page — or was the special master merely window dressing?

The hospital houses 627 patients, primarily at its Salem campus as well as some in Portland. In his report, Hargreaves made worthwhile observations about Oregon’s failures in mental health care; but for the most part, his comments are neither new nor detailed.

The state is embarking on a multi-million-dollar transition in mental health care, as it builds new hospitals and expands the OSH staff. Taxpayers — as well as public officials throughout government — have the right to know what’s going on.

However, the Hargreaves report wasn’t released to the public, legislators or the OSH superintendent until the Statesman Journal recently inquired about its existence.

There appears to be confusion within government about the purpose of the Hargreaves report. But there should have been no confusion about officials’ obligation to promptly release it.

OSH, and Oregon’s mental health system in general, have been sadly neglected for generations. That is changing. The hospital has made significant strides under Superintendent Roy Orr, who’s been on the job for a year.

Following a series of high-profile escapes and other incidents, security has improved. So have the hospital’s working relationships with area law enforcement agencies and community organizations.

Hiring of nurses and other employees has increased, although there still is far too much mandatory overtime. The use of seclusion and physical restraints to control patients has decreased substantially.

And last week contractors started demolishing part of the 19th century campus in Salem to make way for a modern, more-therapeutic hospital.

The Kulongoski administration points to these and other improvements as evidence of Hargreaves’ worth. The governor’s aides say that Hargreaves met regularly with state officials to discuss hospital progress, and that the report merely reflects his departing thoughts.

That’s certainly what the report reads like — a reflection paper. It contains no documentation or evidence to support Hargreaves’ contentions, which is a lost opportunity for Oregonians.

In the report, the special master recommended hiring more outside consultants for the state hospital. Before heading down that path, the state should make sure it will get a worthwhile return on its investment.

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