Mental Health Association of Portland

By Andrea Damewood, Willamette Week, May 14, 2013

Oregon State Hospital in Salem

The Oregon Legislature appears poised to give a planned mental hospital in Junction City $80 million, despite the fact that mental health advocates loathe the idea.

READ – “Junction City hospital the worst way to treat mentally ill” (MHAP guest column in Eugene Register-Guard)

As WW reported in January, mental health experts say building the 174-bed Junction City hospital adds the wrong kind of treatment beds in Oregon, taking the state in the opposite direction from where it should go: toward smaller, less-expensive facilities located near high-population areas—including Portland.

READ – “Committed to Junction City” (Willamette Week)

But the Eugene Register-Guard reported May 10 that “it appears to be a virtual certainty that lawmakers will vote this year to spend the almost $80 million needed to build the structures and finish the project.”

The story says even opponents believe the facility—championed by Rep. Val Hoyle (D-Eugene) whose district would get 2,500 construction jobs and up to 600 permanent jobs—is inevitable. But that hasn’t stopped the Mental Health Association of Portland from starting a change.org petition to House Speaker Tina Kotek (D-Portland), asking her to reconsider the money.

“While wards in the newly built hospital in Salem stand empty, a new hospital, in a small town without resources, is unnecessary and unwanted by the mental health community,” the site reads. “Operations costs may reach hundreds of millions over decades of unwanted and unwarranted treatments”

So far, the change.org petition has 152 signatures. The bill that includes the funding for the hospital, Senate Bill 5507, will have three public hearings in Salem this month, the first being this Friday at 1:30 pm.

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Sign the Petition

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By Andrea Damewood, Willamette Week, Jan. 16, 2013

The road for the Oregon State Hospital in Junction City stretches across an open field, waiting to lead people to the state’s newest mental health facility.

State officials have spent $61.8 million preparing the land in the Lane County town 15 miles northwest of Eugene. New water and sewer lines run to the site.

But as with the road, so far they lead nowhere.

There’s no new hospital in Junction City yet. And many mental health advocates want to keep it that way.

Gov. John Kitzhaber’s proposed 2013-15 budget calls for borrowing $79.4 million to build the hospital, which is already two years behind its original schedule.

Oregon has been undergoing a major effort to bring its mental health system into the modern age. The Oregon State Hospital, built in 1883, in Salem was literally crumbling when the state tore it down.

In its place, legislators approved $458 million for a new 620-bed hospital in Salem, intended to leave behind the days of One Flew Over the Cuckoo’s Nest.

But plans for the second hospital in Junction City are perhaps the least-known—and least-scrutinized—part of the state’s strategy.

And mental health advocates say building it would add the wrong kind of treatment beds in Oregon, taking the state in the opposite direction from where it should go: toward smaller, less-expensive facilities located near high-population areas—including Portland.

READ – Junction City hospital the worst way to treat mentally ill, by the board of the Mental Health Association of Portland

If the Junction City hospital opens (scheduled for 2015), the state would close a 90-bed state hospital campus in Portland and the 60-bed Blue Mountain Recovery Center in Pendleton. Blue Mountain and Portland accept civil commitments, people who pose a danger to themselves or others, not forensic patients, who have been found not guilty of crimes by reason of insanity.

That would leave the state without civil mental health facilities east of the Cascades and no beds in the Portland area, which accounted for nearly half of the state’s civil commitments last year

“We don’t do that for any other health condition,” says Chris Bouneff, executive director of the National Alliance on Mental Illness of Oregon. “Imagine your loved one had a stroke and had to go into some long-term rehabilitation care and was from Portland, and we sent them to Junction City two and a half hours away.”

Linda Hammond, interim director of addictions and mental health for the Oregon Health Authority, says the Junction City hospital is necessary to replace the outdated Pendleton facility. The lease for the Portland branch expires in 2015.

Hammond says her agency wants smaller, locally based facilities, but they would take more time to set up than the state has. She estimates establishing a network of community-based care will take years.

“We can’t suddenly close Blue Mountain and Portland and put those people out on the street if there is not the infrastructure and services to meet their needs,” she says.

The U.S. Department of Justice has put pressure on the state to move away from larger hospitals, so in 2010 state officials cut the capacity of the proposed Junction City hospital to 174, from its original 360.

Overall, the new hospital would add just 22 beds to the state’s mental health system, Hammond says.

The long-term plan, she adds, is to hand over the Junction City facility to the state Department of Corrections, which owns the site.

Bouneff and other opponents say they’re skeptical that will ever happen.

He says smaller facilities of 16 or fewer beds in locations across the state would save money, allow the state to collect Medicaid reimbursements that it can’t with a large hospital, and keep patients nearer their homes.

The lack of good reasons to build a big, new hospital so far from Portland, he adds, has led him to one conclusion: “This is pork, pure and simple.”

The Junction City hospital would bring about 2,500 construction jobs to Oregon’s economy and 500 to 600 sustained jobs once it opens, says state Rep. Val Hoyle (D-Eugene), whose district includes the hospital site.

But to call it pork for her district is “insulting and wrong,” Hoyle says.

The governor’s budget, she points out, includes $1 billion for community mental health and addictions treatment—a 43 percent increase from  the current budget.

Hoyle calls the plans “80 percent” of what advocates want. “If I didn’t think that this was a necessary part of our mental health system, then I wouldn’t be fighting for it,” she adds.

Kitzhaber and Democratic legislative leaders want to approve the hospital.

Despite their backing, Rep. Carolyn Tomei (D-Milwaukie), chairwoman of the House Human Services and Housing Committee, says the high costs of doubling down on larger institutions rather than providing community care could give lawmakers pause.

“It could be stopped if enough of a swell of the population says, ‘Wait, this doesn’t make sense,’” Tomei says. “But I don’t think it will happen.”

By Amanda Waldroupe, for The Lund Report, March 1, 2012

These drugs will continue to be reimbursed by the Oregon Health Authority’s Department of Medical Assistance Programs but provide local officials with more information on the effectiveness of the medications

By July, the Oregon Health Authority is expected to begin providing real-time data to the Central Oregon Health Council, which coordinates the care of Oregon Health Plan patients in Deschutes, Crook and Jefferson counties, on the mental health drugs used by people living in that area.

Senate Bill 1506 passed the House and Senate unanimously earlier this week, directing the Oregon Health Authority to provide data on which mental health drugs are being used, how often patients fill their prescriptions, whether they fill them as prescribed and other information relating to patients’ use of the mental health drugs.

Elizabeth Steiner Hayward

The Oregon Prescription Drug Program, which purchases mental health drugs for some state agencies, including the Oregon Health Authority, will be responsible for sharing the data with the Central Oregon Health Council, which is made up of representatives from various provider groups and county government.

The bill applies to all mental health drugs that are currently paid for directly by the Oregon Health Authority’s Department of Medical Assistance Programs, rather than the managed care plans throughout the state, in what’s known as the mental health “carve out.”

“It is the one piece of the healthcare puzzle that’s still paid for directly by the state,” said Sen. Elizabeth Steiner Hayward (D-Hillsboro).

Chris Bouneff, the executive director of Oregon’s chapter of the National Alliance of Mental Illness (NAMI), said this “carve out” was created to protect patients and ensure that they receive the most effective medication. Also, a patient’s access to these mental health drugs will never be interrupted – even if the costs exceed the budget – the state will continue paying the bill.

Finding the right medication for a person with a particular mental illness can be difficult, Bouneff said, because two people with the same mental illness can react differently to the same drug, and many drugs can take weeks or months to become effective.

“You want to be very careful about starting the person on the right medication,” Bouneff said. “Failure can be catastrophic when we’re talking about mental health drugs.”

But because the state pays directly for these drugs, a patient’s provider or their managed care plan may not know about the effectiveness of these medications until six weeks later. “That’s not helpful,” Bouneff said, particularly when providers are attempting to integrate physical and mental healthcare.

“[You] can’t achieve full coordination without seeing data about those drugs,” said Robin Henderson, acting executive director for the Central Oregon Health Council, which is made up of representatives from various Central Oregon provider groups and county government.

The bill’s supporters say the legislation, and the ability to review current data, will help physicians better coordinate the care of their patients. “Physicians need to have real time access to the data of what mental health drugs a person is taking,” said Rep. Val Hoyle (D-Portland). “It makes sense that if we’re going to integrate care that we also integrate access to information.”

Steiner Hayward believes the data sharing will be a “model for how the Oregon Health Authority can interact with [coordinated care organizations] moving forward.”

Coordinated Care Organizations, or CCOs, will create patient teams made up of doctors, nurses, behavioral health providers, community health workers, and other providers who will integrate physical, mental and dental healthcare for 600,000 patients on the Oregon Health Plan. The hope is that by focusing on preventive care and reducing emergency room utilization, costs can be reduced. With the passage of Senate Bill 1580 last week, the Oregon Health Authority is preparing to implement CCOs throughout the state starting July 1.

Senate Bill 1506 underwent a substantial amount of change from its original version. Originally, the bill would have created a two-year pilot program allowing PacificSource, the managed care plan in Central Oregon, to pay for the drugs themselves.

PacificSource would have used a capitated rate for these drugs — setting aside a certain amount of money, and the health plan uses a capitated rate for its other health services. There was a provision in the original bill that said that if PacificSource exceeded the costs for the drugs, the state would have stepped in and paid the difference.

“It would change who the money was flowing through. It didn’t change access, and there was a backstop,” Bouneff said.

Allowing PacificSource to pay for the drugs, Bouneff said, would have allowed the managed care plan to analyze the cost of the drugs, as well as develop ways to improve a patient’s health so that they would be less dependent on the drugs — and thus save money.

“The thrust of the pilot was getting education out to prescribers, pharmacists and patients so people could make very informed choices,” Bouneff said. “And you had this integration of information so we could really focus on health outcomes. If you use medications strategically, a patient’s health outcomes improve and you can reduce the cost of the medications.”

But the bill received a substantial amount of opposition particularly among pharmaceutical groups, even though there was no testimony during the public hearings. Jim Gardner, a lobbyist for PhRMA, did not return a call for comment, but Bouneff said the pilot project could have affected pharmaceutical companies “free reign to influence prescribing.”

Tom Burns, the Oregon Health Authority’s director of drug purchasing, sent a letter to the Senate’s Healthcare committee saying that the Department of Medical Assistance Programs could develop a way to send data to the Central Oregon Health Council within 24 hours, instead of the typical six-week wait.

Bouneff said he and others doubt whether the Oregon Health Authority will actually be able to provide the data in a timely manner. “This is something we’ve asked the state to do, and they’ve shown no interesting in doing it.”

The Central Oregon Health Council also intends to establish a clinical advisory committee — something that was in the original bill, but not in the final version — that will look at ways to integrate information about mental health drugs, as well as how to better manage the medications, and improve a patient’s health. The council is expected to submit a report on this project during the 2013 legislative session.

Photos for this story appear courtesy of The Oregonian.

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From the Eugene Register-Guard, February 27, 2012

There will be no new bond funding this year for the proposed state psychiatric hospital in Junction City, according to Gov. John Kitzhaber and several key lawmakers.

But that doesn’t mean the project is stalled. State officials now acknowledge they in fact have $20 million in old funding still available and dedicated to the project. That will allow on-site infrastructure and foundation work at the Highway 99 property to proceed this year and early next year.

The pace of construction won’t be as brisk as advocates have wanted. Allocation of new bond funding this legislative session would have allowed construction to proceed more quickly, officials said.

Although the state’s capital construction budget hasn’t yet been finalized, the advocates’ request for $29 million in new general, fund-backed bonds to further the project is off the negotiating table, state officials said.

Opposition this session centered largely on fiscal concerns. The state’s Debt Advisory Committee has recommended that the Legislature take on no additional general fund-backed debt this year — although long-standing philosophical questions remain about whether Oregon should commit to another large psychiatric hospital.

But supporters of the Junction City project, including Kitzhaber, say there’s $20 million in unspent bond funds that were allocated to the project back in 2009 that can be used to keep the work going.

With that money, project managers have said they can complete planning, site preparation and foundation work this year and in the first half of 2013.

Although that will mean a slowdown in the anticipated construction schedule, it won’t prevent the hospital from being completed before its target opening of early 2015, said Tim Raphael, a spokesman for the governor.

The decision on new bonding to complete the construction can therefore be pushed to 2013, Kitzhaber said.

“We knew 2012 would be a difficult year for new bonding, so we asked project managers what they could do within the existing allocation,” Raphael said Friday.

While project backers in recent weeks were pushing the Legislature for new bond money, none had mentioned publicly that the project still had $20 million in prior funding available.

The immediate fate of the big project — and the construction and permanent jobs it would generate — has been portrayed by state officials for some months as riding on the ability of project supporters to get more bonding approval through the current Legislature.

Linda Hammond, director of Oregon’s addictions and mental health treatment programs, had told The Register-­Guard previously that delaying the new bonds by at least a year, into 2013, “would make it extremely difficult to meet the target date of 2015.”

Project administrator Jodie Jones would not comment on the project Friday, referring all questions to the governor’s office.

With the effort to gain additional bonding for the project from the Legislature now clearly dead, officials are disclosing they still have the old money available.

The state already has spent more than $30 million on the Junction City project, to complete work such as water and sewer lines around the proposed site and on hospital design and planning.

Hospital advocates hope they will gain more traction in the 2013 Legislature, when the state’s bonding capacity is expected to be rosier.

Another $84 million is needed to complete the project.

The debt committee estimates that as much as $987 million in general fund-backed capacity could be available in just the first year of the 2013-15 biennium.

Legislative leaders “are being very conservative with capital construction projects this cycle,” said state Sen. Chris Edwards, D-Eugene.

“There will still be opponents on philosophical grounds next year, but they won’t be able to hide behind the state’s fiscal difficulties,” he said. “The bottom line is that we still need the hospital.”

State Rep. Val Hoyle, D-Eugene, said she was happy that the people working the project had been able to “keep the project moving with existing funds.”

“I believe holding off on additional funding until we have more (bonding) capacity is responsible,” she said.

Conversely, state Rep. Dennis Richardson, R-Central Point, the state GOP’s chief budget crafter, said he will continue to oppose the project, which he doesn’t believe to be a cost-effective or humane way of treating people with mental illnesses.

“If the Democrats take back the House (in the 2012 elections), and continue to control the Senate and the governor’s office, the project might move forward,” he said. “But it won’t be based on economic reasons.”

Edwards said he understood that some Junction City residents may be increasingly skeptical about the state delivering on its promise of a hospital in their city. Residents long have hoped that a major state facility could provide an economic boost to the area.

“If I lived in Junction City, it would be easy for me to say, ‘This is typical of the state not to follow through on its assurances,’ ” Edwards said.

“But … those of us in the Legislature that support (the hospital) will continue to fight for it.”

By Saul Hubbard, The (Eugene) Register-Guard, Feb. 22, 2012

A fitting collaboration for a prison-like hospital. (Image: OSH Replacement Project website)

SALEM — As the monthlong 2012 legislative session enters the home stretch, the fate of continued construction funding for the proposed new state psychiatric hospital in Junction City remains unclear.

To keep the project moving through next June and the 174-bed hospital on track to open in early 2015, lawmakers this session need to allocate $29 million in general fund-backed bonds, according to project administrator Jodie Jones.

If lawmakers are to approve some or all of that, the effort probably would originate in the capital construction subcommittee of the Joint Ways and Means Committee, the Legislature’s budgeting arm.

The subcommittee, which has yet to meet publicly this session, features the presiding officers of each legislative chamber — Senate President Peter Courtney, a Salem Democrat, and House Co-Speakers Bruce Hanna, a Roseburg Republican, and Arnie Roblan, a Coos Bay Democrat — and often convenes as adjournment approaches to move key spending bills forward.

But, with the state’s borrowing capacity severely limited for the rest of the 2011-2013 biennium, legislative leaders are keeping silent for now about which projects — if any — might be green lit and how much funding they could receive.

Aside from the Junction City hospital, which has a total remaining price tag of $84 million, some key projects competing for state capital dollars include:

A “sustainability center” in Portland. The 7-story tower near Portland State University would be built to feature the latest in environmentally friendly and energy-efficiency construction and would contain government offices, conference rooms, and lecture halls. Project backers are seeking $40 million in state bonds.

Continued funding for the O­regon eCourt system, which would allow the state’s courts to go “paperless” and make all filings electronically by 2015. Supporters of the long-term project, which has already received state funding, are seeking $13.7 million in general fund-backed bonds this year.

A variety of smaller-scale projects at Oregon’s 17 community colleges, costs of which would total $9.6 million in lottery fund-backed bonds. The projects include $1 million for new LCC classrooms.

Increased funding for Connect­Oregon, which provides grants for transportation work. A proposal to allocate $10 million in bonds could boost the program’s funding from $40 million to $50 million for the 2011-2013 biennium.

A $10 million loan program to fund water and sewer work in Oregon cities. The state has spent millions of dollars installing infrastructure for the Junction City hospital site, but has not begun construction of the hospital buildings.

After a report by the state’s debt commission in January that recommended no increase in general fund-backed debt and only minimal increases in lottery fund-backed debt for “the most critical” projects until the end of the 2011-2013 biennium, some lawmakers — Republicans in particular — are gun-shy about new construction spending this year.

Rep. Dennis Richardson, a Central Point Republican and the GOP’s chief budget crafter, said Tuesday during a House floor speech that the Legislature should “guard” its small remaining lottery bond capacity “very carefully.”

“We cannot continue to incur additional debt without being willing to pay the consequences,” he said. “When we bond additional money that means we’re committing, not just our Legislature, but Legislatures for the next 20 to 25 years to make the debt payments. … We pay for it by not being able to fund programs in the future.”

Richardson’s comments were directed at an attempt by House Democrats to tack on $29.6 million in lottery bonds to an existing and largely unrelated bill, Senate Bill 1544. The allocation would provide the funding for the community college projects, the water and sewer infrastructure loan program, and the additional $10 million for Connect­Oregon.

Rep. Dave Hunt, a Gladstone Democrat, said the appropriations have “broad bipartisan” support but have been blocked from advancing by House Republican leadership. “What better time to issue lottery bonds than when interest rates are low, we have infrastructure projects ready to go, and our work force is hungry,” he said

Attaching the bond funding to SB 1544 allows these “important, job creating” projects to move forward now, said Jared Mason-Gere, a spokesman for the House Democrats, thereby circumventing the capital construction subcommittee.

The proposals “have been hanging out there for a while, and they’re ready to go,” he said.

But the add-on, which would require a majority vote in the House, is a long shot in the evenly-divided chamber.

“It’s more or less a political stunt that will have no bearing on the adjournment of the session,” said House Republican spokesman Nick Smith. “We have a process for bonding projects.”

The House will vote on the bonding add-on tomorrow.

Another obstacle to pushing through funding for construction projects this year is that more than $1 billion in bonding capacity — general fund and lottery fund combined — will open up at the start of the next biennium, according to the debt commission’s report.

But, for the Junction City hospital, delayed funding would make it “extremely difficult” to finish building by early 2015, Linda Hammond, director of Oregon’s addictions and mental health treatment programs, said last month.

Rep. Val Hoyle, a Eugene Democrat whose district includes Junction City, said Tuesday that the decision about hospital funding this year is now in the hands of legislative leadership.

While she acknowledged “the need for the Legislature to work within its means,” Hoyle said she believes the hospital project is “truly critical.”

Whether or not the project is funded, Hoyle said she will “fight to ensure that the conversation focuses on the full spectrum of mental health care that is needed for … (the) severely mentally-ill population.”

From The Eugene Register Guard, January 22, 2012

Supporters of a planned psychiatric hospital in Junction City hope that isn’t the case, but it faces an uphill battle in the Oregon Legislature next month

As soon as the rains slow this spring, preliminary construction work could begin on the long-­promised state psychiatric hospital next to Highway 99 south of town.

READ – all about the Oregon State Hospital

For a community that has dealt with uncertainty over the past five years as the project repeatedly morphed and got hit with delays, that’s tantalizingly close.

“There’s been a lot of highs and lows throughout the process, and I think the community members who have been following it are taking a ‘we’ll believe it when we see it’ approach,” City Administrator Kevin Watson said.

“Once construction crews are out there and dirt is getting moved around though, there will be more excitement. … I definitely think everyone’s hopeful that it could help out the community in terms of jobs.”

For work to commence this year, however, the Legislature will need to approve during its four-week session in February a $29 million allocation of general fund-backed bonds for the hospital (a small portion of which would go to the nearly completed Salem psychiatric hospital). That allocation would keep the Junction City project moving through next summer and take a big bite out of its total remaining construction costs of $84 million.

But the timing is difficult given state government’s dire financial problems. Projected biennial state revenues have decreased by $300 million since the 2011 legislative session was adjourned. The state debt policy advisory commission recently recommended that the governor and the Legislature not authorize any “net increase in general fund-backed debt” until the end of the 2011-13 biennium.

While the hospital was endorsed publicly by Gov. John Kitzhaber in September, the state’s overstretched debt capacity could swell the Legislature’s ranks of long-standing bipartisan opponents of the Junction City hospital, possibly resulting in yet another construction delay — or even a more permanent derailing.

The importance, for the hospital’s future, of what unfolds next month isn’t lost on Junction City residents, Watson said.

“People will be watching what happens,” he said.

The community care issue

Many people elsewhere in the Lane County also will be watching, given that the hospital is projected ultimately to bring hundreds of permanent jobs to a county hammered by the Great Recession.

In late December, Rep. Dennis Richardson, a Central Point Republican who is the GOP’s point man on budget issues, slammed the Junction City hospital project in his monthly newsletter.

Richardson stressed that moving away from institutional mental health care and focusing on community-based care immediately is cheaper for the state and more humane for patients, arguments long made by mental health advocacy groups and other project opponents.

Richardson claimed that the state could build multiple 16-bed facilities in communities throughout the state for less than the cost of completing the Junction City project. He also wrote that, once opened, those facilities would be eligible for federal matching funds to cover operational costs, unlike the Junction City hospital, where operations would be completely state-funded.

Rep. Val Hoyle, a Eugene Democrat whose district includes Junction City, said Richardson’s newsletter ignored the fact that the Junction City project is intended to serve a population that needs 24-hour supervision and that contains many forensic patients — patients who have plead guilty except for insanity to crimes.

“Some people require hospital-level care,” she said. “And when we close the psychiatric hospitals in Portland and Pendleton, Oregon won’t have enough of those beds.”

OSH Portland and Blue Mountain in Pendleton, which would both require significant renovations to meet federal standards, are currently scheduled to be closed by 2015.

Residential security

Hoyle also criticized a proposal in Richardson’s newsletter that smaller mental health care facilities be placed on industrial land. Richardson argued that doing so could appease “neighborhood placement concerns” by keeping patients with mental illness “far from residential neighborhoods, yet close enough for families to visit and provide needed social support.”

Hoyle responded that “when (mental health advocates) say, ‘We want patients to get their treatment in their community,’ they’re not talking about warehousing them next to warehouses.”

Asked about the industrial land idea, Richardson said he had simply been “vetting” the concept in his newsletter, and that he had since changed his position, based partly on some criticism he received.

However, he disagreed with Hoyle that all forensic patients must be treated in institutional settings.

“The security of community facilities is an issue of design,” he said. “Facilities could be built in a way to harden their security and make them safe for nearby residential areas.”

Richardson also stressed that the possibility of federal matching funds for community facilities is “the financial point that is very powerful.”

Asked if Richardson’s newsletter was indicative of a possible GOP caucus position against the project in the Oregon House — an evenly split chamber where every bill requires bipartisan support to pass — House Republican Leader Kevin Cameron of Salem said that there hadn’t yet been “an in-depth leadership discussion about it.”

But he added, “My personal position is close to” Richardson’s.

“Our bonding capacity is maxed out at the moment,” he said. “2013 is a different year. But to be able to fund the bonds for projects like Junction City, we have to get people working again in private sector.”

In light of the fresh wave of opposition to the Junction City hospital, Hoyle said that she believes the project “has become a political bargaining chip (in Salem) for people to get what they want.”

“It’s unfortunate, because delaying or stopping the project would be very damaging,” she added.

Richardson responded that there was nothing “political” about his opposition to the hospital.

“This is not a new position for me to take,” he said. “This project did not make sense four years ago, and it doesn’t make sense now.”

Getting ready to build

Until the Legislature tells her otherwise, Linda Hammond, director of Oregon’s addictions and mental health treatment programs, is implementing a construction plan that would allow the hospital to open in early 2015, to coincide with the expected closures of satellite state hospitals in Portland and Pendleton.

Under that plan, the 257-acre Junction City site would be “prepped” for construction this spring and summer, Hammond said. That work would include building roadways and utility infrastructure on the property and laying down the foundations of some future buildings.

Most of the actual building construction is set to occur during the summers of 2013 and 2014, Hammond said, with most of the building shells going up in 2013.

Should the Legislature decide to postpone the approval of the hospital bonds for a year, Hammond said, “It would make it extremely difficult to meet the target date of 2015.”

“The biggest driver for construction around this state is that you get short (outdoor) construction windows,” she added.

Fitting the remaining work into two summers rather than three would be challenge, Hammond said, because the Junction City site is generally a “pretty wet” parcel.

While no blueprints or sketches of the facility have been made public yet, hospital design work is scheduled to be finished this year, Hammond said.

Making corrections

Jodie Jones, the project administrator, said that despite state plans to transform the facility into a prison eventually, designers are “first and foremost building a hospital.”

Still, Jones said, care is being taken to avoid plan elements that obviously would be at odds with a prison facility.

For example, designers are leaving space between buildings and the property line, so as to potentially accommodate the outside perimeter fence that a prison might require, but that the state hospital does not.

The hospital also will feature several large group treatment rooms that a prison might not have a use for, Hammond said. Therefore, they will be designed so they can easily be transformed into dormitories.

The transition pre-planning can only go so far, however, Jones said.

“We have to be careful about building something completely to Department of Corrections standards now, because we don’t know how much those standards will change in the years it takes to transition the facility,” she added.

A mental hospital long in the making

• February 2007: State officials select Salem and Junction City as the preferred sites for two new psychiatric hospitals to replace the aging Oregon State Hospital in Salem. The new 620-bed Salem facility is to open in 2011, while the 360-bed Junction City facility is scheduled for a 2013 opening.
• September 2008: Work begins on Salem hospital.
• Spring 2009 to summer 2011: State spends about $25 million on water and sewer infrastructure upgrades in Junction City to accommodate the hospital, as well as a proposed prison, both located on the same 257-acre site on Highway 99.
• 2010: State hospital planners reduce the size of the Junction City facility to 270 beds.
• February 2011: Gov. John Kitzhaber reduces the size of Junction City hospital to 174 beds, based on state’s projected needs, and includes all remaining construction costs for the facility — $84 million — in his initial 2011-13 budget. Kitzhaber scraps the proposed prison on the site.
• June 2011: The Oregon Legislature delays the proposed opening of Junction City hospital until 2015 and approves a $5 million allocation for the project to continue infrastructure and design work. Legislators also unveil long-term plans to transition the hospital into a Department of Corrections facility that would treat prisoners with mental health and addiction issues.
• September 2011: Kitzhaber publicly endorses the Junction City hospital at a town hall meeting. Kitzhaber stresses his long-term commitment to community-based mental health care and to transforming the Junction City facility into a prison eventually.
• March 2012: New Salem hospital is set to be entirely completed.
• Spring-summer of 2012: Junction City site preparation scheduled to begin if Legislature provides funding.
• Summer of 2013 and 2014: Majority of construction work in Junction City scheduled to occur.
• Early 2015: Possible opening of Junction City hospital.

From the Eugene Register-Guard, September 27, 2011

Kitzhaber says the Junction City project has a key role in the move to community-based mental health care

Junction City, Oregon

“I would not be in support of building this institution if it wasn’t part of a larger mosaic of how we provide care to those with mental illness in this state,” the governor told a packed house at First Baptist Church.

Kitzhaber said a Junction City facility makes sense because the state will need more secure psychiatric beds when its two smaller hospitals in Portland and Pendleton close in coming years.

“Those facilities are falling apart, and they’re inadequate,” he said. “It’s more cost-effective to build a new facility” than to renovate those hospitals.

Kitzhaber said he wants Ore­gon to transition to a mental health care system that’s focused on community-based, preventive care for most patients — a model that would be cheaper for taxpayers and less restrictive for patients. At that point, the Junction City facility could transition into a prison that specializes in treating mentally ill inmates, the governor said.

“The whole (health care) system is currently set up to reward acute care,” he said. “What we’re trying to do is fundamentally change that system.”

Kitzhaber, local legislators Rep. Val Hoyle and Sen. Chris Edwards, Lane County Commissioner Jay Bozievich and hospital project administrator Linda Hammond took questions from a crowd, whose concerns ranged from the number of nursing jobs the hospital eventually might bring to whether the state can afford the new hospital, as well as public safety questions raised by several prospective neighbors of the facility.

Some spoke in support of the project, including Katharine Schneider, who works in the psychiatric unit of the Sacred Heart Medical Center, University District.

“To our minds, it is unfathomable that we wouldn’t create those beds,” she said. “We had a patient wait for a (secure psychiatric) bed for 90 days. … Until we have more community options, this is just a critical project.”

Several construction industry representatives said the project would bring “desperately needed jobs,” and asked for safeguards to ensure that the jobs stay in Oregon.

Others were critical of the proposed hospital.

“The focus shouldn’t be on jobs; it should be on the appropriate treatment of the mentally ill,” said Gary Crum, a Junction City retiree. “I would feel more comfortable about this project if there was any patient advocacy group that was supporting this.”

Jim Hargreaves, a former Lane County Circuit Court judge who spent a year studying the Oregon State Hospital, asked the governor how he would go about finding sites for 16-bed community mental health care facilities throughout Oregon.

“It’s great to talk about community-­based care, but nobody wants it in their backyard,” he said.

Kitzhaber acknowledged the challenge that siting would pose. He said the state might have to create a board that would have the power to choose sites over the protest of communities.

“It’s one of those things where you can’t have it both ways,” he said. “I don’t see a way around that.”

The Legislature will have to approve an additional $28.5 million in construction bonds in February to keep the Junction City hospital project moving forward and on schedule to open in 2015.

Kitzhaber spent the earlier part of his day in Eugene, where he spoke at a convention for the Oregon AFL-CIO federation of labor unions, and toured Bulk Handling Systems, a local manufacturing business that builds machines that extract recycl­able materials from garbage; it has increased its work force significantly over the past 18 months.

From the Eugene Register-Guard, September 28, 2011

Governor John Kitzhaber

Gov. John Kitzhaber today will attend a town hall meeting in Junction City that will delve into the current status of the proposed psychiatric state hospital here, which could bring hundreds of government jobs to Lane County if it is ever built.

Joining Kitzhaber will be state Sen. Chris Edwards and state Rep. Val Hoyle, Eugene Democrats whose districts include Junction City; Lane County Commissioner Jay Bozievich; and high-­ranking state officials from the Oregon Health Authority and Department of Corrections. Tim Raphael, a Kitzhaber spokesman, said the governor “looks forward to meeting with his constituents in that part of the state.”

Hoyle, a vocal supporter of the project in the Oregon Legislature, said she was “very excited” that the governor had accepted an invitation to attend the meeting.

“People have been able to get little pieces of information about the status of the project, but having the governor — Ore­gon’s chief executive — discuss how (the Junction City hospital) fits in with his vision of overall health care transformation for the state will be very reassuring to residents,” she said.

The hospital project has been in a state of continual flux since its inception in 2007, when lawmakers approved a $458 million plan to build two new psychiatric facilities — a 620-bed facility in Salem and a 360-bed facility in Junction City — to replace the old Salem state mental hospital.

The new Salem hospital largely is completed, but the Junction City project has been stalled, in part because of the state’s financial crisis.

While the hospital would be a boon for Lane County’s economy, bringing hundreds of well-paying jobs, the project has met plenty of resistance, both on financial and mental health treatment grounds.

Earlier this year, the size of the proposed Junction City facility was cut to 174 beds, based on revised projections of the state’s need for psychiatric beds in the coming decades, and funding to move beyond preliminary construction work was postponed because of stretched state finances.

The 2011 Legislature approved $5 million for indirect construction costs — mostly for planning and infrastructure — to be spent in Junction City by early next year. That allocation keeps the project moving forward and could allow the hospital to open on schedule in 2015, according to project administrators.

Legislators also floated the idea this summer of transitioning the hospital eventually to become a state corrections facility for inmates with mental health and addiction problems. The proposed transition would allow many individuals with mental illness, those who are not dangerous to themselves or others, to be treated in community settings around the state rather than in a big psychiatric hospital.

That’s a model of care for mental illness that the federal government and patient advocacy groups have been pressuring Ore­gon and other states to move toward.

Hoyle said today’s town hall meeting would allow officials “to explain the current plan (for the hospital) and to address some concerns that Junction City residents might have moving forward.”

Raphael, Kitzhaber’s spokesman, said the governor “wants to be in listening mode” and get local feedback about the project.

Junction City Councilor Randy Nelson said he expects the meeting to be well attended as local interest remains high.

“When you’re talking about 500 to 600 jobs, people will be interested,” he said.

Nelson added that getting Kitzhaber’s “stamp of approval” will help give confidence to the community that the hospital will be built eventually.

“It has been long time since (people in Junction City) first heard about this project, … and they’re confused about where it is headed now,” he said. “It does feel like the plans change on a day-to-day basis.”

Kitzhaber also may hear from some advocates for psychiatric patients who balk at the idea of the state building a new psychiatric hospital, even one that may serve a different purpose eventually.

[David] Bob Oaks, director of MindFreedom International, a Eugene-based organization, said that politicians continue to paint individuals with mental illness as dangerous and refuse to include representatives of that community in discussions about how the care they should receive.

For all the official proclamations about a future using community-based care, if legislators move ahead with a large new psychiatric hospital, that will send its own message, he said.

“We hear a lot of great buzzwords, like ‘community care’ and ‘empowerment,’ but the proof is in the pudding,” he said. “A facility like that is something that belongs in the industrial age and the 1800s.”

Town Hall Meeting on state hospital for Junction City

When: Today, 4 p.m. to 5:30 p.m.

Where: First Baptist Church, 28957 W. 18th Ave., Junction City