Closure of Pacific Gateway adds pressure to ER

From The Portland Business Journal, September 16, 2001

When the state pulled the operating license for Pacific Gateway hospital after the death of a Mexican national this spring, the county was left without a secure evaluation and holding facility, according to Diane Linn, Multnomah County chair.

And while other hospitals have designated psychiatric beds, there just aren’t enough of them to go around, according to Dr. Christopher Richard, head of emergency room operations at OHSU.

“We have an inpatient unit here, and there are other units in the city but we’re sending people to Salem and Eugene because there are no available beds,” he said.

“We’ve even sent patients as far away as Seattle. When there is nothing available in town, we basically get the map out and we go to the nearest place.”

Worse yet, the cost of housing patients in an acute care bed is astronomical and ineffective for long-term management of mental illness.

Jason Renaud, executive director for the National Alliance of the Mentally Ill, said the current system drains money away from more promising treatment options.

“We’re paying $800 a day for a patient staying in a hospital,” he said. “What can you get at the Hilton for $800 a day? You get a private nurse and a masseuse, food, medication and the Hilton room, too. We need to reclaim that money and funnel it back into the infrastructure.”

The solution proposed by the county–of finding a substitute psychiatric unit that can serve as a holding, evaluating and prescribing area–seems obvious, but circumstances have already made it more difficult for county officials to find an easy answer.

The county is in negotiations with Woodland Park hospital to contract for a county psychiatric unit but the talks have been clouded by recent allegations by three former employees of safety violations and poor patient care.

The Oregon Office of Mental Health Services made an unannounced on-site inspection of Woodland Park in August and a resulting report has turned up critical concerns about patient safety and care. The state has given the hospital 30 days to comply with “six critical areas of noncompliance.”

“We were on track with Woodland in our contract negotiations to provide the holding beds for acute care,” said Linn. “But with the allegations of these former employees and some issues that have surfaced in their psychiatric ward, we have had no choice but to step back and take a good, hard look at that. And frankly, practically speaking that creates another delay.”

Linn said the county will not sign a contract with Woodland Park until quality of care; safety and how people are managed there are assured. On the other hand, she said, the need dictates that talks with Woodland Park must continue in the meantime.

Meanwhile, the former county fallback, Pacific Gateway, may reopen under different management.

“The potential buyer intends to operate the hospital as a behavioral health facility,” said Beth Page, a spokesperson for Ardent Health Services, owner of the facility. “And we are hopeful these negotiations will be concluded in the near future.”

However it still could be some time before the hospital could contribute to the pool of resources.

According to Dr. Peter Davidson, clinical director of the county’s redesign project, the building itself needs major physical renovations before it could meet county and state operating standards.