Oregon State Hospital prepares for feds inspection

A scathing report by federal officials in 2008 spurred major changes at Oregon State Hospital, including plans to build a new facility.

A scathing report by federal officials in 2008 spurred major changes at Oregon State Hospital, including plans to build a new facility.

From the Salem Statesman Journal, July 26 2009

Secondary inspection will gauge progress toward improvements

Patient care and conditions at the Oregon State Hospital will draw new scrutiny this week from a familiar critic.

Starting Monday, a team dispatched by the U.S. Department of Justice will tour the hospital campus, examine patient records and hear progress reports from hospital leaders and staffers.

Hospital Superintendent Roy Orr said in a recent interview that he looked forward to showcasing hospital improvements for the federal team.

“I think this return visit is about progress, it’s not about perfection,” he said. “It’s about seeing firsthand the good-faith effort that the state of Oregon has made to put Oregon State Hospital on the right path.”

The weeklong, on-site federal review comes 18 months after the Justice Department issued a searing critique of Oregon’s main mental hospital.

In a report issued in January 2008, the federal agency slammed the hospital for widespread defects in patient care and conditions. Among the reported problems: high rates of patient-on-patient assaults; poor supervision of suicidal patients; severe understaffing; excessive use of seclusion and restraints; inadequate psychiatric treatment; and dangerous medical errors.

The blistering report rattled state officials and legislators, spurring them to allocate extra money for the hospital to hire hundreds of new employees.

Monday’s follow-up visit by the feds will start with an opening presentation by Orr. He is expected to summarize sweeping changes, including sharply reduced use of seclusion and restraints to control patients, creation of a new treatment mall that provides expanded treatment and activities for dozens of patients and opening of six cottages as transitional homes for 36 patients close to their hospital discharge dates.

Then hospital officials plan to escort the feds on a guided tour of the sprawling campus in central Salem, starting with the remodeled cottages.

The visitors also will be taken to the new treatment mall and get a close-up look at the hospital’s construction zone — a busy area that signals progress toward development of a new $280 million replacement hospital.

Plans call for the new 620-bed hospital to partially open next year and become fully operational in 2011.

After that, the state intends to build another hospital in Junction City. The 360-bed facility, planned for construction on state prison land in Lane County, is scheduled to open in 2013.

Combined costs for the two new hospitals are budgeted at $458 million.

Passing federal muster?

A pivotal question looms: Is Oregon doing enough to pass federal muster and avert a lawsuit that could place the state hospital under federal court control?

“My bias is that it’s impossible to deny an almost half-a-billion-dollar commitment in new facilities and an increase in our budget, essentially all for additional staff in an economy like we’re in now and a legislative session like we just went through,” Orr said.

Even so, the hospital chief acknowledged that the U.S. Justice Department could decide to sue the state.

“I oftentimes have people ask the question, are we really at risk of having the DOJ come in here and take over? Well, they don’t take over. What they do is sue you,” he said. “They take you into a court environment, into a trial, and then you’re under a court decree of some sort. And that gets phenomenally expensive.”

The Justice Department’s first on-site visit to the state hospital occurred in November 2006. It came after the federal agency sent a letter to Gov. Ted Kulongoski, informing him of the pending investigation into allegations that patients civil rights were being violated at the state hospital.

As part of the initial investigation, the feds conducted a massive review of hospital records.

For the new review, the feds asked the hospital to provide another huge load of documents.

“It’s several thousand pages that we’ve collected on nearly every aspect of our hospital operation,” Rick Varnum, OSH director of strategic planning, said Friday.

In recent weeks, two-dozen hospital workers were assigned to collect records requested by the feds, Varnum said. Two more staffers assembled and copied the documents.

In keeping with the federal request, about half of the paperwork was shipped to the agency by July 15. The rest of the batch will be available for inspection by the on-site review team.

The state doesn’t intend to bill the feds for records-retrieval work and copying costs.

“We won’t be billing them,” Varnum said. “This is something we’ll do at our expense.”

Limited press coverage

State and federal officials have deemed most of the Justice Department visit off-limits to the press.

In response to Statesman Journal requests for access to the important visit, hospital officials and a state lawyer representing the hospital agreed to allow a reporter and a photographer to attend Monday’s opening presentation by Orr.

After the 15-minute presentation, the newspaper will be shut out of the rest of the week-long visit.

U.S. Justice Department officials on Friday expressed opposition to even the token access granted for press coverage.

A spokesman for the department said in an e-mail to the Statesman Journal that the federal team would skip Monday’s kickoff presentation if a reporter was present.

“I know that is the arrangement proposed by Oregon State Hospital officials and I understand the value to the Hospital of your presence during their opening remarks. However, if you are present we will have no choice but to not attend the portion of the meeting,” wrote Justice Department spokesman Alejandro Miyar.

“Our outside experts cannot be named or identified in media reports. Our attorneys cannot comment or be involved in discussion with a member of the press present. In reality, it becomes basically a press conference where the Hospital is making a presentation to you without our involvement, as we are prohibited from discussing the investigation with a member of the media present as per Department policy.”

Later Friday, the Justice Department’s lead attorney, David Deutsch, informed Micky Logan, Oregon’s senior assistant attorney general, that “Oregon has put the USDOJ in a difficult position by allowing a Statesman Journal reporter to be present on Monday morning,” according to an e-mail that Logan wrote Friday afternoon, recounting her latest conversation with Deutsch.

Logan’s e-mail, circulated to various hospital officials and the governor’s office, was relayed to the newspaper by one recipient.

Despite the concerns stated by the Justice Department about press access, Logan’s e-mail indicated that the federal team will in fact attend Monday’s opening presentation by the hospital superintendent.

“Deutsch reiterated that they would like the presentation to be as short as possible — 15 minutes would be good,” Logan wrote. “They will likely have questions when the presentation is over (and after the reporter leaves).”

Plans call for the federal team to spend four days at the state hospital in Salem, then move on to the hospital’s Portland campus for the final day of the visit on Friday.

Hospital officials said they hope for an “exit interview” in which the federal review team sums up their impressions and findings from the visit.

However, the feds haven’t given any definitive statement about whether they intend to provide such feedback before they leave Oregon, officials said.

EXTRA – The email for the lead attorney in the DOJ inpection of the OSH is David.Deutsch@usdoj.gov
EXTRA – Everything about the Oregon State Hospital