Oregon State Hospital on Thursday, Sept. 23, 2021. (Amanda Loman/Salem Reporter)
Oregon State Hospital’s superintendent acknowledged administrators’ handling of the Covid pandemic put more stress on staff and meant fewer treatment options for patients.
In a letter sent Monday to Disability Rights Oregon, Dolly Matteucci defended the hospital’s record over the past year and a half, saying decisions she and hospital leaders made successfully prevented the spread of the virus.
“Our efforts have worked. While COVID-19 tore through other congregate settings across the nation and Oregon – from nursing homes to state correctional facilities – OSH did not record a single positive patient case until eight months into the pandemic. To date, no patients at the state hospital have died from COVID-19,” Matteucci wrote.
Matteucci wrote in response to a Sept. 27 letter from Disability Rights Oregon’s executive director, Jake Cornett, who raised concerns about patients receiving adequate care and legal assistance in light of staffing challenges.
The organization has long played a role in motoring patient care and conditions at the hospital, which cares for about 500 Oregonians with mental illnesses and disabilities who are court-ordered to receive treatment.
“During our investigation into the conditions and treatment of people with mental illness during the pandemic, staff and providers paint a picture of a State Hospital in complete disarray and an agency that is unwilling or unable to confront just how bad things have gotten,” Cornett wrote.
The letter was addressed to Gov. Kate Brown and Pat Allen, director of the Oregon Health Authority, which runs the hospital.
Matteucci’s response confirms several findings from a Salem Reporter investigation into conditions at the hospital, published Oct. 12.
That investigation, based on interviews with employees and hospital records, found employees and patients were paying a steep price because of a hospital decision early in the pandemic to spread some of its least stable patients across the hospital to make space available for Covid quarantine and isolation.
The result was employees on units that had previously treated mostly stable, longer-term patients saw a large increase in so-called “aid and assist” patients. Those patients are admitted to the hospital because they are facing criminal charges and determined to be unable to aid and assist in their own defense because of a mental illness or disability.
While hospital records showed fewer recorded patient assaults on employees since the pandemic began, Salem Reporter found other data suggesting violence and aggression in the hospital was more serious and widespread. Incidents of patient-to-patient aggression and assault, internal alarms for behavioral emergencies and accepted worker’s compensation claims for injuries caused by patients all increased over the same period.
Matteucci addressed the shift in patient populations in her letter.
“All of these steps have had necessary and unavoidable consequences. Creating a COVID-19 isolation unit meant asking staff to move to other units to manage new patients with higher levels of acuity,” Matteucci wrote.
She said patients had fewer treatment options as the hospital closed its “treatment mall,” a place where patients from multiple units mixed together for help ranging from cooking classes to therapy groups. Instead, patients received care on the units they live on to avoid mixing between groups.
“The unit-based group treatment model lacks the variety of treatment opportunities we can offer in the treatment mall. Suspended visitations have meant that patients have less connection with family and friends. While we regret these consequences, we stand by the interventions we’ve taken. I am convinced our efforts have prevented patients from becoming sick with COVID-19 and saved patient lives,” Matteucci wrote.
She said providing treatment to patients on units meant less time dedicated to treatment, a concern employees also raised with Salem Reporter.
“Unit-based clinicians dedicated additional time to providing individual and group treatment. But because these clinicians are also responsible for other critical work – assessments, discharge planning, and individual therapeutic interventions, for example – it was not possible to entirely replace the treatment hours and variety of group options provided by the deployed staff,” Matteucci wrote.
She said the hospital has recently resumed some treatment activities mixing groups of patients from several units, and plans to return to its prior treatment model once the risk of Covid infection waves has diminished.
Matteucci also acknowledged training employees on the skills needed to help patients aid and assist in their own defense had lagged as patients were reassigned.
“Staffing our Legal Skills groups has presented a particular challenge during the pandemic. OSH relies on Behavioral Health Specialists to teach most of these groups. The process for training new staff is robust and takes considerable time. Staff efforts to shorten the training time was interrupted … because most of those staff who could train other clinicians were deployed to other priority assignments. These challenges our staff have faced in delivering our Legal Skills groups have largely affected units whose patient populations have not historically been focused on serving aid and assist patients. We continue to work to improve this situation and ensure all (aid and assist) patients have timely access to Legal Skills groups,” she wrote.
Matteucci said the hospital continued to struggle with staffing into the summer even after a state Covid leave policy had expired.
“We thought staffing levels would return to normal when the special COVID leave expired at the end of June. Unfortunately, that time coincided with the beginning of the Delta variant surge, which infected more staff during the summer of 2021 than all the months prior. Stress due to illness, contact tracing notifications, and fear of infection played a large role in staff resigning over the summer, in addition to the reasons mentioned above,” Matteucci wrote.
She reiterated steps hospital administrators have taken in recent months to bolster staffing, including a second deployment of National Guard soldiers and airmen, hiring temporary workers and advocating for money for community mental health treatment so fewer patients are referred to the state hospital.
“At the same time, I am proud of the results we’ve achieved for our patients, and the staff who’ve produced them, even as they have weathered unprecedented trials, including a global pandemic,” Matteucci wrote. “Despite our current challenges, state hospital staff and administrators have prevented large outbreaks of COVID-19, reduced incidents of patient assaults on staff and continued to provide effective, recovery-oriented treatment to an increasing number of patients with higher levels of clinical acuity.”
Prior coverage
Staffers at Oregon State Hospital endure violence, long hours despite promises of improvement
Oregon State Hospital advisory board said it was left out of the loop on staffing crisis
With 30 National Guard members, help is on the way for state hospital’s staffing crisis
With thin staff and others working double shifts, state hospital calls for National Guard help
State hospital shifts managers to nursing work to get through holiday weekend
Contact reporter Rachel Alexander: [email protected] or 503-575-1241.
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