Appeals court ruling allows hospitals’ mental health lawsuit against Oregon to continue

A federal lawsuit that four hospital systems filed against the Oregon Health Authority for failing to adequately care for people experiencing mental illness can continue at the district court level, the Ninth Circuit U.S. Court of Appeals ruled Wednesday.

The appeals court’s ruling sent the case back to the U.S. District Court of Oregon, which had previously dismissed it. The decision hands a legal victory to some of the state’s largest hospital systems in their fight to force the state to do more to care for the state’s most vulnerable residents, who otherwise are forced to languish for weeks or longer in temporary hospital beds without adequate long-term care. 

Legacy Health, PeaceHealth, Providence Health & Services, and St. Charles Health System in 2022 sued the state, alleging the health authority is failing to provide adequate care for people with mental health needs. 

“We’re pleased with the court’s decision, and we’re optimistic that this lawsuit will result in a much-needed course correction from the OHA,” Melissa Eckstein, president of Unity Center for Behavioral Health, said in a statement. “We originally took this action because the state of Oregon consistently violates the civil rights of vulnerable Oregonians by refusing to provide care intended to restore their freedom.”

The four hospital systems run more than half of the state’s psychiatric beds, but those are only intended for short-term needs. Civilly committed patients and their needs are central to the case. The hospitals allege that those patients, even when they need appropriate long-term care, are not moved to facilities as the law requires and spend weeks, months or longer in hospitals, lacking treatment plans or settings that meet their needs. 

The Oregon Health Authority is responsible for those patients, as well as others in the Oregon State Hospital, which largely treats patients who face criminal charges and need treatment so they can go to court. In the past, defendants deemed to be in need of mental health care have sat in jail cells for months without treatment, sparking litigation that led to an ongoing agreement with the health authority on oversight and treatment deadlines for suspects.

Patients who are civilly committed do not face criminal charges and in the past were often treated by the hospital. But now it lacks beds for civilly committed patients.

Amber Shoebridge, a spokesperson for the Oregon Health Authority, declined to comment on the ruling.

“Community hospitals are not equipped, staffed or designed to provide long-term mental health care,” said Alicia Beymer, chief administrative officer of PeaceHealth Sacred Heart Medical Center at RiverBend. “Despite the previous dismissal of our case, we felt duty-bound to appeal on behalf of the many vulnerable patients who are being denied appropriate care.”

The hospital systems want the state to make systemic improvements so people with mental health needs get the treatment they need. Oregon’s behavioral health crisis is well-documented, even by the health authority as it faces the lawsuit. In February, the Oregon Health Authority released a report that found the state needs nearly 3,000 additional beds to meet the needs of people with mental health and addiction challenges. 

In recent years, state lawmakers have pushed to address the state’s behavioral health crisis, putting more than $1 billion toward new facilities and programs. But efforts still languish, even when funding is available. Some providers have raised concerns about the health authority’s slow pace at approving and funding projects, even when money is on hand. 

“The court’s ruling allows us to continue pursuing legal action to ensure that there is a functional mental health system in Oregon,” Robin Henderson, chief executive of Providence Behavioral Health, said in a statement. “Such a system and continuum of care must include secure residential treatment facilities, as well as effective community-based services to meet the various needs of this vulnerable patient population. Oregonians won’t be able to fully realize this system until the state begins living up to its legally mandated role.”

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Ben Botkin - Oregon Capital Chronicle

Ben Botkin covers justice, health and social services issues for the Oregon Capital Chronicle. He has been a reporter since 2003, when he drove from his Midwest locale to Idaho for his first journalism job. He has written extensively about politics and state agencies in Idaho, Nevada and Oregon. Most recently, he covered health care and the Oregon Legislature for The Lund Report. Botkin has won multiple journalism awards for his investigative and enterprise reporting, including on education, state budgets and criminal justice.