New Report Recommends State Hospital Changes

oregon health authority

Dr. Debra Pinals, the mutually agreed upon expert who was chosen to provide recommendations for alleviating Oregon State Hospital’s (OSH) capacity challenges as part of a settlement agreement among Oregon Health Authority (OHA), the Metropolitan Public Defender and Disability Rights Oregon, submitted her second report to the court on June 5, 2022.

The first report was submitted on Jan. 30, 2022. It outlined a short-term compliance plan for the hospital to meet the Mink Order, which requires the hospital to admit patients needing competency restoration (also called Aid and Assist) within seven days of court orders and to also timely admit those under Guilty Except for Insanity (GEI) commitments. The second report, submitted to the court on June 5, 2022, outlines a long-term plan for improving admission wait times for the Aid and Assist and GEI commitments.

“The parties worked diligently with me to discuss various strategies to achieve compliance with the 7-day admission requirement of Mink as soon as possible, and the need of the GEI patients to be similarly released from jail and timely admitted,” Dr. Pinals wrote in her second report.

Dr. Pinals conducted interviews with a variety of stakeholders, including OSH and other OHA staff, advocates and partners and held weekly meetings with the parties in the settlement agreement to receive timely updates. While she points out in the report that “there is no simple single solution that will fix the issues that are contributing to the increased referrals to OSH and difficulties with discharges that create ongoing barriers to opening space at OSH for those waiting in jails and other places,” Dr. Pinals was still able to provide recommendations that would lead to shorter wait times for OSH admissions and discharges.

Those system changes include improving forensic evaluations when assessing people while they are in jail to see if they become fit for trial before they are admitted to the hospital, as well as working with counties to expand the number of treatment beds in the community for people who no longer need hospital level of care, which will improve discharge wait times.

OHA Director Patrick Allen said, “I am encouraged by the thoroughness of Dr. Pinals’ work and her careful assessment of the capacity challenges the state faces. I believe her recommendations are reasonable and achievable and I look forward to seeing them applied.”

Among the many recommendations listed in her report, Dr. Pinals outlined ways the state can improve its system of sharing data and information so that current numbers of patients waiting for admission and waiting for discharge, as well as current capacity levels, are easily found. She also recommended streamlining and improving a variety of hospital processes and outlined in the report several steps to achieve the improvements.

Source: Oregon Health Authority

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