Report Recommends Replacing Oregon State Hospital

Report includes recommendations on both how mental health care is delivered and redesign options for the Oregon State Hospital

(Salem) - Governor Ted Kulongoski and the Oregon State Legislature have received the second report ` in a multi-phase process ` detailing recommendations for the redesign of Oregon`s mental health system, including a new State Hospital. The phase two report, also called the "Oregon State Hospital Framework Master Plan Phase II Report", was commissioned by the Governor and the legislature last session to continue the work started through the "Master Plan Phase I Report" received on May 16, 2005.

Both phases of the Master Plan were led by KMD Architects of San Francisco. The Phase I Report identified the structural and systemic challenges facing the Oregon State Hospital`s Salem Campus and concluded that Oregon should proceed with both the replacement of the Hospital facility and a redesign of the entire public mental health system. Building on those findings, the Phase II Report recommends enhancing Oregon`s delivery of mental health care to its citizens at the community level and clarifies the role that the Oregon State Hospital should have within an improved and enhanced community-based system.

"When I entered office one of my first actions was the appointment of a Mental Health Taskforce, which I charged to study our public mental health system and develop recommendations for how we can improve it," Governor Ted Kulongoski said. "In 2004, my taskforce issued recommendations, among them that the state prioritize the restructuring Oregon`s mental health system, including the State Hospital ` so that we are better equipped to appropriately care for all Oregonians with mental health care needs."

"That restructuring requires attention both to services the state supports at the community level and to services the state provides directly in a state facility," the Governor continued. "Today`s Phase II report moves us closer toward improving Oregon`s capacity to care for individuals with mental illness ` those who need hospital-level care, and those who don`t."

The Phase II Report found that adult consumers of mental health services in Oregon often receive care through the state hospital and in residential community settings than clinically necessary. Based on this finding, the report recommends that the state:

Replace the State Hospital with properly-sized and more efficient modern hospital facilities, located near the homes of the majority of patients;

Continue the systemic mental health changes underway that encourage communities and providers to adopt the "Recovery Model" of care that focuses on maximizing the ability for individuals with mental illness to create the life they want for themselves in their home communities while receiving the care that they need; and

Improve the movement of persons through the mental health system by financing enhanced access to acute care and community-based programs.

The Phase II Report also outlined three viable development options for the state to consider for the redesign of the Oregon State Hospital facilities:

Option 1: One 980-bed facility encompassing all inpatient beds, located in the North Willamette Valley region, and two non-hospital level, 16-bed secure residential treatment settings placed strategically east of the Cascades. $297-307 million Project Costs.

Option 2: One 620-bed facility located in the North Willamette Valley region, one 360-bed facility located south of Linn County on the west side of the Cascades, and at least two non-hospital level, 16-bed secure residential treatment settings placed strategically east of the Cascades. $324-334 million Project Costs.

Option 3: One 600-bed facility located in the North Willamette Valley region, one 320-bed facility located south of Linn County on the west side of the Cascades, and one 60 bed forensic facility in Central Oregon. $326-337 million Project Costs.

KMD Architects recommend that Option 2 be funded to provide state hospital facilities located near the homes of approximately 93% of the individuals who will require hospital-level care. The report contemplates that under any of three options, facilities would open by the year 2011.

The Phase II Report stressed that the size of the recommended hospital facilities is dependant upon a continued commitment to and increased funding for Oregon`s community-based services.

Finally, the Phase II Report identified the next steps the state must take to move into "phase three" of the Master Planning process: 1) Select an Oregon State Hospital development option by May 2006; and 2) Secure the services of a qualified architectural/engineering consulting team by Summer 2006 to focus on programmatic design for the new hospital facility(ies) and to identify the location and specific site for construction of the new facility(ies).

"I remain committed to a shared legislative and executive process to aggressively move forward with this next phase to ensure we are providing quality services to Oregonians with mental illness in the appropriate setting," Governor Kulongoski said. "At my request, the 2005 legislature approved funding to continue this process seamlessly through the interim. The individuals in the state`s care, their families and hospital staff deserve nothing less than our full commitment to this endeavor."

To link to the report, go to: http://egov.oregon.gov/DHS/mentalhealth/osh/main.shtml/ under the title, "Hospital Phase II Master Plan Report."

In addition to the advancement of the Master Planning process, leadership at the state and local levels have acted on recommendations in the Governor`s Interim Mental Health Taskforce to carry out additional mental health system improvements, among them:

More Community Placement Development. Since 2003, the Department of Human Services, Office of Mental Health and Addiction Services, in partnership with local governments, has developed more than 260 new community-based placement options for adults with severe and persistent mental illness. Following those trends, the Office and Mental Health and Addiction Services is on target to increase the number of additional community placements in 2007/09 by 299 `meeting or exceeding the recommendations for additional community placement development in the Phase II report.

Closing the J Building and Improving the Hospital Staffing Ratios. In January, 2006, an additional $3.9 was added to the Office of Mental Health and Addiction Services budget to fund an additional 71 community placements (above the current biennium`s target of 228 new placements), as well as 30 new Oregon State Hospital staff. This additional investment will enable the closure by June 2007 of the three Oregon State Hospital "J-Building" wards identified in the Phase I Report as most at risk in the event of a seismic event.

Closing the Hospital Adolescent Wards. In January 2005, the Governor directed the closure of the last Oregon State Hospital adolescent unit, moving every Oregon youth with a severe mental illness out of institutional-based care and into community-based treatment.

Improving Community Care and State Hospital Connections. The state has invested an additional $6 million for local mental health authority case management services for persons at risk of state hospitalization or transitioning from the state hospital. In addition, local mental health authorities have worked to develop a co-management plan between them and the state to better link the community system to the State Hospital and vice versa, improving the mental health service continuum of care for individuals in the system.

Providing Mental Health Parity. In 2005 Oregon passed SB 1, instituting "parity" for mental health and addiction treatment services with physical health services for individuals with private health insurance coverage.

Reducing Recidivism by Improving Access to Benefits for Individuals with Mental Illness upon Release from Incarceration. In 2005, Senate Bill 913 passed, allowing persons with a serious mental illness to have their publicly funded medical benefits suspended rather than terminated when incarcerated.

Ensuring that Courts Have Accurate and Up-to-date Information about an Individual`s Mental Health Status. In 2005, Senate Bill 39 passed, requiring a mental health evaluation in court proceedings involving a plea of Guilty Except for Insanity.

Education and Training for Judges in Mental Health and Substance Abuse Issues. The state has launched a collaborative effort with the Oregon Judicial Department focused on education and training for judges around mental health and substance abuse issues.

Promoting an Adequately Trained, Stable Behavioral Health Care Workforce. In partnership with the Governor`s Health Care Workforce Initiative and the Board of Higher Education, the state is working to improve the quality and quantity of Oregon`s behavioral health care workforce.

Expanding Evidence-Based Practice. Oregon continues to be a national leader in implementation of evidence-based practices by mental health and addiction service providers in Oregon.