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Do We Need More Government Oversight In Our Hospitals?

Do We Need More Government Oversight In Our Hospitals?

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The Oregonian

April 06, 2010

Apr. 6—SALEM — Following the forced resignation of the superintendent of the Oregon State Hospital and another report critical of patient care, advocates for Oregonians with mental illnesses are calling for increased federal oversight because they do not trust state officials to make progress quickly enough on their own.

“People have been saying: ‘We need change’ for more than a decade,” Chris Bouneff, executive director of the Oregon chapter of the National Alliance on Mental Illness, said Monday. “We are waiting and have been waiting.”

Bouneff and other advocates for the mentally ill and their families say they want a federal judge to oversee and enforce improvements at the state hospital and state mental health care system.

But Oregon’s governor and the state’s Human Services director both say increased oversight isn’t necessary.

“I don’t think this is about oversight. I think this is about a long-term problem that we’ve been making changes on. We’ve made changes. We just need to make changes faster,” said Dr. Bruce Goldberg, who heads the Department of Human Services and the Oregon Health Authority.

On Friday, the hospital’s superintendent, Roy Orr, was asked for his resignation. Orr took the job in February 2008, shortly after the federal Department of Justice issued a stinging report about conditions at the Salem facility. At the time, federal officials warned Oregon officials to fix structural problems and improve patient care or face a federal lawsuit.

Since then, the state has started construction of a new hospital, hired a new chief medical officer and chief of nursing, and received national recognition for reducing the use of seclusion and restraints to control patients.

But a report by the state Office of Investigations and Training concluded the hospital was negligent and failed to provide adequate care to Moises Perez, a 42-year-old patient who died last fall.

That report, released the day Orr’s resignation was announced, depicts a severely mentally ill man who was often shunned or ignored by other patients and staff.

According to the investigation, Perez’s complaints about chest pain were not adequately addressed, his medical file lacked updates about his condition, and he received little follow-up about medication, blood pressure or other concerns.

Perez’s family had tried to alert hospital staff in his last weeks of life, but their calls were not returned, the report said.

Perez died in his hospital bed on Oct. 17 but it took several hours before anybody noticed. The state medical examiner concluded that he’d died of coronary artery disease.

“Reading that report was one of the more discouraging things I’ve ever done,” Bouneff said. “He essentially was there and rotting away in the Oregon State Hospital.”

Bob Joondeph, executive director for Disability Rights Oregon, said the 2008 report and threatened lawsuit from the U.S. Justice Department did bring some federal oversight to the Oregon State Hospital. But it’s not enough.

The state has pledged to do what federal officials have asked, Joondeph said. But it has resisted putting those promises into any kind of official legal agreement.

“We think that court involvement would be helpful because it would create greater incentives for there to be speedy change at the hospital,” he said.

Gov. Ted Kulongoski has resisted greater federal oversight and still does, a spokeswoman said Monday.

“A court-enforced agreement only adds another layer and hurdle to our efforts to improve patient care” at the hospital," said Kulongoski spokeswoman Anna Richter Taylor.

“It would result in ongoing litigation, very expensive legal fees,” Taylor said. “The governor would rather see our resources directed to improved patient care than lawyers and litigation.”

Beckie Child, president of Mental Health America of Oregon, argued that a court-enforced agreement would only be expensive if the state didn’t abide by its promises.

“They’ve had time to do things on their own,” she said. “And we feel that there are still bad results.”

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Copyright © 2010, The Oregonian, Portland, Ore.

Distributed by McClatchy-Tribune Information Services.

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