Significant staffing shortages at the Oregon State Hospital in Salem have prompted health officials to call for the National Guard’s assistance. This week, a call also went out to all managers and supervisors who are state employees to temporarily take shifts.
“We need your help,” Oregon Health Authority Director Patrick Allen wrote on Tuesday to state employees. “OHA has exhausted all other staffing options for the hospital’s Salem Campus, and our circumstances are dire.”
On Wednesday, the OHA, which oversees the state’s psychiatric hospital, requested 30 nurses from the National Guard. The governor’s office has not reached a decision on whether to fill that request.
“The Guard is also usually called in after all other civilian and state assets have been exhausted,” Oregon Military Department spokesman Stephen Bomar told OPB.
The staffing emergency comes as the hospital is full and, this week, temporarily stopped new admissions because it hasn’t been able to release enough patients. Disability advocates worry staff are burnt out, and said closing the doors will lead to long backlogs of defendants waiting in jail cells for care.
The Oregon State Hospital employs more than 1,800 people across two campuses, with more than 600 patients. The vast majority of those patients reside at the Salem campus.
The staffing crisis has persisted on and off throughout the pandemic. But the number of hospital staff out on COVID-related leave has increased dramatically since February.
Hospital Superintendent Dolly Matteucci told state lawmakers May 3 that nearly 700 employees had taken some form of COVID leave. From February to March, there was a 45% increase in direct-care staff taking leave.
Matteucci told hospital supervisors Tuesday they would be required to work weekend shifts on patient units starting this weekend and continuing through July 4.
“Still, we struggle to maintain minimal staffing levels,” Matteucci wrote to staff. “Just last week, we had approximately 33% of our Nursing staff out on COVID-related leave.”
In his plea to state employees, Allen wrote the hospital especially needs state employees with nursing experience or familiarity with behavioral health.
“However, anyone who has good people skills is encouraged to volunteer for an emergency assignment,” he said. “The need is great, and any assistance you can provide will better enable (state hospital) staff to do their most critical work – patient care.”
State employees who volunteer for the emergency assignment would get six days of new employee orientation, nine days of basic training in nursing tasks, and 40 hours of orientation on a unit working with a mentor.
“As you know, the pandemic has been taking its toll on our coworkers, those who have been sick, those caring for sick loved ones, and those who’ve lost childcare due to the pandemic,” Allen wrote. “For many state agencies, this means important work may be put on hold — but the hospital doesn’t have that option. We have people to take care of 24 hours a day, seven days a week.”
The hospital treats some of the state’s most vulnerable: those found guilty except for insanity, civil commitment patients, and those ordered to the hospital by a judge on aid and assist orders. Those are people in jail with mental illnesses, who are charged with a crime. Many defendants are so ill they can’t aid in their own defense, so the hospital helps stabilize them before their criminal cases can continue.
“They don’t leave when they’re cured,” said Tom Stenson, deputy legal director for Disability Rights Oregon. “They leave when they know what a lawyer is and they know what a judge is.”
A decade ago, aid and assist patients made up a small portion of the hospital, but today, they account for the majority, Stenson said. That change in patient population, he said, has made the hospital a harder and less fulfilling place to work.
“The current staffing problem is an outgrowth of how the state is choosing to use the state hospital,” he said. “More and more, the hospital has become a way to warehouse people who are ill rather than treat them. I think that’s burned the staff out.”
Since 2002, the hospital has been under a federal court order to admit aid and assist patients within seven days of a judge ordering them to the hospital for care. The ruling came out of litigation by the Oregon Advocacy Center, which later became Disability Rights Oregon.
Over the years, the hospital has fallen out of compliance at times, leaving dozens waiting in jails for admission beyond the seven-day mark.
In March 2020, after the pandemic struck, the hospital temporarily shut it doors over concerns about COVID-19, before slowly reopening with a modified admissions process that allowed patients to quarantine.
Two months later, U.S. District Judge Michael Mosman relaxed the seven-day requirement at the state’s request.
“It’s necessary in light of the pandemic to modify the injunction and I intend to keep a close watch on the efforts made to make this happen as quickly as possible,” Mosman said last May.
Disability Rights Oregon and Metropolitan Pubic Defender appealed that decision to the Ninth Circuit Court of Appeals, which heard the case May 6 and ruled the “case may be appropriate for mediation.” The court referred the case to a mediation process, where it remains.
Disability advocates argue the shift in the hospital’s patient population is driven by an under-investment in community based treatment centers, as well as a handful of counties whose criminal justice systems send a disproportionately high percentage of patients to the hospital.
“Oregon’s behavioral health system has failed to keep up with demand for services for years,” said Jesse Merrithew, who is representing the public defenders in the lawsuit against the hospital. “The only response has been to increase capacity at the state hospital, all the while we have been telling them that is not a long term solution.”
As of 5 p.m. Wednesday, a spokeswoman for the hospital said two state employees had volunteered for shifts to help relieve the staffing crisis.