Oregon bill making it easier to forcibly treat — and release — people with mental illness moves forward

Oregon lawmakers are moving forward with a sprawling bill aimed at making it easier to force treatment on people with severe mental illness, while also ensuring other patients don’t remain in treatment too long.

House Bill 2005, which passed the House on Wednesday on a 38-13 vote, is a mashup of several major concepts legislators and interest groups have been working on this year.

The first is a significant change to the state’s laws on civil commitment, the process for forcing people into hospital care when they are too ill to seek help themselves.

For years, debates have raged in the Capitol over whether the state’s laws make it too difficult to commit people. Mental health experts, law enforcement groups and others have urged lawmakers to clarify state statutes to make it easier for judges to send patients into forced care. People with mental illness and their advocates have fought such changes.

Now, after intensive negotiations by a work group convened by Rep. Jason Kropf, D-Bend, lawmakers are on the verge of making changes. HB 2005 would modify statutory definitions for what it means to be dangerous to one’s self, dangerous to others, or unable to provide for basic needs – three criteria for civil commitment.

The bill would also set out factors judges can consider and, crucially, ensure that any prospective harms from a mental illness don’t have to be “imminent” to warrant civil commitment. That strict standard has been blamed for preventing civil commitments in cases where they are warranted.

“Too many people at extreme acuity are being rejected for civil commitment and instead are later arrested,” said Chris Bouneff, executive director of the National Alliance on Mental Illness Oregon, at a hearing on the bill last week. “If we are going to compel someone into care, can we at least spare them the criminal record and attach a long-term health outcome to their care via the civil system?”

Defense lawyers, who represent people facing civil commitment, oppose the changes. They argue the state should focus on helping people before they need civil commitment, and that the state doesn’t have enough facilities to handle an influx of cases.

To help respond to those critiques, lawmakers have passed another bill, House Bill 2059, that sets aside $65 million for new residential treatment facilities.

HB 2005 would also make meaningful changes for people whose mental illness prevents them from understanding the criminal charges they face.

Oregon is under federal court orders to admit such patients into the Oregon State Hospital within a week of a judge ruling a defendant is too ill to face charges. But the state has been largely unable to meet that standard – to the point it was found in contempt of court earlier this month.

HB 2005 attempts to address this by setting statutory guidelines for how long a person facing criminal charges can be held in the state hospital.

For instance, a defendant facing a Class A misdemeanor, the most serious type, could be treated for a maximum of three months under the bill before they are released. Prosecutors could then request another three months. Defendants facing violent felony charges would face a maximum of one year in the hospital, though, once again, extensions are possible.

Timelines for state hospital care in the bill hew closely to standards the state already is subject to under an ongoing lawsuit. But the bill also creates new time limits for inpatient care criminal defendants receive not in the hospital, but via community mental health services.

Such “community restoration” is typically reserved for people with less serious charges, or those deemed less risky. But currently there is no limit for how long they can receive treatment in hopes of restoring them to the point they can face charges.

The limits put forward in HB 2005 are an attempt to free up space outside the hospital, in order to more efficiently clear limited state hospital beds. They would lapse in 2028 to give lawmakers the ability to reevaluate whether they are working.

“People are being sent to the state hospital who could otherwise be treated locally,’ said KC LeDell, a senior behavioral health policy advisor for Gov. Tina Kotek. “And people are remaining at the state hospital longer than they need to because they don’t have a safe, stable place to discharge to.”

But the proposal has been controversial. State prosecutors, defense lawyers and judges all opposed a series of limits proposed by the Oregon Health Authority early in session.

Tweaks included in HB 2005 ultimately softened some of that opposition.

“As with any compromise, everyone’s a little bit unhappy,” said Channa Newell, an attorney who represented the Oregon Judicial Department in negotiations. ”We support this package because it’s our best effort at making a meaningful change right now. It’s something that we can do today.”

But prosecutors said they couldn’t back the timelines, saying the bill risks releasing people from state care without ensuring their condition has improved.

“Oregon should do more through legislation than simply trying to protect itself from continued contempt findings and federal court involvement,” Washington County District Attorney Kevin Barton testified earlier this month.

That concern was shared by some House Republicans on Wednesday.

“While I understand the timelines have a two year sunset, I’m not sure I can tell my constituents that this two year trial run will make anyone safer,” said House Minority Leader Christine Drazan, R-Canby.

The civil commitment provisions and hospital timelines originally moved forward this session as separate bills. Kropf said he put them together into one “omnibus” package because the issues are interrelated.

“This bill and the other work we do represents progress, but not necessarily perfection,” he said on the House floor Wednesday.

The bill also takes other steps. It orders up a task force to study how commitments by tribal courts can connect with the state’s civil commitment system. And it limits cities’ ability to block the creation of new residential treatment facilities.

But the mishmash of policies hasn’t pleased some. Marion County Commissioner Danielle Bethell told lawmakers last during a hearing last week that she supports civil commitment changes, but opposes other pieces of the bill.

“The fact that we’re trying to smash these two things together because we have a federal court order over our heads seems asinine to me at best,” Bethell said.

The bill now heads to the Senate.

Correction: This story originally misstated how much money House Bill 2059 dedicated to building residential treatment facilities. OPB regrets the error.