PORTLAND, Ore. (CN) - A federal judge on Friday held Oregon's state health agency and psychiatric hospital in contempt for failing to admit criminal defendants in need of mental health treatment to the hospital within seven days.
Following a two-day hearing in March - in which state officials acknowledged they were out of compliance with a 2002 permanent injunction imposing the weeklong admission window on the hospital and they has been hindered by a lack of resources.- U.S. District Judge Adrienne Nelson found that the hospital had not done enough to rectify the situation.
"Defendants argue that they should not be held in contempt because they have taken all reasonable steps to comply. Not so," the Joe Biden appointee wrote in a 21-page opinion.
Nelson imposed a $500 fee per class member per day while they remain out of compliance.
The order is the latest in ongoing litigation dating back to over two decades, when Metropolitan Public Defenders and Disability Rights Oregon, then called the Oregon Advocacy Center, first sued state health officials over accusations of civil rights violations of mentally ill people.
A 2002 federal court determined that jailing a mentally incompetent person for over seven days is unconstitutional and entered a permanent injunction requiring the state to admit to the Oregon State Hospital any detainee who is found unable to stand trial within seven days.
At the start of 2025, the average length of time a criminal detainee was waiting in jail before being admitted to the hospital was 29 days. Between April 7 and 20, the average waiting period was just under 22 days. At the end of April, there were 46 people waiting to be admitted with an average waiting period of 9.6 days.
Amid these waiting periods, the hospital also struggled to release those who had been cleared for placement back in the community. At the end of April, there were 97 people who remained at the hospital despite being cleared for release.
"Defendants have undertaken efforts to meet the recommendations delineated in the project tracker," Nelson wrote. "However, they remain delayed on several recommendations and have not performed well on others."
For example, the state defendants have lagged on developing a community restoration manual and data report on community restoration and in coordinating efforts between the Oregon Health Authority and the Oregon Developmental Disability Services and the Office of Aging and People with Disabilities.
While Nelson recognized that the state defendants appear to have made an effort to work with Dr. Debra Pinals, an appointed neutral expert, and work toward achieving compliance, those efforts aren't enough to escape a contempt holding.
"Defendants' efforts are belated and appear to be largely in reaction to the court's inquiries and the filing of the present contempt motion," Nelson wrote.
The state argued that part of the problem stemmed from an unpredictable referral rate beyond their control. But, Nelson wasn't persuaded by this, noting that an identical argument failed in the 1992 case Stone v. City & County of San Francisco from the U.S. District Court of the Northern District of California.
"Here, there have been similar predictions of referral rate increases which defendants did not prepare for," Nelson wrote. "In sum, defendants have not persuasively explained why adding more staff, funding and capacity in anticipation of this increased need was impossible."
Nelson also rejected the state's financial argument, turning to a long-held determination in federal courts that "financial constraints do not allow states to deprive people of their constitutional rights."
The state also turned to its efforts to review its contracts with local service providers and argued that the action or inaction of third parties is beyond its control.
"This argument also fails," Nelson wrote. "[Oregon Health Authority] cannot contract away its legal responsibility to provide community behavioral health services as a means to avoid a finding of contempt."
It is up to the state defendants and the state defendants alone to satisfy their constitutional and statutory obligations, Nelson wrote.
Nelson also switched Pinals' role from that of neutral expert to court monitor, allowing her to hire staff and better guide the state in its efforts toward meeting the seven-day admission window.
Along with admitting detainees in need within seven days, Nelson ordered the state defendants to use all reasonable efforts to increase efficiency. This includes reducing community restoration timelines, increasing the health authority's power to discharge patients, eliminating the backlog of forensic evaluations and review the capacity needed to meet demand.
Jake Cornett, executive director and CEO of Disability Rights Oregon, celebrated the order.
"Today's ruling is a major win for our clients whose Constitutional rights have been violated while they suffer in jail instead of receiving the court-ordered mental health restoration services they need," Cornett said in a statement. "We're hopeful swift implementation of the monetary sanctions and remedial measures will kickstart real solutions to fix Oregon's broken mental health system."
A spokesperson for the Oregon Health Authority said it is reviewing the opinion and evaluating next steps.
It wasn't until recent years that the state's noncompliance became a severe problem.
The state maintained compliance with the seven-day rule from 2002 until 2018, when admission times began to stretch longer. The advocacy groups pushed the court to enforce the order and argued the state should be held in contempt. U.S. Judge Michael Mosman denied the contempt motion in 2019, but ordered the state defendants to outline the steps they were taking to get back into compliance.
Since then, Oregon has had brief and fleeting windows of compliance.
Source: Courthouse News Service
