Report: Tear Down Hospital

By Michelle Roberts

Summary: The Oregon State Hospital must be replaced and one building for patients would likely collapse in an earthquake, a study says.

The Oregon State Hospital is so decrepit and dangerous that it must be torn down and replaced with a new facility, according to a report released Monday.

KMD Architects, a San Francisco-based architectural firm hired by the state, found that the 122-year-old hospital does not comply with current building, fire and electrical codes. The firm also determined that the oldest structure on campus, the 500,000-square-foot J building, which holds more than 100 of the hospital's 750 patients, likely would collapse in an earthquake.

"When it comes to the existing state hospital, the status quo is unsustainable," Gov. Ted Kulongoski said Monday, shortly after the report was released during a joint hearing of the Senate Health Policy and House Health and Human Services committees.

"It is no longer a question about what to do," Kulongoski said. "The fact is that we must move forward with plans to construct a new state hospital facility."

The governor said he would urge lawmakers to fund $350,000 for Phase 2 of what's being called the state hospital master plan and ask for recommendations on where to put the more than 100 patients who remain in the J building.

The next phase of the master plan includes determining the design, location and role of a new hospital within the state's mental health system.

"I assure you that we will move forward with the decision-making process as quickly and thoughtfully as possible," Kulongoski said. "In the meantime, we also have an obligation to ensure the safety of all hospital clients and staff and to minimize the risks identified in the report."

Officials said even if the Legislature approves funds for a new hospital this session, it will take three to four years before it would be ready for patients.

KMD, hired by the state in February to study the dilapidated hospital and make recommendations about its future, found that the layout of the patient wards is inefficient, lacks appropriate program space and does not comply with Oregon's Psychiatric Patient Care Rules.

Wards designed for 32 patients frequently hold more than 44, according to the report, and the hospital's linear layout is "inefficient and severely restricts sightlines for patient observation."

The report also said exposed pipes, glass windows and hidden alcoves pose major hazards to patients.

The report did not include an estimate of how much a new facility would cost. But KMD representatives told legislators that even the newest building on the 144-acre campus -- built in 1950 -- would cost more to renovate than to reconstruct.

According to the report, the community mental health system relies too much on the hospital to provide patient services that might better be administered in a less structured environment.

"A project of this magnitude will take time, and there is a lot of information that needs to be developed exactly what that facility will look like and who will be served by that facility," Kulongoski said.

Concerns about conditions at the hospital -- one of the oldest, most rundown state mental institutions in the United States -- have grown in the past several months amid reports of patient abuse, short staffing and crumbling facilities.

In October, Oregon Senate President Peter Courtney, D-Salem, wrote a letter to fellow senators saying conditions at the hospital were so appalling that the institution was vulnerable to a federal lawsuit and possible takeover by the courts.

Courtney's letter followed a meeting with Dr. Marvin Fickle, hospital superintendent. Courtney called for the meeting in response to a two-day series in The Oregonian that detailed the sexual abuse of as many as a dozen patients in the hospital's adolescent unit by psychiatric aides from 1989 through 1994.

The newspaper also reported that the hospital is 30 percent to 40 percent understaffed, routinely overcrowded and that patients had been beaten, kicked, humiliated and tormented by staff in nearly 60 cases of substantiated abuse since 2001. The newspaper also published photos that depicted the hospital's deteriorating physical conditions.

Built in 1883, the hospital, a mile from the Capitol, is a hulking reminder of the state's failure to create a modern approach to treating people with mental illnesses. Several studies in recent years have recommended that Oregon scale back the hospital and invest in a network of community treatment centers that would be cheaper and more effective for patients.

The state has been adding community programs but has been unable to keep up with the growing number of patients, particularly forensics patients who have committed crimes.

Monday's report said that based upon population rates alone, the hospital will need more than 1,100 beds by 2020 unless more community-based services are provided.

Until recently, state officials had been reluctant to talk about closing or drastically reorganizing the hospital and risking a fight with the unions that represent the hospital's 1,250 employees.

But lawmakers on Monday said change would come.

"The state of Oregon now is on official notice that there are significant structural and systemic problems surrounding the hospital," Courtney said. "This is sobering news. We are concerned about the mental health and physical safety of our state hospital patients and workers."

© 2005 Oregonian Publishing Co. All rights reserved. Used with permission of The Oregonian.