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Hospitals Lead Search for Community Solutions to ED Boarding

Lake Oswego, Ore. – June 4, 2019 – Many Oregonians experiencing a mental health crisis lack a good treatment option, and too many of them wind up in the next best place: a hospital emergency department. They can sometimes be there for days as “ED boarding” patients, neither admitted to the hospital nor discharged. The Oregon Association of Hospitals & Health Systems (OAHHS) is part of a coalition working on community solutions to a community problem that is national in scope.

The group has introduced a bill in the 2019 Legislature as a step toward improving this broken piece of the system.

“Emergency departments are not set up to deliver mental health services,” said Danielle Meyer, an OAHHS policy director. “It’s a safe environment, but it’s not a therapeutic one.” Meyer said those patients are not admitted to the main hospital because they lack the necessary medical diagnosis.
ED boarding is a statewide issue, but it’s often more acute in rural areas where there is limited access to in-patient psychiatric beds. “We have a nationwide shortage of psychiatric care, especially pediatric,” said Michelle Brenholdt, Director of Emergency Services at St. Charles hospitals in Bend and Redmond. Brenholdt said they once had a mental health patient for 19 days at the Redmond ED, and statewide a stay of 10 days is not uncommon. Until permanent solutions are found, Brenholdt said St. Charles has increased access to services when mental health patients are discharged (in addition to allowing some to stay multiple days in the ED).

Multiple factors have combined to create this issue, which is why a collaborative solution is required. Senate Bill 140A is the first step in that process. It creates community pilot projects to air concerns and share ideas. The amended bill requires that one of the pilots be in a rural part of the state. The bill would also convene a task force of interested parties, welcoming their input.

The coalition in support of SB 140A includes physicians’ groups, the Oregon Nurse’s Association, and Oregon AFSCME Council 75.