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Wednesday morning, Gov. Tina Kotek threw her political capital into reforming Oregon’s scandal-plagued psychiatric hospital.
A few hours before the Marion County District Attorney’s Office released a damning grand jury report on staffing, training and culture problems that contributed to five unexpected deaths at Oregon State Hospital in recent years, Kotek called for state lawmakers to split the hospital into its own independent agency.
The Oregon Health Authority has overseen the hospital since 2009. Before that, it was part of the Oregon Department of Human Services.
Given the sheer number of tragic missteps and leadership failures that Lookout Eugene-Springfield’s reporting has surfaced over the past 18 months, including the death of 25-year-old Lane County resident Kenneth Hass while held in a hospital seclusion room, there’s sound reasoning behind Kotek’s push for the split.
As its own agency, the state hospital’s top administrator would no longer report to the director of the health authority, a nearly 6,000-employee agency that also oversees Oregon’s Medicaid and public health programs. Instead, hospital leadership would report to exactly one person: the governor.
But without knowing more about Kotek’s vision, one has to wonder if the change would improve patient safety and staff morale, or if the governor is merely moving chess pieces around on a broken board.
After all, since Hass’ death in March 2025, developments at Oregon State Hospital include:
- The April 2025 resignation of the state hospital’s interim superintendent, after Kotek said she learned more details about Hass’ death following Lookout’s reporting on safety concerns raised by hospital staff months earlier.
- The Aug. 1 resignation of Oregon Health Authority Director Dr. Sejal Hathi less than two months after a disastrous hearing before state lawmakers where she claimed ignorance of basic facts about the hospital’s problems.
- The Aug. 12 departure of Sean Murphy, Hathi’s pick for the full-time superintendent role, after less than a month on the job.
State leaders appear to be much better at firing than hiring the people tasked with ensuring the safety and well-being of roughly 600 psychiatric patients at the Salem campus. Would this agency realignment help Kotek — or Christine Drazan, depending on the outcome of the November election — hire the leaders needed to right the ship at Oregon State Hospital? Has a mystery candidate been lurking behind the scenes, just waiting for such a move?
Though Kotek said she plans to introduce legislation pushing for the split when the Oregon Legislature convenes for a long session in January, it will ultimately be up to lawmakers to iron out the details.
And those details will be crucial. For instance, the state’s behavioral health division, which provides services for people experiencing mental illness or substance use issues, is housed under the Oregon Health Authority. If the state hospital becomes its own independent agency, how will lawmakers ensure it doesn’t become siloed from other mental health services that help people in communities outside the state hospital?
Behavioral healthcare funding is already fragmented. The health authority distributes the state’s $760 million share of a massive, multistate opioid settlement fund to local governments to assist with substance use prevention and recovery, as well as state cannabis tax revenue to local behavioral health and drug-addiction recovery services.
Would the new lines of communication between agencies and lawmakers ensure state funding for behavioral health services is equitably distributed between those programs and the hospital?
How will patients preparing to leave the hospital get connected with post-supervision services, enroll in the Oregon Health Plan and get access to residential treatment facilities if needed?
In short, how would an independent Oregon State Hospital interact with the health authority that it was once housed under, and that it would almost certainly continue to rely on?
The stakes are incredibly high. While the hospital is currently considered in compliance with federal standards for Medicare and Medicaid funding, the poor conditions and patient deaths there have repeatedly put those funds — about $14 million annually — at risk in recent years.
In our view, Kotek’s proclamation on Wednesday was her way of saying, “The Oregon Health Authority couldn’t fix this. I will.” It’s a bold, politically risky move. If she wins reelection and lawmakers follow through — but the state hospital’s problems don’t get fixed — who will she fire next?
We give her credit for putting herself in the hot seat on such an important issue. But it’s unclear how the governor can fix what health authority and state hospital leaders couldn’t. The burden will soon be on lawmakers to dig into her plan and determine if a restructured Oregon State Hospital actually resolves these problems, or merely amounts to a political move to fend off bad headlines.
