The state agency approved the proposal with conditions, though a contested hearing could be requested.

The Oregon Health Authority has issued a decision that could soon become final to approve the construction of a psychiatric hospital in Wilsonville.

However, a contested hearing could be requested and that process could lead to the decision's reversal or alteration. And even if the decision is approved, it remains to be seen whether the applicant, Universal Health Services, will want to move forward under the conditions outlined.

After issuing a draft recommendation and then holding a public hearing during which Universal Health strongly opposed many of the conditions and other changes from the initial proposal, including that bed capacity be reduced from 100 to 60, the OHA sent Universal Health a proposed decision Monday, Oct. 11, that largely mirrored the draft recommendation previously issued.

Now, Universal Health and other health care providers will have 60 days to request a contested hearing for the decision. If no hearing is requested, the ruling becomes final.

Universal Health intends to build the for-profit hospital, which is projected to cost $47 million, on Day Road in north Wilsonville, and plans to do so without public funding. In the proposed decision, the OHA addressed the corporation's concern that reducing the allowed beds would jeopardize the profitability of the project. Based on data Universal Health provided, it determined that the hospital would still be profitable even with the reduction.

"The result of the analysis demonstrates that NEWCO would have a positive net income at 60 beds, although not as large as it would be with the proposed 100 beds," the decision read.

One of the primary reasons cited for approving the facility was to lessen the prevalence of the emergency room boarding of psychiatric patients. OHA said that in 2020 over 1,000 patients in Clackamas and Washington County were boarded in such facilities. And for patients who were there over 24 hours, the average time in emergency departments was 56 hours and just over 50% were eventually boarded in a normal inpatient facility.

"This analysis finds that the ongoing presence of ED boarding of psychiatric patients in Oregon meets the 'moderate evidence' standard of unusual circumstances of unavailability," the decision read.

However, the OHA has expressed skepticism that the new hospital would solve this issue because of Universal Health's relative lack of contracts with coordinated care organizations, which are networks of health care providers.

Another condition of approval was that 45% of patients should have a court determination of mental illness, be previously housed in emergency custody or be awaiting a hearing for detention or diversion. Universal Health would need to notify OHA whenever it declines to admit a patient on Medicaid or who is uninsured, while also meeting with affected parties and sharing data quarterly.

Jonathan Modie, a spokesperson for the state, told Pamplin Media Group in September that the 45% requirement was added to ensure that the hospital admits underserved populations who might not be as lucrative.

Universal Health could not be immediately reached for comment.

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