hb 3100 affecting the “front door” of osh 4 major components: a. “gei” misdemeanants no...
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HB 3100Affecting the “front door” of OSH
• 4 major components: a. “GEI” misdemeanants no longer under PSRB b. restorative services should be provided in community unless not available or person too dangerous c. mandatory community mh eval for Class C “GEI” defendants for possible CR d. certification of forensic evaluators
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SB 420Related to the “back door”
• Created two tiers of criminal offenses—Murder/BM 11 vs. all other crimes
• Divided responsibility for conducting “GEI” hearings between PSRB and SHRP based on tier and physical placement.
i.e. PSRB=Tier 1 and all on CR
SHRP=Tier 2 only while in OSH
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The Insanity Defenseand
PSRB/OHA Jurisdiction
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Process by which one comes under the Board
• Individual is charged with a new crime.
--No probation violations• Defense counsel seeks an evaluation by a
certified psychologist or psychiatrist, forensically trained, to determine if client qualifies for defense.
--Not every person with mental illness or mental defect necessarily qualifies
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Legal standard for insanity defense
GEI if:(1) as a result of md/d at the time of engaging in criminal conduct, the individual lacks substantial capacity either to appreciate criminality of conduct or to conform conduct to requirements of law.
Applicable to felonies, misdemeanors & juvenile proceedings.
Available in DUII and DWS cases
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(2) md/d does not include any abnormality manifested only by repeated criminal or otherwise anti-social conduct, nor do they include an abnormality constituting a personality disorder. – This is only statutory “definition” of md/d. Bd
has admin. rule further defining…859-10-005– Md/d in remission is considered md/d for
jurisdiction purposes– Personality disorders excluded in 1983
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• What constitutes a “personality disorder” was further defined by the Oregon Supreme Court in Tharp v. PSRB, 338 Or 413 (2005).
• The Court held that alcohol and/or drug dependency is a “personality disorder” as that term is used in ORS 161.295 (2) despite the fact that those diagnoses are found on Axis I in DSM. Result of legislative history.
• The Court of Appeals indicated the same opinion re: sexual disorders in Beiswenger v. PSRB, 192 Or App 38
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ORS 161.305
• ‘GEI’ is an affirmative defense
- Defendant must prove by preponderance
- Trial judge cannot impose defense over represented defendant’s objection-- State
v. Peterson
- Trial counsel cannot assert defense over defendant’s objection--State v. Bozman
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ORS 161.309
• Defendant must give notice of intent to assert defense
• Notice shall be in writing• If fail to do so, court has discretion to
permit introduction for just cause
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ORS 161.315
• Once defendant raises defense, State has right to its own certified psych examination. Must give notice to court. Court may order client to OSH for that assessment for no more than 30 days.
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ORS 161.313
• When the defense is raised in jury trial, court must give an instruction.
- but it must be complete and accurate
statement of the law -- State v.George
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ORS 161.325
1. Once GEI, either placed under PSRB or OHA (depending on nature of crime and physical placement) or discharged
2. Order shall include:
a) offense for which defendant would have been convicted – determination of Tier I or Tier II
b) if there’s a victim and whether V desires notification
*c) md/d on which defendant relied
d) order to submit blood sample for certain offenses
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• Diagnosis on which parties relied is specified
• Victim notification information
• Crime(s) for which client found guilty except for insanity
• Length of jurisdiction set by court
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ORS 161.327
• (1)(a) Once GEI, if crime was felony, court shall order psych eval and report to court if one not provided prior to trial. Placed under PSRB or OHA if court finds defendant is affected by md/d and presents substantial danger to others requiring commitment or CR
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(1)(b)Length of jurisdiction
Equal to the maximum sentence provided by statute for the crime for which the person was found GEI– Consecutive terms may be imposed but must be
supported by findings comporting with ORS 137.123 -- State v. Brooks
– SGs do not apply -- State v. Nelson– PSRB does not have authority to rewrite court’s order
even if court errs in setting max. sentence -- Romanov v. PSRB
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(2)Physical placement upon GEI finding
• (a) Commit to OSH -- if substantial danger and not a proper subject for release
• (b) Conditionally release -- if substantial danger but can be adequately controlled with supervision and treatment and the necessary supervision and treatment are available.
In making decision, court shall have as its primary concern the protection of society.
* This is other determinant of whether Tier 2 offender is placed under OHA or PSRB
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(2)(b)Court CR Requirements
• CR to special conditions of the court that are in the best interests of justice, protection of society and welfare of the person
• Court must designate some person or agency to supervise person. Prior to designation, the court shall notify person being considered and provide opportunity to be heard.
• Court shall notify Board in writing of its order, supervisor appointed and all conditions of release.
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(4)Determination if Court CR
• Court may order evals, examinations and compliance as provided in ORS 161.336(4) and ORS 161.346(2).
• If defendant is found GEI of Class C felony(ies) only, the court shall order “that the person be examined by a local mental health program designated by the board and a report of the examination be provided to the court”
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Order for Court CR EvaluationQuestions to be addressed by
community provider:
• Appropriate for CR? If so, what is necessary for supervision and treatment?
• If appropriate for CR, specific details of treatment plan.
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Sample Court Conditional Release Order
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• Sample orders for both commitment to OSH (under the jurisdiction of PSRB or SHRP) and conditional release (under the jurisdiction of PSRB) are available electronically from the PSRB.
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Result of successful defense
• Placed under PSRB if crime was Tier I felony and court finds defendant is affected by md/d and presents substantial danger to others requiring commitment or CR or if crime was Tier 2 felony and defendant is court conditionally released.
• Placed under OHA (SHRP) if crime was Tier 2 felony and court finds defendant requires commitment.
• Discharged or separate commitment process if misdemeanor
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ORS 161.329
• If defendant is no longer affected by md/d or no longer substantial danger to others and is not in need of care, supervision or treatment, the court shall discharge the person.
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An adjudication of GEI is not a criminal conviction.
• State v. Gile, 161 Or App 146 (1999). The Oregon Court of Appeals held that a judgment of guilty except for insanity is not a “conviction” for purposes of statutes requiring unitary assessment and allowing awarding of costs.
• State v. Saunders, 195 Or.App. 357 (2004). The Oregon Court of Appeals held that ORS 161.325 provides the plain language that a GEI is not a conviction for any purpose.
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Functions of the PSRB
• To accept jurisdiction• To protect the public• To balance the public’s concern for safety
with the rights of the client• To conduct hearings• To make findings• To monitor progress• To revoke CR if client violates plan• To issue orders• To maintain current history of all clients
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Mission:
• To protect the public through on-going review of the progress of persons found “guilty except for insanity” and a determination of their appropriate placement.
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The Board carries out its mission through 2 arenas:
- Hearings
- Monitoring
.
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Legal Safeguards for Persons Under the Board/Panel• Each is entitled to:
– request hearings– be represented by an attorney, appointed
if indigent– examine all exhibits– subpoena witnesses and documents– cross-examine all witnesses at hearing– appeal any adverse decision of the Board
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At Each Hearing, the Board/Panel Must Decide:
• Does the client continue to suffer from a mental disease or defect? AND
• Does the client continue to be a substantial danger to others when mental illness is active?– If not, the Board/Panel shall
discharge the client.
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• If so, the Board/Panel maintains jurisdiction. It must then determine:–Could the client be “adequately
controlled with supervision and treatment” in the community?• If not, the client remains committed.• If so, is the supervision and
treatment necessary available in the community at this time?
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How Board/Panel assesses readiness for conditional release
planning• Reviews exhibit file that contains the
reports and evaluations of OSH professional staff of various disciplines and others
• Listens to the testimony of all witnesses• Cross examines witnesses to obtain
additional information• Considers the risk to society that the client
may pose if returned to the community
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Factors considered: • Clinical judgments of OSH professional
staff• Results of psychological testing and risk
assessments performed on patient• Recommendation of OSH Risk Review
Board• Availability of resources in the community
to compensate for any residual risk
Board’s determination of risk
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Evaluation process for community provider
• Receive order and client’s PSRB file• Review entire file• Contact OSH social worker to set appt.• Interview client face-to-face• Write report to Board within 30 days with
reasons for acceptance or denial
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Types of residential placements available for PSRB clients
• Secure residential treatment facility (SRTF)• Residential treatment facility (RTF)• Residential treatment home (RTH)• Adult foster home (AFH)• Supported Housing (SH)• Intensive case management (ICM)• Independent living
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PSRB Conditional Release Process
Board holds hearing
If Board approves conditional release of patient
Client released to community provider pursuant to specific plan
Case manager oversees provision of required treatment services and supervises client for PSRB
Board staff monitors conditional release status
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CR of Tier II Clients
• If OHA determines a Tier II offender is appropriate for conditional release, the SHRP must give notice to the Board prior to conducting a conditional release hearing
• Board will review the proposed plan and provide SHRP with conditions it deems advisable for this person’s conditional release
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Tier II Transfer of Jurisdiction
• SHRP conducts hearing and orders conditional release
• Once a Tier II client is conditionally released, jurisdiction immediately transfers to the PSRB
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Monitoring:
• EPR “hits” on the Law Enforcement Data System (LEDS) terminal
• Daily calls and correspondence from case managers, providers and others
• Monthly progress reports*
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C lient rem ains on C RR equest m odif ications of CR
if/w hen appropria te
Yes
R ev iew situation w ith Board staffD eterm ine approp. in tervention
R evoke and return to O SH , if necessary
No
C lient com pliant w ith term s of re leaseand m enta lly stab le?
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Definition of Revocation
• The legal process by which the Board orders the return of an individual on conditional release to the state hospital for evaluation and treatment.
• A revocation order has the same legal effect as an arrest warrant.
• Law enforcement transports individual to OSH
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Grounds for revocation
• Reasonable grounds include:
a) violation of the term(s) of the
conditional release plan
b) a change in mental health status
c) absconding from supervision
d) the appropriate community resources are no longer available
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Revocation of Tier II Clients
• Jurisdiction of Tier II clients who are revoked by PSRB and returned to OSH reverts to OHA. The Panel then conducts the revocation hearing.
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Who OSH can not serve
• Individuals without a valid order• Individuals who only need detoxification• Probation Violators• Municipal Ordinance Violators• Individuals who require treatment for
acute medical conditions that must be provided in general hospitals
• Defendants who have been found able to aid and assist or never able to aid and assist
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Involuntary Medications
Not all patients at the state hospital will receive
anti-psychotic medications.
OSH/BMRC can only give patients anti-psychotic
medications if the patient gives his/her informed
consent, or if there is “good cause” to require
medication without informed consent as
defined in OARs.
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Involuntary Medication (cont.)
Good Cause has 4 elements for most people: OAR 309-114-0020
1. The patient lacks the capacity to make his own treatment decisions (can’t reasonably understand and weigh the risks and benefits of the treatment options); and
2. The proposed meds will likely restore or prevent deterioration of the person’s mental or physical health, alleviate extreme suffering or save or extend the person’s life; and
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Involuntary Medication (cont.)
3. The proposed meds are the most appropriate treatment for the person’s condition according to current clinical practice and all other less intrusive procedures have been considered and some other factors (dangerousness, seriousness of condition, etc) were considered; and
4. A conscientious effort was made by institution to obtain informed consent from patient.
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Involuntary Medication (cont.)
TWO EXTRA FACTORS must be proven in order to
involuntarily medicate someone who is in the hospital
because they were found unable to aid and assist in
their defense.
These factors are based on the Supreme Court
decision in Sell v. US, 539 U.S. 166,123 S.Ct. 2174
(2003), that address the unique population of patients who have not yet had any
opportunity for adjudication of their case.
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Involuntary Medication (cont.)
1. Medication must not be requested for the sole purpose of restoring competency for trial; and
2. The patient is being medicated because of the patient’s dangerousness or to treat the patient’s grave disability.
OAR 309-114-0020
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Adult Client Demographics1/1/2012
Gender: Male 84.4 %
Female 15.6 %
Average Age: 45.4 years old
Ethnicity: Asian 02.2 %
Black 07.3 %
Hispanic 04.5 %
Native American 02.8 %
White 82.2 %
Other 01.0 %
Primary Diagnoses: Schizophrenia
Bi-Polar Disorder
Secondary Diagnosis: Substance Abuse
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Adult Clients by Crime Categories
1/1/2012
98.4% for Felony Offenses• A Felony – 53.4%• B Felony – 22.5%• C Felony – 10.6%• Unclassified – 13.5%
1.6% for Misdemeanor Offenses
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* Numbers as of 12/31 of given year
Adult Clients under PSRB(by Year*)
450
500
550
600
650
700
750
800
2001
2003
2005
2007
2009
2011
2011 731
2010 741
2009 752
2008 744
2007 745
2006 712
2005 704
2004 712
2003 646
2002 595
2001 583
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Clients under SHRP
• On January 1, 2012, OHA/SHRP assumed jurisdiction of 122 Tier 2 clients who were residing in OSH.
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Adult Clients Snapshot as of January 1, 2012:
615 – Total clients605 – for felony offenses = 98.4%
Crime categories:A = 53.4%B = 22.5%C = 10.6%Unclassified = 13.5%
10 – for misdemeanor offenses = 1.6%
18 – Other (UL, DOC, AWOL, etc.)
184 – in Oregon State Hospital
11 – have been found appropriate for conditional release by the Board
24 – have had community evaluations ordered through hearings
413 – on Conditional Release
10 – out of state or country
403 – in Oregon in 21 different counties
18 % = Secure residential treatment facilities 29 % = Residential treatment facilities/homes13 % = Adult foster homes 15 % = Semi-independent or supported housing 3 % = Intensive Case Management20 % = Independent (i.e., alone; with family; with others) 2 % = Other
in various types of residential settings:
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Adult Tier One PSRB Clients Snapshot as of January 1, 2012:
464 Terms (458 Clients)
464 – for felony offenses = 100 %Crime categories:
A = 57.5 %B = 24.8 %C = 0 %Unclassified = 17.7 %
0 – for misdemeanor offenses
14 Terms (14 Client) – Other (UL, DOC, AWOL, etc.)
201 Terms (182 Clients) – in Oregon State Hospital
11 – have been found appropriate for conditional release by the Board
24 – have had community evaluations ordered through hearings
263 Terms (262 Clients) – on Conditional Release
5 – out of state or country
258 – in Oregon in 20 different counties
19 % = Secure residential treatment facilities 24.6 % = Residential treatment facilities/homes 14.1 % = Adult foster homes 16 % = Semi-independent or supported housing 4.6 % = Intensive Case Management 19.4 % = Independent (i.e., alone; with family; with others) 2.3 % = Other
in various types of residential settings:
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Adult Tier Two PSRB Clients Snapshot as of January 1, 2012:
160 – Terms (159 – Clients)
150 – for felony offenses = 93.75 %Crime categories:
A = 40.7 %B = 16.0 %C = 0 %Unclassified = 0.6 %
10 – for misdemeanor offenses
4 Terms (2 Clients) – Other (UL, DOC, AWOL, etc.)
2 Terms (2 Clients) – in Oregon State Hospital awaiting transfer of jurisdiction
151 – on Conditional Release
5 – out of state or country
149 – in Oregon in 19 different counties
14.9 % = Secure residential treatment facilities 33.9 % = Residential treatment facilities/homes 12.3 % = Adult foster homes 16.2 % = Semi-independent or supported housing 1.3 % = Intensive Case Management 20.1 % = Independent (i.e., alone; with family; with others) 1.3 % = Other
in various types of residential settings:
154 Terms (153 Clients) – on Conditional Release
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40
60
80
100
120
1402011 63
2010 63
2009 82
2008 70
2007 106
2006 81
2005 84
2004 126
2003 110
2002 78
2001 76
New Adult Clients(by Year)
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Adult Clients at OSH(approximate as of 12/31 of given year)
0
50
100
150
200
250
300
350
400
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2011
300
2010
350
2009
367
2008
362
2007
351
2006
343
2005
375
2004
403
2003
368
2002
322
2001
327
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* Numbers as of 12/31 of given year
Adult Clients on Conditional Release
(by Year*)
150
200
250
300
350
400
450
2001
2003
2005
2007
2009
2011
2011 413
2010 375
2009 370
2008 367
2007 379
2006 354
2005 314
2004 294
2003 263
2002 258
2001 241
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Adult Clients on CR by Crime Categories
1/1/2012
97.6% for Felony Offenses• A Felony – 50.5%• B Felony – 20.3%• C Felony – 14.6%• Unclassified – 12.2%
2.4% for Misdemeanor Offenses
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Percentage of Adult Clients on Conditional Release
(numbers as of 12/31 of given year)
30.0%
40.0%
50.0%
60.0%
2001
2003
2005
2007
2009
2011
2011 56.5%
2010 50.6%
2009 49.2%
2008 49.3%
2007 50.9%
2006 49.7%
2005 44.6%
2004 41.3%
2003 40.7%
2002 43.4%
2001 41.3%
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Court Conditional Releases
0
5
10
15
20
25
30
352011
22%
2010
14%
2009
16%
2008
13%
2007
15%
2006
15%
2005
26%
2004
25%
2003
22%
2002
32%
2001
30%
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Adult Clients Revoked from Conditional Release
(by Year)
0
20
40
60
80
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
27
30
33
41
59
54
68
72
56
47
39
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Definition of Recidivism
• The percentage of revocation orders that are issued based on a new felony charge.
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Recidivism Rate Percentage of Revocations of Conditional Release Based on Commission of a Felony
* Numbers as of 12/31 of given year
On CR * Revocations New Felonies Percentage
1997 181 40 0 0.00%
1998 194 56 0 0.00%
1999 219 33 1 3.00%
2000 235 44 0 0.00%
2001 241 39 1 2.60%
2002 258 47 5 10.60%
2003 263 56 1 1.80%
2004 294 72 1 1.40%
2005 314 68 0 0.00%
2006 354 54 1 1.90%
2007 379 59 2 3.40%
2008 367 41 1 2.40%
2009 370 33 0 0.00%
2010 375 30 1 3.30%
Average = 2.2%
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Percentage of Adult Conditional Releases Maintained
in Community per Month
98.5
0%
99.1
0%
99.3
0%
99.3
0%
99.4
4%
98.5
%
98.2
0%
98.4
%
98.3
%
98.7
%
98.7
0%70.0%
75.0%
80.0%
85.0%
90.0%
95.0%
100.0%
2001
2003
2005
2007
2009
2011
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Current Adult Clients on Conditional Release in Given County
(1/1/2012)
Benton 4
Clackamas 19
Columbia 21
Coos 8
Deschutes 15
Douglas 2
Hood River 1
Jackson 21
Jefferson 1
Josephine 8
Klamath 6
Lane 23
Lincoln 4
Linn 3
Malheur 13
Marion 53
Multnomah 140
Polk 2
Umatilla 31
Washington 19
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Questions?
71
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PSRB Contact Information
Mary Claire Buckley, J.D. Exec. Director
Psychiatric Security Review Board
620 SW Fifth Ave. Suite 907
Portland, OR 97204
Phone 503-229-5596/Fax 503-229-5085
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OSH Legal Affairs Department Contact Information
Micky Logan, J.D.
Oregon State Hospital
2800 Center St NE
Salem, OR 97301
Phone 503-947-2937