FOR THE ENTIRETY OF HIS TIME AS HEAD HONCHO AT THE ARIZONA STATE HOSPITAL, CORY NELSON HAS WILLFULLY ENGAGED IN DECEIVING HIS OWN STAFF, ASH PATIENTS, AND THE GREATER PUBLIC AS A MEANS TO PRESERVE THE SUBSTANDARD HEALTH CARE PRACTICES THERE. KEEP IN MIND, THIS IS A MAN WHO LEFT HIS PAST POSITION (PRE-ASH) DUE TO CONTROVERSIAL ISSUES SPECIFIC TO FISCAL CORRUPTION IN THE SOUTH DAKOTA BEHAVIORAL HEALTH CARE SYSTEM, WHICH HE HAD BEEN EXPOSED TO BEING CENTRALLY INVOLVED IN, CIRCA 2009-2010. IN OTHER WORDS: WHAT DO YOU DO IF YOU ARE FORMALLY ACCUSED OF MALFEASANT CONDUCT AS A STATE EMPLOYEE IN SOUTH DAKOTA? WELL, YOU GO TO ARIZONA, OF COURSE, AND TAKE A HIGH PAYING JOB WORKNG FOR WILL HUMBLE IN THE DEPARTMENT OF HEALTH, WHERE YOUR DISHONESTY WILL BE VALUED FOR EXACTLY WHAT IT IS!
The following information is a repost of an article I drafted and published last October. It has to do with one of the most tragic events directly caused by the deceitful character of The Arizona State Hospital's administrative employees, including Dr. Steven Dingle, who was the hospital's Chief Medical Officer at the time that this event initially transpired, as well as ASH's current supervisor, Cory Nelson, who followed up on the original criminality by willfully lying about factual details underlying this particular cycle of violence, which began months before he even started working at ASH. It is also about safety, specific to both the patients at ASH as well as the general public. In recent months we have seen an increasing amount of hard data relating to damage that Nelson has thus far caused as ASH's executive administrator, and there is perhaps no one factor on the minds of the public today than Nelson's willingness to reduce the security staff at ASH by as much as 45-60% during the winter of 2011-2012; relating to this, in the last year there have been at least five patient escapes, and various members of ASH's front line staff have expressed serious concern over how that specific change has endangered their very lives, this given that there are no security immediately available to respond whenever episodes of violence arise. In several prime time television news reports aired on Phoenix area stations in recent months, Nelson has personally rejected the notion that these reductions in security might pose danger to staff, as well as in the context of the dramatic increase of patient escapes since he took over the helm at ASH in August, 2011. I am reposting this article today in order to pose the following question:
IF THE FOLLOWING MAY, 2011, ESCAPE OCCURRED AT A TIME WHEN THERE WERE 45-60% MORE SECURITY STAFF ON HAND AT ASH, WHERE IS THE LOGIC IN CLAIMING THAT THE RADICAL REDUCTIONS IN SECURITY AT ASH POSES NO POTENTIAL IN TERMS OF DECREASES IN SAFETY AT ASH, INCLUDING BUT NOT LIMITED TO ESCAPES, PATIENT ON STAFF VIOLENCE, STAFF ON PATIENT VIOLENCE, AND PATIENT ON PATIENT VIOLENCE?
RE: ARS Title 36- 531:The Public Health and Safety; possible disposition; release. This statute dictates the required conduct of any Arizona hospital in specific relation to any voluntary mental health patient's request or action relative to discharge. ASH, meanwhile, is a public mental hospital/entity, funded by the citizens of Arizona, and subject to state (and federal) law specific to the public trust and safety. No hospital has the authority to deviate from the requirements of this statute; as per strictly regulated licensure, all hospitals are required to abide by the full language of this statute. Any deviation by an administrative state employee from these requirements is prosecutable under civil and criminal law. Bottom line.
I am getting sick and tired of hearing the supervisor of the Arizona State Hospital (ASH), Cory "meathead" Nelson, grossly misinterpret and/or mischaracterize very the clear letter of law that readily afforded in Arizona Revised Statutes- 36 Public Health and Safety- Section 531; possible disposition; release, wherein, and as per express language therein, no hospitalized mental health patient has the "right" or "privilege" to simply "walk away" from any hospital in Arizona until they have been granted that option via a very specific and strictly required process, including the fundamental application of medical clearance that may only be granted following a formal mental evaluation. It does not matter whatsoever if the given patient is there under the status of involuntary or not, for if the hospital's chief medical officer (Dr. Steven Dingle), as per the formal opinion of the patient's primary treating physician (Dr. Steven Morris), has reason to believe that the patient poses a danger to himself or to others, as a baseline matter of concern in this context, than the director is bound by law to initiate a petition for continued involuntary inpatient treatment. This applies across the board in each and every form of hospital operating in the state of Arizona, including ASH, and equally applies in varied language in every state in the country today. While it is within any voluntary mental patient's right to request discharge, a health care facility must not grant any such discharge until it has been formally determined that the patient is stable enough (safe) for said discharge, a determination that must be issued by both the treating physician's medical opinion, and an associated confirmation by the facility's chief medical officer. If, in evaluating a voluntary mental patient's state of mind, the facility determines the patient to be a danger to his/her self, or to others, than the facility can- and in fact must, under the applicable statute(s)- retain the the patient for up to 72 hours (under a status of involuntary), during which time the director is afforded the opportunity to seek a judge's authority (court order) to extend the given patients' treatment under the status of involuntary for periods up to 180 days, as applicable.
I have included the entire Arizona revised statue applicable to this subject at the end of this article. But at the moment, I want to draw your attention to the primary section(s) (A., B., C.) of the statute, as shown below:
ARS 36-531. Evaluation; possible dispositions; release
A. A person being evaluated on an inpatient basis in an evaluation agency shall be released if, in the opinion of the medical director of the agency, further evaluation is not appropriate unless the person makes application for further care and treatment on a voluntary basis.
B. If it is determined upon an evaluation of the patient's condition that he is, as a result of a mental disorder, a danger to self or to others, is persistently or acutely disabled or is gravely disabled, the medical director in charge of the agency which provided the evaluation shall, unless the person makes application for further care and treatment on a voluntary basis, prepare, sign and file a petition for court-ordered treatment unless the county attorney performs the functions of preparing, signing or filing the petition as provided in subsection C of this section.
C.The agency may contact the county attorney to obtain his assistance in preparing the petition for court-ordered treatment, and the agency may request the advice and judgment of the county attorney in reaching a decision as to whether court-ordered treatment is justified.
(END OF DOCUMENT EXCERPT- FOR COMPLETE DOCUMENT, GO TO THE BOTTOM OF THIS ARTICLE)
In late May, 2011, a patient (Jesus Rincon Murietta) who was undergoing treatment at The Arizona State Hospital, in Phoenix, AZ, on a voluntary basis, managed to unlawfully steal an ASH staff members electronic pass card and identification, which he then used to unlawfully pass through several electronically secured doors; after gaining access to the exterior area of the main ASH facility (the main parking lot), Murietta evaded ASH security staff who were attempting to apprehend him, including by throwing several large stones at them, placing them in enough jeopardy for their safety that they terminated the attempt to catch Murietta. In early June, 2011, ASH administrators refused to release any information whatsoever about the escape to at least one journalist (JJ Hensely, The Arizona Republic, Phoenix, AZ), and in fact, went so far as to patently deny that their had been any escapes within the last 6 months, or longer. Consequently, approximately 90 days later, in late August 2011, Murietta beat and then cut the throat of a young woman named April Mott, killing her. Once again, the same journalist who attempted to acquire information about Murietta's late May escape, attempted to gain information specific to ASH's refusals to openly communicate with him specific to the underlying sequence of events by which April Mott's death occurred; at that time, ASH supervisor Cory Nelson stated that ASH had no obligation to report Murietta's escape due to the fact that, at the time of his escape, Murietta was being provided treatment at ASH on a voluntary basis.
"State hospital CEO Cory Nelson, who started Aug. 1, said he could not talk specifically about the Murrieta case. But in general, Nelson said, the hospital's obligation to report patients who leave against the advice of doctors extends only to those who are involuntarily committed.
'If they (voluntary patients) choose to leave their treatment environment, that would be their choice," Nelson said. "If someone leaves the facility and they don't really have another attachment to another person . . . we contact law enforcement and let them know that the individual has left the
hospital.' " (excerpt, Hensley, 9/28/11)
hospital.' " (excerpt, Hensley, 9/28/11)
I contend that Nelson knowingly and willfully misrepresented the provisions underlying applicable law in this matter as a strategical pretense for excusing the Hospital's overall unlawful conduct specific to concealing the fact that Mureitta had escaped ASH (and was at large in the greater Phoenix metro area), deceitful misconduct that ultimately led to the brutal slaying of April Mott, in late August, 2011. (see: "Victim's Family Questions Why Man Was Free" JJ Hensley, AZ Republic Sept. 29, 2011).
Now, let's take another look at Arizona law (shown above) specific to a mental health care's facilities obligations to the public.
Piece by piece: (A and B): This is an excerpt from the bright line body of law that applies to all aspects of any Arizona hospital's responsibilities with respect to discharging mentally disabled client-patients on the basis of the patient's request to be discharged. This is how it goes. Period:
36-531. Evaluation; possible dispositions; release
A) A person being evaluated on an inpatient basis in an evaluation agency shall be released if, in the opinion of the medical director of the agency, further evaluation is not appropriate…..
It is important to note herein, that only after the "opinion of the medical director of the agency" (the definition(s) of "agency" in this parlance includes hospital facilities, while "director applies most significantly to the chief medical officer, or alternatively, the facility director ) has been been determined in the context of any given voluntary patients' state of mind at that time (as per the required mental evaluation), "shall" the patient be released. (It is critical to note that at the time of Murietta's May 2011 escape, there was no dutifully hired supervisor/director in place at ASH, this following the April 2011 resignation of CEO John Cooper). This belies the incontrovertible (factual)reality that no patient, whether designated as voluntary or involuntary, may be discharged from any hospital facility unless this specific condition has been met. To do poses clear danger to both the patient and the public, and flies in the face of well established mental heath care and policy.
B) If it is determined upon an evaluation of the patient's condition that he is, as a result of a mental disorder, a danger to self or to others, is persistently or acutely disabled or is gravely disabled, the medical director in charge of the agency which provided the evaluation shall, unless the person makes application for further care and treatment on a voluntary basis, prepare, sign and file a petition for court-ordered treatment…..
Herein, we see that any patient exhibiting the characteristics associated with posing "a danger to self or others…. (or who) is persistently or acutely disabled or is gravely disabled" is not to be released/discharged, on the basis of fact defining that the given patient is not "safe", "stable", and/or not posing "a danger to self or others" (as per the strict language of this statute). It does not matter one iota if the patient is voluntary, and ASH director Cory Nelson has no excuse whatsoever for not understanding this fundamental fact. The fact being, that anytime an individual known to be mentally ill requests discharge from a psychiatric ward, there is a very specific process to be followed. Bottom line. The significance of this bright line standard of law and policy is critical in terms of public safety specific to both the patient, as well the greater public, in general. As such, this is precisely the nature of what we the people reasonably expect from any state employee grated the privilege of caring for Arizona''s seriously mentally ill and disabled citizens, and people like Dr. Steven Dingle and Cory Nelson are among our state's highest paid employees. This is ridiculous, unacceptable, and an aberration in terms of contemporary medical standards. ASH: It really is that bad.
In a very recent Question and Answers session with a reporter from Phoenix's main local newspaper, The Arizona Republic (Mary Reinhart, published on September 23, 2012; see Q&A: Arizona State Hospital chief talks security CEO discusses new measures, trainings that were spurred by 2 escapes in 2011 by Mary K. Reinhart - Sept. 22, 2012 08:43 PM The Republic | azcentral.com) Cory "crazycorycorner" Nelson again misrepresented the applicable law specific to the covered up May, 2011, escape of Jesus Rincon Murietta, by characterizing the escape as a legitimate voluntary discharge.
"We have individuals who are in the facility, very rare but we have them, who are there on a voluntary basis and they can walk out on a voluntary basis. That is one of the privileges that you have when you're voluntarily accessing services. We can't impinge on their civil rights."
(END of article excerpt)
There it is again, in that first sentence: "We have individuals (patients)…. who are there (at ASH) on a voluntary basis and they can walk out on voluntary basis…. " Simply stated, Nelson's statement is 100% in contradiction to the language and intent of applicable law and policy; and as such, I fully believe that every time he has made statements to this effect, he has willfully and knowingly engaged in something disturbingly consistent with pathological lying, in graphic defiance of the public trust. It is likewise, as equally disturbing that he somehow interprets a seriously mentally ill persons' potential ability (no matter how inaccurate the possibility of that potential is, in fact) to leave the safety and care provided in a level one mental health facility regardless of their actual state of mind (and directly related quality of health) as a "privilege." It is as though the "chief" of Arizona's sole long term public mental health facility views any patients actual disability as a mere byproduct of their presence in ASH, rather than being the primary reason that they are there, in fact. This is as graphic a disconnect from the true purpose and role of ASH as public health care facility as one might find in this day in age. Absolute ineptitude and utter breach of the public trust. In contemporary terms and with direst reference to his status as an executive level state employee, I thus find it shoocking to the conscience to witness a man like Cory Nelson discussing "civil rights."
Herein, the man entrusted with overseeing the entire Arizona State Hospital, where the Arizona's most seriously mentally disabled patients expect and deserve nothing short of competent performance by the one's employed to provide them with such, states in no uncertain terms that any voluntary patient, can leave ASH (at any time, in any fashion) as matter of "privilege"; including someone like Jesus Rincon Murietta, according to Nelson's ill-intended logic, who forced his way out of ASH by ripping the electronic pass card off of an ASH staff's neck and proceeding thereafter to run away and escape from pursuing security guards by throwing rocks at them, and then went on to kill April Mott.
I will just say it again. The truth of the matter is that- at a minimum- any voluntary patient desiring to discharge from ASH for any reason must formally request the discharge via a very specific process, involving his or her entire inpatient treatment and discharge planning team (ITDP); as such, all members of the ITDP team are required to provide well founded medical input specific to their knowledge of the given patients' general heath and state of mind at that time. In a mental health facility such as ASH, this process requires a full mental evaluation to be administered by a licensed mental health professional (the primary treating physician, in this case, ASH's Dr. Steven Morris). Short of this required process of evaluation, whereby no patient, rather voluntary or not, is to be released from the given hospital facility in question until these fundamental concerns are addressed, there is (was) no excuse whatsoever to not fully divulge the fact that someone like Jesus Murietta escaped ASH. And yet in spite this fact and the underlying implications (state and federal law and policy), in early June, 2011, ASH's administrators and associated senior clinicians did willfully deny the escape of any patients, this in response to direct inquiries specific to the issue, (posed by JJ Hensley of the AZ Republic); and less then 90 full days later, Cory Nelson knowingly engaged in misrepresenting the provisions specific to a voluntary patient, such as Murietta, obviously in order to compromise the factual information due to the citizens of Arizona, including April Mott's family, and any other concerned citizens (such as myself).
This entire debacle is about a cycle of violence that can be directly attributed to the role of The Arizona State Hospital. It is that simple, it is that straight forward, and there is simply no other way to look at it, in my humble opinion. ASH's administrative staff, including senior counsel (Joel Rudd), and anyone else involved in major decisions in relation to the Hospital's day to day operation(s), misconstrued the underlying truth to Jesus Murietta's escape, and they knew it.
And as shown in the following passage from a letter written to me by Cory "crazycorycorner" Nelson in late September, 2011, the administrative staff at ASH misinterpret/mischaracterize the specific meaning and intent of this body of Arizona law as matter of "standard" practice:
"Patrick I would encourage you to work with your treatment team to address all aspects of your treatment plan while you are still a resident at the hospital. Since your legal status at the hospital is voluntary you may certainly request discharge from your treatment team if you believe that the treatment that you are receiving is ineffective, unnecessary or otherwise not meeting your needs." (ADHS/ASH letter, Cory Nelson to ------- (PJ Reed), September 30, 2011)
As I have described in previous articles (see: "Why Do we Care?" September 26, 2012), Nelson made this statement to me in direct response to my reports to him about gross violations of law and policy in relation to patient abuse and associated administrative misconduct. As such, rather than offering me a forthright response to my well founded and good faith reports in this matter, the supervisor of Arizona's only long term public mental health facility encouraged me to consider leaving ASH at that time, with no concern or respect whatsoever for my actual state of mind at the time, and despite the fact that I was neither stable/safe and ready for reentry into the community. This is on point with Nelson's graphic untruthfulness in relation to the Jesus Murietta affair. And as pointed out in the material provided above, if I had requested discharge during the period of time that Nelson wrote this letter to me (late summer, early fall, 2011), I would have then been the subject of the required mental health evaluation, and presuming that during the course of that evaluation I was open, honest and forthcoming about my thoughts about suicide and other related elements of my specific diagnosis (as I always have been during the entirety of my experiences since May, 2010, and the earliest stages of my time in the Arizona behavioral health care system), my ASH ITDP team would not have even been allowed, as per the letter of the law, to grant me safe discharge, because the fact is, my state of mind in late summer, 2011, was such that I was definitely still willing to predict suicidal intent and action were I not continually involved in ongoing safe treatment in ASH or some other like facility (of course, ASH is the only long term mental health facility in the state of Arizona, so I would have had no option(s) beyond continuing my treatment there at ASH). Thus and therein, if I were not willing to continue my treatment at ASH on a voluntary basis at that time, my clinicians and the senior conical staff ASH (as stated in the statute, the medical director) would have been required by law to initiate a petition to have my involuntary status reinstated for a period of time not to exceed 180 days. This basic fact proves my contention that Cory "meathead" Nelson and Joel "the mortician" Rudd willfully manipulate the provisions underlying law specific to public safety in the context of both the mental health patients needs as well as that of the greater public, in general.
Likewise, in the case of Jesus Rincon Murietta, who was indeed receiving his treatment at ASH on a voluntary basis at the time of his late May, 2011, escape, the Hospital could have only lawfully granted him moderately immediate discharge following his having requested such, and then having been subject to the subsequent process of medical clearance only afforded via the requirement of a full mental health evaluation (as laid out in very clear and simple terms in this statute); but given the fact that he never in fact requested discharge from ASH, and that in the 4 weeks prior to that late May, 2011, escape, Murietta had been involved in several unprovoked physical attacks on several persons at ASH (including staff and at at least one female patient), Murietta's primary attending doctor ASH, Dr. Morris, and the rest of Murietta's ITDP team, as well as ASH's medical director at the time, Dr. Steven Dingle, would have been required to meet the specific requirements of this statute, which rule out the release/discharge of patients exhibiting characteristics associated with posing "a danger to self or others" (from subsection B of the statute, shown above). Thus and herein, Murietta's departure from ASH was anything but a legitimate voluntary discharge, and for Cory "meathead"- Nelson or anybody else to characterize Murietta's as a legitimate discharge falls nothing short of willful and criminal alteration(s) of the truth. ASH's cover up of the truth at the time Murietta escaped directly led to the horrifically brutal slaying of an innocent woman, who would have had nothing whatsoever to do with ASH, Jesus Murietta, and so on, had the administrative staff at ASH met their clearly established obligations in this context. Systematic, obviously purposeful intent to engage in a criminal action specific to covering up a very serous pattern of unlawful actions in this specific matter. Bottom line.
Ding, Mother Fuckers! Try to lie your way out of this one.
In Closing: NOTE: As per the wisdom of ADHS Director Will Humble, there has been a bit of shuffle in agency itself due to staff shortages, and Cory "meathead" Nelson is currently the acting Deputy Director of ADHS sub-agency, Behavioral Health Services. As stated, these people continue to reap the full benefits afforded them through their entrusted positions at the head of Arizona's public heath care system, while the impacts of their ineptitude simultaneously continues to harmfully impact Arizona's collective citizens; and while my anger, as expressed above (please forgive my language), still flows directly from my heartfelt concern relating to the bare boned fact that April Mott did not deserve to be effected by the substandard practices of ASH's administrative staff. Nobody deserves that, including the patients and ASH today. But given these facts, the additional fact cannot be ignored, that Nelson, The Chief Executive Officer at The Arizona State Hospital and current Deputy Director of ADHS/BGHS is a bald faced liar through and through. Documented statements that he has made specific to the issue of safe discharges from ASH, including in the case of this most recent Questions and Answers article from the Arizona Republic, clearly illustrate his unbridled willingness to violate his required obligations to the citizens of Arizona simple as a matter of trying to avoid direct accountability in terms of the substandard mental-medical health care and practices at ASH. In doing this, Nelson breaches his contract with the citizens of Arizona in every conceivable sense. This is unacceptable. And yet the highest ranking officials in the Arizona Department of Heath Services, including ADHS director, Will Humble, refuse to acknowledge the significance of these matters, which thus allows for the gross violations of patient rights at ASH to continue, including but not limited to physical, verbal, emotional, and psychological abuse. In no uncertain terms, the willful misconduct of ASH's administrative staff in the context that I have laid out in today's article also amounts to explicit abuse of patient's rights, and I find it to be as deplorable an state of corrupt hospital management as I can imagine. Bottom line. Do not let yourselves be fooled by Cory "meathead" Nelson's clumsy avoidance of the reality(s) that underlie this specific body of concern; he truly is not very bright, but I find it hard to believe that his ineptude extends to an inability to even recognize how unlawful his conduct is, at times.
IN CLOSING: AS NOTED ABOVE, SINCE THE DEATH OF APRIL MOTT AND THE CRIMINAL SENTENCING OF JESUS RINCON MURIETTA, DR. STEVEN DINGLE HAS BEEN PROMOTED WITHIN THE ARIZONA DEPARTMENT OF HEALTH CARE SYSTEM, WHILE CORY NELSON HAS ALTERNATED BETWEEN THE SUPERVISORY POSITION HE WAS ORIGINALLY HIRED TO FILL AT THE ARIZONA STATE HOSPITAL, AND A TEMPORARY POSITION AS ACTING DIRECTOR IN THE AZ BEHAVIORAL HEALTH SERVICES. BOTH OF THESE DEVELOPMENTS WERE IMPLEMENTED UNDER THE DIRECT AUTHORITY OF WILL HUMBLE. IN THE PUBLIC MILLEU, MEANWHILE, WE AS A NATION HAVE EXPERIENCED MASS SHOOTINGS AND OTHER TRAGEDIES SPECIFIC TO THE PRESENCE OF UNTREATED MENTALLY ILL PERSONS IN OUR SOCIETY, BUT THE RAT BASTARDS AT ASH AND IN ADHS ARE PLUGGING ALONG WITH NO CONSEQUENCES WHATSOEVER IN TERMS OF THEIR WRONGDOING.
THIS- ALL OF THIS- IS STANDARD PRACTICE IN ARIZONA'S PUBLIC BEHAVIORAL HEALTH CARE SYSTEM. IT REALLY IS THAT BAD.
Please do what you can to defend the rights an support the critical need for serious reform at ASH and within the offices of the Arizona Department of Health/Behavioral Health Services, including the Office of Grievances and Appeals, as well. Patient abuse is inhumane and cruel. Let's end the abuse of Arizona's most seriously mentally disabled patients today.
paoloreed@gmail.com
Arizona Revised Statutes - Title 36 Public Health and Safety - Section 36-531 Evaluation; possible dispositions; release3 6-531. Evaluation; possible dispositions; release.
Arizona Revised Statutes - Title 36 Public Health and Safety - Section 36-531 Evaluation; possible dispositions; release3 6-531. Evaluation; possible dispositions; release.
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I would really love input of any kind from anybody with any interest whatsoever in the issues that I am sharing in this blog. I mean it, anybody, for I will be the first one to admit that I may be inaccurately depicting certain aspects of the conditions
at ASH, and anonymous comments are fine. In any case, I am more than willing to value anybody's feelings about my writing, and I assure you that I will not intentionally exploit or otherwise abuse your right to express yourself as you deem fit. This topic is far, far too important for anything less. Thank you, whoever you are. Peace and Frogs.