Fact #Four) Administratively sanctioned exposure to undue risk.

         As stated in my last accounting of Issue #3, the conditions on the Desert Sage East unit were so violent that I had been on the unit for no more than a day or two before some of the more volatile patients on that unit began threatening me with bodily harm. I didn't take it too personally, for the most part, because it was clear to me that many of the patients on Desert Sage east unit simply have violent personality disorders, or whatever.  But I have also mentioned already that prior to my arrival on the Desert Sage East unit, I had been engaged in a good faith effort to address illicit tobacco and other substances sales and use at the Arizona State Hospital (ASH), which is a very prevalent and particularly insidious problem there that really got under my skin once I learned that staff smuggles in 100% of the illicit substances sold and used by patients at ASH, which endorses itself as a "smoke-free environment". My first inquiries into how staff felt about the problems relating to illicit substances were very disappointing, for I learned that these problems were far from unrecognized, and yet, staff seemed to look at it as a necessary evil of a sort, and the patients were always identified as the problem itself. I initially contacted the Arizona Department of Health Services (ADHS) about the issue in March, 2011, because I was very concerned about patient safety; in short, the unlawful selling and buying of these substances creates the same sort of safety issues that the sale and trade of any illegal drug does in any setting, and the patient bathrooms on the patient mall were often crowded with smokers and dealers who would threaten and harass non-smokers needing to use the facility for its intended purpose. In turn, ADHS informed me that they would be addressing the issue by communicating with ASH' administration about my concerns. By may, 2011, I came to realize that my role as a patient informant of sorts who was willing to report illicit substance issues had become common knowledge to at least some of the patients most obviously involved in the selling and use of illicit substances, because certain of these persons threatened me more than once. I reported these threats to both the ASH patient advocate, Sonya Serda, as well as to ADHS officials. There were no dealers on my original treatment unit (Palo Verde East), however, and these problems were somewhat manageable from my end (all it took was avoiding the patient bathroom and the ones most centrally involved in the matter, a "manageable" but nonetheless onerous task that clearly should not be part of the patient experience at ASH or any hospital).  As soon as I arrived on Desert Sage east unit, however, at least one of these persons immediately targeted me as "a snitch," and from thereon out, the problem only intensified for me. I was open about the threats with staff, but it made no difference, and my strongest protests of the fact that I had been transferred from the most peaceful unit to the most violent unit (arguably) were ignored.
      By early fall, 2011, I became resigned to the fact that my care and treatment  at The Arizona State Hospital was no sort of priority (nor that of any patient, per se') to the clinicians and administrators. I had learned the hard way that no degree of good faith efforts to contribute to improving the abusive conditions at ASH could amount to much, because the ones most responsible for responding to reports of wrongdoing had proven themselves unwilling to meet their obligations in this context. No matter how passionately I expressed myself to the various hospital and state officials assigned to the role of advocating for and supporting patient rights and well being, I ran into brick walls. On Desert Sage East unit, I was forced to settle into a habit of spending no more time on the unit than I had to, and when on the unit, to remain away the general population as  I possibly could, all as matter of doing all I could to keep myself safe from bodily harm. Nonetheless, I was continually harassed and threatened, and it was not before long that I became the victim of a violent patient induced crime while there in the Desert Sage east unit. Specifically, one very large and at times aggressively violent patient physically assaulted me at least three times within 5-6 weeks of my arrival on that unit, and three men were also very threatening towards me on a constant basis. I submitted several written grievance documents specific to these incidents, but for all I could tell, no sort of efforts were made to improve the situation on my behalf. In fact, certain staff members on Desert Sage East basically encouraged the behavior of these patients at times, and I began to sense a very bizarre form of danger that manifested in the fashion of patient aggression in combination with very obvious related staff negligence. On September 30, 2011, less than one full month after the transfer to Desert Sage East unit had been unlawfully imposed on me, the above mentioned female patient attacked me from behind with a plastic and metal chair that she used to strike me in the head and upper torso and to pin me with, face first, against a chest high counter for about 10 seconds. I was slightly injured by the attack, and my eyeglasses were bent, but my primary concern, without doubt, had to do with the circumstances surrounding this attach, including the fact that several staff persons basically stood there and watched while this patient approached me from behind with the chair held at shoulder height from a distance of no less than 25' feet, or so. This particular patient was well known for violence of this sort, including incidents specific to her using chairs in order to create havoc. With that particular concern, in mind, following the attack, I proceeded in a process of doing what I felt I had to in order to see that the attack was duly noted and reported to authorities, and found the response of police to be far more consistent with what I would expect of them, than had been the case when I reported the assault on me by an ASH employee (yet another story in itself, that will in time become part of my overall accounting of my experiences while at ASH).  I also reported my concerns about the attack itself, as well as staff negligence, to both the patient advocate, Sonya Serda, and to Kara Burke, who is the manager of the Arizona Department of Health Services Office of Grievance and Appeals (ADHS/OGA). Shortly thereafter, I received a letter from the Chief Operating Officer at ASH, Donna Noriega, dated December 02, 2011, who not only brazenly denied the fact that I had been injured in the attack, this despite me having reported my injuries and bent glasses to staff at the time of the attack (following which, medical staff immediately examined me and acknowledged light bruising on my right cheek, as well as my slightly bent glasses), but who also went so far as to mischaracterize the severity of the attack in language so ridiculously demeaning and absent of legitimate concern for the facts of the case, that I almost had to laugh. As follows, here are a couple of verbatim cites from Ms. Noriega's Dec. 02, 2011, letter:   

"The video tape of the incident was reviewed... (the patient)... proceeded to approach you from the side with a plastic stacking chair... proceeded to place the chair somewhat over your head and gave you a bit of a shove (not enough to make you lose your balance)... the chair... not used as a weapon... made no contact with you at any point. Staff immediately intervened... You at no time appeared to be in pain or suffering from any injuries. You denied injury to staff...."   

         The really twisted thing about all this is that no member of ASH' staff had any problem with me reporting the event to the police, etc., until such a time as I went so far as to include in my report that staff had been in a position to intervene well before I was struck by the chair. Ms. Noreiga reacted to my concerns in classically Pavlovian fashion as a matter of doing all she could do distance ASH from any stated role of responsibility for the incident, while simultaneously misrepresenting the extent to which I was effected by the incident, and in doing so, being far, far too quick to deny the most factual elements of the incident, despite having no apparent familiarity with the reality of the sequence as it had actually played out that day. Police review of the same video tape of the incident led to the woman's almost immediate arrest on charges of assault with a deadly weapon. And so on. This is a glaringly accurate example of how ASH administration commonly alters the truth of the conditions there anytime something not in keeping with their substandard practices arises. My well being and needs as a patient in that damn hospital were absolutely shat upon, yet again. And again I will state that my experiences are not exclusive. This is standard practice at ASH, and it continues unabated because the ADHS officials assigned with the responsibility of responding to good faith reports about such criminal conduct refuse to do meet therms of their obligations in this context. All of it, at the expense of the patients.

        As this particularly sordid affair bled itself out in the weeks following the attack, I decided that it was time to address far wider aspects of ASH' operations as a whole, and I submitted several documents to ADHS specific to this decision. I am far less concerned with the actions of the patient that attacked me that day- she is, after all, mentally ill, and her behavior is thus understandable, in context. But the behavior of ASH clinicians and administrators, as well as various other related officials at ADHS, and so on, will only be understood if the full story is told, listened to and acknowledged, and subsequently reviewed/investigated  by the applicable authorities.
        Ergo, I somewhat recently submitted a summary grievance report to the Arizona Department of Health Services Office of Grievance and Appeals manager, Kara Burke, that is centered upon the reality that, in my well learned opinion, the overall conditions at ASH are so dismally out of keeping with contemporary standards of health care and practice that a formal investigation of the clearly connected factors underlying the entire, sequential body of issues underlying these four specific grievance issues (above) need occur. In the basic provisions of the Arizona Administrative Code (AAC) there is language specific to the requirement that legitimate reports of unallowable conditions must be investigated in due fashion by ADHS/OGA anytime a person such as I submits such a document in keeping with the applicable standards of procedure. I then received a response from Ms. Burke, wherein she advises me that my specific request for an investigation into conditions at ASH does not fall under the provisions of applicable statutes. In my experience, the specific language of this letter is consistent with the language that I have been subjected from that office each and every time one of me grievance issues has arrived in their mailbox. It's a travesty. The provisions of the AAC are clear as day in terms of describing the required procedural processes relative to these matters, but ADHS/OGA reacts with the same Pavlovian consistency that ASH clinicians and administrators do whenever something threatens their willingness to do business as they have always done business, regardless of who gets hurt or how criminally egregious their actions are.

     In closing, I want to assure anybody with the gumption to read about these things, that now that I have  gotten the basics of these four ongoing grievance issues written out, I will do what I can to lessen the basic text load each time I post reports on this blog. I will most definitely be presenting as full an accounting of all of my experiences at the Arizona State Hospital as I possibly can on the coming weeks into months. Hopefully, my resources and so on will not peter out to the point hat I cannot maintain diligent dedication to these issues.
          But I will do all I can, as quickly as I can, for I know with absolute certainty that:
     A) ASH administrators and so on are hoping that I will basically disappear, and leave these ongoing concerns unresolved.
     B) Before long, ASH and/or state authorities will take some nature of action to shut my efforts in relation to this blog down. My willingness to name the one's most responsible for the misconduct and arguably criminal conduct that I have been subjected to is going to piss these rat bastards off, and I am not entirely certain what all they might be willing to do to suppress my voice today.
   C) When these issues do go to hearing in the next 2-3 months (or whatever- it could be awhile because ADHS/OGA is still compromising the process, but I am not going to allow ADHS/OGA to get away with distorting the full breadth of my concerns and the related wrongdoing expressed therein), ASH 'actions and related clinical/administrative misconduct, as well as that of ADHS/OGA, will be defended by the most powerful law firm in the state, the Arizona Attorney General, and I will be at a radical disadvantage in all senses of the word.
          Again, I will hopefully be able to remain afloat and healthy for the the entirety of this process.
I will do all I can to keep my work available for consideration by the greater public. I have nothing to lose, for I have already lost the vast majority of whatever I ever had, and this an extremely important process. As it is, the findings of hearings such as the ones that I will be presenting my allegations and related evidence to a state appointed administrative law judge(s) in the next few months are not made available to the public. I believe that that is wrong in itself, for these are issues involving state employees, some of whom are high ranking employees who by virtue of their positions are granted the privilege and the related  (immense) responsibility of caring for some of the most vulnerable adults in the human population today. This, in my opinion, is a clear issue of public trust, for the patients at ASH are our fellows, and come from our families, and are human beings first and foremost with little to no meaningful voice by which to stand for themselves in defiance of these atrocities. No aspect of the Arizona State Hospital's staff or operational objectives supersedes the rights and needs of the patients there at ASH, and the entire situation is so critically broken at this time, that only sincere oversight with a uncompromised mission of holding the ones responsible for the shortcomings at ASH and throughout the ADHS/OGA network accountable for their wrongdoing to the fullest extent possible under common law and policy.

Coming soon: I am calling for a minimum of some fashion of federal investigation of the problems at ASH. It is overwhelmingly clear to me that the graphic absence of objectivity in terms of the state agencies responsible for such oversight and investigation amounts to nothing more than a broken and grossly corrupt system. Bottom line. With this in mind, I have already opened up a slight line of communication with a representative of The United States Department of Health and Human Services Office for Civil Rights, in relation to very definite violations of the Hospital Information Portability and Protection Act (HIPPA), wherein ASH administration pulled their power trip crap on me again and refused to grant me access to personal health records that I have an absolute right to see (as per the provisions of HIPPA). They are afraid that the information contained in those records will only firther epose the deep, deep criminal conduct that they are up to. Sound fantastic? Well, it is, all of it. And, yep, it continues, and in certain ways, I don't think I have even really begun with my work as a survivor of the Arizona State Hospital.
          I am doing all that I can today with an absolute minimum of resources as a matter of seeing that these these matters are meaningfully addressed. I live in a motel for now. I am paying for all postage, copying, scanning and case preparation out of my pocket, and I am indigent, with less than $100 to my name today. I need your help. Anybody, that is, willing and able to offer anything whatsoever to this very well founded cause is welcome to contact me. Do so via my blog, leave a comment, etc., or email me at: paoloreed@gmail.com. I will follow up accordingly.