Arnold v. Sarn And A Spare $38.7 Million. A brief glance at Arizona's fairly recent history in relation to its mentally ill citizens.

INTRODUCTION

In 1981, a class action suit was filed alleging that the state, through the Department of Health Services (DHS), and Maricopa County did not fund a comprehensive mental health system as required by state statute. The lawsuit, Arnold v. Sarn, sought to enforce the community mental health residential treatment system (A.R.S. §§ 36-550 through 36-550.08) on behalf of persons with a serious mental illness in Maricopa County. In 1986, the trial court entered judgment holding that the state had violated its statutory duty, which the Supreme Court affirmed in 1989.

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I had never heard of the Arnold v. Sarn case when in May, 2010, I was first diagnosed with  mental illness and became a client-consumer of the Arizona Department of Health Care Services/Behavioral Health Services (ADHS/BHS), but once I found myself compelled to learn about the system that I was so deeply involved with, I did eventually come into contact with Chick Arnold, the attorney who spearheaded the relatively well funded services now available to mentally ill persons in this state. I wrote him a letter in late 2011, in order to offer my moral support to his ongoing mental health care advocacy,  and I summarily described the conditions at the Arizona State Hospital (ASH) as I had experienced them to that point in time, as well. I heard back from him shortly before my February, 2012, discharge. He essentially encouraged me to keep up my faith in the very realistic possibility that my dutifully reporting of conditions at ASH would, in time, gain the attention of federal authorities and/or lead to meaningful improvements in not only the ongoing administrative and clinical abuse of patients at ASH, but in terms of the greater community, as well. Mr. Arnold, like many good faith  attorneys wiling to devote themselves to the public interest, is an extremely busy man, and his dedication to  maintaining the flow of funding for mental health services is, in my opinion, more than enough to ask of anybody. That said, my communication with him, thus far, has not been in association to having him become involved in my work, to date. 

But with my work in mind,  the Arnold v. Sarn case is staple food in terms of understanding the state of affairs in Arizona today, and I may in fact be back in touch with Chick Arnold before long, because today, it is increasingly becoming clear that at least some of the matters I am currently working to address will make their way into the federal court venue. 

For example, ADHS/DBHS representative counsel appears to have failed to meet a May 10 deadline set by the administrative judge assigned to this upcoming Thursday's scheduled hearing. Of course, I have already forwarded my direct request that the hearing be postponed (if nothing else) based on the fact that my right to be provided with evidentiary materials in this case has not been met; but knowing as I do that the court has already proven itself to be complicit in the shortfalls of the broader system itself, I don't expect much form them, anyway. Nonetheless, this newest information concerning the missed deadline only bolsters my position on the status of the case today. Monday I will formally be in contact with the Arizona Office of Administrative Hearings in order to discuss this issue, but I I have also already been counseled by an associate of mine concerning the try real practicality of advancing this case to the level of the federal court.

The fact is, all the funding in the world is not going to make much difference in the lives of Arizona'a seriously mentally ill citizens if the state's behavioral health care system is administered in the radically disorganized fashion that is has been for all of these years. The Arizona Department of Health/Behavioral Health Services and its affiliated, subcontracted regional behavioral health authority agencies, who in turn have their own subcontracted provider agencies, is deeply thick with paper pushers and mid-level district managers who have little idea of how to manage the very real needs of a client base that is far too large and relatedly complex for the mechanisms of such a system. And as I have learned the hard way, many of the highest ranking members of the state's behavioral health system willfully disregard applicable standards of law and policy in order to assure that their career paths remain on track. It is a  behemoth sized, classically ineffective bureaucracy thorough and through, and way way down at the bottom of it all, are the mentally disabled individuals who experience nothing short of outright and systemic ineptitude that clearly lies at the root of all of my primer concerns today. 

So while is great to learn that Arizona Governor Jan Brewer has earmarked $38 million on behalf of the system itself, I've no faith whatsoever that the funding will make much difference when it comes to the patient abuse that I experienced and witnessed on a near daily level at The Arizona State Hospital. The state employees that run ASH, including ASH supervisor Cory "crazycorycorner.weebly.com" Nelson and his crew of unethical sub-administrators and managing physicians could give a rat's ass about whether or not this funding has come into existence today, because one way or the other, the patients at ASH are still going to be effectively cut off from the rest of the world. 

(2015 Update: As per having been further exposed for what and who he is in major media, the ASH supervisor mentioned above is now known as Cory "This is the of *!**#!**! that gets people in my position fired!" Nelson..... )

         On another note:      

As reported in the Arizona Republic newspaper on December 08, 2011, in a story published in relation to an investigation of alleged social security fraud, Arizona Governor Jan Brewer's son, Ron, is currently hospitalized at The Arizona State Hospital, where I too spent thirteen long months between January, 2011, and February 2012. I cite the following article  because I do not want anyone taking time to consider my accounting of my experiences at ASH to get the impression that I am unlawfully sharing private patient information, and that in Ron Brewer's case, he has already been outed, as it were. As with Joe Saucedo Gallegos (see this blog, May 02, 2012, last paragraph and photo) and Jesus Rincon Murietta (see this blog, April 5, 2012), Ron Brewer's basic privacy rights have been compromised via some nature of legal quandary, or more specifically in his case, because he just so happens to have the misfortune of being the son of an elected public official. I never got to know Ron Brewer, for he was housed in the most highly restricted unit in the civil section of ASH (Ironwood unit), the wider civil section being where I underwent treatment for major depressive disorder, but Ron Brewer was allowed at times to participate with patients from other patient units  in volley ball games and other like activities, so I did talk to the man once or twice.

Eventually, though, after I learned of the extent of corruption in Arizona state government, and with particular regard for the article about Governor Brewer, I found it too freaky to be playing volley ball with the poor man... Or, to be more honest, the whole picture was unnerving, Ron Brewer being a convicted rapist, and his mother being implicated as yet one more abuser of the mentally ill. As follows, in sum, it is apparent that she may have milked the system in direct relation to Ron Brewer's health issues, and it adds to up to yet one more graphic example of how deeply corrupt the state's most trusted authorities in specific relation to mentally disabled individuals is, and as with the various other realizations I came to while hospitalized, it made me sick to my stomach.

Feds probed role of Gov. Brewer in son's Social Security benefits.

Prosecutors declined to pursue charges; Governor: Benefits not wrongly received Read more: http://www.azcentral.com/news/articles/2011/12/07/20111207feds-probed-role-jan-brewer-son-social-security.html#ixzz1uhJuYk6M

         Gov. Jan Brewer's role in the collection of her son's Social Security benefits was under investigation for more than a year by federal authorities trying to determine if about $75,000 in benefits was improperly paid on behalf of her son.

    Sources familiar with the investigation said the case was referred to federal prosecutors, who have declined to pursue charges. However, sources said, Social Security officials are considering efforts to recover the money through administrative procedures. One source described the case as "highly political."

      The precise scope of the probe could not be ascertained because state and federal officials would not reveal the information, citing federal secrecy statutes and patient-confidentiality laws.

        Brewer and her office have declined to discuss the matter in detail. Brewer said in

a  written statement to The Arizona Republic, after more than a month of interview requests, that she knows no specifics of the inquiry and never spoke to investigators. Brewer's statement said she believed the investigation was a politically motivated attack on her family. She said she believes it began with an anonymous complaint to Social Security before last year's election.

         Her spokesman, Matt Benson, wrote in an e-mail late Wednesday that the target of the inquiry has not been clear. "All that has been evident is that the records of the governor's son Ron were of interest," he said. "To our family's knowledge, my son has never received any Social Security benefits to which he was not entitled, and all the benefits he has received have been spent entirely for his care and well being," the statement said.

             The Arizona Republic has determined:

        The case involves an examination of Social Security benefits paid on behalf of Brewer's oldest son, Ronald. He first received benefits as a minor after his father's death and continued to receive them as an adult because of a disability from mental illness.

         In 1989, Ronald was charged with sexual assault and kidnapping. The next year, he was found not guilty by reason of insanity and sent to the Arizona State Hospital. A court commissioner ordered Jan Brewer, as Ronald's "representative payee," to direct her son's monthly Social Security benefits toward the cost of his hospitalization. The Arizona Department of Health Services, which runs the hospital, declined to release records to The Republic regarding such payments, saying the records either were protected by privacy laws or did not exist.

         Court records said Ronald was receiving Social Security benefits when he was sent to the hospital in 1990. Federal law was changed in 1995, barring Social Security benefits to anyone institutionalized after being found not guilty by reason of insanity.

        Each year, Jan Brewer, as "representative payee," would have been asked by the Social Security Administration to sign a form regarding her son's status. That form requires the representative payee to confirm if there is any change in the living arrangements of the beneficiary. The signature line for that reporting form states: "A person who conceals or fails to tell SSA about events asked about on this form with the intent to fraudulently receive benefits may be fined, imprisoned, or both." Ronald did have a status change in 2002. Court records show he was conditionally released in May 2002 and returned to the hospital by September 2002. He currently is confined to the hospital.

         The basis of the investigation was whether Ronald improperly received benefits at any time; the amount of money in question is about $75,000. Brewer said her son is no longer receiving benefits.

         Read more: http://www.azcentral.com/news/articles/2011/12/07/20111207feds-probed-role-jan-brewer-son-social-security.html#ixzz1uhC3H7YR

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And just today, the Arizona Republic published another story relating to Governor Brewer and her administrative actions in recent years:

Arizona funding will restore help for mentally ill 

       New state funding for Arizonans with serious mental illnesses returns some of the services they lost two years ago and paves the way for a temporary agreement in a decades-old class-action lawsuit.

       The budget for the fiscal year that begins July 1, which Gov. Jan Brewer signed Monday, includes $38.7 million to restore housing, counseling and other services to people with serious mental illnesses who don't qualify for Medicaid.

That's less than the roughly $50 million cut in 2010, and the two-year deal doesn't end the 30-year-old court case. But the money represents a significant turnaround in a lengthy legal battle over treatment of some of the state's most vulnerable residents.            

      About 12,000 people lost a raft of services to budget-balancing reduction. Mental-health advocates and state officials say the new funding brings opportunities for people to recover and thrive with greater emphasis on employment, life skills and peer-support programs.

       "Our overarching principle is to invest this on the front end, not the back end, in community-support systems to keep people healthier," said Arizona Department of Health Services Director Will Humble, who oversees the state's behavioral-health system. "It really has been a priority in the Governor's Office to get some of those resources back."

        The July 2010 budget cuts came weeks after the state and attorneys in the Arnold vs. Sarn lawsuit agreed to put the case on hold for two years, in part to prevent lawmakers from repealing the law that underpins it.

       The lawsuit sought to protect the rights of the seriously mentally ill under an Arizona law that requires the state to provide an array of community services, such as medication, therapy, housing and transportation.

          Later this month, the governor and attorneys for the mentally ill are expected to announce a new two-year deal.

      In the meantime, they'll continue to negotiate terms intended to ensure treatment for people with serious mental illnesses and eventually bring an end to the case, first filed in 1981.

       By the end of the two-year agreement, increased Medicaid eligibility under federal health-care reform -- if it's allowed to take effect -- would cover most, if not all, of the seriously mentally ill who now fall in the non-Medicaid category.

       The state will agree to use the additional funding for a package of services that include job, living-skills and housing programs and expansion of organizations run by and for people living with schizophrenia, bipolar disorder and other mental illnesses.

       In 2010, Brewer, faced with a brutal recession, called for a repeal of the law requiring the state to provide services to help balance the budget. As a compromise, the sides agreed to a two-year stay in the lawsuit that allowed the state to cut about $50 million in services for people who earned too much to qualify for Medicaid.

      Hundreds of people with serious mental illnesses dropped out of sight, dozens lost housing and thousands lost access to group and individual therapy, transportation and community centers. Service providers laid off hundreds of case managers.

      Mental-health-service providers say the new funding is welcome, but people have struggled mightily over the past two years.

      "I wish the government of Arizona would stop using people like they were yo-yos -- up and down, up and down, services, no services -- just because of how much money they make," said Mitch Klein, CEO of CHEEERS Center, a peer-run Phoenix drop-in agency that serves about 400 people. "Treat people who need help, when they need it."

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       IN CLOSING: I can only say: Let's get this thing done. The time is- and has long been- ripe for bringing the substandard mental health care at ASH up to par with the rest of the nation.  

paoloreed@gmail.com