As to the violation of bright line codes of law that has historically shrouded the grossly substandard medical practices and associated administrative corruption at The Arizona State Hospital.

INTRODUCTION

It's been ongoing since I first literally arrived at The Arizona State Hospital on January 11, 2011, and a full bottle of highly regulated medication was stolen from my belongings while still in the hands of security and nursing staff who handled my admission. Ongoing since the May, 2011, cover-up of the violent escape of a patient named Jesus Rincon Murrieta, a coverup that included the participation of virtually all senior ranking ASH staff, most markedly ASH administrators, including ASH's long time on-site legal counsel, Joel Rudd, with no concern whatsoever for the safety of the patient of that of the public; and as the record came to reflect 90 days after that cover-up, it extended into the lives of at least one family, as they were impacted by the death of a young Phoenix woman named April Mott. It was highlighted again in early September, 2011, when I was unlawfully retaliated against by primary care physician, Dr. Perviaz Akhter, in complicity with the then Chief Medical Officer at ASH, Dr. Steven Dingle , for exercising my right to report staff misconduct to fullest of my ability, as my first 7 months of mistreatment at ASH had transpired. And it continued- intensified, in fact- throughout the remainder of my time as an ASH patient. But these specific and vividly loud examples of what I witnessed and experienced in those 13 long months of counter therapeutic mistreatment at ASH barely scratch the surface in terms of the full breadth of my observations as my time there passed; and more importantly, I was only one of close to 300 other seriously mentally ill and disabled patients at ASH, which immediately begs the question: "What else might have occurred in that time, in the case of other patients?"

AND IT IS ONGOING. THIS HAS BEEN PROVEN BY THE RESULTS OF SEVERAL PHOENIX AREA MEDIA RESOURCES OVER THE LAST 10 MONTHS (please see ABC Ch. 15 [Phoenix] for more information). AS WELL AS BY THE VERY RECENT TESTIMONY OF THE ASH HUMAN RIGHTS COMMITTEE, WHICH IN ITS FIRST YEAR OF FUNCTION HAS BEEN REPEATEDLY ORDERED TO IGNORE CLEAR EVIDENCE TO THE EFFECT THAT THE ABUSE OF ASH PATIENTS IS RAMPANT AT ASH.

The "IT", of course, relates to the substandard medical-mental health care practices at ASH, and the role of ASH administrators in furthering these issues no matter how irrefutable the data is. The "IT" goes further up the money tree, too, extending well into the executive offices of ADHS/BHS, wherein highly entrusted state employees willfully abuse their positions in order to condone this situation. It is that bad, and yes, it is ongoing. 

ARIZONA ADMINISTRATIVE CODE
TITLE 9, CHAPTER 21; Article 4 
GRIEVANCES, AND REQUESTS FOR INVESTIGATION FOR PERSONS WITH SERIOUS MENTAL ILLNESS

In recent weeks, the lawfully established Human Rights Committee (HRC) at The Arizona State Hospital (ASH) reported the fact that the executive staff at ASH have engaged in denying HRC's ability to exercise due diligence in terms of responding to evidence about staff misconduct and associated violations of patient rights. These reports are no surprise to me whatsoever. As I have outlined in several RERUN articles over the last few days, I was subjected to similarly unlawful patterns of abject denials in the same context, with respect for my having formally submitted dozens of reasonably documented, good faith grievance reports in relation to my experiences as an ASH patient, circa 2011-12. Not only were a number of those grievance submittals- all of which I submitted as per applicable protocol- patently ignored or otherwise not managed as per Hospital rules and regulations (they did, in effect, vanish), at least  five that made their way into the ADHS Office of Grievances and Appeals (OGA) were grossly mismanaged in clear violation of the Arizona Administrative Code (state law), most specifically in terms of procedural requirements, including but not limited to time line requirements. These specific requirements are designed to ensure reasonably prompt oversight of any possible evidence to the effect of patient abuse, or any other like violations of law that has been established in order to preserve and protect the rights and care needs of any individual due to be provided with services that ADHS/BHS is required to provide (this extends to the operation of ASH as a public entity operating under the authority of ADHS/BHS). 

I will point out, as well, that no area of law and policy is arguably more complicated than administrative law, including what in legal parlance is defined as civil procedure, and I contend that the officials in OGA, as well as in the superseding legal office in ADHS, willfully rely upon these dynamics in order to defy the intention of such law as it stands, in gross violation of their obligations under the public trust. The fact is- and this extends into the administrative offices of ASH (including that of assistant attorney general Joel Rudd)- these people take for granted that no patient at ASH has the capacity to recognize such violations, much less to dig into and interpret the maze of Arizona administrative law as it applies to the operation of ASH; and they exercise this presumption because they deem persons affected by serious mental illness and associated disability to be inherently incompetent in all senses of the word. This sort of behavior is patently discriminative, and occurs in graphic violation of most fundamental provisions of The Americans With Disabilities Act ( See 42 U.S.C [1992], and Public Law 110-325, ADAAA [2009] ).  I can state in good faith that my status as an ASH patient stands as only one example of how ignorant this form of discrimination is, for I- as a person affected by serious illness and disability- am not only able to recognize when my rights are being violated; I can, in fact, also identify triggers that are capable of aggravating my state of mind and emotion when they occur. And I can read and interpret law, including the mind numbing elements of administrative law. No aspect of major depressive disorder as it is understood in medicine today has direct relation to any so affected person's cognitive or intellectual strengths, and this applies to certain other forms of serious mental illness, too. And yet at ASH, where hundreds of persons affected by the full gamut of recognized mental illness are seeking reasonably optimum mental health care, the patients as a whole are uniformly branded as less than human, with little to no capacity for reasoning, moral character, or self determination.

THE FOLLOWING IS A FRAGMENT OF THE FAR BROADER BODY OF LAW THAT APPLIES IN THE CONTEXT OF ARIZONA'S PUBLIC BEHAVIORAL HEALTH AGENCY. IT DIRECTLY RELATES TO TIME LINE REQUIREMENTS, AND THE PROTOCOL THAT APPLIES IF/WHEN THESE SPECIFIC REQUIREMENTS ARE NOT MET. WHILE THERE ARE AVENUES BY WHICH OGA CAN REQUEST TIME LINE EXTENSIONS, I ATTEST TO THE FACT THAT NO ASPECT OF AY SUCH ALTERNATIVES WERE FOLLOWED AS PER THE APPLICABLE PROCEDURAL REQUIREMENTS. VIOLATIONS OF SUCH REQUIREMENTS ARE DEFINED BELOW AS PROCEDURAL IRREGULARITIES.

ARIZONA ADMINISTRATIVE CODE

TITLE 9, CHAPTER 21; Article 4 

ARTICLE 410

B. Request for extension of time.
    -2. The investigator or any other official of an inpatient facility acting according to this Article may secure an extension of any time limit provided in this Article with the permission of the deputy director of the Division.
     -3. The investigator or any other official of the office of the deputy director of the Division acting according to this Article may secure an extension of any time limit provided in this Article with the permission of the director of the Department.
     -4. An extension of time may only be granted upon a showing of necessity and a showing that the delay will not pose a threat to the safety or security of the client.

C. Procedural irregularities.
     -1. Any party may protest the failure or refusal of any official with responsibility to take action in accord with the procedural requirements of this Article, including the time limits, by filing with the deputy director of the Division a written protest. A protest concerning the failure or refusal to take action by the deputy director of the Division or designee should be filed with the director of the Department.
     -2. Within 10 days of the filing of such a protest, the official with whom it is filed shall take appropriate action to ensure that if there is or was a violation of a procedure or timeline, it is promptly corrected, including, if appropriate, disciplinary action against the official responsible for the violation or by removal of an investigator or hearing officer and the appointment of a substitute.

NOTE: A FULL VERSION OF TITLE 9, CH. 21, ARTICLE 410 "A" THROUGH "C" IS PROVIDED AT THE END OF THIS POST). 

I will say again,  that with respect for my experiences as an aggrieved member of the patient community at The Arizona State Hospital, in relation to my good faith attempts to seek meaningful redress via the applicable protocol, ASH administrators and members of ADHS/BHS Office of Grievances and Appeals willfully failed to meet the virtually all of the terms of the above outlined time line requirements, and numerous other like dictates of the law(s) of civil procedure. As to time lines, I attest to the fact that on no less than four documented occasions, the required dead lines were flatly ignored, with no notice to me or in consistency with protocol; likewise, the OGA staff responsible for these matters never presented any showing of necessity in spite of the fact that my safety and security were critically compromised not only by the issues at stake in several of these grievances, but also by the willful dereliction of duty by officers of OHA which did greatly exasperate these threats to me at that time. (see above: B. Request for extension of time, 2-4). Furthermore, as illustrated in my last two articles in this blog, my attempts to protest the failure or refusal of any official with responsibility to take action in accord with the procedural requirements were subsequently ignored. I did as a matter of plain fact submit repeated requests for the violations of these standards to be addressed as per the law to each and every senior ranking official, beginning with OGA, followed by the executive officers in BHS and the legal office of ADHS; until ultimately, I directly appealed to ADHS Director Will Humble himself. (see above C. Procedural irregularities, 1-2) None of these good faith requests and associated protests attained any response, and to date, this is still the case.

Time and time again this happened, as spelled out above. And I have full documentation to the effect, much of which I have shared with a range of associated investigative resources, media and senate members alike. I am convinced that senior ranking ADHS/BHS officials willfully attempt to wear out the energy of aggrieved ASH patients via this  outrageous and overt dereliction of duty (in the hope that any possible threats to the status quo in this context will dissolve and go unaddressed). I am also of the firm opinion that the sole reason the above patterns of gross rejection of Arizona's own laws occur (with respect for The Arizona State Hospital) lies in the associated fact that all ASH patients are- in fact- disabled by the affects of mental illness. And as I have clarified above and in numerous other articles, the ones behind these violations are willfully engaging in unabashed discrimination against the ASH patient community on the basis of disability. I experienced this first hand, via shockingly depraved misbehavior exhibited by my primary care psychiatrists (Dr. Pervaiz Akhter, e.g.,) senior ranking nurses, and more than a few lower ranking staff technicians and security guards. This misbehavior is shocking to the conscience, contributed to aggravation of my own specific state of mind and emotion as an ASH patient seeking reasonable care in the context of my diagnosis (major depressive disorder), and is criminal in nature. That said, it is the role of the Department of Justice Office of Civil Rights to intervene, and that is something I intend to bring about. 

Further, given the presence today of a Human Rights Committee at ASH- of which at least one member has proven to be decent character in relation to my work as it stands (I am sure she is not alone, but she just so happens to be the only member I communicate with)- and the escalating concerns that the HRC has in recent weeks expressed (including in the presence of an emergency AZ senate hearing), I am willing to believe that my original aims in terms of bringing stalwart oversight and due accountability to the substandard care practices at ASH are continuing to advance. This oversight shall include the role that ASH's administrative executives have played in furthering those conditions, as well as any/all state level officials in ADHS/BHS who have been complicit in these issues as they have occurred for time immemorial. 

There is some new blood, too, at the helm of ASH, in the form of an attorney named Jennifer Alewelt, who is now the Chief Operating Officer there; and who I know for a fact has already attempted to intimidate HRC members seeking to exercise due diligence in relation to the function of HRC. She too may well be due some immediate attention, as I see it. But this is sad, for myself, because I came to know Alewelt when she was employed in her previous position as a staff attorney with the Arizona Disability Law Clinic, and I somewhat believed her to be of good character. But our interactions were brief, and I really don't know her at all. With this in mind, I will offer her the same encouragement I have offered all other ASH executives over the last 3+ years (including while an ASH patient), as follows: 

It is never to late to do the right thing. 

For now, that is. 

Act now or pay later. 

And oh yes, as to federal oversight- there's also Joel Rudd.

Rat Bastards Beware.

ARIZONA ADMINISTRATIVE CODE
TITLE 9, CHAPTER 21
ARTICLE 410

R9-21-410. Miscellaneous
A. Disqualification of official. The agency director, deputy director of the Division, investigator, or any other official with authority to act on a grievance or request for investigation shall disqualify themselves from acting, if such official cannot act on the matter impartially and objectively, in fact or in appearance. In the event of such disqualification, the official shall forthwith prepare and forward a written, dated memorandum explaining the reasons for the decision to the deputy director of the Division or designee or director of the Department or designee, as appropriate, who shall, within 10 days of receipt of the memorandum, take such steps as are necessary to resolve the grievance in an impartial, objective manner.
B. Request for extension of time.
1. The investigator or any other official of a mental health agency acting according to this Article may secure an extension of any time limit provided in this Article with the permission of the director of the regional authority.
2. The investigator or any other official of an inpatient facility acting according to this Article may secure an extension of any time limit provided in this Article with the permission of the deputy director of the Division.
3. The investigator or any other official of the office of the deputy director of the Division acting according to this Article may secure an extension of any time limit provided in this Article with the permission of the director of the Department.
4. An extension of time may only be granted upon a showing of necessity and a showing that the delay will not pose a threat to the safety or security of the client.
5. A request for extension shall be in writing, with copies to all parties. The request shall explain why an extension is needed and propose a new time limit which does not unreasonably postpone a final resolution of the matter.
6. Such request shall be submitted to and acted upon by the director of the regional authority, deputy director of the Division, or director of the Department, as appropriate, prior to the expiration of the original time limit. Failure of the relevant official to act within the time allowed shall constitute a denial of the request for an extension.
C. Procedural irregularities.
1. Any party may protest the failure or refusal of any official with responsibility to take action in accord with the procedural requirements of this Article, including the time limits, by filing with the deputy director of the Division a written protest. A protest concerning the failure or refusal to take action by the deputy director of the Division or designee should be filed with the director of the Department.
2. Within 10 days of the filing of such a protest, the official with whom it is filed shall take appropriate action to ensure that if there is or was a violation of a procedure or timeline, it is promptly corrected, including, if appropriate, disciplinary action against the official responsible for the violation or by removal of an investigator or hearing officer and the appointment of a substitute.
D. Deputy director's or director's investigation.
1. The deputy director of the Division or director of the Department may at any time order that a special investigator review and report directly to the director or deputy director as to the facts of a grievance or condition requiring investigation, including a death or other matter.
2. The special investigator, deputy director and director shall comply with the time limits and other procedures for an investigation set forth in this Article.
3. Any final decision issued by the deputy director of the Division or the director of the Department based on such an investigation under this rule is appealable as provided in R9-21-408.
4. Nothing in this Article shall prevent the Department or the Division from conducting an investigation independent of these rules.

TO VIEW THE ENTIRE CONTENT OF ARIZONA ADMINISTRATIVE CODE TITLE 9, CHAPTER 21 HEALTH SERVICES (AAC-9-21, HEALTH SERVICES) SEE: 

www.azsos.gov/public_services/Title_09/9-21.htm

OF PARTICULAR INTEREST, PLEASE SEE: AAC-9-21, HEALTH SERVICES
     ARTICLE 1. GENERAL PROVISIONS 
                   -(Article 1-105 HUMAN RIGHTS COMMITTEES)
    ARTICLE 2. RIGHTS OF PERSONS WITH SERIOUS MENTAL ILLNESS
    ARTICLE 4. APPEALS, GRIEVANCES, AND REQUESTS FOR 
                          INVESTIGATION FOR PERSONS WITH SERIOUS MENTAL    
                          ILLNESS

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