Federal Intervention and Decertification 2018. As per current patient concerns, this may well be needed yet again at Arizona State Hospital. And it certainly won't be the first time over the last 18 years.

August 06, 2004: "New State Hospital fails to win feds' approval." (Arizona Republic newspaper, Phoenix.)

April 09, 2013: “Hi PJ: Here is the latest from ————. Due to the lack of staffing patients are being confined to day rooms for crowd control….  They are also shutting down mall privileges because of lack of staff.  They are telling the patients that it is only going to get worse.” (Posted to

PJ Reed The Arizona State Hospital and Patient Abuse [paoloreed@gmail.com].)

November 12, 2013: "Arizona State Hospital fails federal inspection." (David Biscobing. ABC News Ch15/KNVX, Phoenix.)

 

Photographer: ABC15

"You, Dr. Cara Christ , are 100% responsible for doing the right thing today. So do it, already."

Dr. Cara Christ.
Director, Arizona Dept. of Health Services
2015-the present. 

Since her appointment to the highest ranking position in Arizona’s public health care system in 2015, Arizona Department of Health Director Dr. Cara Christ has repeatedly stated that there have been “great improvements” in the state’s sole long term public mental health care facility, Arizona State Hospital (ASH). To date however, January 2018, Dr. Christ has never provided any evidence or information about just what these “improvements” at ASH are, in fact. This is of very real concern to the staff of this publication, given that Dr. Christ’s immediate predecessor (Will Humble ADHS Director 2009-2015) willfully relied upon producing a pattern of overt and untruthful propaganda that served to delay a subsequent process of critically needed oversight and accountability at ASH. Propaganda that defied the realities specific to the ASH operation, including but not limited to preventable patient deaths, the tragic murder of a young Phoenix woman, and a wide range of patient generated concerns expressed in grievance submissions; and as such, granted the former administrators of ASH further opportunity to continue operatinASH in a manner deeply harmful to the welfare of the Hospital’s patient community. These issues have been exemplified by the information provided in this blog since 2012, as well as in a number of scathing investigative findings of the staff of ABC Ch15 circa 2013-2015; (As reported previously in this publication, at least three preventable deaths occurred due to this fact). 

The following article was originally published sometime in the first twelve months of the life of this blog, PJ Reed The Arizona State Hospital Patient Abuse. We are republishing this information as one means to remind our readers of how dismally substandard the operation at ASH was circa 2010-2012, and in order to raise consideration as to whether in fact any legitimate improvements have in fact come about since Dr. Christ was granted directorship over Arizona’s public health care system. 

“Lawmakers approved the new hospital in 2000 after the old hospital was decertified. That had threatened federal funding in 1998, because a federal review found assaults, filth, overcrowding and patients getting the wrong medications." 

2018 INTRODUCTION:  In the year 1997-98 or thereabout, Arizona State Hospital was formally stripped of its license to operate due to the exposure of substandard care practices and conditions. Following reacquiring the trust of federal regulators in 2000, the Hospital again all but lost its license in 2004, again due to violations of law and policy. In 2013-14, following the (then) two year history of this blog publication, issues of serious concern to the welfare of ASH's patient community yet again led to significant federal intervention, wherein the Hospital's license was almost stripped- yet again. 

History does not have to repeat itself, must not repeat itself, and it is up to us, the people, to make this so. Are the current administrators of ASH up to the task? Does the current director of ADHS have the right stuff?

Only time will tell. But it's running out. Fast.

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Staff Shortages: Wherein the ongoing crisis at The Arizona State Hospital specific to shortages in behavioral health technician staff has grossly unjust impacts on the ASH patient community. As always. 

(Originally published April 19, 2013)

NUTSHELL: Generally speaking, the patients at The Arizona State Hospital are afforded a range of privileges designed to optimize their overall state of mental and physical health and well-being.  These privileges include access to various recreational and therapeutic actives and related in-hospital resources, the bulk of which are provided at different locations throughout the hospital. Such resources include a gymnasium, library, exercise room, art therapy room(s), and so on; while on the Civil side of the hospital (where approximately half of the ASH patients reside), there is an open area referred to as "The Patient Mall", which is comprised of a roughly 1/4 mile long piece of concrete lined on each side by seating areas and other like amenities intended to provide patients with a reasonably comfortably environment not confined within the walls of specific treatment units. These various privileges and related amenities are central to extensive funding that the citizens of Arizona have provided on behalf of ASH's patients over the past 15-20 years, and as illustrated in the 2004 newspaper article that I posted two days ago (see "Teaser", Mon. 04/08/13), even the federal government has emphasized the importance of granting ASH patients clear opportunity(s) to participate in therapeutic and recreational opportunities away from the limited confines of unit "day rooms", where they have nothing more to do than watch t.v. or sleep in filthy overstuffed chairs that are thoroughly wiped down about once every decade while the more rambunctious individuals (staff included) carry on with nerve wracking episodic outbursts and other like mania.     

With respect for the revelations exposed in 1999-2000 by a Medicaid investigation at ASH, these are only a few of the specific details provided at that time:

“Inspectors with the Centers for Medicare & Medicaid Services reviewed 12 patient cases during a May visit to the State Hospital, at 24th and Van Buren streets. They found a hospital where patients were plunked in front of televisions or allowed to wander instead of being engaged in treatment.

The review found:

Patients have cookie-cutter, incomplete or ineffective treatment plans. One patient who had been at the hospital four months told them he couldn’t remember any treatment other than “going to the library once,’ ‘movies and popcorn’, and ‘getting my medicine.’ ”

Current Update: So long as the highest paid state employees in the Arizona Department of Health Services fail to do the right thing by not directly addressing the graphic wrongdoing at ASH, the issues at Arizona State Hospital are never going to change. As illustrated in recent news reports (see my blog article: "RE: Security Cutbacks At The Arizona State Hospital" March 12, 2013), recent major changes to the basic management of The Arizona State Hospital (ASH) have led to shockingly unreasonable staff shortages and related safety concerns, including but not limited to a number of patient escapes. These changes were implemented by ASH's current supervisor, Cory "crazycorycorner" Nelson, in order to establish what he and his superiors in the Arizona Department of Health Services (ADHS and namely Director Will Humble) have characterized as a "CULTURE OF CARE.”

Central to those changes, Nelson has laid off dozens of experienced ASH staff, including a thigh number of security staff. He has done while simultaneously ignoring increasing staff concerns that arose due to shocking incidents of violence that lest more than one staff person gravely injured, and in clear contradiction to promises that he made to staff during in the hiring process in summer, 2011. Now, over the past 12 weeks, there have been several highly publicized news reports that came about in response to reports generated by ASH staff specific to safety, and subsequent investigations of those reports exposed the issue of patient escapes; this, in turn, led to three specific interviews with Cory Nelson in which he patently denied the fact that these changes have had anything but positive results. In one case, for example, he flatly rejected the notion that reduced security staff contributed to a series of patient escapes (no less than 5 in 2012) on the 10 p.m. nightly news, which in the eyes of at least some viewers, greatly brought Nelson's character and capabilities as the man most responsible for managing ASH into question.  

Consistent with these other reports, I am now receiving information from sources about the direct impacts that these staff shortages are having on the patients at ASH. Specifically, one such recent report reads like this:

Hi PJ. Here is the latest from -----… Due to the lack of staffing patients are being confined to day rooms for crowd control….  They are also shutting down mall privileges because of lack of staff.  They are telling the patients that it is only going to get worse. (July 09, 2013)

As usual, in this specific case, we are again seeing how the ineptitude of ASH's administrators is landing squarely on the heads of the Hospital's seriously mentally ill and disabled client-patients. Cory Nelson and Will Humble have absolutely direct responsibility with respect for these matters at this time, along with various other executive staff at both ASH and in ADHS’ sub-agency, Behavioral Health Services. But it is also critical to note that the primary care providers at ASH are also involved in these issues, for they are the ones most directly responsible for each and every ASH patients' welfare, and this direct responsibility flows straight to ASH's chief medical officer, Dr. Laxman P. Patel. All of these individuals are currently complicit in allowing for the patients at ASH to be denied the general resources available at ASH, and this is wrong. Not unusual, mind you, just wrong, wrong, wrong, and 100% consistent with the standard practices at ASH, as illustrated to date by this blog, and as increasingly reflected by prime time news reporting. 

I am not going to send to much time on this today. But you can be sure that there are other developments from my end in the works, even as I write. The administrators and senior clinicians at The Arizona State Hospital are willfully engaging in substandard medical-mental health care and practice, and they are getting away with! 

For now, at least. There are a number of people today looking directly at these matters, and I am increasingly confident that it is only a matter of time before these rat bastards are held accountable to the full extent of applicable state and federal law.   

PLEASE SEE: RESOURCES IDEAS: MARCH 13, 2013: I recently posted a new listing of resources and contact information specific to the affairs of The Arizona State Hospital, and I strongly encourage anybody of like mind to do whatever you feel comfortable with in terms of defending the dignity and rights of the patient community at ASH. The administrators and clinicians at ASH are maintaining that operation at a dismally substandard level of medical care and practice, and they are getting away with lock-stock-and barrel. Patient abuse is highly illegal and when it comes the care needs of the highly vulnerable, seriously mentally disabled patients at ASH, it is sickening to the core. Let's work together and see that this matter is resolved today. I welcome any and all contacts- INCLUDING ASH STAFF, AND I ASSURE YOU THAT YOUR IDENTITY WILL NOT BE PUT AT RISK- and want to extend my sincere thanks to those of you who I have come to know thus far through my writings, and I really appreciate your willingness to consider my concerns in this context. 

DATELINE 2018: "Hi, PJ: Here is the latest from ————. Due to the lack of staffing....." As described above, this was posted to the blog in 2013; and it is a plain fact that due- yet only in part- to lack of staffing at that time, the Hospital was nearly shut down again in late 2013-early 2014. 

This early report from one of my key sources circa 2012-2014 about staff shortages at Arizona State Hospital added up in time to the consequent cause for more federal intervention, and shortsighted yet somewhat meaningful accountability in 2015, developments that came about on the basis of evidence presented in this blog (which the fed in part relied upon), and other such media bases who were taking a concerted look at the questionable care practices and conditions there (media bases which came to me at that time in order to draw from the data contained in this blog).

And here today, I am again receiving inquiries from such resources about what I know about ASH at this time, January, 2018. As much as anything, I know this:

Cara Christ has a nice smile.  

Will Humble’s 2013 propagandized characterization of the conditions and care practices at ASH as a “Culture of Care” overwhelmingly proves how deeply the corruption in these matters runs, in fact. Therein, the most trusted member of the Department of Health, wielding the most authority and related capability to do the right thing, instead engaged in abject complicity with the wrongdoers at ASH that did further the presence of criminal misconduct there for no less then five years. 

In January, 2018, I contend with certainty that the current Director of ADHS, Dr. Cara Christ, and her ongoing characterization of ASH as a “Center of Psychiatric Excellence”, can stand as evidence of ongoing denials about what really goes on at ASH, even today. 

This ongoing emission of inaccurate information about ASH is no less criminal in nature then it was circa 2010-2015, for it patently misrepresents the truth and the factual data that the public- and the feds- relies upon in order to certify and license such facilities. Emitting propaganda to the pubic- and the feds- in this manner is no different from any other like fraudulent misbehavior when it comes to acquiring federal assistance; be it in the case of individuals unlawfully seeking such assistance, or state managed agencies and agency facilities willing to do the same, it is representative of egregious, even malfeasant misbehavior.

And as with 2013, “What really goes on” at ASH today most necessarily includes, as per reports from current ASH patients, inadequate staffing numbers that directly contributed to vey recent a stabbing at ASH. 

The federally managed Centers for Medicaid and Medicare Services certifies and licenses ASH, and as such dictates required staff-to-patient quotients. X-amount of direct care staff in relation to known numbers of patient populations, for example, is required at all times, and Hospital administrators know this. 

Lack of such staff numbers can and does create unreasonably high risks of harm to patients, and to some staff, as well. By “some staff”, I am referring to direct care staff such as Hospital technicians, who spend the most time in direct interaction with the patient community in general; and I am not, it need be clarified, talking about administrative staff, who are behind deciding how many staff are needed on the patient treatment units, and who are rarely if ever at risk of the hazards associated by inadequate direct care staff numbers. Easy to declare “safeness” when you spend your days in the highly secure administrative offices at ASH, and easier yet if you work out of the administrative offices of ADHS/BHS.    

Again, I cite current CEO Aaron Bowen’s attempt to berate the Hospital Human Rights Committee on the basis of his belief that this body of patient advocacy is lacking awareness of law and policy, as a shining example of his questionable if not twisted attitude. To accuse such advocates in this way, while patently ignoring the standards of law and policy by which ASH is certified and licensed, and by which he is- in fact- employed, shocks the conscience. Yet is no surprise by now to the staff of PJ Reed The Arizona State Hospital and Patient Abuse.

Indeed. We have witnessed these patterns for over seven years now. It has made little to no difference at all that a new fish such as Aaron Bowen is now at the helm of the ASH operation. Or that Dr. Cara Christ has concluded in her propaganda that ASH is a Center for Psychiatric Excellence. 

Both of these people were appointed and hired in-house, sharing the bulk of their professional experience as employees of the state health care system. Such "approaches in a vacuum" thwart all notions of valid reform in any bureaucratic institution. The plain fact is, as per the study of such systems, bureaucrats such as Aaron Bowen are altogether incapable of curing broken systems of bureaucracy; this particularly true if they work in such broken systems. 

Leaving the constituent populations that support such institutions through taxation out in the wind. And any population(s) at heightened risk of negligence, exploitation, and abuse (be it the mentally ill, the at-risk elderly, and at-risk children) suffer far more deeply the impacts of broken systems of state managed care. We see this all the time, in state managed child protective agencies, in the federal managed VA, and yes, thought the entire history of public mental hospitals.  

What ASH still is today (and what really goes on there), is a safe haven for miscreants such as chief medical officer Dr. Steven Dingle, a known sexual predator, to carry on as entrusted medical provides with no fear of oversight or accountability. It does not matter what their known histories are outside of such institutions. Predators such as Roger Forney and Steven Dingle know all to well that when the stove gets too hot in any given public realm, they only need find a finding spot in places such as ASH and ADHS/BHS, where no light shines over the experiences of patient-clientele.

"What happens at ASH stays at ASH." Personified.

No one aspect of ASH’s history more illustrates this fact then the fact that, despite documented evidence of highly wrongful care practices and conditions- as seen in the federal interventions that ASH has been subject to on no less then four occasions in just over fifteen years- no one of the licensed psychiatrists have taken to account in context. Not only do these doctors have a very clear view of what patients go through at ASH (be it unlawful restraint, improperly managed medications, and so on), they are also obligated by the precepts of the Hippocratic Oath, the Americans With Disabilites Act, and a host of other like standards of practice and policy, to conduct themselves in a manner representing legitimate concern for the rights and care needs of each and every individual who comes under their primary care at ASH.

As such, why in the hell have these doctors shared in the accountability that former ASH administrators were subject to? How is that despite several federal interventions over the last 15 years have no one of these care providers been identified for what they are? They have clearly condoned if not utterly ignored and therein furthered issues known to harm their patients. 

It is common knowledge in the various professions, that doctors (and lawyers, etc.) basically hate to criticize their peers; this is a matter of practical conduct in the private realm of medicine and practice, where malpractice litigation and other like elements of private practice dominate the conduct of such providers. 

But in state managed facilities such as ASH, it is the direct responsibility of administrative medical staff, persons such as Dr. Aaron Bowen and Dr. Cara Christ, to ensure that all members of any such hospitals’ primary care providers abide by established standards of care. This applies, again, via the provisions of federal law and policy, such as the ADA, and the standards of the medical profession, in general, including but far from limited to the Hippocratic Oath.  

Regardless of how uncomfortable it makes these state employees to call out their peers, it is a simple matter of humane and reasonably civil responsibility. There can be no denying this. 

    

paoloreed@gmail.com