02/17/18. Arizona State Hospital Human Rights Committee.

DATELINE February 17, 2018.

Liu Xiaobo, 1997: Free expression is the base of human rights, the root of human truth and the mother of truth. To kill free speech is to insult human rights, to stifle human nature and to suppress truth.

Liu Xiaobo (b. December 28, 1955, d. July 13, 2017) was a Chinese literary critic, poet, human rights activist and Nobel Peace Prize laureate who called for political reforms and was involved in campaigns to end Communist single-party rule in China.

Faces of danger if not evil.

Former since-fired
ASH chief quality control officer
and short time CEO
Donna Noriega

Former since-fired
ASH CEO and short time deputy
director of ADHS-BHS
Cory Nelson

Known sexual predator
current ASH chief medical officer
Dr. Steven Dingle

Former since-fled ASH psychiatrist
Pervaiz Akhter
(Pakistan)

Former since imprisoned
Child sexual predator
ASH security guard
Roger James Forney

Current ADHS Director 
Cara "nice smile" Christ, M.D.

RE: Allegations of conflict(s) of interest, and the creation of a cognitive disconnect between the function of the Arizona State Hospital (ASH, Hospital) Human Rights Committee (ASH-HRC) and the meaning of advocating in the interest of human rights. 

INTRODUCTION

An emphasized concern of Arizona Department of Health (ADHS) director Dr. Cara Christ revolves around the central allegation that members of the Hospital's Human Rights Committee (ASH-HRC) have conducted themselves in a manner that meets the definition of conflict(s) of interest. In alleging this, Christ directly relies upon the Arizona Administrative Code (A.A.C.), Title 9 (Health Services), Chapter 21 (Arizona Health Care Cost Containment System- Behavioral Health Services for Persons with Serious Mental Illness), Section 105 (Human Rights Committees) subsection F. Christ then goes onto threatening that she will take action to "fire" any member known to have in fact violated these standards of law.

In relying on this standard of state law and policy in providing evidence of her central allegation, Christ falls into a questionable interpretation of legal standards specific to the function of a human rights committee,  in direct relation to the ability of ASHs HRC acting behalf on client-consumers of the services to be provided by ADHS-Behavioral Health Services. 

Title 9-21-104, for only one example, distinctly states a clear relationship between the role of lawfully required state Human Rights Advocates and the function of Human Rights Committees. As such, these specifically designated entities share the lawfully required  obligation to ensure that no citizen-client-consumers in the ADHS-BHS construct- including each and every individual hospitalized at ASH- are subjected to unlawful violations of their given human and civil rights. More specifically, she states that it has been determined as per this statute that there is a clear conflict of interest at issue.

DISCUSSION

Specifically, Christ's claim of a clear conflict of interest reads as follows:

"ASH HRC members are prohibited from participating in a matter in which a committee member has a conflict of interest. A.A.C R9-21-105(F)."

In contradiction to this claim, however, Title 9-21-105(f) specifically reads as follows, in full:

   A. If a member of a human rights committee or the human rights committee determines that a member has a conflict of interest regarding an agenda item, the member shall refrain from:

1. Participating in a discussion regarding the agenda item, and

2. Voting on the agenda item.

No aspect of the letter of notice at issue in this matter offers evidence to the effect that a member of (the) human rights committee or the human rights committee determined this claim (conflict of interest.) As such, as per the specific terms of Title 9-21-105(f), it is inappropriate if not unlawful for any state entity outside of an actual human rights committee or a member or members of a human rights committee to allege this arguably crucial area of concern.    

Indeed, it is only Dr. Cara Christ and her various minions in the Arizona Department of Health's (ADHS) legal office who are behind raising this allegation. Which, very ironically,  is a clear conflict of interest in itself. 

This, a claim very akin to the fact that to my knowledge, no patient(s) at ASH have raised the issue of violations of their protections under the Hospital Insurance Portability and Accountability Act on the basis of the activities of any ASH-HRC member or members.

Not so fine, then, for Christ and/or her fellow bureaucrats in the ADHS construct to threaten that, on the basis of her allegation, any member or members of ASH-HRC are at risk of being dismissed from the committee itself. The fact is, that if it's her wish for we the public to consider the implications of state law and policy as that may apply in this matter, it would be prudent for her in own right to abide by the specific terms of said law and policy, as spelled out by the A.C.C. standard she is relying upon in making this specific claim.

But is it realistic to think that the woman currently bearing the most responsibility over public health care in Arizona is capable of prudence, in fact?

Prudent: 1. wise or judicious in practice affairs; sagacious; discreet or circumspect; sober. 2. careful in providing for the future.

In attempting to justify this allegation, Christ also states that one or more ASH HRC members have willfully engaged in going beyond their given authority, including by stating that it's wrongful for them to engage in actually advocating for ASH patients, versus merely providing oversight, access to information, and review of certain identified concerns. It's an odd thing, indeed, given that human rights as a topic, and the lawful requirement that ASH be provided with an HRC, have direct relation to the equally required presence at ASH of a Human Rights Advocate. This is clearly spelled out  by  A.A.C. Title 9-21-104(B).

A.A.C. Title 9-21-104(B), Human Rights Advocate reads as follows (in part):

The chief officer shall appoint at least one human rights advocate for each 2500 clients in each region... The chief officer shall appoint at least one human rights advocate for ASH. All clients shall have the right of access to a human rights advocate in order to understand, exercise, and protect their rights. The human rights advocate shall advocate on behalf of clients and shall assist clients in understanding and protecting their rights... The human rights advocate shall also assist clients in resolving appeals and grievances under Article 4 of this Chapter and shall coordinate and assist the human rights committees in performing their duties.

It does not usefully serve any element of Christ's overall allegations by  ignoring the various provisions of R9-21-104, while also delineating the actual and required functions of ASH-HRC as specifically spelled out in R9-21-105(F). In fact, by simply reading 105(G), we see that the function of ASH-HRC extends to far more then her claim that the functions are limited to "... (the right to) request information, provide oversight to ensure that those patients rights are protected, and may review possible incidents of abuse, neglect or a denial of a patient's rights"  (letter of notice pp. 3).

Title 9-21-105(G) specifically reads as follows:

7. Each committee shall, within its respective jurisdiction, pro-
   vide independent oversight and review of:
   1. Allegations of illegal, dangerous, or inhumane treatment
   of clients and enrolled children;
   2. Reports filed with the committee under R9-21-203 and
   R9-21-204 concerning the use of seclusion, restraint, abuse, neglect, exploitation, mistreatment, accidents, or injuries;
   3. The provision of services to clients identified under R9- 21-301 in need of special assistance
   4. Violations of rights of clients and enrolled children and conditions requiring investigation under Article 4 of this Chapter;
   5. Research in the field of mental health according to A.R.S. § 41-3804(E)(2); and
   6. Any other issue affecting the human rights of clients and enrolled children. 
   

It's consistent with the intent of ADHS' lawyers to present the terms stated in this letter of notice in a manner that manipulates the full breadth of these provisions. This is what lawyers do, of course, but not generally when serving the public as state employed rules experts. (Noteworthy, that lawyer Jeff Bloomberg, who was fired in spring 2015 with a host of other ASH related state officials and employees, also acted as an ADHS-BHS "rules expert.") Point being, that it is litigation and other like areas of legal practice where such manipulations of the rule of law are common, and not in the realm of public service.

The use of the phrase "review possible incidents"  of abuse, as stated in the letter of notice at issue, for example, grossly mischaracterizes the actual terms of 105(G) (1), which specifically reads:

1. Allegations of illegal, dangerous, or inhumane treatment 
of clients and enrolled children.

There's a graphic difference between the word incidents, versus the word allegations. The simple definition of "incident" being an occurrence or event, and the definition of "allegation" being a claim or assertion that someone has done something illegal or wrong. And abuse, illegal, danger or inhumane misconduct not being an incident, in fact.

It may seem like splitting hairs here, but I know from my past experiences in the field of law that allegations bear far more significance then possible occurrences or events ("incidents), particularly in a context of investigative principles. When police, or other like entities required to play a role in protecting the public, receive actual allegations of illegal activity (versus reports of incidents, events, or occurrences), it is incumbent on those entities to take seriously any element of the information provided to them in that context, and to dutifully investigate those allegations to best of their given ability.

The entire community at ASH are definitely members of the public, and not state employees, or any other like limited class. I have found it a common practice for the administrators and senior clinical staff at ASH to deny this, and as this matter reveals, the involved ADHS lawyers are equally intent upon denying this fact, too.

Ergo, I am willing to contend that ASH-HRC has a similarly serious responsibility, given that they and the ASH Human Rights Advocate are to independently act as protectors of the care needs and rights of ASH patients, each of whom are members the public. And while this may not be precisely spelled in the above discussed terms of state law and policy, I believe it reasonable to perceive that, yes, these statutory guidelines put forward that it's crucial for ASH-HRC to perform their duties to the public (ASH patients) in this very same manner.

As such, to limit the function of ASH HRC to mere oversight, and declare that members have "blurred the lines between their oversight obligations and their personal advocacy" (pp. 3 of the letter of notice) baffles conscientious respect for what human rights are in the first place, and what it is to advocate on behalf of human rights in the second place.

I thus find it ludicrous for anyone to challenge the efforts of ASH-HRC to act as an advocacy source on behalf of the patients there. The above standard of state law and policy dictates that the role(s) of ASH-HRC and the Hospital's Human Rights Advocate work in tandem specific to any patient's ability to understand, exercise, and protect their rights. I contend as per the full provisions of both R9-21-104  and R9-21-105 that the role of AHS-HRC and the Advocate are intertwined and as such rely of the ability of both these entities to fully implement and exercise the objectives by which the AZ legislature enacted these provisions.

With direct respect for the objectives of establishing specific human rights law and policy, there are a wide range of internationally recognized elements to the topic and meaning of human rights. It is critical to note that these elements extend to but do not differentiate between the connotation of human rights and that of human rights advocacy.

As only one bright line example of what human rights are, in fact:

Human Rights are fundamental inalienable rights that you have just by virtue of the fact that you are a person. Although the government can pass laws to protect your human rights, human rights are believed to be granted by God or by some higher power and everyone has human rights even if legislation doesn't protect them or if oppressive governmental entities do not respect them.

Human rights are the most fundamental and important part of rights. They are the rights that the government in the United States spelled out in the Bill of Rights and the Constitution, and they are the rights that the United Nations aims to protect all people. These rights shall exist even without government protection or intervention.

  (See http://examples.yourdictionary.com/examples-of-human-rights.html#7G31R2Ltt62ysk6d.99)

The United Nations takes this subject matter further, as specific to the provisions of human rights charters and international law:

What are human rights?  Human rights are rights inherent to all human beings, whatever our nationality, place of residence, sex, national or ethnic origin, colour, religion, language, or any other status. We are all equally entitled to our human rights without discrimination. These rights are all interrelated, interdependent and indivisible.  Universal human rights are often expressed and guaranteed by law, in the forms of treaties, customary international law , general principles and other sources of international law. International human rights law lays down obligations of Governments to act in certain ways or to refrain from certain acts, in order to promote and protect human rights and fundamental freedoms of individuals or groups.

   Both rights and Obligations

Human rights entail both rights and obligations. States assume obligations and duties under international law to respect, to protect and to fulfill human rights. The obligation to respect means that States must refrain from interfering with or curtailing the enjoyment of human rights. The obligation to protect requires States to protect individuals and groups against human rights abuses. The obligation to fulfil means that States must take positive action to facilitate the enjoyment of basic human rights. At the individual level, while we are entitled our human rights, we should also respect the human rights of others.  (See: ww.un.org/en/sections/what-we-do/protect-human-rights

As described herein, "States assume obligations and duties under international law to respect, to protect and to fulfill human rights. The obligation to respect means that States must refrain from interfering with or curtailing the enjoyment of human rights... Human rights entail both rights and obligations."

As such, the role of ASH or any like HRC must go beyond mere oversight, and even the applicable standards of AZ law state this quote clearly. States assume obligations and duties under international law to respect, to protect and to fulfill human rights.

 Even the applicable standards of AZ law state this quote clearly:

A.A.C Title 9-21-105(A) reads as follows:

    A. According to A.R.S. 41-3803 and 41-3804, the Administration shall establish human rights committees to provide oversight to ensure that the rights of clients and enrolled children are protected.

As stated therein,  the nature of oversight that applies to the function of any HRC extends to ensuring that no client be denied the protections provided by state and federal law. It is incumbent on Cara Christ and the administrators of ASH to ensure that extensive lengths be taken on behalf of the human rights of each and every patient-consumer. Abuses of the mentally ill have far too long been ignored by such state employed bureaucrats, thus creating the well known history of state managed mental hospitals. 

I find it shockingly shortsighted for ADHS attorneys and Christ  to take a minimalist approach to interpreting the legislative findings and meaning of HRC's responsibilities. Given the crucial dictate of both federal and international standards of law in this context, and to deny the significance of these standards  by so narrowly interpreting Arizona state law

That said, if state officials are intent upon watering down the broader implications in this manner (the recognized meaning and critical need for human rights advocates), how in the hell are members of ASH-HRC going to be capable of thoroughly meeting this aspect of their obligations if they cannot, in fact, do what they need to in order to meaningfully ensure that the patients at ASH are provided with these protections? Including by personally interacting with ASH patients via formal meetings with said patients? It is absolutely ridiculous for the director of Arizona's health department to take such drastic action against the function of HRC, when all she and minions should be doing is civilly communicating with HRC about such matters, rather then demanding that HRC be evicted from the Hospital itself.

This matter is directly threatening the care needs and rights of the entire patient community at ASH. And has arisen not due to the conduct of the HRC itself (if the Hospital's administrative staff, including state officials working in the Phoenix office of ADHS, etc., have legitimate awareness of the various accusations included in Christ's letter of notice, they should have civilly communicated with HRC up to five year ago), but due to the misconduct of CEO Aaron Bowen (who willfully denied and violated at least one patient's right to free speech); and to the equally questionable conduct of some number of state employed attorneys, including Greg Honig, who willfully attempted to manipulate the function of HRC in order to diminish the significance of the Hospital's long standing chief medical officer, Steven Dingle, known history of sexual abuse.

As I have stated more then once, no reasonably intelligent American would be willing to agree to treatment of a doctor with such a history. And yet, at ASH, administrators have been complicit with ADHS officials in condoning Dingle's history, in a manner that I contend adds up to overt discrimination against the consumer-patinet clients. This issue also suggests that these highly entrusted state employees are choosing to further potential abuses of their clientele, this given that they are willing to condone sexual abuses of women, children, and you are damn straight, the seriously mentally ill.

It has been presented by the ongoing scrutiny of KNVX ABCCh15, which reported that sexual issues including but not limited to employee generated sexual abuse, that this issue is, in fact, all but rampant in the facility, as recently as 2016. 

 I have also heard fairly reasonable rumors about both ASH physicians, as well as at least one former administer, Cory "since fired" Nelson, that these individuals have engaged in sexually harassing female employees, if not, in fact, engaging in outright adultery. Rumors being rumors, however, it is not possible to confirm these specific suggestions at this time. But I am willing to attest that as per my very real experiences at ASH, it may be true that these issues have occurred in the recent history there.

IN CLOSING: Faces of danger, if not evil, to the well being and welfare of ASH's highly vulnerable patients. Remember these faces well, and do not for a minute be duped by those smiles, for their time is coming

As clarified above, Cara Christ  very ineptly misinterpreted the bright line language of A.A.C. Title R 9-21-105 in order to unjustly try and shut down the ASH-ASH. And while I am certain that she engaged in this effort via the advice of bureaucratic attorneys working in association to her office, it from here on out is her turn to bear the full onus of emergent wrongdoing by her and various staff. 

The most significant form of conflicts of interest at ASH flow from the undeniable fact that state employed lawyers are able and willing to represent the interests of ASH administrators and ongoing corruption there, rather then dedicating themselves to the interests of Arizona citizens who just happen to be committed to ASH. Herein we have state lawyers who I feel are subjects of possible violations of the civil rights of patients, as personified by the events November 17-21, 2017, taking authoritative control over the function of HRC, which is operate as independently as possible from state employees; this as per A.A.C. R9-21-105(E): 

No employee or individual under contract with the Administration, regional authority, or service provider may be a voting member of a committee.   

Having state employees and officials act in complicity as means to drastically influence the function and very presence of the ASH-HRC on Hospital grounds is grossly inappropriate. And that's putting it nicely. No, these people have not actually voted in fact on any decisions of ASH-HRC itself, but they sure the hell have gone too far in utilizing their disproportionate power over ASH-HRC and the ASH patient community in order to defend their highly questionable interests at this critical point in time. Textbook conflict of interest wherein citizens of AZ have legitimate concern about possible wrongdoing of specific state employees, and to then have these same state employees utilize their given authority to deny such citizens their lawful right to meaningful redress.  

This is the way it goes in Arizona, I know this all to well. The Arizona Office of the Attorney General, for example, is required to defend and protect the civil rights of all Arizona citizens, and yet, it is staff members of that office who have been engaged in discriminating against ASH patients for well over 25 years. I learned of this years ago, when I took grievance appeals to the AZ Office of Administrative Hearings (AOH), and had to deal with ASH's former on-site legal representative, assistant attorney general Joel Rudd. In those hearings, former since fired ASH CQCO-CEO Donna Noriega perjured herself during court testimonials, patent exhibitions of untruth and lying that Rudd complicity supported, if not encouraged.  

I will hesitate in going after Joel Rudd's replacement. For now, that is. Requests for transcribed records of aforementioned, more recent (circa 2015-2018) hearings in AOH have been made in recent days, wherein we the staff of PJ Reed The Arizona State Hospital and Patient Abuse can get an picture of how those hearings are going today. We are also reviewing transcribed records of the AZ Psychiatric Review Board, which acts as the ultimate authority over discharges of ASH's forensics patients, who Cara Christ very recently opted to remove from the services of HRC, arguably due to the role that forensic patients such as recently discharged John Mancini have played in exposing issues specific to corruption, abuse, and outright criminal conduct of ASH administrators and primary care physicians.

Our next article(s) will more deeply examine the fact the forensics patients, who are just seriously mentally ill as any civil patients and deserving a reasonable medical treatment as clients of ADHS while being treated at ASH, are denied the same protections of their needs and rights on the basis of grossly shortsighted state law.

Thanks to Senator Nancy Barto's intent to support the rights of ASH's forensics patient community. It is an ongoing effort. But far from over. 

paoloreed@gmail.com