RE: Dr. Cara Christ. Dr. Aaron Bowen. Deceivers of Truth.

                                                       "Things are much better now."
                                                      Dr. Cara Christ
                                                    Current Director
                                                 Arizona Department
                                                  of Health Services,
                                                      2015-present.

"This is the state hospital. What do you expect?"

Dr. Laxman Patel

Late January, 2011.

INTRODUCTION: One patient is stabbed by another patient with so violent a known history that he should have been closely monitored at all times. All aspects of this incident are part of the documented record on the date it occurs. Subsequently, ASH administrators in direct complicity with ADHS officials omit that record from an annual report about the conditions, care practices, and general operation of ASH. 

As stated in yesterday's article "The Arizona State Hospital's ANNUAL REPORT FISCAL YEAR 2017. Of Ongoing Mistruths in the Official Record and Complicity Between Hospital Administrators and State Employed Officials In Furthering Corruption In Arizona's Public Health Care System.", we now have emerging documented evidence to the effect that the administrators of Arizona State Hospital (ASH) are engaging in shrouding the truth specific to patient safety (or lack thereof) and associated record keeping in terms of patient on patient violence. And they are doing so in complicity with the director of the state's public health care agency.

As per law and policy, this 2017 report was produced by the Director of Arizona Department of Health Services (ADHS), Dr. Cara Christ, in direct cooperation with the Chief Executive Officer at ASH, Dr. Aaron Bowen.

THE FULL 2017 ASH FISCAL REPORT IS PUBLIC RECORD. YOU CAN FIND IT AT:

www.azhds.gov/documents/director/agency-reports/ash/2017-ash-annual-report.pdf

PAGE EIGHTEEN AND THE SECTION "PATIENT ON PATIENT ASSAULTS" IS WHERE ONE CAN VIEW THE FACT THAT THE OCTOBER 03, 2017, STABBING OF AN ASH PATIENT WAS OMITTED FROM THE REPORT ITSELF. 

-------------------------------

FACT: 

On October 03, 2017, patient A.W. at Arizona State Hospital (ASH) was viciously stabbed six times by another patient. The aggressor in this matter has a known record of very violent behavior, enough so that he was to be closely observed at all points in time when not in seclusion. In recent history, formal petitions had been filed to ensure that this individual was even more closely monitored. But despite these varied facts, this individual had opportunity to not only acquire a weapon, but also to viciously attack one of his patient-peers, nearly killing him.

Had patient A.W. died, in fact, this would stack up to just one more preventable death caused in part by the ineptitude and criminally negligent misconduct of some ASH staff, who are "guided" by the authority of ASH administrators, including but not limited to long time Chief Medical Officer Dr. Steven Dingle and Chief Executive Officer Dr. Aaron Bowen.

Incidents of this magnitude occur due to insufficiencies specific to available staff, which in itself is one form of administrative-medical negligence. Such shortages in staff put both patients and staff alike at grave risk of possible harm. Some staff, that is, as in only those who work in direct proximity to patients, namely staff technicians and nurses. While Hospital administrators spend there time in off-limit office areas that patients have no access to. As such, administrators and their immediate counterparts- psychiatric staff- bear little to none of the risk that lower ranking staff have to contend with on a day-in day-out, 24/7 basis. This is the core reason for why staff shortages in these facilities are the norm, the simple fact that the issue poses risk to all but the ones most responsible for ensuring that staff meet the required numbers, as per federal law. Abject disregard for the safety of patients and direct care staff.

And as much as many folks today still believe that mental hospitals are inherently dangerous, akin to corrections facilities (prisons and jails), I contend that in contemporary terms, in direct relation to the simple fact that we are talking about hospitals, it is highly irresponsible for state employed officials to further the myth that mentally ill persons across the board are inherently dangerous. Likewise, such hospitals require a sufficient number of security staff and other like resources that can maintain reasonable safety with reference to patients known to be dangerous to others. 

It is ridiculous, as well, for anyone to claim that it's reasonable to expect that state mental managed health facilities inherently have abusive staff, as Dr. Laxman Patel put it to me early on in my time as an ASH patient (2011-12): "This is the state hospital. What do you expect?", when I chose to report to him the fact that some staff were regularly engaged in verbally and psychologically abusing certain members of my patient-peers (more vulnerable to abuse type patients). 

FACT:

As also discussed yesterday, the 2017 Annual Fiscal Report specific to the operation of has a section (found on page 18 of that report) required to provide factual data specific to patient on patient assaults. This data is critical to the Hospital's ability to provide a reasonably safe environment, by specifically identifying all such incidents regardless of the severity of these assaults. In the sub-section October 2017, that period of time when the attempt to murder patient A.W. occurred (I feel that when someone opts to stab you six times, chances are good it is their intent is to kill you), Bowen and Christ willfully chose to omit this incident from the record. In criminal law and procedure, such lying by omission is lying, bottom line. The staff of PJ Reed The Arizona State Hospital and Patient Abuse would welcome either these people to challenge this standard of law, but as per history of ASH and ADHS, we know that they won't.

What we also know is that directly due to the willingness of these highly entrusted state employees to manipulate or otherwise alter the facts that are to be included in this Fiscal Report, any number of other aspects of the data contained in the Report may well be flawed, And what we also know from the still recent history of ASH, such administrators and officials engage in this nature of mis-truthing as an unlawful means to avoid due oversight and accountability.

More specifically speaking, circa 2013-14, former ASH CEO Cory Nelson allegedly destroyed some proportion of ASH's  public  records (this allegation was made by one of his staff when interviewed during a federal investigation of ASH), records that had been lawfully requested for review by the Phoenix area ABC news affiliate, KNVX Ch15. What's even more disturbing is that ADHS's then Director, Will Humble subsequently promoted Nelson to a higher position in the ADHS construct. I recall this period of time well, and feeling that it was although Nelson was rewarded for his known lack of character.

Cory Nelson
Former since-fired
Deputy Director, Arizona Department
of Behavioral Health Services.

Cory Nelson, of course, was summarily fired in early 2015, along with his previous underling at ASH, Donna Noriega, a ADHS staff attorney, Jeff Bloomberg, and a handful of other entrusted state employees working at ASH and for ADHS. While Humble hastily resigned his position in the weeks immediately preceding these firings.

Still today, this is how it goes at ADHS, and at ASH, as well. Patent lying and willful deception designed to maintain the sub-standard conditions and care practices at ASH. These patterns exist as well in the ADHS Office of Grievances and Appeals (OGA), which is required to ethically manage the process of investigation specific to patient generated reports about the issues needing attention at ASH. 

I attest to the fact that in terms of grievance filings that I provided this office, staff at OGA routinely failed to abide by a range of terms included in Arizona's administrative law; time line requirements, for example, which are designed to provide consumers of ADHS various services (including the patient-consumers at ASH) timely response(s) to such reports. This practice was obviously oriented towards the hope that ASH patients such as I would let these reports go, on the basis of overtly inept bureaucratic misconduct.

This failure of state employed health department officials to acknowledge the significance of patient generated grievances is another form of administrative-medical negligence, and has direct relation to the cover up of the attack on patient A.W. No matter how critical the nature of such grievances are, Hospital administrators and their supervisory staff in the Department regularly participate in suppressing all elements of the issues most at stake, including patient safety, criminal abuses of patients by staff, medical ineptitude displayed by ASH psychiatrists, and on the list can go. And no matter how serious the nature of certain incidents of violence are, these same state employees willfully do whatever they have to in order to keep such incidents secreted away and out of the public eye.

It's that bad. I could not make it up- any of it- even if I had to.

------------------------------

IN CLOSING: I have been interviewed by more then one interested party in recent days, persons with some nature of vested interest in addressing the ongoing substandard conditions and care practices at ASH. This is far from the first time, and I have always been happy to do so. I do so in the interest of the patient community at ASH, at least some of whom are personal friends from my time there. 

If only Cara Christ was capable of sharing this dynamic in her given attitude about the patient community at ASH. When she took over the helm of ADHS in spring 2015, I immediately contacted her, and encouraged her to keep a close eye on the realities at ASH. Several months later, after she had appointed Dr. Aaron Bowen as CEO at ASH, Christ contacted me, and stated in an email "Things at ASH are much better now." At the time I was willing to believe her, and I was willing to stand in support of her presence in context. A position I maintained for many months, as a matter of good faith respect. 

The Author, 2012.

I know better now. It's 2012 all over again. For it is readily apparent the Christ is taking the same risks that her predecessor took circa 2014, with no regard for the implications as they apply to the welfare of ASH patients. And it is too late for her and her brood of incompetents to presume I will not do whatever I have to see that they are all held accountable. I have contacts in the federal government from back in the proverbial day when I first took on the issue of seeing that ASH patients be provided reasonably optimal care and treatment. I am still in touch with David Biscobing, and at least one newer contact in Arizona media. And I am as well prepared as I have even been in terms of doing good work in my own right, in context. We warned them....

MORE LATER. AS ALWAYS.

paoloreed@gmail.com