VIOLATIONS OF ARIZONA ADMINISTRATIVE CODE R9-21-312:  UNLAWFULLY CONDUCTED INPATIENT  TREATMENT AND DISCHARGE PLANNING MEETINGS, DENIAL OF PATIENTS' RIGHT TO A REPRESENTATIVE; February 09, 2012: Wherein my primary attending physician at the Arizona State Hospital, Dr. Sylvia Dy, in Complicity with Veneranda Heffern and Robert Washington of ASH Social Services tried to unlawfully subject me to a procedurally invalid inpatient discharge and planning meeting, and refused to allow me to invite a representative of my choice to attend.

      At 3:00 p.m., February 09, 2012, my then assigned Arizona State Hospital social worker, Robert Washington, advised me that "Several people want to talk to you at this time in the Desert Sage East conference room. I immediately asked him to clarify who these people were, but he refused to do so. After several minutes of discussion during which I advised him that I was very uncomfortable with any such unscheduled meetings, particularly given his unwillingness to be forthcoming, I agreed to at least look into the nature of this meeting. We then entered the conference room, where my current primary attending ASH physician, Dr. Sylvia Dy, and a managerial social services staff member, Veneranda Heffern, as well as a Desert Sage East charge nurse named Gladys, were already waiting for me. I immediately inquired as to what was going on, but neither of them would respond, at which point Mr. Washington stated: "Patrick, I am going to show you a document." Needless to say, I found the goings on very suspicious, and I respectfully asked for a clear description of the nature of the meeting, but again, the three of them refused to offer an explanation, and Dr. Dy refused to even look me in the eye. I then stated in very clear terms that I wanted to invite a representative of my choice to this unannounced meeting, and asked to have them use the available conference phone to call this person. They were initially reluctant to grant me this request, but when I told them that I wanted to call a hospital liaison named Lori McGoffen, they all looked at one another, and Ms. Heffern said "Well, that's ok. She already knows, right?" Ms. McGoffen was unavailable, however, so I then requested that another representative of my choice be called, and gave them the number of a patient advocate who had to date been assisting me with my treatment planning, but Ms. Heffern, Dr. Dy, and Mr. Washington all flatly refused to grant me the right to have this advocate present at the meeting. This was a criminally unjust action on the part of all three of these individuals, and should, at a minimum, have consequences in terms of their respective licensure.

         As it turned out, the document that they unlawfully insisted that I look at was a one page Arizona State Hospital pronouncement stating I was to be discharged from ASH on February 20, 2012. The significance of this issue has to do with the fact that at least three other parties were centrally involved at that time in my discharge planning (agency representatives, including my outpatient case manager, and at least one other member of my outpatient clinical team, as well as an ASH liaison) , and the intent of ASH administrative and clinical staff to unilaterally issue my discharge date without fully involving these parties is in clear violation of Arizona Administrative Code (AAC) specific to such matters. As such, my flow of ongoing treatment and discharge planning was severely disrupted, and I was forced to experience unreasonably high anxiety over the fact that I was going to be sent out the front door of ASH on February 20, 2012, regardless of whether or not all of the logistical planning had been adequately established. 

        The Arizona State Hospital is required to ensure that all involved parties in these sorts of processes are granted the opportunity to participate, and the decision by ASH to put me through this unlawfully conducted meeting while refusing me the right to bring in a representative of my choice was egregious to the extent that no patient/client should be so burdened by any of these conditions, and there are numerous provisions of the AAC that apply, as follows:    

Arizona Administrative Code Title 9-Chapter 21- Article 312 (R9-21-312)
Department of Health Services – Behavioral Health Services for Persons with Serious Mental Illness

Inpatient Treatment and Discharge Plan

A. General provisions

1) Every client of an inpatient facility shall have in Inpatient treatment and Discharge Plan (ITDP)
2) An ITDP shall be developed by the inpatient facility, the case manager and other members of the clinical team, as appropriate.
3)  The ITDP shall include the most appropriate and least restrictive services available at the inpatient facility, as well as a plan for the Client's discharge to the community.
4) The ITDP shall identify those treatment interventions and services which maximize the client's strengths, independence, and integration into the community.
5) The ITDP shall be developed with the fullest possible participation of the the client and any designated representative and/or guardian.
6) The ITDP shall contain goals and objectives which are measurable and which facilitate meaningful evaluation of the progress toward attaining those goals and objectives.
7) The ITDP shall be written in language which can be easily understood by a lay person.
8) Delays in the assignment of a case manager or in the development or modification of an ISP or ITDP shall not be construed to prevent the appropriate discharge of a client from an inpatient facility.B. The Individual Treatment and Discharge Plan (ITDP) meeting.

     1) The case manager shall encourage the client to have a
designated representative assist the client at the meeting
and to have other persons, including family members,
attend the meeting. The case manager shall ensure that
the human rights advocate is notified of the time and date
of the ITDP for clients who need special assistance.
    2) The following persons shall be invited to attend the ITDP
meeting:
  a. The client;
  b. Any designated representative and/or guardian;
  c. Family members, with the client’s permission;
  d. Members of the client’s inpatient facility treatment
      team;
  e. The case manager and other members of the clinical
      team, as appropriate;
  f. Other persons familiar with the client whose pres-
     ence at the meeting is requested by the client; and
  g. Any other person whose participation is not objected
      to by the client and who will, in the judgment of the
      case manager, contribute to the planning process.

     As a matter of clarification, Dy. Svlvia Dy, Veneranda Heffern, and Robert Washington did not even inform my case manager , or anyone else from my ITDP team, about their intent to assemble the February 09, 2012, treatment and discharge planning meeting that I have described above. As such, they engaged in an attempt to unlawfully assemble this meeting in direct defiance of aplicable codes of procedure and practice. I cannot speculate as to whether these individuals engaged in this action because they are unaware of the statutory standards in such cases (which effectively tells me that they are unqualified in terms of meeting the responsibilities of their respective licensureship, much in the same way that ASH Chief Operating Officer, Donna Noriega, was recently exposed as being [see this blog, 04/17/12: "News Flash: Busted!), or they blatantly disregarded these standards (in which case I feel they should be held fully accountable under the law).
           The existence of standards such as these, as applicable to a patients' ongoing needs and interests at all phases of their respective treatment and discharge planning, are critically important in terms of all patients fundamental (constitutional) right to self determination in the context of participating in their own treatment. In my experiences, however, the conceptual foundation underlying this theme is one of the most commonly abridged element of any mentally ill persons fundamental right(s), this by virtue of the fact that discrimination against mentally ill persons is largely based upon the belief that mentally ill are cognitively incapable of managing their own personal life affairs. Worse yet, many people in society today- including numerous medical professionals that I interacted with at The Arizona State Hospital- actively deny mentally ill persons the right to participate in their own treatment due to the belief that mentally ill people are less than human, and not deserving of such opportunities.
      Below is a copy of a letter that I put in the outgoing mail at ASH on February 12, 2012. To my knowledge, however, the letter never made it out of the hospital,  which very strongly suggests that it was unlawfully seized; the illegal seizure of my outgoing mail was a regular thing for the entirety of my time at ASH (something I verified through USPS and ACLU participation) and with respect for this specific event, it stands to show that my fundamental rights were violated at ASH in every sense of the term, from the very first day that I entered the environment of The Arizona State Hospital (at which time some of my personal belongings- medication- were stolen) until that time at which I was finally discharged (near literally).           

       I am aware that my various allegations and assertions sound extreme at times, but as a matter of keeping things in reasonable perspective, the case of Audrey P. is extreme, too! (see this blog, 4/12/12, "No Electric Wheel Chair For You, Audrey P.!"). Wherein, a primary attending physician, Dr. Ramos-Roxas has, to date, denied a female ASH patient (who lost three out of her four limbs in direct relation to her mental disability) access to the most modern technology available today on the basis of an electric wheel chair being inconsistent with the woman's "treatment needs." Abuse of authority in that particular context is something that I witnessed and experienced ASH physicians, and staff in general, engaging in on a day to day basis, effectively using the justification  of "treatment needs" every time they choose to do whatever the heck they want to, regardless of the legality or true therapeutic benefit to the patient. It is one of the easiest ways for for state hospital staff (and beyond) to pull their vast array of clinical misconduct without attracting attention, and arguably the oldest trick in the book in terms of sanctioned medical malpractice. The reality, however, is that for a doctor to say "we know best" in contexts and circumstances that are entirely outside of their given authority amounts to criminal abuse of power and related authority. In the case of Audrey P., who has the constitutional right as a citizen and consumer to be made aware of the fact that a philanthropic entity of some sort wants to gift her an electric wheel chair, Dr. Ramos-Roxas' decision to restrict Audrey's awareness of the individuals who offered to gift her the electric wheel chair was an absolute attack on the fundamental liberty of any American citizen to benefit from the generosity of her fellow citizens, and in my honest opinion, this sort of mistreatment directly contributes to my friend Audrey's struggle with self esteem and related sense of worth as a human being, as well. Bottom line.

      As I have already made clear in my prior entries, the administrative and clinical staff at ASH conduct this sort of unlawful business conduct as a standard matter of practice, which utterly exacerbates the presence of patient abuse at every other level of inpatient treatment at ASH. In the case of my experiences on February 09, 2012, Ms. Heffern and Dr. Dy's only response to my concern over being denied my rights amounted to each of them denying that this meeting was a legitimate individual treatment and discharge planning meeting, which is ludicrous, given that there is no single element of such planning then the planned date of my discharge itself. This action posed the very real risk of me being discharged into homelessness in the metro district of downtown Phoenix, AZ, despite there having been a substantial bit of invested effort put out by my outpatient providers, an effort that was still in the works and as of yet uncompleted at that point of my discharge planning process. ASH' action in this regard very nearly threw my entire immediate future into literal disarray, and when I stated this in no uncertain terms a that time, Mr. Washington made it clear that in the opinion of himself and ASH administrators, this risk was "not something that the Hospital is responsible for," a statement that amounts to a blatant disregard for the language of the applicable procedural codes.  
      I cannot emphasize enough how disturbing these issues are when a patient such as myself does everything he can to state his given preferences and related rights, only to have ASH staff blatantly disregard these expressions as though the patient doesn't even exist in these sorts of very practical terms. ASH conduct in this context flies in the face of clearly established procedural standards that are designed to grant patients a full and meaningful opportunity to be involved in all aspects of their treatment, and all of the persons involved in this described incident are fully aware of these standards, as per their training and professional licensing.
      
paoloreed@gmail.com

The Americans With Disabilities Act (ADA) Title 42- The Public Health and Welfare

CHAPTER 126- EQUAL OPPORTUNITY FOR INDIVIDUALS WITH DISABILITIES

     Section 12101 Findings and purpose
            
              (a) Findings. Congress finds that

     (1) physical or mental disabilities in no way diminish a person's right to fully participate in all aspects of society, yet many people with with physical or mental disabilities have been precluded form doing so because of discrimination; others who have record of disability or are regarded as having a disability also have been subjected to discrimination;
     (2) historically, society has tended to isolate and segregate individuals with disabilities, and, despite some improvements, such forms of discrimination against individuals with disabilities continue to be a serious a pervasive social problem;
     (3) discrimination against individuals with disabilities persists in such critical areas as employment, housing, public accommodations, education, transportation, communication, recreation, institutionalization, health services, voting, and access to public services;
     (4) unlike individuals who have experienced discrimination on the basis of race, color, sex, national origin, religion, or age, individuals who have experienced discrimination on the basis of disability have often had no legal recourse to redress such discrimination;
     (5) individuals with disabilities continually encounter various forms of discrimination, including outright intentional exclusion, the discriminatory effects of architectural, transportation, and communication barriers, over protective rules and policies, failure to make modifications to existing facilities and practices, exclusionary qualification standards and criteria, segregation, and regulation to lesser services, programs, activities, benefits, jobs, or other opportunities;
     (6) census data, national polls, and other studies have documented that people with disabilities, as a group, occupy an inferior status in our society, and are severely disadvantaged socially, vocationally, economically, and educationally;
     (7) the Nation's proper goals regarding individuals with disabilities are to assure equality of opportunity, full participation, independent living, and economic self-sufficiency for such individuals; and
     (8) the continuing existence of unfair and unnecessary discrimination and prejudice denies people with disabilities the opportunity to compete on an equal basis and to pursue those opportunities for which our free society is justifiably famous, and costs the United States billions of dollars in unnecessary expenses resulting from dependency and nonproductivity.
 
  (b) Purpose. It is the purpose of this chapter

     (1) to provide a clear and comprehensive national mandate for the elimination of discrimination against individuals with disabilities;
     (2) to provide clear, spring, consistent, enforceable standards addressing discrimination against individuals with disabilities;
     (3) the ensure that the Federal Government plays a central role in enforcing the standards
established in this chapter on behalf of individuals with disabilities; and
     (4) to invoke the sweep of congressional authority, including the power to enforce the fourteenth amendment and to regulate commerce, in order to address the major areas of discrimination faced day-to-day by purple with disabilities.

     (Section 12101 note: ADA Amendments Act of 2008, partial)
  
   (a) Findings. Congress finds that

    (1) in enacting the Americans With Disabilities Act of 1990 (ADA), Congress intended that the Act "provide a clear and comprehensive national mandate for the elimination of discrimination against individuals with disabilities" and provide broad coverage;
     (2) in enacting the ADA, Congress recognized tat physical and mental disabilities in no way diminish a person's right to fully participate in all aspects of society, but that people with physical and mental disabilities are frequently precluded form doing so because of prejudice, antiquated attitudes, or the failure to remove societal and institutional barriers.

    (b) Purposes. The purposes of this Act are

      (1) to carry out the ADA's objectives of providing a"a clear and comprehensive national mandate for the elimination of discrimination" and "clear, strong, consistent, enforceable standards addressing discrimination" by reinstating a broad scope of protection to be available under the ADA
    
SUBCHAPTER II- PUBLIC SERVICES

    Part A- Prohibition Against Discrimination and Other Generally Applicable Provisions

    Section 12131. Definitions
   
 As used in this subchapter:
      
      (1) Public entity. The term "public entity" means
           (A) any state or local government;
           (B) any department, agency, special purpose district, or other instrumentality of a State or States or local government.

       (2) Qualified individual with a  disability. The term "qualified individual with a disability" means an individual who, with or without reasonable modifications to rules, policies, or practices, the removal of architectural, communication, or transportation barriers, or the provision of auxiliary aids and services, meets the essential eligibility requirements for the receipt of services or the participation in programs or activities provided by a public entity.

     Section 12132. Discrimination

Subject to the provisions of this subchapter, no qualified individual with a disability shall, by reason of such disability, be excluded from participation in or be denied the benefits of services, programs, or activities of a public entity, or be subjected to discrimination by any such entity.

How To Measure Integrity: Putting Arizona State Hospital Administrators On the Front Burners


     Update: Yesterday's meeting with the lawyer went well, and I have established syndication (sharecropping) of this site.

      I am looking forward to getting the Judge David  L. Bazelon Center for Mental Health Law on board with mental health care reform here in Arizona, particularly in terms of the Arizona Department of Health Services/Behavioral health Services (ADHS/DBHS) training, oversight, and accountability standards, which are as backwoods as you might find in the nation today. (http://www.bazelon.org/.)
     I have also been putting off communicating directly with ADHS' Director Will Humble, but he has a web-site thing going on, and I encourage anybody looking at the issues at The Arizona State Hospital that I have been talking about in this blog to go ahead and visit him, as follows:      http://directorsblog.health.azdhs.gov/ (http://www.azdhs.gov/).

       I am really hoping that somewhere in the current ADHS administration there is an honest soul willing to take on the task of sincerely looking at the problems at ASH in a fashion that doesn't merely add up to more hoodwinking and pandering, which is all I ever got while I was hospitalized at ASH and took the time and energy to follow the suggested steps as a patient to bring up the wrongdoing I was experiencing then and there. I would back off immediately on my somewhat scathing commentary about the matter if I knew that there was a reasonably serious bit of investigation and oversight occurring in relation to not just my my own, personal input on these issues, but also in terms of the facts that have already been publicly presented (e.g. the murder of April Mott and the ASH administrators reresponsible for their end of that sequence of horrific events). To date, I have seen nor heard anything positive or in any way encouraging in this context, but I am willing to believe that Will Humble may be up to the task, he is the top authority in the branch of state government responsible for ASH, after all; plus, I have heard good things about him from the few folks in the state system that I am willing to trust, and he also played a significant role in the outcome of one state administrative process that I was involved in late last year. Will Humble will be issuing the final determinations of all four of my upcoming administrative hearings (after an adminstrative law judge issues a recommendation following each hearing, as per state procedural code), and I look forward to working with him on those matters when the time comes.

paoloreed@gmail.com

An Attorney With Teeth: Of Federal Courts And Public Interest Law

      Later today I will meet with one of several public interest attorneys who have thus far expressed interest in the potential of taking the concerns I have about corruption at the Arizona State Hospital to the federal courts. The chief mission at this point is getting one of these legal eagles to wrap their minds around the full breadth of the problem(s), this in order to generate the momentum I need so as to get these issues out into the public arena.
      I recently completed a task board that I am sharing with advocates and activists who work in the legal field here in Arizona and beyond, which they can utilize as they independently go about conducting their research, while also   contributing at will to my site, or to one of the other mental health advocacy organizations that I am hooked up with. My efforts in relation to exposing and addressing patient abuse here in Arizona is becoming more of a team effort every day, for there are folks all around the United States who have dedicated themselves to this work for many years. Arizona seems to be stagnating, in effect, which somewhat explains how and why it is that sub-standard mental health care exists so openly at ASH, but I am confident that before long, a meaningful base of statistics will be available for consideration, data that can be submitted to any number of authorities, including judicial bodies, and federal agencies such as The US Department of Justice.
      Here is a quick example some of the research that is being considered:
      
        1) A hospital wide record of serious/critical incidents reported by ASH patients in relation to the number of confirmations (vs. denials) of those reports by hospital representatives and the Department of Health Services Office of Grievances and Appeals over.
        2) A record of the number of security responses to the various units at ASH,
the nature of those responses, and the outcomes/remedies; and again, the role of patients in both the reporting phase as well as the remedial phase is central to the inquiry.
       3) Performance records specific to ASH physicians, nurses, social workers, and behavioral health technicians, and the level of connectedness between those records and the public arena.
       4) Data relating to the number of times that ASH and Department of Behavioral Health Services have the subject of civil actions, and the basis of those actions.
        5) Recent precedent at the national level and related disciplinary actions in the context of physician and administrative accountability.

More on this later, after I scramble some ideas with the attorney.

paoloreed@gmail.com 
   

April 18, 2012: Corrupt Social Worker Staff At The Arizona State Hospital: Wherein I Again Initiate Contact With The The AZ Board Of Behavioral Health Examiners

       It occurs to me from Arizona State Hospital Chief Executive Officer Cory Nelson's Personal web page (www.crazycorycorner.weebly.com) and the letter that ASH Chief Operating Officer, Donna Noriega, wrote to me in relation to the woman who attacked and struck me with a metal and plastic chair (see April 10, 2012) that the lives and general welfare of the patients at ASH are somewhat of a joke. The patients, mind you, and the day to day life experiences of the patients, are somewhat amusing to these two, but not the security that comes with their jobs. As with the lower tier staff at ASH, Cory Nelson and Donna Noriega will go to great lengths to protect the reputation of their duty to the public that pays their salary, while somehow not being to comprehend the sanctity of patient dignity. Take Cory Nelson's description of the conditions at ASH, for example: 
       "People getting whacked right and left, patients having wild sex all over the hospital..." (Cory Nelson)
      All of it, a comedy of errors in terms of what the families of patients and the greater public expect when it comes to persons granted the privilege of caring for the lives others.
      This is a hospital that has upwards of 300 patients, all of whom are seriously mentally ill and 100% protected under applicable vulnerable adult statutes, and these two individuals have virtual control over the day to day operation. One, a man who writes a personal statement reflecting the mentality  of a fifteen year old kid, the other a woman who is currently being censured by state regulators due to her inability to conduct herself in a manner consistent with the terms of her professional license.
       The problem, of course, with administrative lapses of this sort, lies in the fact that the same attitudes trickle all the way down through the ranks of staff at ASH, leading the worst hospital technicians and nurses- who, without a doubt, have more close interaction with patients than any other form of staff-  to perceive that the lives of their wards are a somewhat of a joke, or at best, worth little more than the slightly above poverty wages that they earn.
       As exhibited by the recently exposed unlawful conduct of Donna Noriega (see "News Flash: Donna Noriega- Busted!" April 17, 2012), there are a variety of ways that ASH administrative staff abuse the responsibilities of their positions. It is classic ineptitude and greediness at the state level, and there is no better place for people like Donna Noriega to try and get away with their crap than within the administrative construct of ASH, where oversight and accountability is practically nonexistent (I am really curious about who exactly reported her in relation to these new revelations about her activities at ASH). In any case, it is my theory that I must unloosen one or another of the various staff persons that I interacted with at the Arizona State Hospital from their ingrained allegiance to the corrupt standards of practice at ASH, this if I am going to create any momentum on behalf the interests of the patients still at ASH. I was reluctant to go to far with certain aspects of my advocacy while still a patient at ASH because I had very real concerns for my safety, but I also did not want to compromise the well being of the staff members who had the good conscience at least offer their moral support of my efforts. But I am not a patient at ASH anymore, and the situation is no less critical today than it was prior to my discharge.  I am thus compelled to begin naming as many staff names as I can find in the documented records of my experiences at ASH.        
       As I have sated already, there is an endemic state of fear amongst the staff at ASH and throughout the Department of Health Services (ADHS), whereby individual employees have less faith in the system that they work in than I do, this in the sense that despite knowing that they are protected by federal whistle blower statutes and so on, and in spite of the fact that the terms of their employment contracts with the state require them to report unprofessional and/or criminal conduct, ASH staff are as a rule unwilling to come forward with any meaningful reports of wrongdoing. ADHS runs a tight ship in this context, and while I am certain that my accounts don't always seem to hold much water, anybody with employment experience in the Arizona system knows how things work. In the trenches, as it were, all of the mission statements and official dicta means little to nothing, and the consequences of this reality lands directly on the heads of the most vulnerable clients, especially those behind the fences and security manned gates of the Arizona State Hospital.    
       As stated already, I did come into contact with several ASH employees who were willing to go about covertly assisting me in patient advocacy when I was still hospitalized at ASH, but only to a very limited extent, and the bottom line was that they were afraid for their jobs, and of the opinion that no established provisions of administrative law and policy would protect them even if they did report misconduct in good faith. I have already attempted to enlighten the above state licensing board in relation to social worker misconduct at ASH that, due to graphic unreliability and deceit, both detrimented my state of mind, as well as contributed to a very clear waste of taxpayer money, but I fear that the correspondence that I tried to mail from ASH in this context never made it out of the hospital. And while it is generally the case that a patients' individually assigned social worker holds direct responsibility for their own conduct, at ASH there is a very clear chain of command through which the individually assigned social workers administer their duties, and the misconduct that I identified was always dealt out by the supervisory social worker staff, and my assigned social workers would try to hide behind the nefarious authority of "management."
     I am in the process of filing formal complaints about the following ASH social worker staff:

           1) Veneranda Heffern, LCSW; who came off as though she has authoritative qualifications at ASH,  but who may not even be licensed in Arizona yet, although I am in touch with the Texas licensing board, where she was located prior to 2012. She willfully denied me the right to have a representative (a patient advocate) of my choice attend a very critical treatment planning conference on February 09, 2012, which is in violation of state and federal law specific to such conferences, and flies in the face of basic human rights. As such, her conduct reflects the grossly unlawful abuses of authority and power that I encountered at ASH, and she was clearly unwilling to abide my these standards at the time, despite the fact that I very clearly informed her of my express desire to have this person attend the conference via phone.    

            2) Robert Washington; this poor sap became a member of my clinical treatment team at ASH in late October, 2011, and he inherited an ongoing process of mismanaged treatment and discharge planning that had been absolutely mangled by my three  previous primary attending doctors and four previous assigned social workers. I tried to advise him of how messed up the picture was in order to try and make things easy for him (as it were), and that I was in the process of seeking formal redress through every available channel of authority in regards to my case at ASH, in the hope that he would avoid the pitfalls employment at ASH. But he didn't listen, and by the time I left ASH in February, 2012, Mr. Washington had willfully engaged in the same sorts of lying and related misconduct that I had been putting up with for over 12 months at that point, including being present at the February 09, 2012, treatment planning conference described above, and as such, being party to the abuse on that date.        

           3) Laura (or Lara); a rail thin social services supervisor who was always very careful to not disclose her last name, but who did in fact appear several times in support of the misconduct of her staff. I will establish her identity before long, and presuming she hasn't left ASH, will follow through accordingly in submitting specifically documented reports of her misconduct.
           4) Megan Mitscher; did leave ASH, right in the thick of my efforts to expose unlawful conduct in direct relation to her role as my assigned social worker, in complicity with Dr. Perviaz Ahkter, and she may have left the state, I hear she is Louisiana, and I intend to report her through that licensing board. I have a good friend in Louisiana, too. It is the least I can do.

     The administrative misconduct at the Arizona State Hospital occurs at all levels and in every departmental office. The Office of Social Services at ASH functions in direct relation to the care needs of patients while they are hospitalized and beyond, and the staff of that office works directly under the authority of the Chief Medical Officer, Dr. Steven Dingle. 

In closing on the day: The insidiousness of these systematic shortcomings flows outward into the greater community, too, where the inflexible schedules of case managers with 80-90 client-patient case loads can't accept the arguably fluid schedules of mentally ill persons, and clinic physicians charged with managing the medical wellbeing of mentally ill clients are unwilling to allow for even a 10-15 minute tardiness in term of 90 day appointment times. The client-patients end up being hammered by the worst elements of these circumstances, and then wind up back in the acute wards of psychiatric hospitals simply because an overworked (or inept) social worker can't stay ahead of the curve of her assignments. The fact is, people die every day because of systematic shortfalls in the mental health professional community, including in state hospitals such as ASH. It is my contention that it all begins at the level of the human heart, but it is also an enormously challenging task, and arguably a body of requisite that eludes the cognitive skills and conscientiousness of people like CrazyCoryCorner Nelson and Donna Noriega LCSW 10959.
        You can't teach love and compassion in college, in other words, and the state of Arizona is going to have to look beyond the standard resume process if these matters are going to be meaningfully resolved. 

paoloeed@gmail.com

In The Presence Of The Sacred: Of My Father and My Family, and Related Notes: Wherein I suggest that the misconduct of medical and administrative staff at the Arizona State Hospital insults the very life blood/heritage of its many patients

My mother, Dolores Sharon, passed away on my birthday in 2005, following a series of strokes and related complications, and my father, Jackson Reed, died in a single car accident in 1970.

I never knew my father well, my parents separated before I was 5 years old and I have no clear memories of him whatsoever, which is sad, because I know that he loved his children. On my father's side, I am half Chickasaw, and my father was born on the reservation in Oklahoma in 1924 to Jackson Reed, SR., and Jewell Maulsey Baker. Immediately following high school, he played triple A baseball for two years in the New York Yankee's farm program. Due to an issue with his throwing arm, he left professional ball and entered the United States Naval Academy, where he starred on the baseball team and once appeared in a photograph with Willy Mays following an historic game against Army.  He served in the navy for over 20 years, attaining the rank of Lt. Commander in a very rich and active career that included administrative duty in relation to the Amphibious Force Seventh Fleet/Expeditionary Strike Force early in the Viet Nam, command of several amphibious fleets, and extensive aircraft/pilot service, as follows:

• 1954 - CTF 76 participated in Passage to Freedom, the largest operation of its kind in history. Operation evacuated 310,000 people from communist-controlled North Vietnam to South Vietnam and carried 58,000 tons of cargo and humanitarian aid.
• 1965- Participated in amphibious landings, assaults and demonstrations off the eastern coast of the Republic of Vietnam. Also cleared mines off the Vietnamese coast toward the end of the conflict.

..... as well as assistant command of the USS Tallahatchie County, as follows:


- On 3 February, 1962 the TALLAHATCHIE COUNTY was redesignated AVB-2, with CMDR Courtland Babcock and LT CMDR Jack Pickens in command. She now had a complement of 265 and quarters for 180 men of an aircraft squadron. Her mission was to be able to beach anywhere that an airfield existed, unload her 14 mobile support vans, and be operational in 4 hours. The vans contained spare parts and equipment for weather forecasting, aircraft repairs, electronic repairs, and communications.

- On 15 May, 1962 TALLAHATCHIE COUNTY got underway for the Mediterranean and arrived at Naples, Italy, her new home port on 8 June 1962. One 25 June she relieved from duty the USS Alameda County AVB-1 (formerly USS LST-32) which was sold to the Italian navy was renamed ANTIO.

- During the next 17 months, she conducted advanced aviation base maneuvers at Souda Bay, Crete, and Cagliari, Sardinia. From 1 November to 15 December 1963, she made a 4800 mile cruise of the eastern Mediterranean in support of the naval Oceanographic Office.

- During September 1964, she participated in an advanced aviation base exercise in conjunction with NATO operation FALLEX. IN February 1965, the TALLAHATCHIE COUNTY was called upon to salvage a jet aircraft that had splashed into the waters off the coast of Libya. She then returned to Naples to prepare for her longest advance aviation base operation to that time. Patrol Squadron 24 operated from TALLAHATCHIE's advance base in Souda Bay from July through September while the runways at the Naval Air Facility, Sigonella, were being repaired.

- During the summer of 1967 the TALLAHATCHIE COUNTY underwent and overhaul at the Socieata Escercizio Bocini Napoletani and then returned to operation in support of the Sixth Fleet. 

- On 9 February, 1968 the TALLAHATCHIE COUNTY responded to an SOS form the Portuguese freighter DIAS which was sinking off the coast of Spain; and rescued her captain and crew of seven.

- TALLAHATCHIE COUNTY operated out of Naples until 15 January, 1970 when she was decommissioned and struck from the Navy list. She was sold for scrap to Contieri Navali Santa Maria, Genoa, in July 1970.

I also know that my father dealt with the effects of chronic depression in the latter part of his life, as well as alcoholism, and the only clear memory that I have of my him is from a day when I was taken to visit him in a sanitarium of some kind not long before his death; he had two gloves and a ball with him that day, which we tossed back and forth in a grassy area under the looming presence of that hospital.

            Live it, send it all the way
            to the woods, my father
            smelled leather and oil,
           Oklahoma summers;

            saw just that shade of light, those
           fern laden briar horizons
           with the odd colored weather
           of summer, thunder
           storming. Throw, son!

           Keep throwing,     
           you are going, now
           to play big league ball,
           no shadow of ours or theirs
           will suck you from the sun.
                                                                    (December 2010)

     

My mother was born in Peoria, Illinois, to first generation Irish and German immigrants; her parents, my grandmother Margaret Ann Mahoney, and my grandfather, Fritz Saurs, were the only extended family I really had for most of my childhood, but I recall a number of people, albeit vaguely, with respect for various other relations on both sides of my family. My mother raised me by herself from the year 1972, and struggled in her own right with alcoholism for many years, which had its detrimental impacts on me, particularly during my adolescence. But in time, she did acquire sobriety, and established a lucrative business that allowed her to retire in comfort. 

My parents married in 1946 or '47, and my oldest sister, Sharon, was born in 1949 in Pearl Harbor. My oldest brother, Reed, was born in 1951 in Naples, Italy, and my other brother, Calhoun, was born there, too, in 1954. These dates are not firm, I have never been 100% certain of my siblings birth dates, or the history of my parent's relationship; due to the fact that my oldest brother died in 1974, and that I have been estranged from the other two for many years, I have had to piece together this information. It is close enough.

I was born at Jackson Naval Air Base Oceana Hospital in 1961, and my family lived in Bermuda until I was 2 years old, or so; we later resided on Oceanfront Drive in Virginia Beach, VA. After my parents divorced, my mother and I settled in New Mexico. My oldest brother died shortly later of complications from a drug overdose. Alcohol, drugs, and related mental-emotional health issues play heavily into the history of my immediate family, as well as my own life, in general. It is fair to say that my depressive traits and alcoholic tendencies flow from both of my parents, as well as in terms of my early relationships with all three of my siblings. I never graduated high school, and had effectively home by the time I was 17. By the age 25, I had lost contact with both of my living siblings. I spent much of my time during my twenties skiing and racing bicycles, and generally carved out a reasonably satisfying lifestyle for myself, given my circumstances. In time, I found my way into college, where I attained good enough grades for a BA (1996, Magna Cum Laude, University of New Mexico), an MA (2000, University of Arizona), and a full ride scholarship to law school (2001-2003, UA). And although I stayed away from my mother for a number of years, we rekindled a reasonably healthy relationship in the last 20 years of her life, during which time to she was sober.

It genuinely angers me to know that I, the youngest child in my family, was abused at the hands of mental health providers at the Arizona State Hospital. I find this odd, the anger (because I am not, by nature, an angry person), but I believe I've identified where it comes from. My maternal grandmother, Margaret, volunteered for many years during the 1940s  and 1950s in Illinois hospital settings for the "mentally retarded" and "insane," and I know that many of things she witnessed at those hospitals greatly disturbed her. Her dedication turned slightly activist in her later years, when she became actively involved with mental health care reform in the state of Illinois in the 1960s and 1970s; while I was not aware of any of this at the time, I had opportunities to hear some of her stories after my grandfather, Fritz, died in 1984, and she moved to live with my mother in New Mexico.

I am also aware that my own deep resentment towards abuse of authority and discrimination flows from my American Indian heritage and directly related feelings that arise through knowledge about my father, who had to cloak his Chickasaw identity in order to avoid racial discrimination when he was growing up. That he went to excel in all capacities of the expression in his own personal life pursuits despite the pitfalls of being an American Indian in a nation built upon racial conflict is evidence enough when I look inward to my own heart and soul in terms of trying understand why I have come to abhor the perpetrators of patient abuse at the Arizona State Hospital.  

My own anger at the notion that I became victimized by the malfeasant conduct of the doctors and nurses technicians at ASH, is selfish however, and narrow minded. Each and every patient at ASH is somebodies child, and so on, and I am not one of those who will have to spend out the greater years of my life there.

       How dare the administrators, doctors, nurses and technicians at the Arizona State Hospital abuse these children, these human beings! How dare the Arizona Department of Health Services condone these things! Where is the humanity in this? Who the hell are you people?

    
            Me.... This...
            Is not about me.
            This is about you.
            But it relates to me
            subjectively,
            and to every other one of us,
            we who came to you
            because we felt we could rely
            on you.

            I... This....
            I come from a long family line
            of high achievers,
            but I realize now,  today
            as though for the first time,
            that mental illness runs, too,
            so be it.

            You... This...
            is about you,
            all of you as dirty
            as a dead hobo's underwear,
            and you know it.

            You... This...
            I will burn you down,
            I intend to smoke you out, all of
           You... This... It is so large, it is...

            You wound up with
            the wrong patient,
            and you picked the wrong century
            to write shit on the wall,
            and you are not going to get away with it.
                                                                             (September 2011)

It is clear to me now, that beyond my basic need to do whatever I had to try and survive the abuse at ASH while I was hospitalized there by advocating for my own rights and protections, my willingness to maintain a dedication to addressing the wrongdoing at ASH has its roots in the history of my family, and I am actively engaged in directing whatever anger I have in relation to these things immediately upon the welfare of the patients still in ASH. For I know today that at least some/most of the abusive nurses, doctors and technicians I encountered are victimizing the patients at ASH even as I write. In thinking about the relative horrors that my grandmother must have witnessed in her time, I am reminded of the staff at ASH who sometimes commented to me about how much "better" things are today. I would hear this, knowing, too, that I was a witness and victim of wrongdoing that I know for a fact  is unlawful and inhumane in contemporary term. They seem to use that as an excuse, that things today are "better."

      Again: Anybody willing, or even interested in learning more about the conditions at ASH, please. All it takes is consideration of simple facts. The patients as the Arizona State Hospital need our help.

paoloreed@gmail.com  

News Flash: Donna Noriega- Busted! March 09, 2012: The Current Chief Operating Officer at the Arizona State Hospital Found In Violation of Arizona Revised Statute 32-3251(12(c)(i) By The State Board of Behavioral Health Examiners. Censured. See Case #2012-0047.

        Donna Noriega, LCSW 10959. In short, this woman is Arizona State Hospital Chief Executive Officer Cory Nelson's deputy, and she's been censured by an state administrative credentialing committee for lying while on the clock. I've not a lot of time for Donna Noriega's current legal issues tonight, but I am telling you folks, the administrative staff at the Arizona State Hospital are messing around with federal and state law, and the deceitfulness that I encountered ran true at all levels of staff representation.

UPDATE: At a March 09, 2012, meeting of the Arizona Board of Behavioral Health Examiners Social Work Credentialing Committee, the Chief Operating Officer at the Arizona State Hospital, Donna Noriega, was found to have engaged in unprofessional conduct in direct conflict with the requirements of her right to be a social worker, as follows:

 ARS 32-3251 (definitions)
      (12) Unprofessional Conduct 
      (c)   Any oral or written misrepresentation of a fact by an applicant or licensee
       (i)   to secure or attempt to secure the issuance or renewal of of a license.   

         The Arizona Board of Behavioral Health Examiners is looking at some of my work already, because the social workers that I relied upon at ASH, including that department's supervisors, engaged all sorts of administrative misconduct that I experienced or otherwise identified as a patient there, including blatant lying and misrepresentation of facts central to my status and needs as a mentally ill person in the state of Arizona. And while it may not be obvious how or why those particular people would be in a position to detriment the lives and well being of mentally ill persons, the fact is, that branch of state certified practitioners are responsible for the social welfare of mentally ill persons who rely 100% on social workers in the field to ensure that their day to day needs are in order, as well as high ranking representatives such as Donna Noriega to maintain the integrity of the field. Food for thought, indeed. 
       Also, I hope some of you got a look at ASH Chief Executive Officer Cory Nelson's personal web page (www.crazycorycorner.weebly.com) before today, because that fast, I believe he may have removed it from the web. 

paoloreed@gmail.com

OF: www.crazycorycorner.weebly.com Ego, Cory Nelson Style (CEO, AZ State Hospital)

     Cloaking tactics designed to mask or mischaracterize incentives and objectives in the field of big business are generally not something you would think the supervisor of a public hospital would be engaging in. Then again, maybe Cory Nelson, the current Supervisor/Chief Executive Officer at the Arizona State Hospital, is really a angel of some sort, and the above web site was created out of good faith intent. Hard to say, but you can be sure that not one current patient at the Arizona State Hospital is able to access the site, so as usual, the patients at ASH, some of whom have lived there for decades (long before I or Cory Nelson showed up) and won't be going anywhere anytime soon (far longer than I or Cory Nelson) have no voice in side projects such as Mr. Nelson's personal web page (see above); and given that the term "crazy" is as insulting as the expression "retarded" and "subhuman" to those of us effected by mental illness, it is surely a good thing for him. I will just add to this, that as a former patient, I find it personally insulting, as well, to have him parody the conditions at ASH, where any given patients normal life (I am talking sex lives, family lives, and on) is effectively out of reach, by virtue of very real illness (never a laughing matter) and applicable standards of hospitalization; and I will state again with absolute verity, that the only true mischievousness going on at the Arizona State Hospital has to do with staff misconduct and is criminal in nature. Mental illness in itself is horrifying, and for most of us, our sense of connection with the way things are supposed to be is never entirely lost. The self-amusement that Mr. Nelson obviously finds in his position and his related responsibility for others is shocking, at best. As per the norm, at the Arizona State Hospital. Way to go, Cory Nelson. You are a superstar, indeed.  
      Mr. Nelson took over the helm at ASH in August 2011, following a period of 4-5 months of no duly hired supervisor, a period of time during which Jesus Murietta escaped and God only knows what else went on, and a woman named Ann Froio (described in Arizona Department of Health Services information as a "fix-it specialist") played the role of interim chief executive.
       Most patients were well advised of the fact that a new boss of the house was coming in well before Mr. Nelson arrived, and I had submitted a letter of inquiry addressed directly to Mr. Nelson through the administrative office at ASH by July 15, 2011. My intent was to openly share with him the fact that I was very, very frustrated by the state of affairs specific to most of the issues that I have thus far tried to describe in this blog, and that I was on the verge of contacting federal authorities in order to bring some nature of rigorous and meaningful oversight into the situation. My intent was good faith, and the language of the letter was very civil (and, of course, I do have a copy of that letter), but I was still ignorantly willing to believe that the highest ranking representatives ASH admin. had souls, in effect.
       Sadly, I didn't hear from Mr. Nelson until almost 8 weeks had passed, by which time I had been physically assaulted by a staff member on  July 07, 2011; as well as subjected to the unlawful and retaliatory transfer by Mr. Nelson and Chief Medical Officer, Dr. Steven Dingle, of my care and treatment to the most violent unit on the civil (as in civilly committed vs. criminally committed) side of the ASH complex in early September, 2011.
      By the time I did get to meet Mr. Nelson, he was clearly in a defensive posture, and I am certain that his understanding of my character as a patient and person had already been distorted by ASH Chief Operating Officer, Donna Noriega, Dr. Dingle, and so on. But I had already been visited at least once by members of the local press by then, too, and I had lost all faith in the situation, anyway. However, I did make clear to him the first time we first met in mid September, 2011, that I was not desiring of an adversarial relationship and that I believed it would be most effective for us to work together. Sadly, again, he was not interested in that, and chose to patronize me instead, asking me to give some idea him of "what the heck" I was referring to, this despite the fact that there was over 6-7 months of documented communication (and conflict) between staff and me, including administration, on record. So I told him "You're too late," and left him with my basic plea: "At least try to do the right thing, please."
      In the end, Cory Nelson affirmed his role as a supervisor more interested in preserving the image of the Arizona State Hospital than anything else, and referred to my dedication to addressing the sub standard practices at ASH as "prerogatives."  I'd like to believe that he was complimenting my efforts in a roundabout way at the time, but his actions in subsequent months proved that to be far from the case. It was all is to be expected, really. Cory Nelson is not a medical professional, and likely has a superficial familiarity with health care ethics and professional medical practice, at best. As such, in his mind, he is not obligated by his position to put the patients at ASH first, and I have documentation that proves this. 
        Dr. Pervaiz Ahkter, my second primary attending doctor at ASH, asked me if I felt that I was on "some kind of a mission" when I shared with him my deepest concerns about wrongdoing at ASH (this was about a month after he asked me if I was a felon), which made me question at the time whether he knew anything about life itself. It is one thing for a business man like Cory Nelson to be relatively out of touch with health care ethics, but compassion for others is central to the Hippocratic Oath, and it was very unsettling to have medical professionals like Dr. Ahkter, and Dr. Laxman Patel, challenge me whenever I brought up the topic of staff misconduct. Again, I presume that my values are different from men like them, perhaps because of the differences in our cultural background. There must be some reason for why people like them conduct themselves so maliciously. In my way of seeing things, questioning the simple willingness of one human being to look out for the well being of others is evidence of disconnectedness with the basic principles of health care.  

      My thoughts today in relation to the Arizona State Hospital and the very reason(s) for why and how I had arrived in that accursed facility are mixed, at best. I cannot in all honesty say that I received much in the way of treatment during my 13 months at ASH. The conditions at the Hospital more or less aggravated my depression and led me to question the very existence of a facility like ASH, because I realized before long that abuse and staff misconduct are rampant, and if a person can't find safe haven in a publicly managed hospital, where can thy find it? I made all this clear to my care providers, too, time and time gain,but in the end it was a waste of my time. They absolutely refused  to acknowledge the fundamental merit of my concerns, leading me to understand how gravely at risk all of the patients at ASH are. 

        Meeting the many patients that I did at ASH and learning of their predicament, not as mentally ill persons, but rather as persons committed to treatment in a criminally operated hospital, did something to open my mind and heart to new possibilities. For, in seeking death, legitimately, sincerely, lethally, I was seeking my identity, somehow, somewhere; something akin, perhaps, to silent and permanent empathy for other tortured loners like I, at the time; which is something I still do today in seeking to open doors, as a survivor of nothing that I ever felt to be torment, my own mental illness being derived of my most personal sense of identity in the first place, and the effects of moderate  chemical imbalance in my brain. And while I am still drawn, at times, to notions of the goneness and deadness of death, and the related ultimateness (?), I am also aware today of the presence of death in the form of such persons as the wrongdoers at the Arizona State Hospital. Strange, I know. But I am nothing if not cognizant to my own journey in life, and this is what I see today. I have perhaps waited for an identity like this one, for I am a survivor of inhumane torment imposed on me by people who have absolutely no legitimate power or authority to so carry on... Somebody has to be where I am today.

     At some point in my time at ASH, I became a spy. I was not hidden to the enemy, per se', but I did increasingly engage in documenting the criminal conduct of staff as time passed, and I came into contact with people on the outside who brought me materials by which I was able to meaningfully conduct investigations into the things I was most concerned about. At the same time, I was able to establish relationships with the minority of staff members who were willing to assist me, because they cared, and they did what they could to improve my observations of wrongdoing; not much, but enough to get a ball rolling, and I am not wanting to put anybodies job in jeopardy, so they are at present watching from the proverbial sidelines, hoping that things work out. 
      And I have no idea whether Cory Nelson knows what he is doing, or not. I am not really sure what his job is, in fact. I can only hope that he has the insight to identify and acknowledge the best of the staff there, for they are good people and deserve the privilege of their positions and the patients need them; and that he has the integrity to recognize the worst, for they are not morally eligible or conscientiously capable, in fact, of caring for others.

       My attention is still often drawn to the fear that I heard in patients' voices when they described the abuse they had experienced...
       "I am terrified by staff." I heard this from one of the nicest and least violent men I knew at ASH about 2 months after I had arrived, and as we got to know one another over the next 10 months, I learned that his words were not derived of delusion or fantastical personality disruption. He was an ill man who has been at ASH for close to 9 years, and he has to live his life in fear of the one's assigned to care for him, because some high proportion of the staff at ASH can and do willingly and somewhat openly abuse patients as a matter of standard, day to day practice. He knows that he cannot live on the outside, this man, and that ASH is the best that life today has to offer him, and he somewhat begrudgingly accepts his plight with a grain of salt. He warned me, too, when I first began engaging in my efforts to advocate for myself; he advised me in no uncertain terms that the technicians and nurses and doctors and administration would retaliate, and that in his opinion, such efforts are a waste of time. And he was for the most part, correct, of course. To date, that is.
      In my time at ASH, I witnessed and was subjected to innumerable incidents of abuse and related cruelty, and the relationship that I had with the above patient was far from unique. Mentally ill persons are not inherently dishonest, unintelligent, or lacking in character. I know this today. I have spent thousands of hours in the close company of seriously mentally ill adults, and I have to come to understand that they share with me an inherent understanding of what cruelty and abuse looks like and feels like.  Through my friendships with patients at ASH, I learned that the disenfranchised and abused are bound by their own experiences to less immoral than their abusers. It is a simple dynamic of contemporary human survival, and I am also aware that this basic phenomena appears where ever one group of people harbors all the power over another. I have studied and discussed in the halls of higher education. The abused person understands the mind of the abuser better than the abuser understands himself. Because of this, many of the patients cling to the only sources of good available at ASH, and it is between themselves that this is found.
      The very real evil at a place like the Arizona State Hospital is seemingly omnipresent by virtue of the corrupted minds and character shortcomings of the staff, particularly administrative staff, who willingly wield their authority in a twisted and deviant way. It is that simple, really. Pure and simple cruelty, and I have never had a thing to gain in making that assertion. I don't want the attention, I don't want windfall deliveries of cash, I don't want enemies. But the Arizona State Hospital in the condition that it is in today is a dangerous place for mentally persons to be treated. The administrative officials are dangerous the doctors are dangerous, and because of these basic facts, the lower level staff -almost as a matter of necessity- are dangerous. I know these things as well as I know my own big left toe, I attest to my own traumatic experiences at ASH, and I know that any sincerely directed efforts by agencies or organizations not affiliated with the state of Arizona to investigate the wrongdoing at ASH will benefit the patients. Bottom line.
       Any direct characterizations of my concerns that Cory Nelson or any other like person chooses to make will be designed to reduce and distort the significance of these concerns. For men like Mr. Nelson, such things are a matter of professional (business) ethics (as any educated person knows), and by virtue of my willingness to openly criticize the wrongdoing at the Arizona State Hospital, I am in conflict with the true objectives of a man like Cory Nelson. He made that very clear to me when I was still hospitalized at ASH, and I have no reason to believe that the situation has changed.
        
paoloereed@gmail.com 

       Refusal to Abide by the Provisions of HIPPA Wherein clinical and administrative staff at the Arizona State Hospital grossly violate federal law as a matter of standard practice by willfully denying patients access to medical records in order to hide their misconduct and criminal behavior.

      The Hospital Information Portability and Protection Act requires that hospitals release a patient's  own medical records anytime the individual requests such, and hospital administrations are expressly forbidden from refusing to release the records, as follows;

     Section 164.524: ACCESS OF INDIVIDUALS TO PROTECTED HEALTH INFORMATION. (a) Standard (1) Right of Access: Except as otherwise provided in paragraph (a)(2) or (a)(3) of this section, an individual has a right of access to inspect and obtain a copy of protected health information about the individual in a designated record set, for as long as the protected information is maintained in the designated record set... except for: (i) psychotherapy notes.

     There are a handful of related clauses to the above HIPPA standard, and it is a bit technical, classic policy mumbo-jumbo. But in the end, none of it amounts to granting the Arizona State Hospital any excuses whatsoever in terms of having denied me access to my medical records. State operated facilities such as the Arizona State Hospital are subject to the direct authority of several federal agencies in terms of issues relating to such enactments, including the above HIPPA document. I formally requested designated aspects of my personal medical records time and time again while hospitalized at the Arizona State Hospital, following all applicable procedures in this context, but my requests were flatly refused by a social worker named Megan Mischner on one occasion in spring 2011, Dr. Perviaz Ahkter in early summer, 2011, and by my last assigned social worker, by Mr. Robert Washington, in February, 2012. These refusals were mandated by ASH administrative officers, although in Dr. Ahkter's case, I believe he may have acted alone in the decision. 
     The most obviously criminal denial of my right to review records relating my care and treatment at the Arizona State Hospital arose in early April, 2011, when Dr. Ahkter made comments at one of my monthly inpatient treatment team conferences to the effect that nursing staff on the unit I was housed in at the time had reported my behavior in standard day to day notes as being (amongst other things) combative, grandiose, and generally in violation of hospital rules. At the time, I requested to see these nurses notes, because in my opinion at the time (and today), I am a civil and non disruptive individual in any reasonably legitimate setting, and I was very concerned to hear that unnamed nurses were making statements about me that I felt were patently untrue. Following the conference, I submitted a standard Arizona Department of Health Services records request form to Megan Mischner, as per applicable procedure, and was informed three weeks later by my assigned social worker at the time, Megan Mischner, that Dr. Ahkter had denied my request. In issuing this denial, Dr. Ahkter did not follow basic hospital and state procedures in his own right; and  
it is my contention that he issued the denial because the notes either did not exist in the first place (and that Dr. Ahkter had flatly lied about the existence of such notes), or that any said notes alleging negative behavior on my part had been reported by nurses who I had ongoing issues with relating to patient abuse (and would thus stand out from other nurses notes who both understood my concerns as well as offered their full moral support for my efforts in relation to reporting patient abuse). In any case, I had the express right to see these notes, as nurses notes are not a form of health information protected by any provisions of applicable law and policy, and Dr. Ahkter's refusal to cooperate with my good faith and lawful request was/is a direct violation of such law and policy. Bottom line. As such, Dr. Ahkter should have been held fully accountable at the time, because I went to a lot of trouble in the subsequent months to further my basic request through the appropriate channels, including the ASH patient advocate/ombudsperson, Sonya Serda, and then the  Arizona Department of Health Services Office of Grievance and Appeals, but each of these so called resources flatly refused to support my rights in this instance.
        In my experience as a patient who spent 13 full months at ASH and attempted on multiple occasions to participate in the clearly established process of participating in my own treatment ad representing myself in relation these sorts of matters, this sequence of events pretty clearly reflects standard practice at ASH, as well as throughout the affiliated agencies at the Department of Health Services. As such, I am today calling for a meaningful investigation of these matters by an objective authority, and I believe that anything short of a federal inquiry is bound to fail. Patients at the Arizona State Hospital will continue to be abused by nurses and technicians of the floors of the various units there and the in-hospital administrators will continue to look the other way, while any patient with the wherewithal to request assistance from the state agencies will run into the same brick walls that I ran into while hospitalized at ASH and am still running into today. This is how it is at ASH, it is wrong in every sense, and it needs to stop today.    
       I put in many long hours of dedicated effort in the hope of securing meaningful support for my concerns while a patient at ASH, from federal resources and beyond, and I cannot easily describe how deeply despairing it is to experience one closed door after another when one is being subjected to a constant barrage of clinical and administrative abuse. At various times during my "treatment" for depression at ASH, I experienced high anxiety, fear, and deep dismay for the welfare of not only myself but for all of us- the patients- and my depression in general was without doubt aggravated, for who wouldn't find graphic abuse of vulnerable adults depressing, frightening, and so on? The absolute lack of meaningful response to my expressed concerns while I was hopsitalized (at ASH) underlies the reality that mentally ill persons in state hospitals like ASH are systematically and unlawfully disqualified from receiving the same privileges and liberties that all American and human beings are due. It is blatant marginalization and patent discrimination. Bottom line.
      Now, I did at one point receive a little bit of assistance (in relation to accessing my own personal health records) from an "equal opportunity specialist" with United States Department of Health and Human Services Office of Civil Rights (Region 9, San Francisco, CA) after I submitted a formal complaint with them in late 2011, which at the time was pretty encouraging; but to date, I've not heard anything more about it. Other past efforts to communicate with federal agencies and organizations while I was still hospitalized, including the United States Department of Justice, The American Civil Liberties Union, and The Joint Commission, all came to naught. The typical response from these agencies amounted to rejections that fell along the lines of scarce resources, and related advisement's that my clearly documented reports of administrative misconduct have no legitimate standing to because I was (and am still) alone in my expressions of concern about the conditions at ASH,. Please note that due to given circumstances of the high majority of ASH patients, wherein by virtue of their mental illness and related legal status they have no express right to engage in their own right in any sort of self advocacy, it was (and is today) virtually impossible for a patient like myself to include other patients in my own advocacy efforts.
            Fact) Inter-office memos and e-mails between all/any staff at public entities/institutions like the Arizona State Hospital are not protected from open public scrutiny. In my case today, these sorts of records are central to some of my own investigative efforts, and ASH administration is refusing to release any of these records to me. 
          Fact) Specific (personal) personal medical records, including nurses and physicians notes (with very few exceptions) are not to be withheld from any individual desiring such personal records. Here, too, I have very good reason to believe that I will find evidence in support of some of my fundamental allegations of clinical misconduct, but ASH administration is refusing to release any of these records to me.       
         Fact) By refusing to release my records, ASH is directly interfering with my effort to adequately prepare for this hearing, which amounts to blatant abridgments of my constitutional  rights in the context of due process and equal protection, and which is in violation of HIPPA and other fundamental federal standards of law and civil rights.
        Fact) I am currently trying to get the state to issue a subpoena in order to force the Arizona State Hospital to release aspects of my personal medical records that I intend to research and potentially utilize as evidence in support of allegations that I will be presenting against ASH in an upcoming (May 17, 2012) administrative hearing in Phoenix. I am testing the waters, as it were, and will before long know more about the quality of services in terms of the Arizona Office of Administrative Hearings (www.azoah.com) 

        It should not be difficult in any capacity for patients in American hospitals to voice concerns about abuse or administrative misconduct. In the 13 months that I was a patient in the Arizona State Hospital, my experiences in this context were fraught with criminal abuses of authority and gross violations of established medical practice, as described in this account. I attest to the truthfulness of my statements, and am more than happy to share my documented evidence with anyone interested in learning more about the wrongdoing at ASH.
        It should likewise not be difficult for the citizens of this state and nation to come to the aid of the patients in the Arizona State Hospital by seeing that the ones responsible for their care operate within the law and respect fundamental standards of medical practice and health care. And yet here I am still, writing away over 12 months after I first began trying to advocate for myself, and still without any meaningful support. I am continuing my heartfelt mission to provide such aid in the only way I can today because it the right thing to do, and nobody else seems willing to take part. Please, if you can do anything: paoloreed@gmail.com.   
       MY NEW DISCLAIMER: I CLAIM NOTHING THAT I DO NOT HAVE SOLID DOCUMENTATION OF.

COMING SOON: WHAT I KNOW OF THE ILLICIT SUBSTANCES TRADE AT ASH, WHERE STAFF SMUGGLES IT IN AND SELLS IT TO THE MENTALLY ILL PATIENTS AT EXORBITANT PROFIT, WHICH ADMIN FULLY KNOWS ABOUT AND DOES NOTHING ABOUT (SECURITY HAS FREE LICENSE AT ASH- NOTHING ABUSIVE ABOUT THAT, HUH?). ALSO, I'VE NOT EVEN BEGUN TO APPLY THE VIOLATIONS OF THE AMERICANS WITH DISABILITIES ACT TO THIS ACCOUNTING. 

paoloreed@gmail.com

I Smell the Blood (or is that feet?) of an Arizona State Hospital Administrator or Two.Oh, My!

       So, how will it come? How will the monsters that hold the care and well being of the patients at the Arizona State Hospital in their hands move in for the kill? For I see from the records of visits to this site that both the ASH chief executive officer, Cory Nelson, and the chief operating officer, Donna Noriega, have dropped by in recent days. It's only a matter of time before these administrators at the Arizona State Hospital formally react to this blog and the accounting of my experiences thus far provided. Oh me, oh my! What shall I do?
       Er... Uh... Hi,  you two! How's the fuddle-dudding going? I feel a little embarrassed, in that my best writing is going into the book...  But congrats, you guys! I've been following the relatively high praise that you've gotten in recent months in relation to the proposed changes at ASH. Less security guards, more technicians- yep! That should solve the problems! More droogs in the trenches with the lunatics, less fire power in the sky. It certainly appears good, and we all know how important appearances are in your world. It is kind of sad that all of that praise formulates in the same offices that have either directly or indirectly contributed to the worst problems at ASH in recent years, for it all winds up looking like confetti and stick-on tattoos in the end. But what the hell, that's government, right?
        And while I have you:
                     -What sort of input are you providing to the patients on all these changes? Are you conducting weekly or monthly patient to administrative staff meetings to discuss these things? You know what I'm talking about, Donna. The weekly Care Counts meetings that were being held prior to the resignation of the last CEO, before all the shit hit the fan.
                      -How about the hospital human rights panel? You know, the panel that is in accordance with state and federal standards is supposed to be available there at ASH whereby patients can directly communicate their concerns about life at ASH? What kind of input are they getting? Oh, wait, I forgot. There is no human rights panel at ASH.... Sorry about that. What was I thinking?    
        And I wish I had more time, but I don't. It is snowing here in Flagstaff, the roads are very wet, and I have work to do at the local family food center. You two go ahead and keep flogging the infirm and unempowered for now, and we'll catch up on things at a later time. Trust me.