Governor Jan Brewer of Arizona hailed a settlement that effectively ends legal action against the state and Maricopa county for failing to provide adequate services to those determined seriously mentally ill or SMI.
The lawsuit, Arnold vs. Sarn, was filed in 1981 when advocates for the seriously mentally ill in Maricopa County resorted to file a lawsuit for relief to force the state of Arizona and Maricopa county to treat mentally ill patients who didn’t otherwise qualify for Medicaid. Since then, a succession of Maricopa County Superior Court judges have served in roles as watchdog for people with mental-health issues, doing such things as monitoring state funding and hearing arguments about the in- adequacy of care, from housing to employment to skills training.
But after she became governor in 2009, one of the first things she did was she sign off on “deep cuts” to the mental-health budget as she and the Legislature grappled with billion-dollar deficits. Some of that money was restored in the 2012 agreement, but still falls way short of what it could have been.
The new settlement agreement covers nearly 19,000 seriously mentally ill residents of Maricopa County. However, Brewer said the services the agreement outlines for this population will also extend to mental-health patients in Arizona’s 14 other counties. In total over 70,000 people in the state have been determined SMI (or Seriously Mentally ill).
According to Charles “Chick” Arnold, the “Arnold” in the original 1981 court filing, praised the agreement.
“I’m excited about it,” said Arnold, an attorney. “This has been the culmination of a whole lot of energy over the years.”
He said he was especially proud the agreement includes a provision to provide “supportive housing,” which combines a permanent place to live with counseling, case management and other support services.
“You can’t recover if you don’t have a place to live,” he said, in an article on azcentral.com.
The reality is not quite so clear – the sad fact is we still have far too many people not getting those services in the community they desperately need. Many SMI patients still don’t get adequate housing services, case management and bus passes. This is especially true of the People of Color Network and other mental health providers under the Magellan umbrella. Magellan is the Regional Behavioral Health Care Provider – which just lost its $5 billion dollar plus contract with the state of Arizona. In part because they failed in their contractual obligations under the contract.
At the People of Color Network – Capitol Center, 1540 w. Van Buren, in Phoenix, Arizona – the center is both “under resourced and understaffed.” Some people who go to this clinic don’t have assigned case managers and can’t even get so much as a monthly bus pass without restrictions.
The settlement that now ends the lawsuit in “Arnold vs Sarn” – simply didn’t go far enough. As a result people with SMI still suffer.
At the Capitol Center – no one would go one record in response to the settlement. Its as well they don’t. The center has over 600 SMI clients assigned here, many fall under the category of “chronically homeless individuals” that still can’t get housing or professional case management services. All one has to do is go to CASS (Central Arizona Shelter Services) or Nova Safe Haven to see that many with serious mental illness still don’t have adequate housing.
I personally know we have SMI clients assigned to the Capitol Center who are still homeless living on the street and eating out of garbage cans. Many SMI are disillusioned with the lack of services they get and refuse to go to this clinic for anything but to get psych meds.
They also have problems seeing their case managers, that is if they have one assigned in their case. Many still don’t. An ugly secret the People of Color Network is loath to admit.
The Capitol Center however has made progress in terms of hiring one new psychiatric doctor (Dr. Martinez) and hiring at least one additional case manager (who is still in training) – but it is not enough to handle crush of clients they must deal with on a daily basis.
I know this to be a fact having served myself as the Chairman of the Capitol Center Clinic Advisory Board. I also think its way to premature to hail the new settlement under such circumstances.
For more information see Arizona Department of Health Services website http://www.azdhs.gov/bhs/pdf/sarn/arnold-v-adhs-stipulation-for-providing-community-services-and-terminating-litigation-01-07-2014.pdf