Bill to provide oversight, nix bed limits at Arizona State Hospital

The Arizona State Hospital, which cares for some of the state’s most vulnerable people, is subject to oversight by the Arizona Department of Health Services, the same organization that runs it. Lawmakers say that should be changed. 

Instead, state legislators on Feb. 14 unanimously advanced a proposal to create an independent board to oversee the hospital, which treats severely mentally ill people.

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The legislation, Senate Bill 1710, would also nix a 55-bed-per-county patient limit, which had been in place since 1995. This would cut down on long wait times for patients from populous counties like Maricopa when there are unneeded beds sitting open for patients from other counties. Maricopa County’s population in 1995 was around 2.5 million, but it has grown to around 4.4 million as of the 2020 census. 

The state hospital admits patients “on an involuntary basis pursuant to a court order due to the severity of their mental illness and an inability to be treated in a community facility, or as a result of their involvement in the criminal justice system,” according to Steve Elliott, a spokesman for the Department of Health Services.

The bill, introduced by Sen. David Gowan, R-Sierra Vista, would create a state hospital governing board, with five governor-appointed members from different political parties and from different counties to serve five-year terms. 

The state hospital is currently headed by a superintendent, but the board would be tasked with appointing a director to that job, whom they would also have the power to fire for any reason. 

The members of the newly created board would be required to have experience in behavioral health. 

The board would be tasked with setting goals for the hospital, evaluating its performance annually and assuring its work aligns with its mission, vision and goals, providing feedback on possible improvements, and ensuring that medical staff is accountable for quality of care and treatment, in addition to numerous other responsibilities.  

Elliott told the Arizona Mirror that the hospital is already certified by the Centers for Medicare and Medicaid Services, is subject to oversight from a long-term care ombudsman, as well as subject to Arizona Health Care Cost Containment System grievance process, AHCCCS’ Office of Human Rights, the Arizona Center for Disability Law and an Independent Oversight Committee established by state law. 

“ASH (Arizona State Hospital) is one of the most heavily regulated hospitals in Arizona,” Elliott said.

Even so, some whose loved ones have been hospitalized at the state facility and Will Humble, director of the Department of Health Services during Gov. Jan Brewer’s administration, believe that a change in oversight is necessary. 

Humble, who now heads up the Arizona Public Health Association, told the Senate Health and Human Services Committee that the issue of oversight has been a problem since 1974, when the state hospital was put under the operation and regulation of the newly formed Department of Health Services. 

“You shouldn’t be regulating the same place you’re running,” he said.

When he was in charge at DHS, Humble said he informed his staff to treat the hospital no differently than an outside entity, but he believes it would be easy for the agency to decide to “go easy” on the hospital to avoid a bad inspection report. 

Barbara Honiberg, a board member for the Association for the Chronically Mentally Ill and the mother of a 31-year-old son who is seriously mentally ill and has been hospitalized many times, said that oversight is lacking. 

“Right now, it’s a hodgepodge of people who have no understanding or no experience with behavioral health,” Honiberg said. 

She compared allowing DHS to provide oversight for its own facility as “the fox watching the hen house,” and said that patient complaints are often swept under the rug — and sometimes they even face retaliation for speaking up. 

“That’s reprehensible,” Honiberg said. “The staff is not held accountable for their actions. We’re talking about human beings who are in there for a reason, but they’re still people, and they deserve the respect and professional treatment that they need, and that is not happening.” 

In October, staff at the hospital also dealt with an alarming incident, when three patients were accused of barricading staff members inside one of the facility’s units. Officials said that the patients assaulted the staff members, who sustained minor injuries. 

Within a two-week period in October 2021, two state hospital patients were suspected of taking their own lives in the facility, raising questions about oversight, staffing and training at the hospital. 

Sommer Walters is the guardian for her brother, Darren Beach, who she said has schizo-affective disorder and was undergoing court-ordered treatment at ASH when he was arrested for allegedly assaulting a worker who Walters had complained about multiple times. 

Walters claims that her brother was a “star” patient when he arrived at the hospital, but he quickly became more aggressive and easily agitated after his medication was changed without explanation. 

“Darren went from being the most beloved patient, who was known to rescue staff members from serious harm by other patients, to being labeled a problem,” Walters said.

She asked his treatment team at least 20 times to reevaluate his meds while she watched him spiraling further, but they refused, she said. Walters also claimed that the security footage needed to substantiate or refute the assault allegation was accidentally deleted. 

“I believe this is an attempt to cover up their negligence,” Walter said. 

Walter’s greatest concern about the situation is that Beach will be sent back to the state hospital after his criminal case is resolved, and possibly end up getting in trouble again. 

“Right now, the jail is providing better care for him than the state hospital, and that speaks volumes,” she said. “They’re being more kind, they’re medicating him, he’s not as aggressive and agitated. So, we have a jail that’s treating this seriously mentally ill person better than our state hospital. That says something.” 

Elliott told the Mirror that the Department of Health Services could not comment on pending legislation or provide information about specific patients.

“Our staff provide inpatient psychiatric care and are committed to treating patients with dignity and respect,” Elliott wrote in an email. “Interdisciplinary care is delivered in collaboration with the patient, family, legal representatives, the Superior Courts, the AHCCCS Health Plans, and community providers with a focus on recovery and community reintegration.”

Sen. T.J. Shope, a Coolidge Republican who chairs the Health and Human Services Committee, said that he’d recently toured the hospital. 

“There are wonderful people there who do wonderful things and work hard,” Shope said, adding that the extremely mentally ill are not an easy population to work with. 

But he also believes that changes need to be made. 

The Senate’s Health and Human Services Committee voted 7-0 on Feb. 14 to approve Senate Bill 1710. It heads next to consideration by the full Senate.

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