MENTAL HEALTH MASQUERADE

ARIZONA SET OUT TO CREATE THE BEST MENTAL-HEALTH-CARE SYSTEM MONEY COULD BUY. IT ENDED UP WITH A PROGRAM AS DYSFUNCTIONAL AS THE PEOPLE IT SERVES.

Girardin's Fair Hearing unfolded in two sessions last August 31 and November 16. The hearing officer was Robert Hungerford Jr., a onetime judge who also hears cases for other state agencies.

Rocco conducted his examinations of Girardin and Pugliese--who attended the August session in a wheelchair--with a vengeance.

"I cannot tell you why Mr. Rocco was so personally aggressive with the client and the advocate, but he was," says hearing officer Hungerford. "It made me wonder what was going on here."

In a separate interview, Howe also commented on the vitriol.
"There was a dark side to this," Howe says. "If I didn't know better, I'd have believed there was something personal the way Joe [Rocco] went after my guy and after Pat. The mentally ill may not have any true rights, but they should have the right to tell their story without being chewed to pieces."

Rocco says he was just doing his job.
"I believe there were a number of legally acceptable and appropriate ways to attack Mr. Girardin's credibility, and I used them," he says. "I thought there was good evidence that the, quote, crisis, had been falsely reported by Mr. Girardin."

But last December 5, Hungerford sided with Phil Girardin in his findings of fact and conclusions of law.

"ComCare violated the law and rights of the appellant by failing to manage and intervene in [Girardin's] crisis in November 1993," Hungerford wrote in a nine-page decision. "ComCare [failed] to provide a continuum of care in a unified and cohesive system."

But Hungerford didn't stop there.
"ComCare's failure is greater than that. This hearing officer concludes that ComCare was not motivated to respond to [Girardin's] crisis. Even a casual review of the case manager's handling of the case would lead to this conclusion.

"It is recommended that the [DHS] Director require an audit of ComCare's performance of its obligations to the SMI [seriously mentally ill] under the law. . . . It is recommended that the Director require ComCare to provide a plan for achieving better management of the treatment of the SMI."

Director Dillenberg, the ultimate arbiter, issued his own conclusions one day later. He agreed Phil Girardin had been treated badly by ComCare in the crisis situation. But he dismissed Hungerford's suggested reforms.

"The hearing officer digressed from the issues presented to him regarding [Girardin] and sought to address perceived 'systemic' problems by offering recommended solutions," Dillenberg wrote. "This was outside of the scope of the issues and evidence presented . . ."

A week after the decision, Bob Farmer mailed Pat Pugliese a certified letter placing her on permanent disability leave. She says she had been feeling better every day.

"I believe it was retaliation for all the so-called hassles I had caused for Bob by raising questions about the office's unethical practices," Pugliese says.

(Farmer did not return phone calls from New Times.)
Bob Hungerford isn't working for DHS anymore, either. He says he hasn't gotten an assignment from the agency since the Girardin case: "The director's [Dillenberg's] decisions and his manipulations of my findings indicate that the agency was not satisfied with where I was coming from. I just called it like I saw it."

Everyone thought the Girardin case had been put to rest with Dillenberg's December 6 ruling. It resurfaced a few weeks ago.

New Times asked DHS about Girardin on the morning of May 18. That day, DHS associate director Charles "Chip" Carbone sent a letter to ComCare president Hyde. Carbone said his staff "recently" had reviewed Girardin's file, and that he had some observations.

"Documentation does reflect that Mr. Girardin attempted on six occasions to reach his case manager or psychiatrist during his reported crisis in October/November of 1994," Carbone wrote. (He was off by a year; Girardin's crises occurred in 1993.)

"There is no evidence . . . that suggests that Mr. Girardin has an Individual Service Plan (ISP) in place. Given his significant history of attempting suicide, along with the coexistence of a substance abuse problem, it would seem that Mr. Girardin would benefit from an ISP."

It would also seem to be the law.
"You have the right to a written service plan (ISP) that lists the services you need," the Blueprint says. "Those services must support your personal liberty, goals and desires."

A Layman Loses Faith
Unlike the pugnacious Pat Pugliese, Bill Adams is a most unlikely rabble-rouser.

A conservative Republican, the retired Air Force lieutenant colonel's idea of making waves is a bumper sticker deriding "Hanoi" Jane Fonda.

In 1993, he agreed to chair a state Human Rights Committee, whose nitty-gritty mission is spelled out in the Blueprint:

"To provide independent oversight of claims of illegal, dangerous or inhumane treatment of persons receiving mental-health services and [of] legal-rights violations. [Committee members] receive monthly reports on the use of seclusion and restraint from agencies in their area and review whether the use is inappropriate or illegal. They provide assistance to persons who have been determined to need special assistance."

There are three Human Rights Committees statewide, two in the Valley and one in southern Arizona. Adams says he volunteered for the committee because he has a seriously mentally ill daughter and he wanted to help the system work better.

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