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.

His experience has turned him into something of a radical.
"I looked at us as being able to lend a helping hand, a positive role," says the 61-year-old Scottsdale man. "To be blunt, it hasn't gone as expected.

"No one in charge wants anyone buzzing around asking too many questions. If you listen to ComCare and the state, they'll tell you to just trust them. But what they say and what's happening in the bowels of the system are two different things."

Adams' committee had been deprived of the most basic tool it needs to do its job--names. ComCare has refused to provide the committee with the names of its clients or even the providers treating them.

"My reading of [Arizona law] and rules indicates that we are not legally required to disclose identifying information about a client," ComCare's Melody Emmert wrote to Adams last October.

Internal state documents show that an assistant attorney general, Eileen Bond, has attempted to prod DHS' Chip Carbone into resolving the issue. But, predictably, Carbone hasn't challenged ComCare's secrecy.

Without access to names and places, Adams says, it's impossible for the committees to do anything more than guess what's happening.

"We sign an oath of confidentiality, so that's just a smoke screen," says Adams. "It's so frustrating. I want ComCare to succeed, I really do. But it's hard to support an organization that tries to crush people who raise legitimate issues as if they were bugs."

Last September 27, Adams complained to Court Monitor Linda Glenn.
"My people are telling me, 'Why can't we do our jobs, Bill?'" Adams wrote. "We are confident there are widespread human-rights abuses happening daily in the system and we are frustrated because there is nothing we can do about it." Adams is still awaiting Glenn's response.

"I'm coming to the conclusion that having human-rights oversight in this system just isn't going to work," he says.

Clients' Charts Doctored
Former ComCare case manager Bob Campbell wears a pin on his lapel that says, "Mental Health Is Overrated."

ComCare thought Bob Campbell was overrated.
The firm fired him a few weeks ago--one day, coincidentally, after he first spoke with New Times.

Campbell claims he was fired in large measure in retaliation for having recently filed an official complaint of misconduct against a supervisor.

His complaint reads: "Progress notes in a client chart which was under appeal was reviewed by the Area Director. Pat Razo ordered me to remove the note I had written and rewrite as she directed. She stated I could NOT under any circumstance write a note which placed ComCare actions in a bad light. I questioned the practice of 'altering' documents in the chart and was told if I wanted to keep my job to make the changes. I wrote the note as directed and kept the original . . ."

Campbell says it wasn't the first time he'd been ordered to alter a file.
Campbell says that in February 1994, outside auditors told ComCare they'd need to see randomly selected files in a few weeks. One of the files belonged to a client Campbell had seen.

Documents obtained by New Times show that a supervisor twice ordered Campbell to re-create a "progress note" he wrote for the file because it reflected badly on another case manager--and on ComCare. "To err is human, as I well know," says Campbell. "But ComCare takes it one step further. The bosses seem to think that to cover up is human, too. The auditors don't see problems because they're not seeing true charts--they're seeing spit-and-polish charts."

Campbell was the only current or former ComCare case manager who agreed to be identified. But New Times asked two current case managers about the alteration of client records, which is illegal. Both said it doesn't happen very often--but not because it's a crime.

"Most of us know better than to put anything critical about ComCare on a document," said one of the case managers. "That's just the way we do business. We're kind of paranoid. Bob Campbell probably was on the money. But he should have known better."

ComCare says Campbell has no credibility.
"Bob was fired because he did many things inappropriately," says ComCare president Pam Hyde, who insists it is Campbell, not ComCare, who has broken the law.

"If he gave you information that came from a client file, he has violated the law," Hyde says. "And that is precisely the kind of thing that he was fired for."

In February 1994, according to records provided for New Times by Campbell, a supervisor asked Campbell and another case manager to drive a seriously mentally ill client home. The client, whose name is blacked out on the records, had told ComCare that she had weapons inside her home.

Neither Campbell nor the other case manager knew the client, so he reviewed the chart for some background. He found little. The case manager's previous entry was four months old. The chart failed to mention that the woman had been hospitalized just ten days earlier.

Campbell updated the chart, noting that the client had complained to him repeatedly about her case manager's lack of attention: "Client stated that she had requested chemical dependency counseling, but no current records of any request and/or referral were found."

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