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.

He dated the progress note, "2-22-94." But he says he actually wrote it in early March.

"I actually wrote the first note, my real note, on February 22," Campbell says. "But a few weeks later, my team leader told me to do a rewrite because the auditors had picked it at random to study. In other words, creative writing was to ensue."

Campbell apparently wasn't creative enough because his supervisor wrote him a note ordering him to try again.

Pam Hyde insists the rewrite order was legitimate and wasn't intended to skew an auditor's findings.

"That was a legitimate concern, and there are ways to bring it up," Hyde says, "[but] it's inappropriate to put certain things in records. Bob put his opinions about another staff member in the record. He was asked to remove it and focus on the client."

Campbell says he also was asked last year to redo another ComCare client's file, months after the fact. The client was Debbie Reagan, a seriously mentally ill woman whose grievances against the firm were about to be heard by DHS.

"No one is asked to redo a file that's going to stay internal," Campbell says. "But when an auditor is coming in or a case may go to a Fair Hearing, the supervisors look at the files with a magnifying glass."

Reagan's story is a tragic one, even by the standards of the seriously mentally ill. She's now 37, and court records and interviews indicate she's a manic-depressive ex-hooker who has been strung out on heroin for much of her adult life.

Campbell first met Reagan in early 1991, when he was assigned as her case manager. Reagan was about to be released from prison, where she had served nearly three years on a drug-related conviction.

"I wanted to have a chance at making it when I got out," Reagan says, "so I tried to get help before they let me go."

After Reagan's release, Campbell referred her to Living Dynamics Incorporated, one of his company's providers.

"It made a big difference to me," Reagan told a judge last December. "Everything seemed like it was gonna work out. I knew I would be in therapy a lot longer than I would be on parole, but that was okay."

Unfortunately, Reagan was one of the clients who lost services when ComCare canceled LDI's contract.

"LDI ran into a problem," Reagan told the judge. ". . . They had no money to pay the therapist, so I lost mine. Then I was all alone."

Her probation officer concurs that Reagan was doing well on parole--staying off drugs and alcohol, keeping out of trouble and religiously taking her antidepression medicine. She was living alone in a Glendale apartment, on a waiting list for semisupervised housing.

"[Debbie] had been seeing a therapist on a weekly basis to discuss a wide range of issues, from daily life problems to substance abuse," the probation officer wrote last December. "Unfortunately, the counseling agency's contract with [ComCare] ended and the defendant was abruptly without a therapist."

Campbell says he attempted to place Reagan with other counseling agencies, but was thwarted.

"Things were so jammed up because of the LDI mess that some providers weren't even putting clients on waiting lists," Campbell says. "Debbie couldn't understand why all this was happening, and I had a hard time explaining it to her."

Campbell's difficulty becomes apparent in an April 25, 1994, progress note about Reagan: "Client [called] to complain about services from Living Dynamics being dropped. ComCare has dropped all services provided by Living Dynamics, with no explanation given to either clients or ComCare staff."

Campbell's case file indicates Reagan missed several meetings with him and other ComCare personnel to discuss things. He also noted in a May 17 entry, "Client has already contacted Arizona Center [for Law in the Public Interest] and client advocate. Has scheduled meeting, which was canceled due to unavailability of Area Director."

Campbell says Area Director Pat Razo then instructed him to rewrite the file, which he did.

He toned down his comments about LDI's sudden demise to say, "Client had already heard parts of a story about why services were being dropped. Client was informed by case manager that the matter was an administrative decision by ComCare."

Campbell adds that Razo specifically told him to remove his notation, "Meeting [with Reagan] was canceled due to unavailability of Area Director." The new entry read: "Has scheduled a meeting, which was canceled."

At the same time, Campbell says, Razo ordered him to retain the references to Reagan missing appointments with ComCare.

"My note about Pat Razo not being available wasn't a big deal," Campbell says. "She's a busy person, and canceling one meeting isn't the end of the world. But it's indicative of how much into spin control we are, in public and private."

ComCare's Pam Hyde counters that she's confident that no one--other than Campbell--is guilty of wrongdoing in the Reagan affair. Without her regular, intensive counseling routine, Debbie Reagan began to slide. Last July, police arrested her for stealing some things from a neighbor. As a one-time loser on parole, there was no hope of leniency.

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